Entries from May 2016 ↓

DSS and LARCs

Last week, I mentioned that the director of DSS stopped by to talk to me about her plans for the agency and her love for the Brookings Institute. She asked me to watch a couple of videos, all of which I will share at some point this summer but the first is linked to the book she also asked me to read and I already have some basic knowledge on the topic so we’re starting with LARCs, or Long Acting Reversible Contraceptives. Short yet informative video below.

Now, I’m just going to say this before we go too far, both Bell and I think that single parents often do a wonderful job at raising children (I’m the daughter of a single mother and I think I’m pretty great) and I can’t speak for Bell on this one but I fully believe that two or more people can get together and decide to raise a child without the institution of marriage. Bell focuses a lot on the marriage part but I think the bigger picture is that 1) with more than one person raising a child, there are more resources to go around and the child is more apt to thrive and 2) a lot of the instances of single-parenthood aren’t choices that are made but instead instances of a lack of resources. Here at the DSS, we like to let people know their options and LARCs give women in a lot of at-risk categories (young, uneducated, racial minorities, low income, or usually some mixture) more chances to choose. Another important factor in getting access to any kind of birth control is being able to afford it. The DSS provides applications for Medicaid to clients who may qualify and fortunately for people on Medicaid LARCs (and actually birth control in general) is covered so that there is no out of pocket cost.

So lets get a LARC lowdown.

ParaGard/Copper IUD

Pros

  • Hormone free which means it won’t mess with the hormones you already have and that it functions by thickening the cervical mucus in order to block sperm.
  • Can last 10-12 years (!!!)
  • Is more than 99% effective (comparable to male/female sterilization)
  • You can have sex immediately after placement (no waiting like with the pill)
  • Can be used while breastfeeding
  • Ability to become pregnant returns quickly after removal

Cons

  • While the procedure for placing the IUD may be quick, it is not painless. In order to place the IUD, your doctor has to open your cervix. I know many people who have IUDs and while they often say it’s the best choice they’ve ever made, they also say it’s one of the most painful things they’ve ever gone through. From what I’ve heard and read, reports of the procedure being painful mostly come from women who have never given birth and that women who have don’t think it’s that bad. So take that as you will.
  • Heavier and longer periods are common (although that should end within 2-3 months) and I have heard a lot of personal stories about very painful cramping.

Mirena/Hormonal IUD

Pros

  • Can last anywhere from 5 to 12 years depending on the brand
  • Functions by preventing the egg from leaving the ovary and thickens cervical mucus to block sperm (two things are happening at once which personally just makes me feel better)
  • Also 99.9% effective
  • May reduce period cramps and on average menstrual flow is reduced my 90% (some women stop having a period all together)
  • Can be used during breast feeding but because this one is hormonal women should wait 4 weeks after giving birth to get this kind of IUD
  • Ability to become pregnant returns quickly
  • You can begin to have sex immediately after the IUD is placed if it is inserted within 7 days of the start of your period

Cons

  • Just like the copper IUD, the insertion of the IUD can be very uncomfortable. I hear it’s worth it but if you don’t have a high pain tolerance, you should know in advance.
  • 3-6 months of irregular periods

Nexplanon/Implant

Pros

  • Lasts 3 years
  • Relatively easy insertion. Basically, a doctor takes the implant that’s about the size of a matchstick and inserts it into the underside of your arm. Most women I’ve spoken to say that it’s only as painful as a shot.
  • Functions by releasing progestin (a hormone you already produce naturally) which keeps the egg from leaving the ovary and thickens cervical mucus. Like I said earlier, I just like knowing that more than one action is taking place. It feels like a fail safe.
  • 99.9% effective (I’m loving the odds of the LARCs)
  • Can have fewer, lighter periods after 6-12 months and 1 in 3 women will stop having periods entirely
  • You can begin having sex immediately if the implant is placed within the first 5 days of your period
  • Can be used while breastfeeding
  • Can become pregnant quickly after removal

Cons

  • Can interact negatively with medications
  • Irregular bleeding in the first 6-12 months and some women report heavier, longer periods

So those are the big things about LARCs I thought everyone would want to know. Just as a reminder I AM NOT A DOCTOR. Always consult with your doctor to make sure any form of birth control is right for you. If you choose any LARC from the list above and experience prolonged, negative symptoms, speak with a doctor immediately. I want everyone to be happy with the choices they are making about their bodies and futures, which means being safe. If you aren’t on Medicaid but are thinking of getting a LARC, call your insurance company to check.

I hope this was helpful in some way. If anyone has any questions, just leave a comment and I’ll do my best to answer. More next week!


Sources:

plannedparenthood.org

mirena-us.com

paragard.com

nexplanon.com

I’ve also used personal stories from friends and family. Most of the time people you have relationships with care about you and aren’t invested in selling you something so I think it helps to hear from real people.

First week on the job

I’ve just finished my first week with DSS and I think I’m settling in pretty well. The office is a little hectic but understandably so. If I’ve learned anything this week it’s that this job is all hands on deck. One of my supervisors told me that, while there are roughly thirty people in the department, only two of those people are actually caseworkers. Around this time last year, there were approximately enough cases for each worker to have a full caseload (which is around 15 cases) and right now they have almost double that number of cases. So I know if I’m feeling overwhelmed at any point, I’m in good company.

I spoke with my supervisors a few times about what I wanted to be doing at DSS and, while I want to use this experience to create a resource (this blog) for others who may be involved with DSS, who may want a career in social work, or who are interested in what they can do to affect policy change, I am also very much trying to get an idea of what I want to do with my degrees once I graduate. So, my answer to “What do you want to do here?” is always “Anything I’m allowed to do here.”

It turns out that’s the best answer I can give because sometimes the work that a typical intern would do, like filing or shredding or anything that might put me in contact with very personal information of clients, is very much off limits for me because this is a government job and I signed a confidentiality agreement and DSS promised the government that unpaid employees would not have access to those records. That makes my confidentiality agreement a lot easier to fulfill anyway.

What I can look forward to this summer is going out when anyone has to pick up kids or assess a living situation (I’ve already gone to pick up an abandoned baby this week), sitting in on meetings to assess family needs or how much money can be allocated to foster parents, reading manuals on policy, and writing grants for the director. She’s provided me with some reading material and has shared her love of the Brookings Institute with me which has given me some amazing ideas for future blog posts. There should be some excellent videos in the future as well as a review of the books she wants me to read and how they’re being used to direct DSS. I’m incredibly thankful that the director and I appear to be coming from the same place in terms of helping people here in town and I’m looking forward to the rest of my time here.

More next week!