Last spring, just a few weeks after the start of the pandemic, Christina García spent her days struggling to help her two young children adapt to virtual education, when she had a period so intense and painful that she could barely support herself
After a few days, his vision began to blur and he was so weak that he could not even open a vial.
By then, the doctor’s office her obstetrician-gynecologist, like most, was closed, and the woman was terrified by the possibility of spending hours waiting in an emergency room, along with people who might have covid – 19.
When he arrived at the newly opened OB-GYN Bascom urgent care clinic at the Santa Clara Valley Medical Center, with a pillow pressed against Her belly, García was pale and dehydrated from blood loss, and convinced that she was dying.
“If I hadn’t gone to the clinic in that m omentum, I think things could have ended very differently, ”said Garcia, 34, who underwent an emergency hysterectomy for uterine fibroids.
Her story illustrates a long-standing gap in women’s healthcare. For years, many women with common but urgent conditions, such as painful urinary tract infections or excessive bleeding after a miscarriage, have faced the grim choice of waiting weeks for a medical appointment, or spending hours in the waiting room for an emergency.
Urgent care clinics specializing in gynecology and obstetrics have begun to emerge across the country in recent years, and the covid pandemic – 19 demand has increased.
While there is no data available on the number of these clinics, they are part of a renewed interest in health care clinics. emergency services in general and in other alternative models such as clinics within markets or stores (retail clinics) and the so-called new digital healthcare companies. One of them, New York-based women’s health startup Tía, made 24 millions of dollars in venture capital funding last spring and is opening physical spaces across the country.
“It is clear that, for consumers, access and convenience are increasingly important than seeing a specific provider,” said Rob Rohatsch, Medical Director from Solv, an app that books urgent care appointments.
The Urgent Care Association has reported a steady increase in visits from people using its members’ clinics, which do not require an appointment prior, as an alternative to hospital emergency rooms. Traffic to these clinics has increased over the past year, according to Solv.
The Bascom clinic had been the dream of a decade of doctors Cheryl Pan and Anita Sit, two obstetrician-gynecologists at the Center Medico del Valle de Santa Clara, a sprawling public hospital that serves as a regional trauma center: treats critical cases like car accidents and firearm victims, but relegates people suffering from problems that are less risky to life to long waits. life.
“Women, maybe pregnant or bleeding, could be sitting there from 12 to 14 hours, depending on the time of day, ”said Pan.
After the start of the pandemic, doctors were told Concerned that women with serious, or even fatal, problems like Garcia’s might not seek treatment for fear of contracting COVID – 19.
Emergency visits dropped by 42%, a percentage without precedents, in the first months of the pandemic, according to the Centers for Disease Control and Prevention (CDC).
A June report from the CDC noted that, while the number of visits to the emergency room for heart attacks had increased, visits for nonspecific chest pain had decreased, suggesting that people could be risking their lives by avoiding going to the hospital.
“You can imagine that a woman with three children at home could be even more scared, ”said Sit. “We couldn’t keep sending women who had miscarriages to wait hours in the covid tent.”
Instead, women can now be evaluated by phone and seen in a day or two at the clinic OB-GYN Bascom urgent care providers, the same way they would at your local Planned Parenthood branch, for contraception or a test for STDs.
Bascom is equipped to treat conditions ranging from severe morning sickness to ectopic pregnancies requiring emergency surgery. In its first year, the clinic has treated about 1, 300 women and supported local clinics that provide basic reproductive health services, in counties hundreds of miles away. .
However, it is still in its pilot phase, operating from Monday to Friday from 8: 30 am to 5 pm, which that “leaves a lot of hours in which we cannot attend to women”, acknowledges Sit.
A handful of other clinics have taken the concept of urgent care for women a step further . Dr. Miriam Mackovic runs Complete Women Care, a chain of four clinics in the Los Angeles area that also has an emergency care center in Long Beach, staffed by the 24 hours a day, 7 days a week, with a specialized nurse and equipped with a laboratory and a pharmacy.
Women are usually seen in 30 minutes, according to Mackovic, and each patient receives a follow-up call the next day.
A woman who presented at one of the Complete Women Care clinics He said that after desperately seeking treatment in an emergency room one Saturday night for a nasty yeast infection, he received a bill for $ 1. 500.
“In the middle of the night, urgent care centers are closed. OB / GYN offices are definitely closed. So what’s your option except the emergency room? ”Asked Mackovic, who is an OB-GYN but also has a degree in business administration.
Mackovic told stories of patients who They came to their clinics from as far away as Arizona and Nevada after suffering for weeks while trying to schedule routine operations for twisted ovaries or uterine cysts.
“Medical breakthroughs are here. Most emergencies can be resolved on an outpatient basis – a woman can have a hysterectomy with just a small incision and go home the same day, ”Mackovic said. “But a woman who has had a miscarriage calls her gynecologist, who says she doesn’t have appointments available for weeks, so she goes to the emergency room and the doctor says, Are you dying? Not? then, follow up with your gynecologist. ”
Fees for uninsured patients, around 20% of Mackovic’s clientele range from 100 to about 600 dollars, he said.
Women in the United States The United States has for years lagged those of other wealthy countries in both access to health care and health. The United States has the highest maternal mortality rate among developed nations.
Some women see a doctor only in emergencies.
“We have diagnosed so many cancers in the last few years because women went to appointments for another reason, ”said Dr. Adeeti Gupta, founder and CEO of a chain of clinics open every day in New York City called Walk In Gyn Care that provides comprehensive care. , without having to make an appointment.
Gupta’s three clinics have been growing steadily since he opened them seven years ago, largely due to frustration over waiting months for a Appointment at your own OB / GYN practice in Queens. But after the coronavirus hit the city hard, it has seen an increase in patients: 40% at a single facility.
The The country needs more accessible and comprehensive women’s health care to treat everything from the menstrual cramps of teenage girls to the hot flashes of postmenopausal grandmothers, Gupta said.
And he added: women is that their problems never end. ”
This story was produced by Kaiser Health News (KHN) an editorially independent program of the Kaiser Family Foundation unrelated to Kaiser Permanente .