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Chelsea sits down with OBGYN and reproductive educator Dr. Ashley Jeanlus to talk about the end of Roe v. Wade, abortion rights, and all your contraceptive and reproductive questions.




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Hello, everyone, and welcome back to an all new episode of The Financial Confessions.

It's me, your host, Founder and CEO of The Financial Diet, Chelsea Fagan, and person who loves talking about money. And when it comes to talking about money, and it's important, I think, to reiterate for those who don't know, although I'm sure if you're a frequent listener or viewer of TFD, you're probably aware to some extent, about 90-plus percent of our audience is women.

And there are a lot of reasons why I think that has been an early enabler to TFD's success. When we entered into the world of personal finance, it was pretty much a world that exclusively catered to men. And not only are women often left out of the financial conversation, it's also something that tends to be a problem, especially long-term financial planning, regardless of things like education levels.

A lot of you may be aware that women are increasingly more educated on average than men, but in heterosexual partnerships, it is still, even when that is the case, generally the case that men will manage things like long-term finances. They'll make the big decisions, they'll plan for retirement. They will also typically earn more.

And in cases where couples have children, while women will see long-term punishments on their earning potential and face a lot of consequences in the workplace, men actually earn more as time goes on with having children because they're taken more seriously at work. They're seen as being able to handle more responsibility. And they're also not expected to be cutting out of work early in order to take care of the children they chose to have.

And from inception in speaking to women as we do, again, for the most part, but we do have a few boys in the comment section, and you're always welcome, we're happy to have you here, it's been very top of mind for us at TFD that women's financial freedom is inextricably tied up to reproductive freedom. If women can't choose when and how to become mothers, if people can't choose when and how to become parents generally, then they really have no freedom at all. Again, especially in a context which so heavily punishes them for becoming mothers, there are many ways in which we need to make our society in America better for parents, but there are also many ways in which we're actually taking massive steps backward.

If you're not aware, I'm frankly jealous of you, but recently, Roe v. Wade was overturned, ending federal protection for abortion in this country and leaving it up to states, many of whom had trigger laws to essentially immediately eliminate access to abortion for people who needed it as soon as that happened. We at TFD recently held a fundraiser on our YouTube channel and other platforms where we were able to, with our own contribution, raise $15,000 for abortion funds, which we will link in the description, which is an incredibly important organization, which helps people all over the country have access to abortion services without money being an inhibiting factor, which it often is.

And of course, reproductive health is about a lot more than abortion, but that has to be a big part of the conversation, especially right now. We've been wanting for a while to speak with someone who works in this space, who understands this space both from a medical and a political point of view. So we were lucky enough to get an OB/GYN here with us today to answer-- and we'll basically focus on entirely you guys' questions because you sent in so many, she's joining us here on Zoom from San Francisco, Dr.

Ashley Jeanlus. Hello. Hi, thanks for having me.

Thank you for using your platform to talk about this issue. It's very, very important to us here. Now I have to say, I'm getting a little bit Doogie Howser energy, because I feel like you're too young to be a doctor.

Can you talk to us a little bit about your story and how long you've been practicing and all of that stuff? Oh, it's so interesting that you say that. I actually work for teen clinic.

And my first day there, they thought I was a patient. So I'll take it. But essentially for my pathway, I am also currently a complex family planning fellow.

So I focus on contraception and abortion care services. But essentially my pathway is four years of undergraduate school, four years of medical school, four years of OB/GYN residency. And I'm doing now my second year within this partnership, to be able to provide evidence-based medicine for contraception and abortion care.

Amazing. Now it wouldn't be TFD if I didn't ask you quickly about the finances of becoming a doctor. Can you talk a little bit about that.?

Oh, it's very cringe, cringe, cringe, cringe. I was fortunate for my undergraduate school that I actually don't have that much loans from there-- I went to Cornell. It was need-based, thank you very much.

So it's a very small amount of funds that are loans that I owe them. But with medical school and residency and relocating, I'm about 400,000k in debt that one day I have to pay. And I think that's very typical and average for people who are on this pathway.

And at Cornell you were studying pre-med? Yes. I was a human biology health and society major, and I was pre-med at that time.

And being on a need-based scholarship at an Ivy League university, did it feel-- were there challenges, especially from a class perspective, you faced in wanting to pursue becoming a doctor in such a highly competitive and elite environment? Yes. I think with any sort of training, there's exams and board preps for those exams.

So I do remember feeling sometimes at a disadvantage not being able to afford having an extra tutor or being able to afford certain exam prep courses to help make sure that you give your best foot forward for these state exams. Yeah. So there's definitely sometimes a lot of pressures and disadvantages with just financial constraints when trying to pursue becoming a physician.

And you also TikTok. Yeah. I do TikTok.

It's my way-- I think for me, it's my stress reliever, and also, it's one way for me to able to talk to people. I think what's so important about abortion care is fighting the stigma surrounding it. It's a very common medical procedure.

One in four people who are capable of becoming pregnant will have an abortion in the United States by the time that they're 45, yet it's a procedure and a topic that we never talk about. And I feel that my way of utilizing TikTok is a way to talk to people, make sure that they feel that they have support within the medical community, make sure that they realize that they're being treated with compassion and dignity and respect while they are pursuing options that are best for their lives and the lives of their families. Is there something that specifically made you want to pursue this branch of medicine?

Yeah. So when I was growing up, I never really felt welcome within the health care community. I never actually had a provider that looked like me.

And whether or not it's because of biases within the health care system, I just never felt welcomed. So I pursued a career in medicine because I always wanted to make sure that people felt welcome, especially when they're pursuing health care. Health care for me, it's a human right.

There are so many other things that you should be spending your energy and your time exploring in life, and access to health care shouldn't be an undue burden that you as an individual have to navigate for yourself. And then when we talk about all things under the umbrella of reproductive health care, it becomes even more so isolating. It becomes even more so stigmatized.

So I really wanted to become an OB/GYN that provides abortion care so people have a safe environment to discuss with their health care provider about what's best for their lives and what's best for the lives of their families. Now you're obviously in California, which is a state that is amongst the more progressive with regards to abortion and reproductive resources. Do you speak a lot with OB/GYNs in states where this is now illegal or heavily, heavily restricted?

Yeah. So I have colleagues across the country, and we are all experiencing different restrictions and different bans when it comes to abortion care. And they have had very, very heartbreaking stories of being able to provide abortion care.

And especially these past few weeks in certain states, it's just kind of like a countdown as to how many patients that they're able to help before a new law is enacted and they're no longer able to take care of people and they're turning them away. So I have colleagues who work in Georgia just recently, that they were able to take care of people, and just like that, they're no longer able to take care of people. I have colleagues in Utah, same scenario, that they were able to just take care of someone just yesterday and now they no longer can and they're turning people away.

So they're heartbreaking stories. And then you also always have to center back to the patients who are now traveling to other states to try to continue to get access to abortion care that they're not able to receive in their own community. This is maybe a naive question, but if one is a doctor who specializes in providing abortion services in a state where it has now become illegal, do they just switch to doing other things?

Or what do they do in terms of their profession? Well, it depends. A lot of us are OB/GYNs.

So we still perform and provide care within the whole reproductive health care spectrum. A lot of abortion health clinics that no longer can provide abortion care, they're just still continuing to provide STD testing, they're still providing contraception care. So there's still lots of work that can be done by health care providers that still provide abortion care.

A lot of people are asking, can you please talk about how it feels to be an OB/GYN right now? The chilling effect, the hostility, et cetera. I go through waves of emotions.

At baseline I'm very proud and I feel very privileged to be able to take care of people. I feel very privileged that people are able to have the opportunity to finally have control over their lives and I play a role in that. But there's also times where I'm highly discouraged.

We talked about in the beginning this pathway of finally becoming here. I had this huge idea of I get to work with a reproductive justice framework. So I get to be able to help people have the right to have children, have the right not to have children, or have the right to parent their children in safe environments.

And on a daily basis I see laws being passed to take away their rights. And then it continues to make people feel ashamed or stigmatized. So it does get very discouraging at times to see what society, or at least in the political realm, what's being induced and forced upon people.

And then I also get really scared. I get so scared about our future because we are going to have people who are not going to be able to have access to abortion care. They're not going to be able to travel and raise the funds to be able to travel miles, have child care, have their jobs wait for them to get the abortion care that they desire.

So then they're going to have their pregnancy. And pregnancy and childbirth itself has a lot of consequences. We don't live in a country where child pregnancy is actually a very safe options for patients at times.

The mortality, morbidity of pregnancy outcomes is horrendous in our country, and we're not providing the support that people need to be able to continue these pregnancies. So I see a lot of horrendous consequences down the line. I also see people who are going to have horrific outcomes in their health care when they're being denied an abortion.

And we're already hearing stories now, people who have ectopic pregnancies who are essentially waiting until it's life threatening to the very end before they get care. We have patients who might break their water before it's viable, and again, they're waiting until they're into septic shock and having infections until they finally get their abortion care. So I'm very concerned about the patients and the lives that they're going to have and that gets depressing.

And then I get concerned, too, because now we're going to have health care providers who are not going to have opportunity to get training for these past few years now that Roe's overturned, and they will be our physicians and providers in the future not having the care if one day this is finally fixed. So I get really scared, too, about just like what people are going to experience now, and then what kind of future we're going to have to take care of people. So on that note, a lot of the people writing in asked some form of, I'm in a state that has good laws around this stuff.

What can I do to help people who aren't? Oh my gosh, I love this question. So it's very simple things that people could do is say the word abortion.

I know it sounds like such a simple task to ask of people, but it helps to chip away the stigma associated with abortion care. There's research and studies out there that people who are opposed to abortion, they use the word abortion more than people who are pro-choice. So we really need to take back and own the word abortion, because it's part of health care, it's common, it's safe, it's normal.

So we need to utilize that word more often. And then another thing to really help people is to help support abortion funds. So abortion funds are organizations that are actually helping people get abortion care.

So when we talked about the logistics of traveling outside of state, finding childcare, finding lodging, supporting with food while they're getting their care, abortion funds have been working for decades to help people get access to abortion care. So everyone can be able to help support abortion funds that then help people get the care that they deserve. Well said.

I really like that. Menopause, why does nobody talk about it? That's a really good question.

Wow. I don't know why no one talks about it. I probably don't talk about too much because I'm a subspecialist now within abortion care and contraception care.

And usually within that age it wouldn't be the same individuals who are in menopause. So I don't-- maybe that's it. Majority of people we still think about the reproductive age, and sadly that's before the menopausal age, so maybe that's one reason a lot of folks don't talk about menopause.

Yeah. I mean, I would also throw out there that we do still live in a pretty starkly misogynist culture in a lot of ways, and so nobody-- if women are beyond reproductive years in general-- In general. Yeah.

We don't want to hear from you in any respect. Like one only has to look at those charts that shows the average age of romantic male leads in movies and their female counterparts, and you're like, oh, OK, after 40 you just like get put out to pasture and never to be heard from again. OK.

Are insurance companies still covering abortion care post-downfall of Roe? Or is it all out of pocket? So about 54% of individuals actually seek abortion care using out-of-pocket funds.

Even before Roe, utilizing insurance is very difficult. A lot of patients may not know whether or not their insurance covers abortion care. Also in certain populations, like we've talked about people with abusive relationships.

Not having something that's documented for to show that partner that they are seeking abortion care is a safety matter, so it's not used. Similarly, patients who are very young. If they're not interacting with parents or, again, with confidentiality, they are not utilizing their insurance to make sure that that is not being shown to their parents.

Also in terms of insurance, sometimes there's a lot of paperwork to be able to be finally used to make sure that it's capable for patients to be able to access it. Also in terms of people who don't have insurance, there isn't support from the federal government to help cover the costs of abortion care, and it really depends on which state that you live in whether or not they provide access or some assistance to abortion care. And that's just what the procedure itself.

When you think about other costs associated with abortion care, it really can get out of control. For people who are traveling-- so that in itself is a cost with the logistics. Costs of lodging is a concern.

Now that you're traveling, you're not working, so there's loss of wages. A major portion of patients who are having abortions are also parents, so now seeking child care. So it really just adds up the cost of abortion care.

That is such a, I think, stat worth repeating, that most people getting abortions are already parents. And I think there's just such a really cynical tendency in media to portray those as two completely different groups. And I feel like that's so-- I'm sure it's intentional at some level to portray them as not being part of the same community, but it's so infuriating.

Yeah. I mean, as an OB/GYN, the patients who are having abortions are the same patients who are having children, just at different stages of their lives. It's a spectrum.

This person has said-- and we got quite a lot of this question in some form. I'm a career-oriented woman who is very interested in freezing my eggs. I'm 31 and worried that I'm not going to be able to have a kid.

Should I see a fertility specialist, and is there financial help for this procedure? It depends on a few things. Certain states are trying to provide some assistance with freezing your eggs.

Also, some employers can actually help sustain the costs or offset some of the costs of freezing your eggs. It just-- it really depends on the state that you live in and which company that you work for. And then-- I'm sorry, what was the rest of the question?

Like if there's difficulty or-- Should I seek a specialist for this? I mean, you can always at first talk to your OB/GYN about what your options are or what you're hoping to accomplish. And then if you're seeking to have your eggs frozen prior to a certain age, then we would refer you to an REI.

So they are also a subspecialist within the OB/GYN field to be able to help with that. Awesome. Another question that we got quite a bit is, what are some natural options for birth control outside of the typical ones offered, things like cycle tracking, et cetera, as someone who is very heavily affected by hormonal birth control and doesn't want to take it?

Yeah. So we do have a few non-hormonal options. So you do have your barrier methods.

So that's using some-- either for-- of a condom or diaphragm. You also have an option of-- we now have vaginal gels that essentially disrupts the acidity of the environment of the vagina to help make sure that your aren't able to get pregnant. Also again, there's ideas of tracking of your cycle.

That sometimes could get tricky because not all individuals actually have normal cycles, and things like stress can offset your cycle as well, so that can become a little bit difficult. And then other forms that doesn't have any hormones in it is a copper IUD. So that's an intrauterine device that can be placed within your uterus.

That does not have any hormones in it. A follow-up on that, is it true that copper IUDs usually make your periods worse? They sometimes do.

The number one factor usually is someone wanting to remove the IUD, it's because their bleeding is really too irregular. I always say every patient's different. That's why we have so many different forms of birth control.

I feel like I'm a matchmaker of what works best for you and what options are out there. And there's medications that can help to offset that, or we could try a completely different form of birth control, too. Someone says, can you explain in your own words why you feel that adoption is not a substitute for abortion?

So, hmm. That's a very interesting question. Whenever I see a patient, I provide them with all options.

And adoption may be an option. I actually never equate anything else to abortion care besides abortion care. So I think that would be like my very basic answer.

But when you think about adoption, there's still a huge time, a period that a person has to undergo through. They have to go through pregnancy before they can finally be able to be at the point of an adoption. And then they also have to undergo labor.

Most abortions are performed before the first trimester, so that's around 13 weeks, versus nine months of pregnancy. That takes a huge toll on someone's body, on their mental status, on, let's say, their educational achievements that they been doing or their jobs. So it's not the same at all in a variety of different ways.

Very true. Also, we did-- last season we did an interview with an adoptee who also has adopted her own children, as well as having some biological children, who speaks out specifically on how traumatic the adoption process often is for all parties, which I do think is such a-- I mean, there's nothing more sinister than those people who stand outside in those protests in clinics with like, we'll adopt your baby. Because even if they were going to do that, which I'm sure they likely aren't, that is such a fraught potential process, and even in the best cases can have such issues with PTSD and trauma and abuse and all of these things, and it's just-- it's really mind-blowing that we offer that up so flippantly, I think.

Yeah. I don't know how that's an easy solution. But then I also don't think that the solution for fixing abortion bans is also focused on birth control.

Like I said before, I think the best way for us to fix and work against these abortion bans and abortion restrictions is to make sure that we allow people to have access to abortion care. Absolutely, absolutely. Is it worth it to invest in a menstrual cup and do they really last 10 years?

Everyone's different. I have a few patients that love their menstrual cup. It's reusable.

It's great for the environment because you can store it nicely and then just make sure you do well-care for it. In terms of 10 years, I think it would just have to depend on the manufacturer. I haven't heard of using the same menstrual cup for 10 years, and I probably wouldn't do that.

No, yeah. I feel like I'm not-- like, I mean, I'm sure it's probably possible, but I feel like if it's going inside your body, s would probably want to replace it a little bit more frequently than that. I never heard of anyone wanting to use the same menstrual cup for 10 years, but-- I should clarify that we have an extremely frugal audience in a lot of cases, so they're always looking to pinch a penny.

OK, yeah. Yeah, I would just be concerned. And then the only thing with menstrual cups to be aware of, it's nothing that's in the literature not to be used.

But if you do have an IUD, just being very careful with your menstrual cup and when you're releasing the suctioning not to rub the IUD and also pull it out. I've had a few patients that need to have their IUD replaced because unfortunately they self-removed it. So there's just like one little caveat-- like be aware of if you are using your menstrual cup and you have an IUD as well.

I have a nightmare anecdote that I must share in that respect to emphasize how important it is to be careful. I have a girlfriend who by accident did essentially I guess like the plunger effect on herself with the cup and didn't realize that her IUD had come out because it was in the toilet. And so just flushed it away, just not aware whatsoever, and only like by chance happened to find out at the gynecologist.

She was like, oh, you don't have an IUD anymore. Like nightmare situation, but it can happen. Definitely can happen and I've seen it happen.

So it's like be aware. But I'm not saying you can't use a cup with an IUD, just saying be very careful and be aware that each time you release the suctioning, you might suck that IUD out as well. It's no joke.

OK. What are things I should prepare for in terms of side effects, et cetera in going off of hormonal birth control which I've been on for over 10 years? Side effects that you can be concerned about is things like breast tenderness sometimes can be noticed.

Nausea can also be noticed. But really, I don't think it's that bad. I haven't heard a lot of people, once they get off of birth control, that it's that bad.

It kind of depends to why you were on birth control. Some people started taking birth control because they had heavy bleeding and bad cramps. Once you remove that hormone that was stopping that effect, it'll probably return and sometimes it will look worse than before you started it.

So it's usually like, what were you at baseline before you started the birth control? And if you were having symptoms beforehand, it might be similar or a little bit worse in the beginning. Any tips on asking for sterilization as a 33-year-old single woman with no children and no interest in them?

You know what's so interesting? I know that a lot of people are seeking to advocate for themselves about seeking a birth control-- or a BTL or bilateral salpingectomy or a tubal ligation. Honestly, if you're having difficulties with a provider, just leave them.

You really shouldn't have to advocate and have a case for yourself as to why you are seeking to have sterilization, whether or not you're 33 or with no kids or 20 with lots of kids. Look, honestly, that shouldn't be the case. There's lots of websites online that will provide you a link to providers who will be able to take care of you and provide you with that tubal ligation and not ask you so many questions and basically judge you or be the ownership or the gateway between you and what you think is best for your own life.

And we'll include links to all of that down in the description. Do I really need to go to an OB/GYN before I'm pregnant or is my PCP enough? So I'm so biased.

I'm OB/GYN. But I think I'm like a cool OB/GYN because I love the idea of working with primary care doctors, working with nurse practitioners and also midwives. I think especially if your health is-- if you have a normal healthy life, seeing a PCP or a nurse practitioner or a midwife for your care is completely fine and completely normal.

And then your PCP would be able to refer you to an OB/GYN if they think that there's anything that needs to be consulted with. Is hormone testing necessary or is it a scam? Well, it depends as to what you're testing it for.

So in general, anything in medicine, it's like, what are your results that you're expecting to receive from the test? So I think that would be like my generic answer. So in the case of a hormone testing that's worth it, you're saying, like if it's a person who's experiencing some sort of negative effects of-- they're dealing with something and the typical answers are not coming, so next step is testing if maybe a hormone is really out of balance.

Yeah. So I would pursue hormonal testing in cases of infertility. So I've done my own basic assessment of history and exam and we're still trying to figure out what's going on with the patient, what's causing the infertility.

So then hormones would be able to perhaps guide us as to what is going on with the patient. So it's always like, what are you trying to get out of the test that you're performing? Now I know you're not a urologist, so also feel free to pass on this, but are vasectomies actually reversible is a question.

Oh, they are. They definitely are. OK.

See? OK, well, you're able to answer that. Some OB/GYNs and family medicine doctors actually perform them.

OK. I'm a married woman not planning on having children. How often do I really need to be getting a pap smear?

So typically, depending on the pap test-- or pap smear test that you had before, and if they were all normal, you can actually have a pap smear between every three to every five years depending on what sort of test your OB/GYN performed for you. At what age do I realistically need to start getting mammograms. There's two different guidelines, essentially, that would tell you what to have mammograms.

And actually, I have to look this up because I always forget if ACOG says 45 years or-- sorry, you're really testing my-- I'm sorry. That's the audience. OK, so ACOG is 40 years, but then there's the USPSTF, and they recommend 50 years.

So if you see an OB/GYN, they would recommend 40 years, but then perhaps maybe if we saw a family medicine doctor, they would recommend starting at the age of 50. Are C-sections more expensive than natural birth? Or I guess vaginal birth.

So in terms of insurance reimbursements, yes. The C-sections are reimbursed at a higher cost compared to the vaginal delivery. In your personal opinion, should assisted reproduction be subsidized by the government?

It definitely should. I think every part of your reproductive health care system should be subsidized by the government. So that's from your contraception care, your prenatal care, your abortion care, any sort of assistance for becoming-- having a pregnancy should be covered because it's all health care.

Can you talk a little bit about how I should budget for giving birth? Wow. These are great questions.

These are great questions. I actually don't know who you should ask about the budgeting aspect of giving birth. I can help with the scientific and medical outcome, but I'm not too sure about the budgeting here.

Well, I mean, one thing that I can say from the budgeting perspective is that there is, for basically every state, information available online about average out-of-pocket costs for a lot of these things. So there are ways to research that. There are also-- you can speak with your insurance company about what is covered, what your deductible is, all of that kind of stuff.

And I do think that it's important we talk a lot about a thing called sinking funds, which are savings accounts for shorter to medium-term goals, projects, needs, et cetera that are outside of your regular savings, and we'll have them for things like vacations or buying a car or what have you. You can also have them for being pregnant and giving birth. No reason you can't.

Also very related to the kind of parental leave that is offered at your work and what will be entailed in that, as well as child care options, or if mom and dad are watching the kid for free, that's very different than if you have to hire a baby nurse. OK. Why do you think-- and again, this is like an opinion question, but why do you think birth control is still mainly viewed as a woman's responsibility in heterosexual couples?

Probably because it's focused and geared towards the female in that relationship to take the birth control. I don't know how, but in the year 2022, we actually don't have a lot of resources or options for males who would want to take ownership over their own bodies in terms of contraception. There's a gel that's being studied right now that hopefully will go through all the steps and then be able for individuals to take, but that's-- I think that's probably the reason why.

It's just something that they don't have the option yet so far to be able to say, oh yeah, I'm on birth control. Yeah. Well, that was a follow-up question from a lot of people, is where are we with male birth control?

What's going on? Yeah. I'm aware of one study right now that's going on that's utilizing like a gel that they put on.

And we'll see if that actually goes down through the pipeline. Interesting. I wonder what-- I wonder how much it will be used if it comes out.

It's hard to say. I'm optimistic. I think we don't give our male counterparts credit.

But I think if it's available and it's there, people will use it. I'm hopeful. I'm an optimistic at baseline.

I should be more optimistic. Would you have any suggestions-- would you have any suggestions for a woman who is complaining of nausea and vomiting during every period that aren't birth control? So, hmm.

These questions are great. I feel like it would be great if they're right in front of me because there's lots of follow-ups. It's like, is it associated with anything specifically within their lives?

Is it associated with any eating habits? Is it associated with any exposure to anything new? Usually when I hear pain, nausea, bloating that's associated with periods, I think to my mind endometriosis-- or endometriosis, which we do usually treat with some sort of hormonal birth control.

But there's also a lifestyle modifications. There's things like exercising, there's things about certain diets to help improve those symptoms. So I would recommend those if medication isn't an option for them.

Man, a fate worse than hormonal birth control, having to exercise. A lot of people are asking some version of what are the best hormonal birth control options for minimizing weight fluctuations? So it depends on what you're saying is like best.

One hormone that-- a form of birth control that is known to sometimes cause weight gain is Provera, Depo-Provera, which is like an injection shot that you take every few months. It's progesterone only. So that's one.

Whenever someone is coming to me and they're concerned about weight gain, I would perhaps steer them away from that one of like birth control form. And then I always say that everyone's different in terms of how they react to the birth control option. So I say we can still try to see if OCPs or the patch or of a ring or options that you want to utilize.

And if you're noticing side effects that you don't like, then we could definitely stop and then pick something else. Are there side effects of the copper IUD beyond just having more intense periods? Sometimes additional heavier cramping or sometimes heavier bleeding or sometimes irregular spotting.

I think one of the most reasons why people will actually request to have the copper IUD removed is because of that irregular breakthrough bleeding. So people knowing whether they're going to bleed because it's an unwanted, unexpected surprise when it's there. You could never wear white pants again.

You're always have to be like doubly prepared, yeah. So as a last question to take us out, obviously we talked about a lot of the logistical stuff and some of the practical ways we can help support and whatnot. But I would say probably one of the most popular questions-- and again, we got so many, you guys really flooded us.

But we had a lot of questions essentially boiling down to, I don't know if I ever want children or not. How does reproductive care play into that as I move through adulthood? Yeah.

So, I mean, if they're not currently interested in having children now, there's a variety of different birth control options. And one birth control option, what might be what they're seeking is something that we call Long-Acting Reversible Contraception, so our LARCs. Those are medications that can be placed by a health care provider and within a person's system for years without lots of management until they finally decide what they would want to do with child care or childbearing.

So some of those options are intrauterine devices which could be placed for up to three to 12 years. It could be something called Nexplanon which is also a progestin-only implant that is FDA-approved for three, but we through research that it's actually great for five years. And then we also have what I mentioned before with the weight gaining, the [INAUDIBLE] shot.

And that's something that can be used every few months. And those are great options because they're a longer term form of birth control where you don't necessarily always have to go and see a health care provider. It's still protects you within the realms of not being able to get pregnant.

But then it's also easily reversible. So whenever you do decide, OK, this is a time that I want to have a pregnancy, that you can go to your health care provider and have it removed. Well said.

And I feel like I'm a fairly savvy person when it comes to health stuff and I didn't even know about the second one. Yeah. Nexplanons are-- they're a good option.

Yeah. So one website that's very easy for people to use is It has all your options.

It's like patient-friendly in terms of the words that they use. And I think it's really unbiased. It'll tell you some of the pros and cons of every different form of birth control as well.

Wonderful. And I would just add, if you're not sure, definitely at least create a financial plan long-term that includes the possibility of having kids because you don't want to reach the point where you're ready to get pregnant and only then start budgeting for having a kid because that will be quite expensive. Yeah.

Well thank you so much, Ashley, for coming on the show. It's been such a pleasure. And aside from obviously seeing you in practice, where can people go to find out a bit more about you and what you do?

I guess my TikTok. I'm usually-- I'm more so-- yes, I'm a clinician and I'm a researcher, but if you're seeking to find me outside of those two settings, I guess it would be via social media on my TikTok. @DrJeanlus. Mm-hmm.

Love that. I have to say, my OB/GYN, a lot less cool. Not a frequent TikToker as far as I know.

I don't think I'm all that cool either. In fact, I know I'm not because the residents make fun of me while I'm TikToking. But it's fine.

Oh my gosh. Well, thank you so much, and thank you, guys, for tuning in. And as a reminder, it's never too late.

You may have missed the live, but donating to abortion funds is always such a powerful thing that you can do if you have some financial privilege and want to spread it around. We'll link to that in the description as well. And as always, guys, thank you for watching and we'll see you next Monday on an all new episode of The Financial Confessions.