Author: Richard

I am a retired obstetrician-gynecologist who has been fortunate to live and work in the wonderful community of Durango, Colorado for 40 years.

Is Durango a Reproductive Health Desert?

Post author By Richard
Post date Sunday, April 27, 2025

Well, the answer to the title’s question is “yes, no and maybe”.

First, I should define a “reproductive health desert”. It is an area without a provider of reproductive health. Thus, there are maternity, fertility, contraceptive and abortion deserts.

Cortez (Montezuma County) was a maternity desert for a brief period of time. The hospital’s administration closed down their birthing center. Outrage from the community pressured the management to open it up again.

There were a few years that we had sophisticated infertility services in Durango. Unfortunately, the two doctors who provided this care are gone. The OB-GYN doctors who remain can help couples with most fertility issues, but some folks will need to go to Albuquerque or elsewhere for more complex infertility problems.

There shouldn’t be a real shortage of effective contraception anywhere in the US now that OPill® is available to anyone with a uterus. Or without—I got a package of this over-the-counter birth control pill for an art project from Amazon. They didn’t quibble over my gender.

(More about Opill®: It is a birth control pill that is available without a prescription. The only contraindications are pregnancy or a history of breast cancer. It needs to be taken every day at the same time.)

However, there are women who don’t want to use hormones or aren’t regular in taking pills or cannot afford $20 a month. They may live in a county without a clinic that provides the full range of family planning methods—this is how “contraceptive desert” may be defined, and almost 20 million women live in counties that lack this care.

La Plata County is far from a contraceptive desert. Even though Planned Parenthood is closed, the health department (in the beautiful AXIS Health System building), many physicians, and midlevel providers are happy to prescribe desired methods.

Unfortunately, we do live in an abortion desert now that PP is closed. PP clinics in neighboring Cortez and Farmington do provide medication abortion care, however they are limited to 11 weeks gestational age. Regrettably, procedural abortions (those done in the clinic) are not available in the Four Corners area at this time.

While on the subject of abortion, I just read a reason that the religious right has chosen to fight against this important part of healthcare. It was written by a Methodist pastor, David Barnhart.

‘“The unborn” are a convenient group of people to advocate for. They never make demands of you; they are morally uncomplicated, unlike the incarcerated, addicted, or the chronically poor; they don’t resent your condescension or complain that you are not politically correct; unlike widows, they don’t ask you to question patriarchy; unlike orphans, they don’t need money, education, or childcare; unlike aliens, they don’t bring all that racial, cultural, and religious baggage that you dislike; they allow you to feel good about yourself without any work at creating or maintaining relationships; and when they are born, you can forget about them, because they cease to be unborn….

‘It’s almost as if, by being born, they have died to you. You can love the unborn and advocate for them without substantially challenging your own wealth, power, or privilege, without re-imagining social structures, apologizing, or making reparations to anyone. They are, in short, the perfect people to love if you want to claim you love Jesus but actually dislike people who breathe.

‘Prisoners? Immigrants? The sick? The poor? Widows? Orphans? All the groups that are specifically mentioned in the Bible? They all get thrown under the bus for the unborn.”

A small group of concerned people are working to bring back both medical and procedural abortion services to Durango, but it may take months.

Environment Population

Sierra Club Population Policy

Post author By Richard
Post date Sunday, April 27, 2025

Environmental groups are only treating the symptoms of overpopulation

Several years ago a friend asked if I would be interested in helping start a population interest group in what became the Sierra Club’s SW Colorado Group. Today the Group is going strong, including leading discussions about possible new mining in the La Plata mountains, learning about the pros and cons of beavers and introducing a local organization that advocates for giving legal status to features of nature.

I remember when the national Sierra Club (SC) had a large, energetic Population Issues Committee. There was an active chat group where we traded information back and forth. Before then, SC published Anne and Paul Ehrlich’s classic book The Population Bomb. Past SC president, Carl Pope, used the term “most overpopulated nation” to describe the USA, acknowledging the huge footprint Americans leave on the environment.

What happened that the SC no longer seems concerned about human population? Journalist and Durango native, Kathleene Parker, may have part of the answer. She wrote that a 2004 Los Angeles Times article gave a clue to this change in policy.

At the end of the 1990s there was a tug-of-war in the SC’s board. People such as Dave Foreman pushed for a strong policy to limit immigration and population growth. Other members had a laisse faire attitude; they won the dispute. They were perhaps helped by a rich donor, David Gelbaum, who gave over $100 million to the SC. He wrote: “…that if they ever came out anti-immigration, they would never get a dollar from me.”

Personally, I am ambivalent about immigration, but passionate about slowing population growth voluntarily.

The current national SC Population Policy starts off stating: “The Sierra Club is a pro-choice organization that endorses comprehensive, voluntary reproductive health care for all. Sexual and reproductive health and rights are inalienable human rights that should be guaranteed for all people with no ulterior motive.”

This sounds pretty good. However, it further states: “This includes policies and positions made in the name of preventing ‘overpopulation’ by ideas and means that include, but are not limited to: zero-growth, population stabilization, family planning as climate mitigation, or promoting women’s empowerment or girls’ education as an indirect means to limit population growth.”

To me, this seems like an attempt to be politically correct by ignoring the basic cause of all the environmental problems that the SC tries to deal with. It is too late to “prevent” overpopulation; overpopulation is already attacking the integrity of our planet, our life support system. Three billion people, more or less, is the maximum human population that can be sustained without causing degradation of our environment. We are approaching 3 times that number!

In the USA we are consuming much more than is sustainable. Yes, consumption is a major factor; people often bring it up. I am tempted to ask these advocates of reduced consumption if their carbon footprint is 2 tons or less; this is what is considered to be sustainable. (The average carbon footprint of people in the US is 16 tons!) I know few people who are trying to consume less. However, I have met hundreds—no, thousands—of people who wish to have control over their family size. Slowing population growth is, indeed, the “low hanging fruit.”

The word “population” seems to be anathema to many people, perhaps because it goes against the biblical admonition “be fruitful and multiply”—and all the religious hang-ups about pronatalism and sexuality. Perhaps it brings up racial and genocidal disasters of the distant past—and also recent and near. We need to get over it and face up to the fact that “we have met the enemy and he is us”. And the more of us, the worse things will get.