New York City: Difference between revisions

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'''OVERVIEW'''

By American standards, New York City is a very progressive city regarding sexual and reproductive health services. Abortion is legal and accessible, and Planned Parenthood facilities exist in all five boroughs. There is an especially large concentration of clinics in Manhattan and Brooklyn, but clinics can be found throughout the city. However, it should be noted that some parts of the city are more conservative than others, and there have been cases of pharmacies refusing to sell Plan B in the past.  

Although New York City is very expensive, many residents find cheap (even free) ways to cover health care costs. If you're insured, there are a wealth of health care options. If you are uninsured or have minimal insurance coverage, prices can be exorbitant -- but there are viable ways to cut down these costs. Some clinics are free or sliding-scale in fee structure. There are also many public hospitals that actively work with low-income communities. If you're currently uninsured, it's recommended that you see if you're eligible for Medicaid or seek out hospitals/clinics that actively work with low-income individuals (see below for more details).

Regarding transportation, it is very easy to get around NYC, and you can visit most clinics without a car. The subway system runs 24/7, though trains run less frequently on late nights and weekends. There are also city buses. The fare for a subway or local bus ride is currently $2.75. If you want to visit Staten Island, there's a free ferry that runs between Manhattan-Staten Island. If you prefer to get around by taxi/car, there are a plethora of taxis and  ride-share services, like Uber and Lyft.

'''General Note:''' There are many types of contraceptives, also known as "birth control," including IUDs, oral contraceptives, patches, shots, and condoms, etc. If you would like to view a full list, click [https://www.plannedparenthood.org/learn/birth-control here].

In New York, birth control pills are legal for both minors (under 18 years old) and adults. Minors do not need parental permission to obtain birth control. However, minors and adults both need a prescription, written by a physician, to obtain many forms of birth control, such as pills, IUD, etc. This typically involves a basic consultation with a doctor. However, depending on your medical history, you may also need to receive a pelvic exam before getting the prescription. Once the prescription is written, you can typically fill the prescription immediately. If a special procedure is required, this will usually only be scheduled after the initial consultation/exam. Note for minors: If you go to a Title X clinic, your appointment, billing and records will remain confidential.

[[File:NYC_Condoms.jpg|300px | thumb|left|frame|'''Some of the free NYC condoms available at over 600 locations in the 5 boroughs'''.]]

* Planned Parenthood NYC provides many birth control services, including birth control implant, birth control patch, birth control pill, birth control shot, birth control vaginal ring (NuvaRing), diaphragm, condom, female condom, fertility awareness method, IUD (hormonal), IUD (copper), etc. For a relatively low cost, Planned Parenthood writes and fulfills birth control prescriptions. If you don't have a prescription, you can receive the prescription and pills in the same day. If you choose to go to a location like Staten Island, you'll probably be able to book an earlier appointment than in Manhattan or Brooklyn. As of 2015, Planned Parenthood only provides one form of pills: [[Chateal]]. To schedule an appointment, call 212-965-7000, Monday-Friday, 8am-6pm.

* Women's Health Free Clinic, which is a free, student-run clinic, provides birth control pills, Depo-Provera shot, IUDs, condoms, Nexplanon implant for low-income patients. Clinic Hours: Sat 9am-1pm, Tel. 212-206-5200. Address: 16 East 16th Street, New York, NY 10003  

* Callen-Lorde Community Health Center in Chelsea (356 W 18th St; (212) 271-7200) -- Resource for the LGBT community, and provides a variety of 'women-well' services, regardless of cost.

Regarding condoms, there's little social stigma, and they can be purchased in most pharmacies. You can also get the NYC free condoms, which are found all over the city in over 600 locations through the five boroughs, such as Addiction NYC (27 St. Marks Place), 9th Avenue Saloon (656 9th Avenue), AIDS Center of Queens County (121-61 Jamaica Ave 7th Floor), Albert Einstein College of Medicine (804 East 138th Street, Bronx) and many more locations. For a full locator of free condom venues, check out the official [https://a816-healthpsi.nyc.gov/DispensingSiteLocator/mainView.do;%20jsessionid=BF50C86CD11C7151057D1292F3B000DB condom site locator] put out by NYC.

If you are an American citizen, your birth control exam/consultation may be covered for free, with no copay. As for birth control prices, there is no one standard price, as this greatly depends on which method is used. But, if you are uninsured, you can expect to pay between $20-$150/month supply of pills. For IUD insertion, you can expect to pay $175-600 if uninsured (or $10-$30 copay if insured). You can also get condoms for free in NYC (see above for info).

'''Important Notes:''' Emergency contraception may prevent pregnancy for three days (72 hours) and sometimes five days (120 hours) after unprotected sex. Take EC '''as soon as possible''' after unprotected sex. If you don't have access to dedicated EC, oral contraceptives can be used as replacement EC, but remember the following: 1) Only some contraceptives work as EC 2) Different contraceptives require different dosages and time schedules to work as EC 3) You must only use the first 21 pills in 28-day packs and 4) They may be less effective than dedicated EC. For general information on emergency contraceptives, click [https://www.plannedparenthood.org/learn/morning-after-pill-emergency-contraception here] and [http://ec.princeton.edu/info/ecp.html here].

[[File:planB.jpg|300px | thumb|right|alt=Image provided by Creative Commons.|'''The most commonly used emergency contraception pill in the US'''.]]

In the US, Plan B pills are the most common forms of emergency contraception. It is legal to purchase Plan B in New York without a prescription, and there is typically little stigma related to the act. You can buy Plan B at many drug stores, such as CVS. However, a 2012 Columbia study found that 20% of NYC pharmacies unlawfully refused to sell Plan B to male shoppers. In other words, you should be able to find Plan B -- and, if one pharmacy refuses, simply visit another one (and there are many).

'''Note:''' The longest-lasting EC is currently [http://www.ellaone.com/ ellaOne]. It lasts up to 5 days (120 hours) after unprotected sex. Check to see if your country carries ellaOne. If your country doesn't carry ellaOne, copper IUDs may also prevent pregnancy up to 5 days after unprotected sex. If none of these options are available, and it's been over 3 days since you had unprotected sex, you can still take EC, which may work up to 5 days. Note that EC pills are not 100% effective and should be taken as soon as possible.

Nearly all NYC pharmacies should have Plan B. There are also many 24 hour pharmacies in NYC, for example Rite-Aid (408 Grand St) and Duane Reade (769 Broadway at E. 9th St) in Downtown Manhattan. For a full list of 24 hour pharmacies in Manhattan, check out this [http://manhattan.about.com/od/citylife1/a/24hourpharms.htm this link]. For Brooklyn 24 hour pharmacies, CVS pharmacies in Park Slope (341 9th St), Flatlands, East Flatbush (4901 Kings Hwy) and Midwood (2925 Kings Hwy). For Queens 24 hour pharmacies, there's CVS in Bayside (212 Northern Blvd) and Duane Reade in Downtown Flushing (13602 Roosevelt Ave).

Plan B pills typically cost between $35-$60/pill. If you can't afford Plan B, call up your local hospitals and Planned Parenthood. Some hospitals offer free pills, and Planned Parenthood does give free pills to some people in need. Also, consider seeing if Medicaid can cover the pill. There's also [https://afterpill.com/ AfterPill], which is a cheaper morning after pill, which costs $20 and can be bought online. Since you usually want to take the morning after pill as quickly as possible, it's recommended to only purchase AfterPill as backup for future events -- not if you're currently in need of a pill.

'''Important Notes - Learn about PEP and PrEP:''' If you think that you've been recently exposed to HIV (i.e. within 72 hours), seek out PEP (Post-Exposure Prophylaxis). It's a month-long treatment to prevent HIV infection after exposure, and it may be available in your city. Take PEP as soon as possible. For more information, click [https://www.aids.gov/hiv-aids-basics/prevention/reduce-your-risk/post-exposure-prophylaxis/ here]. If you are at risk of HIV exposure, seek out PrEP (Pre-Exposure Prophylaxis). It's a daily oral pill that can prevent HIV infection before exposure. To learn more about PrEP, click [http://www.whatisprep.org/ here].

The United States has no travel restrictions related to HIV status. There are many low-cost and free STD testing services in New York City. They typically do not require appointments, and they run on a first come, first serve basis. So it is recommended that you arrange for a test on a day when you have time to wait to receive your tests and results. Some STD clinics also offer vaccines for meningitis, Hepatitis A and Hepatitis B, as well as alcohol and drug treatment.

[[File:Gonorrhea-at-home-test-kit.jpeg|230px | thumb|right|alt=Image provided by Creative Commons.|'''One of the "at home" STD tests readily available in NYC.'''.]]

The New York City Department of Health offers free, same-day STD tests at facilities around the city. You can also get STD tests at Planned Parenthood. There are also a few companies that manufacture STD tests you can buy online and take in the comfort of your own home. To learn more about the pros and cons of these tests and find out how to purchase them, [http://stdtestoptions.info/std-testing-in-nyc-3-ways-to-get-tested-without-seeing-a-doctor/ click here].

For all patients over 19 years old, the New York City Health Department does charge fees for STD clinic services. This means that, if you have an insurance policy, your insurance will be billed. However, if you do not have insurance or do not want to bill your insurance, you will be typically asked to pay a sliding scale fee based on your family size and yearly income. Note that you will not be asked to prove your income or family size.

In NYC, some medications can be obtained over-the-counter while others require a prescription. For yeast infections, you do not need a prescription. But, for urinary tract infections, it is necessary to have a doctor test for a possible UTI -- and, if tests come back positive, then you will be given a prescription for UTI medication. For STD medication that require antibiotics, such as gonorrhea, you will also need a prescription.

[[File:Manhattan CVS pharmacy.jpg|300px | thumb|left|alt=Image provided by Creative Commons.|'''A Manhattan CVS pharmacy that is open 24/7'''.]]

Nearly all NYC pharmacies should have basic medications for yeast infection, UTIs and STD medications. For yeast infection medication, Monistat 1, 3 or 7 are some of the most common medications, though many brands tend to be sold. For STDs like gonorrhea, chlamydia and herpes, the physician can usually send an electronic prescription to your local pharmacy. Hepatitis B, hepatitis C, syphilis and HIV often require more complex treatment as managed by a physician, though many medications can be picked up at a local pharmacy as well.

For yeast infections, Monistat 7 at Walgreens is $14.99 while Walgreens generic brand is $11.49 (which seems just as effective). For UTIs, you can expect to pay about $60 for the antibiotics. Chlamydia medication generally costs $10 but can go up to $50. Gonorrhea medication usually costs about $17 for a single dose. For uninsured consumers, some  medications may be steep, so you may want to seek out sliding-scale clinics.

'''Note:''' In addition to pads and tampons, you can also use menstrual cups and menstrual underwear for your period. To learn more about menstrual cups, click [https://en.wikipedia.org/wiki/Menstrual_cup here]. To learn more about menstrual underwear, click [http://menstrualcupreviews.net/best-period-panties-reviews/ here].

There is no social stigma against tampons in NYC or generally in the USA. They can be obtained as readily as pads in most drug stores. As for [http://divacup.com/ DivaCups], they are available but not widely sold in stores (see below for details).

You can find tampons and pantyliners and pads in most drug stores, pharmacies, grocery stores, etc. If you want to buy the DivaCup, you can find it mostly in downtown Manhattan, such as CVS Pharmacy locations (298 Mulberry Street, 148 Bleecker Street, 500 Grand Street) and Bluestockings -- also an awesome bookstore/feminist space! (172 Allen Street). In Brooklyn, you can buy DivaCup at the 156 Henry Street CVS, the 44 Court St Walgreens or the Perelandra Natural Foods (175 Remsen St). Some women in the States are getting into [http://www.shethinx.com/ Thinx underwear], too, but it cannot currently be bought in stores (only online).

Prices will vary, but as an example: You can get a box with 36 tampons for $7 at Walgreens. One of the cheapest tampon brands is Equate, but it is considered low-quality and not recommended. OB is also a cheap brand and higher quality. The DivaCup costs about $25 and lasts for a year. If you have a Costco Wholesale card, you can buy pads or tampons in bulk at their NYC locations, or ask someone who has a Costco card.

In June 2016, the New York City Council unanimously voted to require access to free menstrual hygiene products in public schools, shelters and prisons. This means that tampons and pads will now be included in the city budget. Bill de Blasio has yet sign the bills, but it looks promising.<ref>[http://nymag.com/thecut/2016/06/nyc-will-provide-tampons-in-schools-shelters.html New York City Will Provide Free Tampons and Pads in Public Schools, Prisons, and Shelters]</ref>

Also known as 'Well-woman exams,' there are many options in NYC, whether you're insured or uninsured, low-budget or high-budget. There is little social stigma attached to gynecological exams, generally-speaking. Since there are a wealth of options, it is critical to consider doctor reviews (check out ZocDoc), budget and location (the city is big, and distances can be far).

If budget is not an issue, there are many private practice and larger-scale hospitals in NYC. Cheaper options:  

* Planned Parenthood -- Offers "checkups when you have a reproductive/sexual health problem," as well as pap tests, cervical cancer screening, vaginal infection tests, UTI tests, breast exams and mammogram referrals. Facilities in all 5 boroughs.  

* Women's Health Free Clinic -- "The nation's first comprehensive, free, student-run women's health clinic, providing a full range of women’s health and reproductive care... Patient care teams may include NYU medical students, reproductive health fellows, and family medicine attendings."

* Callen-Lorde Community Health Center -- Caters to LGBT community & offers "empowering, non-judgmental, body-positive healthcare in an open and welcoming environment."  

* Gouverneur Health (227 Madison St, New York) -- a clean, advanced facility, affiliated with the NYU School of Medicine, but catering to lower-income patients. They have some great gynecologists on staff.

Costs vary, ranging from $300 to free for one 'woman well' exam. Note that some clinics charge an additional cost for the pap smear, which may range between $55-$600. If you are an American citizen, you can receive an annual free gynecological exam under ObamaCare. If you are not a citizen or have already received your annual exam, there are cheaper options. Some clinics provide a flat rate for the entire examination while other charge an extra fee for the pap smear and associated lab work. At Planned Parenthood, a sliding scale fee is offered for low-income patients. Otherwise, it will run about $175/exam. Other clinics, like One Medical Group (in the Bronx) and Women's Health Resource (Manhattan), charge about $150-175, which is generally cheaper than other providers.

While pregnant adults are typically celebrated in American culture, there is often social stigma against teenage mothers, single mothers and poor mothers (the idea of the "welfare mom"). From a legal perspective, New York state doesn't have great maternity leave policies. For the period before birth, NY law allows women to be covered under temporary disability. Since they are unable to work, they are given partial wage replacement (50% of the employee's wages up to a weekly cap). But, once the child is born, there are no parental leave requirements in New York, exceptive for adoptive parents. Many employers offer some time off, due to the National Family and Medical Leave Act (FMLA), which guarantees 12 weeks maternity leave. But the FLMA has loopholes (for example, it doesn't apply to companies with less than 50 employees). So, now New York is finally poised to change. In March 2016, the NY State Legislature finalized a budget deal that will include 12-week Parental Leave in New York for all full-time and part-time employees. These changes are set to go into effect in the coming years: up to 8 weeks of leave by January 1, 2018, up to 10 weeks of leave by January 1, 2019, and up to 12 weeks of leave by January 1, 2021.

For sliding-scale facilities, check out Bellevue Hospital, Metropolitan Hospital Center, Jacobi Medical Center and Elmhurst Hospital Center. Some of the best hospitals for delivery are thought to be Mount Sinai Hospital, New York Methodist Hospital and Lenox Hill Hospital, though they may be much more expensive. NYU Langone has also been recommended.

For teenagers, prenatal services are offered in Manhattan at Community Health Network - Downtown (150 Essex Street) and Gouverneur Health (227 Madison Street). In Brooklyn, check out Cumberland Women's Health Services (100 North Portland Avenue). For a full list of teen prenatal care providers in NYC, visit the [http://www1.nyc.gov/apps/311utils/providerInformation.htm?serviceId=1226 Prenatal Care for Teens Finder].

If you're uninsured, the Affordable Care Act now requires private insurance companies to accept people with pre-existing conditions, including pregnancy.  

If you are a NY state resident, you may be eligible for Prenatal Care Services through Medicaid. This is a comprehensive program for both women and teens, regardless of immigration status. Program participants receive prenatal health services, including lab tests, nutrition screenings, HIV tests, etc. The services extend for at least two months after delivery, and babies receive health care services for one year after birth. To see if you qualify, check out the [http://www.nyc.gov/html/hia/html/home/home_pregnant_women.shtml NY gov income guidelines].

'''Important Note:''' There are two main types of abortions: medical (also known as the "abortion pill") and surgical (also known as "in-clinic"). For medical abortions, you take a pill to induce abortion. For surgical abortions, a procedure is performed to induce abortion. For general information about medical and surgical abortions, click [https://www.plannedparenthood.org/learn/abortion here].

[[File:Margaret-Sanger-Square NYC.jpg|300px | thumb|left|alt=Image provided by Creative Commons.|'''The intersection where you'll find Planned Parenthood's main office in Manhattan''']]

New York has been called the “abortion capital of America,” where it has been legally protected since 1970. This makes New York the first U.S. state to provide statewide abortion access. Furthermore, New York does not impose restrictions such as 24 hour waiting periods or required parental involvement, which can be found in other U.S. states.

In New York, all women, teenage or adult, can receive abortions without permission from parents or outsiders.  State law requires that abortions are performed within the first 24 weeks of pregnancy or in order to save the mother’s life. The abortion must be performed on advice of an M.D. If an abortion is performed and not considered justifiable, or if it is not done within 24 weeks, the abortion can be considered a felony.

* In Manhattan, the largest clinic is Planned Parenthood’s Margaret Sanger Clinic (26 Bleecker Street). You can also get an abortion at ParkMed Physicians -- its website says it is "the most respected Abortion Clinic in NYC" (no idea if this is true -- can someone confirm). They're located at 800 2nd Ave #6, +1 646-898-2150.  

* In Brooklyn, there's Planned Parenthood Boro Hall Center (+1 212-965-7000, 6th Floor, 44 Court St,), Brooklyn Abortion Clinic (14 Dekalb Ave, +1 718-369-1900), Professional Gynecological Services (14 Dekalb Ave, +1 718-875-4848).  

* In Staten Island, please note that the Planned Parenthood location does not provide abortion services. It's best to visit in one of the other boroughs. You can also call Staten Island Planned Parenthood for a referral list in your area (212.965.7000).  

Note: Be careful -- there are some places that advertise themselves as abortion clinics, and they're actually religious anti-abortion clinics. For example, Free Abortion Alternatives can appear to be a women's counseling/abortion clinic but it is NOT.

Nationwide, the abortion pill can cost $800, but often less. For an in-clinic procedure, abortions can cost $1500, but often less. You can often find cheaper options at Planned Parenthood or some clinics. For low-income women (regardless of citizenship status), there are a variety of program in NYC that can help pay for these costs, including Medicaid for Pregnant Women & Teens, Prenatal Care Assistance Program, Child Health Plus, and Family Health Plus. If you're pregnant, you can get coverage through Presumptive Eligibility. Coverage begins the same day that you apply. Some clinics offer emergency Medicaid services for same-day abortions. If you don't qualify for Medicaid, you may qualify for the Prenatal Care Assistance Program (PCAP), which is for women with income below the Federal Poverty Level, regardless of immigration status.

The city of New York has made a genuine effort to provide low-cost counseling services, including hotlines and support groups. Some support groups are managed by large public hospitals, such as Bellevue Hospital or Harlem Hospital, but there are many smaller, non-profit organizations/clinics. Many of the hospitals are affiliated with universities, and you can find deeply compassionate physicians, social workers and therapists throughout the city. Of course this is not to say that everyone has a great experience. There are horror stories, as there are everywhere, and public hospitals can sometimes feel overwhelmed and understaffed. It is advised to call programs in advance, learn about their counselors and services, and see if they work for you. For emergencies, please call hotlines (listed below).

* LifeNet -- This is a 24 hour hotline, run by the NYC government to "help New Yorkers in crisis." Deals with issues like domestic violence, family problems, women's mental health, sexual abuse, rape, substance detox, etc. Also has 24/7, non-judgmental teen texting service (text 65173 for help). Offers referrals. If the call was placed by a third party, they can also intervene and visit a person's home. Phone: 800-LIFENET (English), 800-AYUDESE (Spanish), or 877-990-8585 (Asian Languages), or 65173 for the teen texting service --  

* SafeHorizon -- Helps victims of domestic abuse, incest, rape, homeless youth. Offers 24/7 24-hour Rape, Sexual Assault & Incest Hotline (New York City): 212.227.3000. Domestic Violence Hotline: 800.621.HOPE (4673), Crime Victims Hotline: 866.689.HELP (4357), Rape & Sexual Assault Hotline: 212.227.3000, TDD phone number for all hotlines: 866.604.5350

* National Eating Disorder Association -- Toll-free, confidential Helpline, Monday-Thursday from 9:00 am - 9:00 pm and Friday from 9:00 am - 5:00 pm (EST): Holiday Closures, 1-800-931-2237

The hotlines should all be free. Many clinics and counseling services offer free or sliding-scale services, based on the income and needs of the individual. It is advised to discuss potential costs in advance before visiting.

(thanks to NYU Langone Medical Center for providing much of this info)

* Callen-Lorde Community Health Center (356 W 18th St, +1 212-271-7200) - "Callen-Lorde’s team of LGBT friendly insurance navigators are available to help determine if you’re eligible for free or low-cost health insurance under Medicaid and the Affordable Care Act and, if so, help you enroll. Our trained staff will meet with you, screen what programs and financial assistance you qualify for, help choose a plan that fits your healthcare needs and submit the application on your behalf. Enrollers are available at our main clinic located at 356 West 18th St, and our satellite location at 39 West 19th St. during the following hours: Monday-Thursday: 9:00 am – 8:00pm, Friday – 1:30pm – 4:45pm, Saturday: 9:00 am – 3:00 pm" More info: [http://callen-lorde.org/getinsured/ Callen-Lorde Get Insured]

* NY Department of Health Medicaid Info: https://www.health.ny.gov/health_care/medicaid/

* HealthFirst -- Free & Low-Cost Health Insurance in NYC (http://healthfirst.org/)

* New York City Free Clinic (917.544.0735, 16 East 16th Street, New York, NY 10003)

* Weill Cornell Community Clinic (646.962.9222, 505 East 70th Street, 1st Floor, New York, NY 10021)

* Al Hirschfeld Free Health Clinic (exclusively for people in the entertainment industry) (212.489.1939, 475 West 57th Street, New York, NY 10019)

* HHC Options Facilities Find a Facility Requires proof of income or letter of support

* Bellevue 212.562.1000 462 First Avenue, New York, NY 10016

* Stevenson Family Health Center 718.589.8775 731 White Plains Road, Bronx, NY 10473

* [http://www.bookofchoices.org/ Book of Choices]

*[https://www.plannedparenthood.org/ Planned Parenthood]

* Staten Island Center 212.965.7000 23 Hyatt Street, Staten Island, NY 10301

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