Louisiana's Birth Control Program Called Model for Nation and World

              Family Planning Executive Dr. Joe Beasley
. . . 'a laboratory {or the rest of the nation'
Family Planning Unit
Began Here in '68
Shreveport's own Family Planning
Clinic opened in 1968.
"We started everywhere," l a u g h e d
Mary Lou B u t c a 1 i s, acting project
director for Area "A," which is made up
prefabricated building at the Caddo-
Shreveport Health Unit and the medical
clinic in a crowded cubicle at Confeder-ate
Memorial Medical Center.
A few months ago they moved to their
own building — a two-story brick house
at 1165 Janther Place. Clinics in Bossier
Parish are held at the Bossier Health
Unit.
Mrs. Butcalis has been interested in
women controlling their own fertility
"every since I was married myself."
Like Dr. Joe Beasley, Family Health
Foundation head she had seen "so
many large f a m i l i e s , mothers with
children so close together."
"Seeing that," she said, "and knowing
');rom my own personal experience what
it takes to raise children . . ."
Area "A" includes Caddo, Bossier,
Webster, Claiborne, Bienville, Red River,
DeSoto and Sabine parishes.
Lincoln Parish Was First
Lincoln Parish — which housed the
first Family Planning Clinic in the state
— is in Area "B."
Other parts of North Louisiana are
divided into Area "C," which includes
Union, Morehouse, West Carroll, East
Carroll, Madison, Tensas, O u a c h i t a ,
Richland, Caldwell and Franklin parish-es,
and Area "D" Natchitoches, Winn,
Vernon, Grant, Rapides, LaSalle, Cata-houla,
Concordia and Avoyelles parishes.
Dr. Vestal Parrish is project manager
for Area "B", Evelyn McCoy for "C,"
and Carol Edwards for "D."
The service has tried to make the
e l i g i b l e requirements as lenient as
possible, according to Mrs. Butcalis, a
registered nurse who holds a bachelor's
degree from Northwestern State Univer-sity,
a diploma from the Old Schumpert
Memorial Hospital Nursing School.
Criteria has been, mostly, any woman
who has been at a charity hospital in the
last five years; any woman who receives
aid for a dependent child; family with the
income range for the Office of Economic
Opportunity p o ve r t y guidelines, and
"anyone referred to us by a private
physician or minister is automatically
eligible."
"The poor or near-poor are the ones
we mainly service," she said.
Many of today's referrals are by word
of mouth, but Family Planning has a
prescribed formula for reaching clients.
Nurses like Mrs. M. B. Collins Jr., a
Dillard School of Nursing graduate who
joined the staff several months ago, visit
each female patient in Confederate
Memorial Medical Center who has had a
baby.
For officials have determined that
women are most r e c e p t i v e to the
program immediately after the birth of a
baby.
Stopping by the bed of a Natchitoches
woman on Confederate's 4th-floor mater-nity
ward, Mrs. Collins told her she had
made an appointment for her at the
Family Planning Clinic.
"I used family planning before," the
woman offered.
"What happened?" Mrs. Collins asked
with her wide smile.
"I stopped. I was getting too fat," the
patient answered.
"If you can't keep the appointment,
call. They will be waiting for you," the
nurse advised handing the new mother
an appointment card.
She told one 22-year-old who looked 15
that everything at the clinic was free,
but be prepared to be there about three
and a half hours. (This i n c l u d e s
presentation of a film, examination by a
physician and counseling by a nurse.)
To one woman she said, "Bring your
baby, if you don't have any place to
leave him." (The New Orleans clinic has
a nursery, with attendants.)
Mrs. Collins talks softly and privately
and confidentially with each patient,
even in a four-bed ward, making it
impossible for other patients to eaves-drop
on the conversation. This is to
follow Beasley's theory Chat the poor will
.subscribe to a program where they are
treated with dignity — so different from
many other state or federal health
programs.
She tells the new mothers that several
methods of contraception will be de-scribed
at the clinic and they can choose
any method they like.
She reminds them birth control will
help space their children.
"I'm scared of those pills," said one
woman with a ninth grade education and
six children "You can get cancer from
them."
"Who told you that?" Mrs. Collins
questioned, with a grin.
"Some older people," the woman
n o d d e d her head and spoke with
assurance.
"There are other methods than the
pill," the nurse told her. "There's the
• IUD (intrauterine device . . . we'll
discuss it with you."
"I'll be there when you come," she
adds.
Will the woman attend the clinic?
Mrs. Collins shrugs, thinks a moment,
"she probably will. Her sister has been."
All of the Confederate patients are
given their postpartum check-up at the
Family Planning Clinic. They are given
a physical, receive a free test for cancer
and a gonorrhea culture, if they want it.
If the women miss the appointment
there is a follow-up visit by a home
health counselor, like Betty Glass, a 1962
graduate of Booker T. Washington High
School.
She and other lay people speak the
language of the poor and understand
their fears and hopes and feelings
Mrs. Glass is a part of Family
Planning's Outreach Program. It has
also helped make the program succeed,
because, foremost, the client is talked to
with dignity and respect.
"The ladies we balk to are always
right. We are concerned with them and
their health," said Mrs. Glass, who was
put in the field only after days of
intensive practical and classroom train-ing.
Told of Methods
"We introduce ourselves to them and
tell them we would like to talk to them
about family planning," she continued.
They are told they will be given a
three-month supply of the method they
choose and will be given an appointment
to pick up another supply at their
nearest neighborhood center. They can
• _
Classified Local News
Metropolitan
News
Area News
Sunday, Oct. 22, 1972 Section C, Page One
Louisiana's Birth Control Program
Called Model for Nation and World
By Margaret Martin
Times Medical Writer
" . . . the Louisiana Family Planning
Program is the No. 1 such program in
the United States and the world.'
You can talk like that if you are
42-year-old Dr. Joseph Diehl Beasley and
can remember back seven years ago
when it was a felony in the state
to disseminate birth control information
and compare that time to today when
Louisiana is the globe's laboratory for
family planning.
There are clinics in Caddo, Bossier
and Webster parishes. North Louisiana
parishes are covered by their own clinic
or by consolidation with another parish.
In addition, Dr. Arthur Fort, head of
the Department of Obstetrics and Gyne-cology
for the Louisiana State University
School of Medicine in Shreveport, and
Confederate Memorial Medical Center, is
medical coordinator for family planning.
Dr. E. E. Dilworth, Shreveport obstetri-cian
and gynecologist, is a member of
the state medical advisory board.
Beasley heads the Family Health
Foundation based in New Orleans but
has 144 clinics in most parishes. The
agency, Beasley says, is "trying to build
a better foundation upon which to
develop the potential of the individual
child."
A Matter of Respect
"Everyone alive today, w h a t e v e r
race, creed, color, sex or background,
has a right to demand respect from
everybody else. Human dignity and
respect for one's f e l l o w m a n —
that's what we're all about," he ays.
For the wealthy and afflent middle-class
American, birth control has always
been easy. It is a more difficult for the
indigent, many of whom, studies have
found, aren't even aware of how they get
pregnant.
Beasley came to Tulane University
School of Medicine in 1963 from the
Hospital for Tropical Dis3ase, London.
He serves as. chairman of the Depart-ment
of Applied Health Sciences f*r the
Tulane U.n i v e r s i t y School of Public '
Health and T r o p i c a l Medicine. His
12-page curriculum vitae is a testimony
to his capabilities.
He came to Tulane for a fellowship in
pediatrics.
He found high-risk mothers (mothers'
with high blood pressure) getting preg-nant
again and again , un-wed teen-ager
having babies; and the mentally
retarded pregnant.
Why? he asked.
The answers wiped away the myth
that: 1—Poor people want a lot of
children so they can get welfare. 2—The
Discussing The Statewide Family Planning Program
are local officials (left to right) Dr. Arthur Fort,
head of obstetrics and gynecology for Confederate
Memorial Medical Center and medical coordinator
for family planning; Mary Butcalis, acting project
manager for Area "A," and Dr. E. E. Dilworth,
local obstetrician and gynecologist and a member
of the state Family Planning Medical Advisory
Board. (Times Photo by Ken Aclin)
indigent who are many timss also
uneducated aren't good pill takers.
"One thing we asked the women why
they kept getting pregnant when there
was a risk of the baby dying or dying
themselves," Beasley said-in an inter-view
in the executive conference room at
the foundation's New Orleans office.
He found that most of the women did
not want to get pregnant but had lack
of knowledge of the reproductive physiol-ogy
or the knowledge that they had the
power to control their own fertility.
"No other program even remotely
approaches the percentage of women
who have continued actively in the
program or the percentage of eligible
women reached," Beasley said of the
program.
The records are kept by computer,
flow charts, cost accounting — the most
advanced managerial techniques.
(Times Photo by Ken AdirU
Sign Depicts Goal
. . . healthy children
also report to the clinic, or call, if they
have a problem.
If the patients miss an appointment to
the center, or a revisit for supplies, "I go
back to see what happened."
. Most of the people Mrs. Glass visits
accept her, but some are skeptical at
first, ". . . some flatly refuse to let us
in."
"You learn to accept what happens,"
she said philosophically. "You aecept
that there are going to be bad days.
Sometimes a person hurts your feelings
and you are reluctant to go to the next
house."
Many of the women are lonely and
"just need someone to talk to."
Mrs. Glass has learned that you have
to be able to listen and at the same time
steer them back to the matter at hand —
family planning.
"Some of the women will not accept,
no matter how badly they need it. But we
don't argue. We just present our case,"
Betty Glass said.
When the women r e p o r t to the
Janther Place establishment they are
greeted by polite clerks who have their
charts in hand. They are u s h e r e d
u p s t a i r s where a nurse like Betty
Matlock delivers a lecture on the seven
birth control methods.
The methods prescribed include the
diaphragm, the pill, IUD — still not
widely used by private physicians but
common in the Family Planning project
— foam, diaphragm, and the perma-ment
methods—vasectomies and tubal
ligation.
In an honest and frank discussion she
explains the reproductive system, how
each method works — or why it might
fail, and calls for questions.
Why did the women on this particular
day seek help?
Simple. Most of them don't want to
have any more children.
"I didn't want no more babies. My
sister came here," said one 22-year-old
white girl who has had three children.
She selected the IUD.
"I just don't want any more babies,"
answered one proud and attractive black
divorced welfare mother of four, 8 to 15,
Who had decided to take the pill.
"This is a very good thing to be do-ing,"
she said.
She understood Mrs. Matlock's lec-ture,
"and what I didn't undrestand I
asked."
"1 liked the way they answered, too,"
she added.
Another woman from a small town
outside of Shreveport said she and her
carpenter husband want four children,
"but we want to plan our family."
A 27-year-old woman with seven,
including twins and five-week-old infant,
said she was told about Family Planning
by the nurse who came to see her in the
hospital.
Nurse supervisor at the clinic is
Frances Baily who has been with the
program for four years.
She started with the project "when
everyone went to New Orleans for
orientation," and remembers that one of
the things they stressed was treatment of
patients.
"They wanted the patients treated
nice," she said.
Shreveport obstetrician and gynecolo-gist
Dr. E. E. Dilworth who is a member
of the state medical advisory board, says
the program as it now stands "is a great
thing . . . no question about it."
"It not only helps patients," he said,
"but it is a training program for
Confederate doctors who work in the
clinics."
Too, Dilworth feels that "lives are
saved through the Cancer Detection
Program which is given routinely and it
is an effective source of venereal disease
control"
"It is a very high level of care for the
individual patients," he added.
As medical c o o r d i n a t o r for the
program, Dr. Arthur Fort, head of
obstetrics and gynecology for Confeder-ate
helps make medical policies and is
available to organizations which have
questions.
He, too, has seen poor and high risk
mothers and teen-agers getting pregnant
over and over again.
For Healthy Children
"It is the result of poor family
planning. It is getting pregnant too soon,
having to many babies too close together
in a life style where there is no prenatal
care and poor nutrition," Fort said.
To the black critics who blast the
program by crying "genocide," Fort
emphasizes, "my interest is not in
stopping black births, but in helping the
black and white h a v i n g births as
healthily as possible by planning where
contraception will occur."
The number of births at Confedeate in
the last year have been relatively stable,
Fort said, "despite an increase in people
of the child-bearing age."
"I believe in this program," Fort said
earnestly.
Maybe that's the reason he was able
to define it most succinctly, "family
planning is giving people the knowledge
and power to plan their families so that
the children who are born will be born
well, wanted and born with a future.
"i am not so interested in numbers as
in quality. Let's have I he number of
children at the right time under the right
circumstances so they will be healthy
••hildren." j
The figures show that, as of a few
weeks ago, 109,389 Louisiana women
have been initiated into the 144 clinics in
Louisiana.
Of those initiated into the program
some 89,000 or 74.2 per cent continue in
the active files.
Of the estimated 171,000 eligible, poor
and near poor women, 64 per cent have
participated in the clinics around the
slate.
In a state known for political and
religious conservatism, how did Joe
Beasley do it?
Began in New Orleans
A Tulane University medical team's
survey of scientifically selected cross
section of New Orleans citizens — 368
men who were or had been married and
540 women between the ages of 15 and 45
who were or had been either married or
p r e g n a n t showed: 1 — There was
ignorance of the reproductive facts; 2 —
They waated help in controlling their
families.
Armed with these figures he talked to
Catholic officials in the state, assuring
them that no patient would be talked into
using any birth control method contrary
to the church's teaching. The rhythm
method he assured them, would be
among the methods of contraception
detailed at the clinics. (Indeed, at the
New Orleans facility Patient Educator
Gloria Johnson said, "This is the only
method a p p r o v e d by the Catholic
church.") It would also cut down on
illegal abortions, he predicted.
The Tulane team — backed by the
Louisiana State Board of Health — got
the state's attorney general to re-inter-pret
the state criminal law forbidding
birth control centers. Then Gov. John J.
McKeithen approved.
His ground work well laid, Beasley, a
baby doctor who sees few patients now,
opened the first clinic in the rural
Lincoln Parish Health Unit in the fall of
1965.
Lincoln was considered a good sample
of other Louisiana parishes. Besides, its
population was s m a l l enough to be
reached within two years.
Within 16 months legitimate births
were down 40 per cent (as compared
with a 2 per cent rise in neighboring
parishes); illegitimate births declined
41.5 per cent and the over all birth rate
among the poor was down 32 per cent in
one year.
U n d e r a grant from .the U. S.
Children's Bureau, the. clinic initially
directed its services to women on charity
who had just given birth; higher risk"
mothers (women w.'io had given birth to
•six or more children); women who had
had a still birth;.women'with a history of
infant or child, deaths and women whose
last child was born out of wedlock.
Today many of the clients are students
trom nearby Louisiana Tech, according
to otlicials at the Lincoln center.
Another law has been changed since
1965.
"State law allows any physician to
treat minors without consent from their
parents," Fort pointed out. This applies
to all physicians in the state and includes
the Family Planning Clinics.
Among agencies funding the Family
Health Foundation's programs are the
Children's Bureau of the U. S. Depart-ment
of Health, Education and Welfare,
the Bureau of the Federal Office of
Economic Opportunity and several pr-vate
groups and foundations, including
the Ford Foundation and the Rockefeller
Foundation.
How has he achieved success without
avoiding controversy about what could
be a volatile subject?.-
Beasley, ever packing his pipe or
bumming a cigarette, laughed: "Well.
we walk through fire without spilling
gasoline,"he answered.
About the Future
What does the future hold?
ContinueJ operation, of course, but
more research and d e v e l o p m e n t
''meshed into the on going services."
He feels that the Louisiana program
could be a model for the entire nation
and the world.
Illinois has already copied the state
program, and an agreement has been
established with the Republic of Brazil
for a research and demonstration pro-gram.
The experiences learned in the
Louisiana program, Beasley said, can be
put to use throughout the world.
"What we learned is a laboratory for
the rest of the nation and several major
countries i» the world," Beasley com-mented.
»
(TIIIICS Photo by Ken AclirO
Registered Nurse Mrs. 1\1. B. Collins Jr.
\ . . explaining birth control options
The Shreveport Times