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April 24, 2024 29 mins

Jamie Rich is a telehealth abortion provider for out of state patients.

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https://www.tsthealth.org/

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Episode Transcript

Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:02):
So it's around six point thirty and I'm just getting
ready to start my day. I'm going to have two
very excited dogs who are ready to go outside and
see what other kind of animals may have come through
our property overnight. Anything from something big like bears and elk,
to something small like a fox or even a squirrel.
This morning, I'm going to go ahead and text my

(00:23):
son and just tell them to have a great day.
About the time the dogs come back in, I know
that my daughter's going to give me a call. I'm
really lucky that she calls me every morning on our
way to work. And as soon as all that's done,
then I'm going to jump in and start working and
see what the day brings. This is finally a show

(00:46):
about an abortion provider for over twenty five years. Jamie
Rich is a nurse with the Satanic Temple's first ever
telehealth abortion clinic.

Speaker 2 (01:01):
My name is Jamie.

Speaker 1 (01:02):
I am an OBGYN nurse practitioner. I'm lucky enough that
I get to work from home in northwestern Colorado and
I provide telehealth services to people in New Mexico. I
can remember at four or five someone asking me what
do you want to be when you grow up. And
my answer has always been I want to be a nurse.

(01:23):
It never changed, it never wavered. I never wanted to
be a doctor. I feel like the philosophy of care
is just a little bit different. Nursing looks more at
the holistic patient, not just oh, the person who has
a breast slump or the person who needs surgery. But
there are many other layers to a person, from their
mental health, to their socioeconomics, to possibly their religious or

(01:45):
spiritual beliefs, what's going on in the home that is
impacting the way that they're able to take care of themselves,
and so on, and so different philosophy of care that
just worked better with my beliefs and how I wanted
to take care of people. I grew up in kind
of a conservativeative family. My dad was Catholic, my mom
was not Catholic, but was pretty religious. And you know,

(02:06):
like birth control and premarital sex, you don't talk about
that because that doesn't happen until you're older and married,
and you don't worry about that. And so I think
a little bit was that normal kind of teenage rebellion.
I'm going to figure out who I am. I'm going
to figure out what my beliefs are and where I
want to go and what I want to do. And
to my parents' credit, they were like, you know what,
if that's what you want to do, that's what you
want to do, that is great. And so my husband,

(02:29):
right when I graduated from college, we got married, we
were still married, was a photojournalist. He stayed here in
Colorado and I went to Los Angeles, moved up here
to where I am now, and started working for Planned Parenthood.
The community is supportive, or if they're not supportive, then
it's basically whatever you know, don't you do what you

(02:50):
want to do. I'm not going to interfere, but I'm
not going to support it either. So I left Plant
Parenthood a little over a year ago. Before I left
Planned Parenthood, though, I had been approached by some folks
who were starting TST Health, which is the telehealth that
I'm working for now, to provide abortion services to folks
in New Mexico. TST Health is the Satanic Temple Health,

(03:13):
which then provides the care to the Samuel Alito's Mother's
abortion clinic.

Speaker 3 (03:21):
So get your abortion today in the name of Samuel
Alito's Mom.

Speaker 1 (03:26):
You can find out more on our website. And you know,
Alito obviously on the Supreme Court definitely not pro choice,
definitely very conservative, has voted against religious and reproductive rights.
And I think it is intentionally a little bit provocative
to get people talking about it and to get people

(03:46):
to hopefully do some research, find out what is and
what it isn't, and be able to make decisions again
based on facts. The telehealth laws with the New Mexico
are a little easier to manage. New Mexico was kind
of a safe haven. You know, they're surrounded by Arizona
and Texas and pretty close to Oklahoma and all of

(04:09):
those states that are not friendly to women or abortion services,
and so New Mexico kind of made sense in terms
of where we could provide services and hopefully get some
people who didn't have any other option to get into
New Mexico to be able to access care. There's been
a few articles in the paper against having abortion services

(04:32):
and against TST health, but that also tells people where
to access care as well. New Mexico, where we're providing service,
does not have abortion restrictions, and so we're not fighting
that fight here. But the Satanic Temple is in process
of legally trying to get care provided in some other
states where it is not so friendly. So TST Health

(04:55):
is a component of TST, which is the Satanic Temple.
At this point, it's a start, it's less than a
year old. We actually have only been seeing patients since
February of twenty twenty three.

Speaker 2 (05:06):
In some of these.

Speaker 1 (05:06):
States that are very unfriendly or who have essentially banned abortion,
they are using religion, especially Christianity religion to state that
this is something that goes against God and should not happen.
And so what TST the Satanic Temple is doing is saying,
you know that this is these are our religious tenets
and our religious beliefs, and by you restricting or outright

(05:28):
banning abortion, is that you are infringing upon my religious convictions.
The mission of the Satanic Temple is to encourage benevolence
and empathy, you know, to really advocate for practical, common sense,
factual based information really really important for this group. They
oppose injustice like taking away rights for women who want

(05:50):
to have abortion as part of their healthcare, trans rights,
LGBTQ rights, those kind of things, and so that's really
the overarching kind of mission, statement of the Satanic Temple,
and making sure that decisions that are being made, whether
that's at a local government level or at the upper
levels of the United States government, that those decisions are

(06:11):
based on facts and based on science and not based
on a religion that is not based in science or
based in facts, and is you know, and excludes certain
people because for whatever reason. The fundamental tenets of the
Satanic Temples, so there are seven of them. The ones
that we tend to use the most for an abortion

(06:32):
ritual or for folks who are interested in having some
type of a ritual with their procedure is that one's
body is inviolable, subject to one's own will alone, bodily autonomy,
beliefs should conform to one's best scientific understanding of the world. So,
in other words, we are providing care that is based
on the best practices, on scientific evidence on twenty five

(06:54):
plus years in the United States more than that in
other countries, on how this is safe and effective. So
those are the two that we tend to use the most.
The tenants also talk a little bit about compassion and
empathy towards people, trying to understand people, not judging struggle
for justice, you know, and not having certain groups marginalized.

(07:15):
Freedom of others should be respected. In other words, I
may believe this, you may believe that doesn't make one
of us more right on the other person wrong or
anything like that, but that you know, as people, we
all have different beliefs and different views, and that that
should be celebrated. We talked about people are fallible. You know,
if you make a mistake, then you should once you

(07:35):
recognize that, own up to your mistakes, move forward, try
not to do that again again, you know, get the
information that you need to be able to move forward
and make better decisions. And then the last one just
talks about all of these tenets are used kind of
as an overarching principle. It's as to inspire nobility and
action and thought. And I think that that's really great

(07:55):
way of saying that to be compassionate and to continue
to learn and to continue to grow, and to continue
to help provide justice to those groups that may be marginalized,
that we should be looking at the written and spoken
word and using all of these tenets to be kinder,
gentler and learn more and continue to move forward in

(08:17):
this world. Some people are actually member active ongoing members
of the Satanic Temple, or they have a friend who
is who tells them about it. There are so many
things that the Satanic Temple does. It's a group of
folks who believe in facts, and believe in science, and
believe in bodily autonomy, who are getting together and trying

(08:40):
to make a difference in their communities. I think when
when people hear the Satanic Temple, they're thinking, oh my gosh,
they're worshiping Satan. I tell you you really cannot make
this stuff up.

Speaker 3 (08:51):
This group pledges to provide quote religious medication, abortion care,
and not how they identify themselves as not believe in
a literal Satan, but when you associate yourself with Satan
at all, Satan is the father of lies, So how
are we supposed to believe that that's even true? Gather
together to stand as one unified voice against this demonic

(09:16):
spirit that is trying to invade.

Speaker 1 (09:18):
Our petitioning for access to abortion, and what they say
is to quote, continue performing voluntary abortions as part of
its religious rituals. And to me, that is a huge ordeal.
You know that they're sacrificing and all of these horrible
things that you hear about with Satan worship, and that's
not what this is at all. I mean, I think
some people probably would be concerned with the name the

(09:42):
Satanic Temple, although this health clinic part of it is
TST Health, which I think sometimes people don't know what
it is until they've actually gotten into the paperwork. But
once they get in the paperwork, I think they realize that,
you know, this is a really professional organization. We are
dedicated to providing the highest standard of care that you know,
everything that we're asking is very clear and has a

(10:03):
purpose and is very medically focused. They can always ask
as many questions as they'd like to about our training
and you know how everything got started, and you know
what we're doing for quality control. And I haven't had
anybody who made an appointment who has said this is
kind of strange or whatever. It's mainly thanks so much
for being available. This is you know, you made this

(10:24):
much easier for me and I can do this on
my own time, and it's been a great service. I
have a daughter and a son. My daughter is a
high school English teacher, also in a small town in Colorado.
So this is really funny. Actually it's a funny story.
So my daughter was in college and she did a
semester abroad, and it was the semester you know that.

(10:49):
It was during the time when Trump got elected, and
I can remember a few days before the election, I
said to her, if Trump gets elected, you're going to
have to stay where you are, and she's like, okay,
and kind of laughed it off. And then of course
he got elected, and so she called me and she
was crying and she's like, I can't believe this happened.

Speaker 3 (11:08):
One.

Speaker 1 (11:08):
I don't want to stay here. I really want to
come home. And I'm part of the Satanic Temple too.
I joined because, you know, I just I just thought
it was a good thing to do. And I'm like, well,
good for you. That's great. I don't know anything about it,
but you know, that's wonderful.

Speaker 2 (11:21):
What are you doing?

Speaker 1 (11:22):
She goes, I don't really do anything because there's nothing
here that I can do with them, but I just
wanted to do that as a protest. I was like,
that's great, that's fine. I think it's really funny. When
she was in middle school, the school approached me and
asked if I would teach their sex ed class, and
I was like, sure, absolutely, And so my daughter actually
sat down and did all the flashcards and all of
the handouts for the sex said class for her middle

(11:44):
school class. And then my son I also did his
sex said class and he was great with it, and
you know, made sure he participated to make his friends participate.
You would look at him and just you know, make
a judgment of looks pretty concernedative. You know, he's kind
of a I don't know, like a cowboy kind of rancher,

(12:07):
mechanic kind of looking kid, and that's that's what he
does for his full time work.

Speaker 2 (12:12):
But he's probably the most liberal of all of us.

Speaker 1 (12:18):
There were a few times that it was probably uncomfortable
for them, you know, that they had friends or family
who weren't real keen. You know, it was not a
secret where I worked and what I did that weren't
too keen on that, but they they handled it well.
Funny story, I was going into work and I had
my daughter with me, who at the time was in college,

(12:40):
so she wasn't little. But even then we have talked
about this from the get go with both both my children.

Speaker 2 (12:47):
But my daughter was.

Speaker 1 (12:48):
With me and the protester yelled that the angel of
death was behind me and that my daughter was going
to suffer because of it, and it just we both
looked at each other, my daughter and I and we
both walked in chase.

Speaker 2 (12:59):
You know, we not engage with people like that.

Speaker 1 (13:02):
And we both walked in and we said, good, we
are going to you know, She's like, Mom, You're going
to continue doing what you do and I'm like, yes,
i am. She goes me too, you know, I'm going
to continue to be you know, outspoken and an advocate
for whoever needs me with this work. I was just thinking,
you know, I know that people who are our anti

(13:24):
choice really do say, you know, how do you live
with yourself? How can you do this? And I guess
my response to that is how can I not?

Speaker 2 (13:32):
This?

Speaker 1 (13:33):
Again, is essential health care. This is providing a very
safe service to folks who need it for whatever the
reason is, and again, no different than anything else. And
so I couldn't live with myself if I didn't provide
the care that I feel is appropriate and necessary for
the people I see. TST Health is not a temple

(13:54):
or a gathering place for folks who have the beliefs
of the Satanic temple. However, we do incorporate those tenants
with the patients that we see to whatever extent that
they would like to go through any type of a
ritual with their abortion care. I'm going to read what
the TST Health site says about the abortion ritual so

(14:16):
it serves as a protective right. Its purpose is to
cast off unwanted feelings that a patient may be experiencing
due to choosing to have a legal and medically safe abortion.
The ritual is designed to alleviate stressors and empower the
patient to be guided by the Satanic Temple's third and
fifth tenants when pursuing their decision. The ritual serves to
assist in affirming their decision and to ward off the

(14:36):
effects of unjust persecution which can cause one to stray
from the paths of scientific reasoning and free will. And
those third and fifth tenants. One of those is bodily autonomy.
The other, the fifth one is talks about the scientific
and best practices and utilizing the best knowledge that we
have or care. Some folks want to participate in some
type of a ritual, even if it's I have chosen

(14:59):
to do this. This is right for me, this is
right for my body. I am firm and clear in
my decision. It could be as simple as that, which
we do want everyone to be able to verbalize to
us that this is their decision that they want, that
they're not being coerced in any way. Or it could
be that they may actually take one of the seven
tenants from the Satanic Temple and actually say those out
loud prior to taking their medication or when they take

(15:21):
their medication. So the patient that we're seeing today, we
ask if she would be willing to come onto the
podcast just so that everyone can kind of hear the process,
the consent process, how we explain everything to the patient,
my part of the visit, the provider part of the visit,
and she said that she's more than willing to do that.

(15:43):
So we just got a message from our support person
just that the patient has joined and so we are
going to join the call as well.

Speaker 2 (15:54):
It's a video call.

Speaker 1 (15:58):
Perfect get started.

Speaker 4 (16:01):
I'll just tell you a little bit about me, so Jessica,
I will be going over the process with you in
a little bit about the medications, what to expect and
all of that. I do go over quite a bit
of information, so I at any point you need me
to stop or repeat myself, just let me know and
the medical isms.

Speaker 1 (16:20):
That you filed out. The way the telehealth works is
that they can fill out the paperwork online. Wherever they
are doesn't matter.

Speaker 2 (16:29):
We get it, no big deal.

Speaker 1 (16:31):
When they do their telehealth visit with me, which is
a video visit kind of face to face, we each
get to see each other and talk to each other
and you know, hopefully get a little bit of a connection.
They need to physically be in New Mexico, whether that's
one foot over the line from Texas or wherever. They
just have to physically be in New Mexico. Some patients

(16:52):
really stick in your mind because they had to travel
two thousand miles and you know, they had to get childcare.
And many of them have traveled, but a lot of
them we have seen have actually been in New Mexico
and they're in small, little towns. The reason I was
really excited to work with TST Health is that through
their membership and through donors, the only cost to the

(17:15):
patients who are accessing is the cost of the medication,
which is about eighty dollars. Other places, it's anywhere from
six hundred to twelve hundred dollars for a medication abortion.
And so especially for folks who maybe need to travel,
folks who are in some of these really tiny towns
in New Mexico that socioeconomically are not stellar, this is

(17:39):
a really affordable, great way to access abortion care if
they need that service.

Speaker 4 (17:44):
Medication, and we send you to pregnancy tests.

Speaker 1 (17:48):
So the first.

Speaker 4 (17:49):
Medication that you will be taking, it's called if a
persona is just one pill.

Speaker 1 (17:54):
I think we lost her. Hey, Jess, I think we will.
I think we did. There you go. Can you hear me? Yeah,
I can hear you.

Speaker 4 (18:07):
Okay, perfect, thank you technology? Alrighty, So so that you take.

Speaker 1 (18:17):
So medication abortion is safe and effective for someone who
is eleven weeks pregnant or less, someone who maybe had
a wanted pregnancy and for whatever reason, it's not a
normal pregnancy. We don't tend to find that out until
you know, sometimes fifteen, sixteen, even twenty weeks into pregnancy.
And so that the person who's in that situation would

(18:39):
have to have a surgical or an in office abortion
procedure determinate a pregnancy that is abnormal. The prescriptions for
the abortion pill and for the other medications that we
prescribe along with that go through a mail order pharmacy,
and so if they're in New Mexico, it can come
to their house, it can go to a PO box,

(18:59):
it can go.

Speaker 2 (19:00):
Wherever they needed to do.

Speaker 1 (19:01):
If they don't live in New Mexico, they can either
wait for that package because we can overnight it, or
they can do mail forwarding from a physical address and
then it'll forward it to their home. The reason that
we do the mail order is that most pharmacies do
not carry the medications for medication abortion. There are two

(19:22):
main medications. One is called mifipristone are you for eighty six?
The French abortion pill. Those are all names that have
been used, and when it was first approved for use
in the United States back in two thousand and one,
there were some very strict guidelines in that as a provider,
I had to contract with the manufacturer. They had to

(19:42):
verify that I really knew what I was doing and
that I knew how to prescribe it, knew how to
take care of it, and I gave the patient all
the right stuff and I could take care of them.
And as we have found, you know, because it was
it had been legal in European Union for much longer
than that, we.

Speaker 2 (19:58):
Had all their safety data, we had all this.

Speaker 1 (20:00):
Data from the United States as well, and we realized, wow,
it is pretty safe. And so even though I'm still
contracted with the manufacturer to say that I can prescribe it,
most pharmacies do not carry it. It's crazy that. Yeah,
it's just crazy to have to jump through all these
hoops for a medication that is super safe and should

(20:22):
be available when someone needs it. You kind of want
to be like, why can't you understand how important this is?
And just because you don't believe in it doesn't mean
you should take that access away from someone else. You know,
I may not believe in I don't know having a
root canal, but I would never take that away from
someone else. It just astounds me that still in this

(20:47):
day and age, we are taking things away from a
certain group of people, whether that's you know, people of color,
whether that's people who you know are assigned female at
birth who can get pregnant and we're taking their abortion
access or their birth control access or whatever it is.
It's just I'm kind of dumbfounded by it all. I

(21:08):
try not to get in arguments about it because I
feel like if someone is that has those beliefs so
entrenched that they're not willing to listen. Just like I'm
willing to listen as long as what you're telling me
is factual and again based on not just feelings but
on actual facts and what's going on, I'm willing to listen.

(21:29):
But if someone is so entrenched in it's wrong because
you know, the Bible says it's wrong or whatever, then
I'm not going to get in an argument. And so
there are some people I don't want to talk about
it with. You know that I know what their beliefs are,
and so we just we won't talk about it, or
you know, like in large family gatherings, I may say, okay,
everyone listen, we are not talking about these five things.

(21:52):
You can talk about anything else you want, not those
five things, because it doesn't do any good to argue.

Speaker 4 (22:09):
Information that you'll need once you receive the medications and
once you start taking them.

Speaker 1 (22:14):
Okay, so to make sure that you do have them. Yeah, Hi, Alicia,
my name's Jamie. I'm one of the nurse practitioners with
TST Health. How are you. I'm good, Thank you. So,
once you receive your medicine, you just want to decide
when you want to take it.

Speaker 2 (22:32):
I know just told you.

Speaker 1 (22:33):
The first medicine you're going to take is the mifipristone
that stops the pregnancy from developing any farther without any
major side effects or problems at all. And then, since
you're going to be taking your other medicine buckley, which
is in between your cheek and your gum, you're going
to wait twenty four to forty eight hours after you
take that first medicine to finish this process with the
medication abortion. So whenever that timing works out best for you,

(22:58):
when you're ready to take your second set of medicines,
you're gonna first take your nausea pill, which is called
on danceatron or zofran. It dissolves on your tongue. You're
gonna take that. Then you're gonna take one of your
prescription ibuprofen pills, and you're gonna wait thirty minutes let
those medicines get in your system and start working. The

(23:20):
next thing that you're gonna take then is you're gonna
take your four mesa prostal pills. You're gonna put two
here and two here in between your cheek and your
gum and you're gonna leave them there for thirty minutes,
swallow down whatever's left, and then the process will get started.
It usually starts fairly quickly after you swallow those down.
So that's why I want you to take that other
medicine before you take your mesa prostal pills. Okay, So

(23:44):
most people feel better within twelve hours. You should definitely
feel better within twenty four hours. If you don't, or
if at any point you're worried or concerned, that's when
you want to call our on call nurse. As Jess said,
we do have somebody who's on call twenty four hours
a day, seven days a week. So if you have questions,
that's when you want to give us a call. We

(24:05):
are here to support you kind of before, during, and after,
so make sure if you need us let us know.

Speaker 4 (24:10):
Okay, just confirming that you're okay doing these standards should be.

Speaker 1 (24:15):
There's such a wide range of folks who access abortion care,
whether that's through TST Health or anywhere else for that matter.
And yes, there are the teenagers who you know got
pregnant accidentally, didn't know or didn't care about birth NIRL whatever.
All the way up to you know, the fifty one
year old woman who thought she was going through menopause

(24:36):
and oh crud, and I'm now pregnant and my children
are already grown, or I never wanted to have children
in the first place, or whatever the situation is. Through
TST health, we don't see anyone who is under seventeen,
partially just because of you know, some minor abuse reporting
in those kind of things. So we do see some
older teenagers. That's been a very very small percentage of

(24:59):
who we seen. I see a lot of people who
are in their twenties, mid to late twenties. We see
a lot of people who are in their late thirties,
and we've even seen a few people who are in
their mid to late forties. And so I can't say
that there's one demographic of who we see because we
have seen the entire gamut of folks. Some patients do
stand out. I was so proud of this young woman

(25:22):
who I didn't even know, but she was in college
unintentionally pregnant. She had all of these plans for her future,
which she was able to share some with me, and
she's probably going to be running the world someday, and
pregnancy did not come into her plan, and so she
filled out her paperwork. She wanted to talk about birth control.

(25:44):
She was concerned about timing because she needed some she
lived in the dorm. She needed a time when her
roommate wasn't there and she had some privacy. So we
worked around her schedule. And that's the other beauty about
TST health is that we can work around somebody's schedule.

Speaker 2 (25:59):
Okay, you know this was.

Speaker 1 (26:01):
My roommate has a class from six to nine pm
Mountain time.

Speaker 2 (26:04):
Can you please? Can we please?

Speaker 1 (26:05):
I'm like, absolutely, what time works for you. We went
through the whole process. She had downloaded all of re forms,
she had all of these questions. We got all of
those questions answered. You know, she was firm and clear
in her decision and didn't have family that she could
turn to because of their beliefs. But her partner was
supportive and she had a friend who was supportive and
had someone to help her kind of go through this process.

(26:27):
And it was just it was wonderful to see this
person is taking charge of their life. They know what
they need, they've gotten the facts, they know how to
take care of themselves. They reached out and they got
the care that they needed. We were able to connect
and do that and she can have children at the
time of her choosing. You know, we see people at

(26:52):
some of their worst moments and to be able to
say I hear you, and it's okay, and I can
help you, and let's talk about this to when maybe
somebody else in their lives doesn't want to talk about it,
or they didn't get any support, or they didn't nowhere
else to go, and it's it's just it's a wonderful career.

Speaker 4 (27:15):
Perfect, Okay, great, Well.

Speaker 1 (27:18):
Thank you so much, really appreciate it. Take care of yourself,
and again, please reach out if you need us, because
that's what we're here for.

Speaker 4 (27:25):
Thank you guys so much.

Speaker 1 (27:26):
I really appreciate it. I just want to say, this
is a great organization. You guys are doing great things
for people. Well, thank you, Thank you guys very much.

Speaker 2 (27:34):
Thank you so much.

Speaker 1 (27:35):
And like I said, take care of yourself and please
let us know if you need anything from us.

Speaker 3 (27:39):
Thank you guys.

Speaker 1 (27:40):
All right, bye, bye bye. There's no way that I
could do the work that I'm doing without the support
of my family, you know, not only my partner of
thirty five years, but you know, my kids as well,
who have their own set of beliefs and values, and

(28:02):
everyone is just so supportive and has enabled me to
do what I do, and for that, I'm really grateful.

Speaker 3 (28:09):
You know.

Speaker 1 (28:09):
I've talked to a lot of people who are looking
at a nursing career or a nurse practitioner career, or
you know, want to go into sexual and reproductive health,
or even specifically when I go into abortion care. And
it's been the biggest honor and privilege to do what
I do, and I wouldn't change a thing, and it's

(28:30):
so awesome, hard but awesome. Yes, I am tearing up
because it's just it's the best thing ever. As I'm
finishing up my workday, I just kind of review and
make sure that everything that was on my to do
list today got done, or if it didn't, I just

(28:53):
move it over to tomorrow. I turn out the light
and leave my little office here in my house, and
once I'm in the living room, I usually pour a
drink and touch base and connect with my partner. Okay, puppies,
let's go outside.

Speaker 2 (29:12):
It's about nine thirty and I'm getting ready.

Speaker 1 (29:14):
To go to bed. I usually let the dogs out
for one last little romp around the yard, good night,
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