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They told her to come back two weeks later.
他们要她两周后再回来。
Even holding down two jobs, she managed to borrow that car and make that three-hour journey and get the day off, but was told once again they couldn't place it that day.
即使有两份工作，她还是想办法借了车，请了假，跑了那趟三小时的路，却又再次被告知当天不能装避孕器。
They told her to come back a third time, but this time, she couldn't get the time off.
他们要她再来第三次，但这次她无法再请假了。
Five months later, she did come back, this time unintentionally pregnant.
五个月后，她真的再去了一次，这次，她意外怀孕了。
Sophia's story demonstrates how unplanned pregnancy is rooted in inequitable access to birth control.
苏菲亚的故事呈现出不在计划中的怀孕根源于无法平等取得避孕方法。
Sophia didn't know that many providers aren't trained to offer contraception beyond the pill.
苏菲亚不知道许多医生没有受过避孕药以外的避孕方法的训练。
Many health centers don't even stock the full range of methods, so it can take multiple visits and referrals to get one of the more effective methods of birth control.
许多健康中心甚至不备有所有的避孕方法，所以可能要多次造访和转介才能取得比较有效的避孕方法。
Sophia didn't have the privilege of that kind of time for birth control, so she ended up settling for the only option she had.
苏菲亚不幸就是没有那么多时间来做好避孕，所以最后她只能妥协，接受她唯一的选项。
Now instead of that experience, imagine a regular doctor's visit in primary care like this.
现在，把那样的经验换成这样的想象：
First, no matter why a patient comes in for care, they're asked a deceptively simple, standard screening question.
想象到这样的基层医疗机构去看医生，首先，不论病人为什么来寻求照护，他们都会问一个看似简单的筛选用标准问题。
"Do you plan to become pregnant in the next year?"
「你有计划在明年怀孕吗？」
The answer to that question opens up a whole dialogue about what they care about and what they want.
这个问题的答案能够让他们开始畅谈他们在乎／想要什么。
Second, if the answer is no, patients should be offered the full range of contraceptive methods with full information, so they can really choose the method that works best for them.
再来，如果答案是否定的，就会提供病人所有可得的避孕方法，以及完整的信息，让他们能选择对自己最好的方法。
And most importantly, they should be able to leave that visit with the birth control method of their choice, not be asked to come back two or three more times.
最重要的是，他们当次造访就能带着他们选择的避孕方法离开，而不是被要求要再回来两、三次。
This is really about shifting the system of primary care to empower patients.
重点是在于转变基层照护体系，赋权给病人。
Well, you don't have to imagine it, we actually did this.
各位不用想象，因为我们已经做出来了。
We trained up the entire health care system in Delaware to work this way.
我们训练了德拉威州的整个健康照护体系这样运作。
We worked there because patient surveys showed, when we started, that more than half of all pregnancies were unplanned.
我们努力，是因为调查指出，刚开始时总数有超过半数的怀孕在计划之外；
Three years later, the percentage of births from unplanned pregnancies dropped 23 percent.
三年后，计划外怀孕的比例减少了 23 %，
The abortion rate dropped 37 percent, the largest decline of any state in the country.
堕胎率减少了 37%，是全美各州的最大降幅。
And within six years, infant mortality dropped 24 percent.
六年内，婴儿死亡率减少了 24%。
Upstream is now working in 14 states with plans to go national.
「上游」现在在十四个州努力，打算要扩展到全国。
It is unconscionable, unconscionable, that Sophia, and millions like her in this country, don't have access to birth control like this.
很不合理，很不合理的是，苏菲亚和美国数百万像她这样的人无法取得像这样的避孕方法。
Especially in a post-Roe world.
特别是在罗诉韦德案后，
I think we can all agree that ensuring people have access to the birth control they need so they can plan their families or decide if they want to have one or not, isn't a blue, red or a purple-state idea.
我想我们都认同，确保大家能取得自己需要的避孕方法来做好家庭规划，或决定是否想要孩子，并不是政治党派的想法，
It's a smart, just, empowering idea for everyone.
而是聪明、公平、赋权的想法，对象是每个人。
If we care about giving young people the best start at their dreams, let's make sure they have access to fully equitable, fully informed, patient-centered contraceptive care as a part of basic primary health care.
如果我们在乎要让追梦的年轻人有最好的起跑点，咱们就要确保他们能取得完全公平、信息完整、以人为本的避孕照护，并将之纳入到基层健康照护当中。
We can empower patients like Sophia with the choices and tools they need to become the intentional parents they want to be.
我们可以赋予像苏菲亚这样的病人他们所需要的选择和工具，让他们在想成为父母时才成为父母。
Access to best-in-class health care and best-in-class contraceptive care is a health equity issue, but it is so much more than that.
取得优质健康照护以及优质避孕照护是个健康公平性的问题，但它远不只如此，
It's also a foundation of equal opportunity.
它也是平等机会的基础。
Thank you.
谢谢。
