Family Planning

Family Planning

by Elizabeth Letts

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I’m Kim Alexander and this is Fiction Nation.

When I lived in Richmond Virginia about 10 years ago, I worked at a women’s health clinic. I didn’t work inside the clinic as a doctor or a nurse; I stood outside on Saturday mornings and escorted young, often frightened women with no insurance to the front door, past a long line of protestors. I’m not going to get into the specifics of the debate; this is supposed to be about fiction and literature, not a tirade. But I have to say I believe everyone deserves access to health care without being screamed at and leave it at that.

The women who often turn to clinics like these are the ones being pushed into the spotlight these days — they are here illegally. And when they need help, where can they turn? It’s a brutally uncomfortable debate — should we deny them health care? How about birth control? How about education? What is our responsibility to the poorest and the neediest?

In her new book Family Planning, Elizabeth Letts takes us to a clinic called El Centro by the uneducated, uninsured, often illegal women who rely on it. It sits between horse country and mushroom farms in rural Pennsylvania, and Charlotte Hopper is the nurse practitioner. We meet the women who run the clinic, and the women who come for visits. When an abandoned fetus is discovered in a dumpster on the property, the media and protestors descend on the place. It’s not the sort of attention of struggling clinic is looking for, and when a possibly miraculous vision of the Virgin of Guadeloupe appears in the upstairs window, it’s hard to tell whether that’s good or bad news. While every character responds to the image of Mary in her own way, it’s clear that these women’s faith ultimately resides in their own hard work, raising their families, feeding their children and in each other. They are nothing if not practical.


I’m Kim Alexander and this is a Fiction Nation minute. The book is Family Planning by Elizabeth Letts. In many books, the main plot revolves around the hero saving the world, while in the background his girlfriend or wife raises the babies and pays the bills. Here, those domestic stories are brought forward and we see they are vivid, dramatic, funny, sad and challenging. The story revolves around El Centro, a women’s healthcare facility, where you go when you have no insurance. Charlotte Hopper is the nurse practitioner who is having some problems of her own. Then she finds a fetus in the dumpster, and then it’s the police, the news, and protestors. In Family Planning, the author draws on her own experiences working in clinics like these and makes you understand the choices women who have no choices are forced to make. Far from being preachy or morbid, this book is a hopeful look at a workplace that becomes a family. Family Planning by Elizabeth Letts. I’m Kim Alexander and this is Fiction Nation on Book Radio, SiriusXM Channel 80.


I’m Kim Alexander and this is a Fiction Nation minute. The book is Family Planning by Elizabeth Letts. The author draws on her experience as a midwife to tell the story of people who are often left on the sidelines — the poor, the uneducated, the illegals, women with no health care and few choices. They all show up at ‘El Centro’, the clinic run by Charlotte Hopper. Charlotte herself may be pregnant, and in fact the title, Family Planning, seems like advice no one’s taking, with pregnancies everywhere, both wanted and unwanted.  Charlotte and her staff wind up being accused of a tragic crime, the media shows up, and it’s not the kind of attention a struggling clinic needs. In Family Planning, the author goes to great lengths to treat all her characters with kindness and respect, even the difficult ones, and it’s refreshing to watch characters develop in unexpected ways. Family Planning by Elizabeth Letts. I’m Kim Alexander on Fiction Nation on Book Radio, SiriusXM Channel 80.


I’m Kim Alexander and this is a Fiction Nation minute. The book is Family Planning by Elizabeth Letts. This book takes us to a clinic called ‘El Centro’ by the uneducated, uninsured, often illegal women who rely on it. It sits between horse country and mushroom farms in rural Pennsylvania, and Charlotte Hopper is the nurse practitioner. We meet the women who run the clinic, and the women who come for visits. When an abandoned fetus is discovered in a dumpster on the property, the media and protestors descend on the place. It’s not the sort of attention a struggling clinic is looking for, and when a possibly miraculous vision of the Virgin of Guadalupe appears in the upstairs window, it’s hard to tell whether that’s good or bad news. While every character responds to the image of Mary in her own way, it’s clear that these women’s faith ultimately resides in their own hard work, raising their families, feeding their children and in each other. They are nothing if not practical. Family Planning by Elizabeth Letts. I’m Kim Alexander on Fiction Nation on Book Radio, SiriusXM Channel 80.


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