100 Guanacastecan Women Receive Free Intrauterine Contraceptive Devices

Dr. Cara Simmonds recently returned from her women's health-focused mission trip to Guanacaste, Costa Rica. We caught up with Dr. Simmonds when she returned to find out what she learned and discovered from her trip.

Q: How did you get involved with this organization, and have you gone on women's health-focused or other mission trips before?

A: "This was my first trip with The Paul Chester Children's Hope Foundation.  And this was their second mission with Cepia. The first mission was performing laparoscopic tubal ligations."

Q: What made you want to get involved? Why do you believe this mission was worthwhile?

A: "I spent my college years volunteering at The Ronald McDonald House. During medical school at The University of Miami, I was a regular volunteer and volunteer student coordinator at The Camillus Health Concern for the homeless.  

When I moved to DC for residency at Georgetown, I performed non-medical volunteer work in DC. Once I entered private practice, my career obligations along with marriage and 4 children, prohibited me from continuing medical volunteer work. The only volunteer work I participated in was with the children - mostly at soup kitchens or church.

I am now at the point in my career and personal life when I finally feel able to pursue medical missions and volunteer work again.  I have known Dr. Bill Chester, the founder of the foundation, since 1995 and was at the funeral for his son Paul for whom the foundation is named.  Bill has been participating in medical missions for decades and has invited me over the years. I am so thrilled to finally be able to join him for the trip to Costa Rica!

In Costa Rica, we partnered with Cepia - which is an organization that provides services for families in poverty including education, medical, psychological services, and meals.  Our foundation donated Copper IUDs - which we inserted in women who had been educated, screened, and counseled by Cepia and our team.

Costa Rica has 2 healthcare systems: a government-run universal health care system and a private healthcare system. The country is Catholic and birth control is not covered by any health insurance. Therefore the same IUD we provided would cost almost $500 for women in Costa Rica. There are very limited and costly options for hormonal contraception as well. There are also cultural deterrents to condom use. Abortion is illegal in this Catholic country as well. Many women have multiple children and are unable to pursue an education or careers.

The women we encountered were mostly married and well below poverty level - and some were immigrants from neighboring countries. In the US, we are extremely fortunate to have affordable and often free birth control options available. Listening to these women's stories was humbling and frustrating. They are all trying to do what is best to provide for their families with the limited resources they have available.

The most unfortunate story was of a 19-year-old with 1 child who had been interning at Cepia and was next in line to receive a scholarship from Cepia to attend university. Her pregnancy test was positive and we were unable to place her IUD.  She will now have to wait to be considered for the scholarship after the birth of her second child.

Another woman rode 40km on a bicycle once she learned of our mission on Facebook. We were able to screen and treat for STDs as well as place approximately 52 IUDs over 2 days. We were also able to teach two local physicians how to place the IUDs and care for these patients in the future.

Cepia had also partnered with 10 local gynecologists who agreed to see any patients with complications post insertion. Cepia will conduct follow-up interviews with all 52 patients and use these interviews as marketing for our next mission. I believe word of mouth will be enough and we will have at least twice as many patients for our next trip in the fall."

Q: Why do you feel these trips are important?

A: "I have been blessed by a superb education, good health, a thriving family, and many talents. I believe that if I can help even one of these women achieve any one of those things - I have succeeded in giving back to the world and showing gratitude for all that God has bestowed upon me."


Dr. Cara Simmonds

Dr. Simmonds’ warm personality and expertise are recognized by both patients and colleagues. Dr. Simmonds received her Doctor of Medicine from The University of Miami. Her Obstetrics and Gynecology residency was completed at Georgetown University.

She is a board-certified practitioner and has been in private practice in Montgomery County, Maryland since 1995. Since 2010 she has focused on Office Gynecology and especially the areas of adolescent gynecology, perimenopause and menopause.

She is a member of The North American Menopause Society and will become a Certified Menopause Practitioner in 2018. Dr. Simmonds recently published an article titled “Genitourinary Syndrome of Menopause” on The Lady Docs Corner Café blog and was recognized as a 2017 Washingtonian Top Doctor.