Daily Women's Health Policy Report

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Daily Women's Health Policy Report by the National Partnership for Women & Families
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Featured Blogs

Fri, 07/25/2014 - 16:59

"Anti-Choice Protests Target New Orleans Clinics, Homes, Churches" (Wilson, RH Reality Check, 7/24) and "Number of Texas Women Living 200 Miles From an Abortion Clinic Has Jumped by 2,800 Percent" (Culp-Ressler, "ThinkProgress," Center for American Progress, 7/23).

July 25, 2014

FEATURED BLOG

 "Anti-Choice Protests Target New Orleans Clinics, Homes, Churches," Teddy Wilson, RH Reality Check: "In the first few days of planned protests in New Orleans, anti-choice activists have disrupted the community by targeting reproductive health-care clinics, personal residences, and even houses of worship in the hopes of intimidating abortion providers and reproductive rights supporters," Wilson writes. Wilson explains that the protests, organized through Operation Save America, target "two New Orleans clinics that provide abortion care, a construction site where a Planned Parenthood facility is being built, and the home of a physician who is an abortion provider," among other locations. The protests "have focused primarily on harassing the staff, volunteers, and patients of reproductive health-care clinics," Wilson writes, adding that the protests "come in the wake of legislative efforts to reduce access to reproductive health care in Louisiana" (Wilson, RH Reality Check, 7/24).

What others are saying about the antiabortion-rights movement:

~ "Anti-Choice Groups Seek to Stack State Courts," Zoe Greenberg, RH Reality Check.

~ "I Scream, You Scream, the Anti-Choice Crowd Is Mad About Ice Cream," Madeleine Davies, Jezebel.

FEATURED BLOG

 "Number of Texas Women Living 200 Miles From an Abortion Clinic Has Jumped by 2,800 Percent," Tara Culp-Ressler, Center for American Progress' "ThinkProgress": The omnibus antiabortion-rights package (HB 2) approved in Texas a "year ago this month" has "wreaked havoc on reproductive health access in the state, and half of Texas' clinics have been forced to shut down," writes Culp-Ressler, citing research from the Texas Policy Evaluation Project. According to TPEP's research, "the new abortion law is compromising women's ability to exercise their right to choose," as demonstrated by a "13 percent decline in the legal abortion rate in the Lone Star State," Culp-Ressler writes. She adds that because the rate is "steeper than the recent declines in the number of abortions observed across other states," it suggests that "the decreased access to clinics is preventing some Texas women from being able to have the medical procedure," an unsurprising finding given that "the number of women of reproductive age who live at least 200 miles away from an abortion clinic has skyrocketed by 2,800 percent -- jumping from 10,000 women in 2013 to 290,000 women in 2014." Culp-Ressler adds, "[I]t's important to remember that the new report focuses solely on legal abortions obtained in clinics, and doesn't reflect the number of women who may be resorting to illegal means of ending a pregnancy" (Culp-Ressler, "ThinkProgress," Center for American Progress, 7/23).

What others are saying about abortion restrictions:

~ "The Onion's Brilliant Take on Abortion Restrictions Will Make You Laugh/Sob," Katie McDonough, Salon.

~ "Super-Restrictive Ireland Abortion Laws Are Violating Women's Rights, and the UN Knows It," Lauren Barbato, Bustle.





NYT's 'Op-Talk' Blog Highlights Debate Over 'Personhood' Laws

Fri, 07/25/2014 - 16:56

New York Times columnist Anna Altman in an "Op-Talk" piece highlights the conflicting sides of the debate over "so-called personhood laws," which often "recognize fetuses, embryos and fertilized eggs as persons who are separate" from the women who carry them.

NYT's 'Op-Talk' Blog Highlights Debate Over 'Personhood' Laws

July 25, 2014 — New York Times columnist Anna Altman in an "Op-Talk" piece highlights the conflicting sides of the debate over "so-called personhood laws," which often "recognize fetuses, embryos and fertilized eggs as persons who are separate" from the women who carry them.

According to Altman, while personhood laws vary in the 38 states that have them, they mostly "seek to protect this category of persons, whether from strangers or from the" women themselves. Altman writes, "Causing especially intense controversy are laws targeting substance abuse during pregnancy," noting a few recent examples of women who were incarcerated for using illicit drugs while pregnant. Tennessee Rep. Terri Weaver (R) -- who sponsored a personhood measure (SB 1391) that permits a pregnant woman to be charged with a criminal offense if she uses illicit drugs -- said "these defenseless children deserve some protection and these babies need a voice."

During an NPR "Fresh Air" segment exploring the issue last year, Barbara Levy of the American Congress of Obstetricians and Gynecologists detailed potential issues with such laws. She said, "I understand the concern about the unborn fetus," but "the very best outcome for the unborn fetus is to treat the mom and the baby as a unit." She added that it is extremely important "to get the best care for the mom. That means she has to be comfortable and free to seek care without concern that she will be placed in jail."

Meanwhile, Kylee Sunderlin, a Soros Justice fellow at National Advocates for Pregnant Women, told Altman that incarceration can place extra burdens "on women who may be already struggling." Altman also discusses the experience of Deborah Jiang-Stein, whose own mother had substance use issues and gave birth to Jiang-Stein while in prison. Jiang-Stein, who wrote a recent Washington Post opinion piece describing her experience, has said that "addiction is a physical and mental health disease, and not a criminal justice problem."

Critics of the laws say that while the measures are "ostensibly intended to safeguard children," they "are making it harder for their mothers to care for them," Altman concludes (Altman, "Op-Talk," New York Times, 7/23).


N.Y. Will Allow Medicaid Reimbursements for Long-Acting Reversible Contraceptives for New Mothers

Fri, 07/25/2014 - 16:55

New York has joined five other states in making it easier for new mothers in the Medicaid program to access long-acting reversible contraceptives after giving birth, NPR's "Shots" reports.

N.Y. Will Allow Medicaid Reimbursements for Long-Acting Reversible Contraceptives for New Mothers

July 25, 2014 — New York has joined five other states in making it easier for new mothers in the Medicaid program to access long-acting reversible contraceptives after giving birth, NPR's "Shots" reports. Under a policy change announced last week, women participating in the fee-for-service portion of the program can receive coverage for LARCs immediately after giving birth.

According to "Shots," most states' Medicaid programs will not reimburse physicians for delivering a newborn and administering LARCs during a single visit. Women can receive Medicaid coverage for LARCs at a six-week post-partum appointment, but "Shots" reports that many women are much less likely to obtain contraception at that point.

New York City Assistant Health Commissioner Deborah Kaplan said the state's "bottom line priority" is to get rid of barriers to contraceptive access. Kaplan added, "We want women to have the options and then [work] with their provider to make the best decision with all the information available" (Farrington, "Shots," NPR, 7/23).


Blogs Comment on Annual Pelvic Exams, Equal Rights Act, More

Fri, 07/25/2014 - 16:43

We've compiled some of the most thought-provoking commentaries from around the Web. Catch up on the conversation with bloggers from The Nation, Ms. Magazine and more.

Blogs Comment on Annual Pelvic Exams, Equal Rights Act, More

July 25, 2014 — We've compiled some of the most thought-provoking commentaries from around the Web. Catch up on the conversation with bloggers from The Nation, Ms. Magazine and more.

WOMEN'S HEALTH: "Do Healthy Women Need Annual Pelvic Exams?" Rachel Walden, OurBodies OurSelves' "Our Bodies, Our Blog": "More than 60 million pelvic exams are performed each year, but a new guideline from the American College of Physicians suggests that for most healthy women, they're not needed," Walden writes, noting "that the recommendations apply only to 'average risk' adult women who are not pregnant and who do not have any symptoms, such as pelvic pain, which might mean there is a problem such as endometriosis, ovarian cysts, other pelvic organ problems, or infection." During a review of prior exam guidelines, ACP "considered whether the harms of the pelvic exam are outweighed by the benefits, and whether these vary by patient or provider characteristics." The group found there was no existing data supporting their effectiveness and recommended "against routine pelvic exams." However, Walden notes that the "American College of Obstetricians and Gynecologists responded to the recommendation by urging women to continue to see their healthcare providers each year for well-woman visits," which "can sometimes include a pelvic exam, but are also an opportunity to get medication refills, review your medical history, have age-appropriate screenings and immunizations, and discuss other concerns with your provider" (Walden, "Our Bodies, Our Blog," OurBodies OurSelves, 7/24).

REPRODUCTIVE JUSTICE: "We're Arresting Poor Mothers for Our Own Failures," Bryce Covert, The Nation: Covert discusses the cases of Shanesha Taylor, "who was arrested for leaving her children in the car while she went to a job interview," and Debra Harrell, a "South Carolina mother arrested for letting her 9-year-old daughter play in a park alone while she worked her shifts at McDonalds." She writes that while "[n]either of these are ideal situations for children," none of them was harmed, and questions who is really at fault for the children being "put in these situations to begin with?" Covert notes, "These weren't mothers doing drugs or other dangerous activities and neglecting their children; they were both mothers trying to hold down jobs to provide for their children while stuck swirling in a Catch-22": not being able to "work or interview without childcare" and not being able to "afford childcare without a job that pays enough to cover the ever-increasing cost." Covert concludes, "Low-income mothers of color are trying to fulfill their end of the bargain. But they face multiple roadblocks, many of which we've set up in front of them. No one should be surprised when they end up making choices we don't think are best" (Covert, The Nation, 7/22).

ANTIABORTION-RIGHTS MOVEMENT: "Anti-Choice Protests Target New Orleans Clinics, Homes, Churches," Teddy Wilson, RH Reality Check: "In the first few days of planned protests in New Orleans, anti-choice activists have disrupted the community by targeting reproductive health-care clinics, personal residences, and even houses of worship in the hopes of intimidating abortion providers and reproductive rights supporters," Wilson writes. Wilson explains that the protests, organized through Operation Save America, target "two New Orleans clinics that provide abortion care, a construction site where a Planned Parenthood facility is being built, and the home of a physician who is an abortion provider," among other locations. The protests "have focused primarily on harassing the staff, volunteers, and patients of reproductive health-care clinics," Wilson writes, adding that the protests "come in the wake of legislative efforts to reduce access to reproductive health care in Louisiana" (Wilson, RH Reality Check, 7/24).

What others are saying about the antiabortion-rights movement:

~ "Anti-Choice Groups Seek to Stack State Courts," Zoe Greenberg, RH Reality Check.

~ "I Scream, You Scream, the Anti-Choice Crowd Is Mad About Ice Cream," Madeleine Davies, Jezebel.

ABORTION RESTRICTIONS: "Number of Texas Women Living 200 Miles From an Abortion Clinic Has Jumped by 2,800 Percent," Tara Culp-Ressler, Center for American Progress' "ThinkProgress": The omnibus antiabortion-rights package (HB 2) approved in Texas a "year ago this month" has "wreaked havoc on reproductive health access in the state, and half of Texas' clinics have been forced to shut down," writes Culp-Ressler, citing research from the Texas Policy Evaluation Project. According to TPEP's research, "the new abortion law is compromising women's ability to exercise their right to choose," as demonstrated by a "13 percent decline in the legal abortion rate in the Lone Star State," Culp-Ressler writes. She adds that because the rate is "steeper than the recent declines in the number of abortions observed across other states," it suggests that "the decreased access to clinics is preventing some Texas women from being able to have the medical procedure," an unsurprising finding given that "the number of women of reproductive age who live at least 200 miles away from an abortion clinic has skyrocketed by 2,800 percent -- jumping from 10,000 women in 2013 to 290,000 women in 2014." Culp-Ressler adds, "[I]t's important to remember that the new report focuses solely on legal abortions obtained in clinics, and doesn't reflect the number of women who may be resorting to illegal means of ending a pregnancy" (Culp-Ressler, "ThinkProgress," Center for American Progress, 7/23).

What others are saying about abortion restrictions:

~ "The Onion's Brilliant Take on Abortion Restrictions Will Make You Laugh/Sob," Katie McDonough, Salon.

~ "Super-Restrictive Ireland Abortion Laws Are Violating Women's Rights, and the UN Knows It," Lauren Barbato, Bustle.

VIOLENCE AGAINST WOMEN/RAPE/SEXUAL HARASSMENT: "The Disturbing Reason Why Some Rape Kits Are Tested While Others Aren't," Mindy Townsend, Care2: It is "hard to blame anyone for not reporting a rape," and "[i]t certainly doesn't help that," according to the Department of Justice, "there are an estimated 400,000 untested rape kits in cities across the country," Townsend writes. However, what "makes the whole situation even more problematic" is that "law enforcement ... is prioritizing 'classic' rape cases -- stranger rape, violent rape -- over the vast majority of cases, which means that the vast majority of victims are being left without justice." She concludes, "Think of how many rapes could have been avoided if we just took sexual assault seriously to begin with and stopped giving preferential treatment to only a certain type of rape" (Townsend, Care 2, 7/22).

What others are saying about violence against women/rape/sexual harassment:

~ "NFL Will Bench You Longer for Driving With No License Than Violently Assaulting Women," Katie McDonough, Salon.

~ "World's Most Famous College Marching Band Fires Director, Was a Cesspool of Sexual Harassment," Judd Legum, Center for American Progress' "ThinkProgress."

~ "Montana Judge Censured for Suggesting Teenage Rape Victim Partly to Blame for Attack," Jessica Mason Pieklo, RH Reality Check.

EQUAL RIGHTS: "It's Been 90 Years: Time To Pass the ERA," Stephanie Hallett, Ms. Magazine blog: "Reps. Carolyn Maloney (D-NY) and Jackie Speier (D-CA) gathered on the steps of the Supreme Court Thursday morning to demand that the Equal Rights Amendment finally pass," Hallett writes. She adds that the lawmakers, joined by Feminist Majority Foundation President Ellie Smeal, "NOW President Terry O'Neill and other feminist leaders and activists, called on legislators to codify women's equality in the constitution." She notes that both Speier and Maloney have introduced legislation to enact the ERA, Speier through legislation (H.J. Res. 113) that would allow the states that failed to ratify the amendment by its last deadline in 1982 to do so now, and Maloney through a resolution (H.J. Res. 56) that would reintroduce the ERA and submit it to states for ratification. "Ninety years is long enough -- it's time to pass the ERA," Hallett writes (Hallett, Ms. Magazine blog, 7/24).

What others are saying about equal rights:

~ "After Hobby Lobby, Democratic Legislators Push Anew for Equal Rights Amendment," Emily Crockett, RH Reality Check.


Report Shows Rates of Female Genital Mutilation/Cutting Decline, But 63M Women Still at Risk of Practice Over Next 40 Years

Fri, 07/25/2014 - 16:32

The rate of women undergoing genital mutilation/cutting has declined in the past 30 years in many of the 29 countries in Africa and the Middle East where the practice is concentrated, but the total number of women undergoing the procedure has increased because of population growth, according to a UNICEF report, NPR's "goats and soda" reports.

UNICEF Report Finds Decline in Rates of Female Genital Mutilation/Cutting, But 63M Women Still at Risk of Practice Over Next 40 Years

July 25, 2014 — The rate of women undergoing genital mutilation/cutting has declined in the past 30 years in many of the 29 countries in Africa and the Middle East where the practice is concentrated, but the total number of women undergoing the procedure has increased because of population growth, according to a UNICEF report, NPR's "goats and soda" reports.

The report -- presented at London's first "Girl Summit" this week -- found that more than 130 million women in those 29 countries have undergone some form of FGM/C and that another 63 million are at risk of undergoing the practice by 2050.

Report 'Exciting and Worrying'

Researchers found a significant decline in rates of women undergoing FGM/C in some countries. For example, in Kenya, nearly 50% of girls ages 15 to 19 underwent FGM/C in 1980, compared with less than 20% in 2010 (Poon, "goats and soda," NPR, 7/24). According to the report, the prevalence of women undergoing FGM in the past 30 years has also dropped by about two-thirds in Tanzania and by up to 50% in the Central African Republic, Iraq, Liberia and Nigeria (UNICEF release, 7/22).

However, the report found that progress against FGM/C is distributed unevenly among the 29 nations. While the rate of women undergoing FGM/C in Somalia has declined, it is still more than 90% ("goats and soda," NPR, 7/24). Other countries with FGM/C rates near or above 50% include Burkina Faso, Gambia, Guinea-Bissau and Mali, according to the report ("goats and soda" chart, NPR, 7/24).

Susan Bissell, chief of child protection at UNICEF, called the report "exciting and worrying," adding that "population growth will far surpass the gain we've been seeing if we don't step it up." She noted that more women have begun speaking out against FGM/C, saying, "Ten years ago, it was like a handful of feminist organizations talking. But now everybody's talking, and when you have public discourse, things change" ("goats and soda," NPR, 7/24).


Conservatives Crafting Antiabortion-Rights Message Ahead of Midterm Elections

Fri, 07/25/2014 - 14:18

A "vocal group of social conservatives, dismayed both by [Republicans'] apparent dismissiveness of their passion and by the Democrats' success at portraying Republicans as prosecuting a 'war on women,' are rewriting the anti-abortion movement's script," the New York Times reports.

Conservatives Crafting Antiabortion-Rights Message Ahead of Midterm Elections

July 25, 2014 — A "vocal group of social conservatives, dismayed both by [Republicans'] apparent dismissiveness of their passion and by the Democrats' success at portraying Republicans as prosecuting a 'war on women,' are rewriting the anti-abortion movement's script," the New York Times reports. The social conservatives believe that Republicans "say too little, and do it in the wrong way," according to the Times.

Republicans' rhetoric re-evaluation comes after several divisive comments on women's issues were made during the 2012 midterm elections that alienated female voters. Some Republicans believe that making antiabortion-rights language a larger part of campaigns will help rally the party's base.

How Republicans Are Refining Antiabortion-Rights Language

Marjorie Dannenfelser, president of the Susan B. Anthony List, has coordinated roughly half-a-dozen "boot camps" across the country to train Republican politicians on how to phrase their opposition to abortion rights, the Times reports. During the boot camps, lawmakers are filmed answering a question about why they oppose abortion rights and then are critiqued on their answers. According to the Times, Dannenfelser has suggested that Republicans keep their comments about abortion to a maximum of two sentences.

Similarly, another consultant -- Kellyanne Conway, a Republican pollster -- has told Republicans to consider the word "rape" a "four-letter word" and to "[p]urge it from [their] lexicon." Conway also has urged them to challenge Democrats when they use the term "women's health," arguing that women's health issues "are osteoporosis or breast cancer or seniors living alone who don't have enough money for health care."

Marilyn Musgrave, a former member of Congress from Colorado and longtime abortion-rights opponent, has advised candidates to engage Democrats by asking, "Exactly when in a pregnancy do you think abortion should be banned?" Meanwhile, Susan B. Anthony List has hired a polling firm that found women switched their vote to a Republican candidate after learning that a Democratic candidate did not support limiting abortion after five months' gestation. According to the Times, Dannenfelser's organization plans to fund $3 million in political ads in Arkansas, Louisiana and North Carolina (Peters, New York Times, 7/24).


CDC: More Teenagers Receiving HPV Vaccine, But Vaccination Rate Still Too Low

Fri, 07/25/2014 - 14:15

The number of girls receiving the full dosage of the human papillomavirus vaccine increased by about four percentage points between 2012 and 2013, but the overall rate remains well short of CDC's 80% vaccination goal, according to new research from the agency, Reuters reports.

CDC: More Teenagers Receiving HPV Vaccine, But Vaccination Rate Still Too Low

July 25, 2014 — The number of girls receiving the full dosage of the human papillomavirus vaccine increased by about four percentage points between 2012 and 2013, but the overall rate remains well short of CDC's 80% vaccination goal, according to new research from the agency, Reuters reports.

According to CDC, 79 million U.S. residents have HPV, the most common sexually transmitted infection in the country, and there are 14 million new cases each year. The virus has been linked to cervical, vaginal, penile and anal cancers (Beasley, Reuters, 7/24).

For the survey, CDC researchers randomly interviewed parents of about 18,000 adolescents by phone. The teenagers' medical records were also examined. According to CDC's Anne Schuchat, many people declined to respond, and those who did could be considered "more likely to embrace HPV vaccinations," meaning HPV vaccination rates might be even lower than what CDC reported (AP/U-T San Diego, 7/24).

Key Findings

The report found that 37.6% of girls ages 13 to 17 received all three doses of the HPV vaccine in 2013, compared with 33.4% in 2012.

Schuchat, assistant surgeon general and director of CDC's National Center for Immunization and Respiratory Diseases, said, "It's frustrating to report almost the same HPV vaccination coverage levels among girls for another year."

Meanwhile, the percentage of boys who received all three doses more than doubled to 13.9% in 2013 from 6.8% in 2012 (Reuters, 7/24).

In addition, the survey found that 57.3% of girls ages 13 to 17 received at least one dose of the vaccine, compared with 53.8% in 2012. The percentage of boys who got at least one dose rose to 34.6% in 2013, compared with 20.8% in 2012 (Bankhead, MedPage Today, 7/24).

Still, the survey found that while CDC recommends that all girls and boys ages 11 and 12 receive the vaccine, doctors failed to recommend it to one-third of girls and more than 50% of boys (Reuters, 7/24).


N.Y. Will Allow Medicaid Reimbursements for Long-Acting Reversible Contraceptives for New Mothers

Fri, 07/25/2014 - 14:11

New York has joined five other states in making it easier for new mothers in the Medicaid program to access long-acting reversible contraceptives after giving birth, NPR's "Shots" reports.

N.Y. Will Allow Medicaid Reimbursements for Long-Acting Reversible Contraceptives for New Mothers

July 25, 2014 — New York has joined five other states in making it easier for new mothers in the Medicaid program to access long-acting reversible contraceptives after giving birth, NPR's "Shots" reports. Under a policy change announced last week, women participating in the fee-for-service portion of the program can receive coverage for LARCs immediately after giving birth.

According to "Shots," most states' Medicaid programs will not reimburse physicians for delivering a newborn and administering LARCs during a single visit. Women can receive Medicaid coverage for LARCs at a six-week post-partum appointment, but "Shots" reports that many women are much less likely to obtain contraception at that point.

New York City Assistant Health Commissioner Deborah Kaplan said the state's "bottom line priority" is to get rid of barriers to contraceptive access. Kaplan added, "We want women to have the options and then [work] with their provider to make the best decision with all the information available" (Farrington, "Shots," NPR, 7/23).


NYT's 'Op-Talk' Blog Highlights Debate Over 'Personhood' Laws

Fri, 07/25/2014 - 14:06

New York Times columnist Anna Altman in an "Op-Talk" piece highlights the conflicting sides of the debate over "so-called personhood laws," which often "recognize fetuses, embryos and fertilized eggs as persons who are separate" from the women who carry them.

NYT's 'Op-Talk' Blog Highlights Debate Over 'Personhood' Laws

July 25, 2014 — New York Times columnist Anna Altman in an "Op-Talk" piece highlights the conflicting sides of the debate over "so-called personhood laws," which often "recognize fetuses, embryos and fertilized eggs as persons who are separate" from the women who carry them.

According to Altman, while personhood laws vary in the 38 states that have them, they mostly "seek to protect this category of persons, whether from strangers or from the" women themselves. Altman writes, "Causing especially intense controversy are laws targeting substance abuse during pregnancy," noting a few recent examples of women who were incarcerated for using illicit drugs while pregnant. Tennessee Rep. Terri Weaver (R) -- who sponsored a personhood measure (SB 1391) that permits a pregnant woman to be charged with a criminal offense if she uses illicit drugs -- said "these defenseless children deserve some protection and these babies need a voice."

During an NPR "Fresh Air" segment exploring the issue last year, Barbara Levy of the American Congress of Obstetricians and Gynecologists detailed potential issues with such laws. She said, "I understand the concern about the unborn fetus," but "the very best outcome for the unborn fetus is to treat the mom and the baby as a unit." She added that it is extremely important "to get the best care for the mom. That means she has to be comfortable and free to seek care without concern that she will be placed in jail."

Meanwhile, Kylee Sunderlin, a Soros Justice fellow at National Advocates for Pregnant Women, told Altman that incarceration can place extra burdens "on women who may be already struggling." Altman also discusses the experience of Deborah Jiang-Stein, whose own mother had substance use issues and gave birth to Jiang-Stein while in prison. Jiang-Stein, who wrote a recent Washington Post opinion piece describing her experience, has said that "addiction is a physical and mental health disease, and not a criminal justice problem."

Critics of the laws say that while the measures are "ostensibly intended to safeguard children," they "are making it harder for their mothers to care for them," Altman concludes (Altman, "Op-Talk," New York Times, 7/23).


Pittsburgh Post-Gazette Examines Efforts To Encourage More Vaginal Births Instead of C-Sections

Fri, 07/25/2014 - 14:03

The Pittsburgh Post-Gazette looks at how new guidelines on caesarean sections might be affecting rates of vaginal births.

Pittsburgh Post-Gazette Examines Efforts To Encourage More Vaginal Births Instead of C-Sections

July 25, 2014 — The Pittsburgh Post-Gazette looks at how new guidelines on caesarean sections might be affecting rates of vaginal births (Smydo, Pittsburgh Post-Gazette, 7/21).

C-sections account for one in three births in the U.S. Although the procedure can be lifesaving, it carries serious health risks and is sometimes performed for non-medical reasons, such as convenience or physicians' fear of lawsuits (Women's Health Policy Report, 2/20).

At Allegheny Health Network in Pennsylvania, the number of c-sections spiked last year, prompting obstetrical department leaders to issue guidelines on when they should be performed. The department also began monitoring doctors' individual c-section rates. Allan Klapper, chair of obstetrics and gynecology at Allegheny, said, "It really took just a month or two, and the rates plummeted down to where they'd been historically" (Pittsburgh Post-Gazette, 7/21).

In February, the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine published guidelines in an effort to reduce c-sections. The recommendations suggest doctors should give healthy pregnant women more time to labor before considering a c-section (Women's Health Policy Report, 2/20).

The Post-Gazette reports that there is increased interest in services by midwives and doulas. Ann McCarthy -- clinical director of the Midwife Center for Birth and Women's Health -- said the clinic is "struggling to keep up with the demand," with the center's midwives delivering 423 infants in 2013 and having an 8.5% c-section rate (Pittsburgh Post-Gazette, 7/21).


Datapoints: 'Bad Medicine' in the States, Myths About Abortion Providers & More

Thu, 07/24/2014 - 20:40

This month's visual snapshot of women's health developments highlights dangerous state laws that put political ideology above medical evidence. We also debunk a common claim from abortion-rights opponents about abortion providers in minority communities.

Datapoints: 'Bad Medicine' in the States, Myths About Abortion Providers & More

July 24, 2014 — This month's visual snapshot of women's health developments highlights dangerous state laws that put political ideology above medical evidence. We also debunk a common claim from abortion-rights opponents about abortion providers in minority communities.

'Bad Medicine'



The majority of states have enacted laws that go against medical evidence and mandate how women's health care providers must practice abortion care, according to a report and infographic out this month from the National Partnership for Women & Families.

The report -- "Bad Medicine: How a Political Agenda is Undermining Women's Health Care" -- found that 33 states have passed at least one abortion-related law imposing ultrasound requirements, biased counseling, mandatory delays or medication abortion restrictions that are not supported by medical evidence. Sixteen of the 33 states have all four types of medically unsound laws on the books, the report found (National Partnership release, 7/14).


Abortion Providers and Minority Communities



While antiabortion-rights activists like to claim that most abortion providers are located in predominantly black or Hispanic neighborhoods -- supposedly because they "target" minority women for abortions -- the fact is that the majority of abortion providers are in areas where most residents are white, according to this infographic from the Guttmacher Institute.

Findings from Guttmacher's most recent census of abortion providers nationwide found that fewer than one in 10 abortion providers are located in majority-black neighborhoods, while about 13% are in majority-Hispanic neighborhoods. By contrast, six in 10 abortion providers are located in majority-white neighborhoods, Guttmacher found (Guttmacher release, June 2014).


TRAP Surge



Guttmacher's midyear report on state-level reproductive health care laws highlights a surge in targeted regulation of abortion providers, or TRAP, laws in recent years. Nationwide, nearly six in 10 women live in states with such laws, which include requirements such as mandating that abortion providers have admitting privileges at nearby hospitals (Guttmacher release, 7/8).


Appeals Courts Issue Different Rulings on Legality of Tax Subsidies in ACA's Federal Marketplaces

Thu, 07/24/2014 - 20:37

Two federal appeals courts on Tuesday issued conflicting rulings on whether the federal government can provide subsidies to U.S. residents who purchase coverage through the Affordable Care Act's federally operated insurance marketplaces, the New York Times reports.

Appeals Courts Issue Different Rulings on Legality of Tax Subsidies in ACA's Federal Marketplaces

July 23, 2014 — Two federal appeals courts on Tuesday issued conflicting rulings on whether the federal government can provide subsidies to U.S. residents who purchase coverage through the Affordable Care Act's federally operated insurance marketplaces, the New York Times reports.

Both cases involve an Internal Revenue Service regulation that permits consumers shopping for health insurance through the federal marketplace to receive tax subsidies.

In the first case, a panel for the U.S. Court of Appeals for the District of Columbia in a 2-1 decision ruled that the Affordable Care Act allows subsidies only for consumers purchasing insurance through state-run marketplaces. The law "does not authorize the I.R.S. to provide tax credits for insurance purchased on federal exchanges," the panel said. According to the panel, the law "plainly makes subsidies available only on exchanges established by states." A dissenting opinion filed by Judge Harry Edwards called the case an "attempt to gut" the ACA and said the majority opinion "defies the will of Congress."

Meanwhile, in the second case, a three-judge panel for the 4th U.S. Circuit Court of Appeals in Richmond, Va., unanimously ruled to uphold the subsidies. That decision declared the IRS regulation "a permissible exercise of the agency's discretion." The panel noted that the ACA's language is "ambiguous and subject to multiple interpretations" and, thus deferred to the IRS (Pear, New York Times, 7/22).

Effects for Consumers

The rulings will have no immediate impact on consumers, according to government officials (Savage, "Nation Now," Los Angeles Times, 7/22). DOJ said the federal government will continue providing the subsidies in states that use the federal marketplaces while the issue is reviewed in courts.

According to the New York Times, if the ruling outlawing the subsidies stands, more than 4.5 million people who purchased coverage through the federal marketplaces could lose their financial assistance. The White House estimated that the subsidies have helped lower average monthly insurance premium payments from $346 to $82 (New York Times, 7/22). Avalere Health Vice President Caroline Pearson said if the ruling stands, "individuals in at least 25 states who remain in their current plans could see an average premium increase of over 70%."

Issue Could Land at Supreme Court

Legal experts have noted that the split rulings indicate the cases could end up before the Supreme Court (Wolf, USA Today, 7/22). According to the Los Angeles Times' "Nation Now," if the issue does end up before the high court, the case could be heard as early as next year ("Nation Now," Los Angeles Times, 7/22).

Meanwhile, at least two other cases challenging the subsidies are pending in federal district courts in Indiana and Oklahoma (New York Times, 7/22).

In the meantime, Congress or states could act to address the issues. According to the New York Times' "The Upshot," Congress could fix the language in the ACA to clarify how the subsidies are awarded. In addition, states that do not operate their own marketplace could move to do so, which would mean consumers there would be eligible for subsidies (Sanger-Katz, "The Upshot," New York Times, 7/22).


Datapoints: 'Bad Medicine' in the States, Myths About Abortion Providers & More

Thu, 07/24/2014 - 20:35

This month's visual snapshot of women's health developments highlights dangerous state laws that put political ideology above medical evidence. We also debunk a common claim from abortion-rights opponents about abortion providers in minority communities.

Datapoints: 'Bad Medicine' in the States, Myths About Abortion Providers & More

July 24, 2014 — This month's visual snapshot of women's health developments highlights dangerous state laws that put political ideology above medical evidence. We also debunk a common claim from abortion-rights opponents about abortion providers in minority communities.

'Bad Medicine'



The majority of states have enacted laws that go against medical evidence and mandate how women's health care providers must practice abortion care, according to a report and infographic out this month from the National Partnership for Women & Families.

The report -- "Bad Medicine: How a Political Agenda is Undermining Women's Health Care" -- found that 33 states have passed at least one abortion-related law imposing ultrasound requirements, biased counseling, mandatory delays or medication abortion restrictions that are not supported by medical evidence. Sixteen of the 33 states have all four types of medically unsound laws on the books, the report found (National Partnership release, 7/14).


Abortion Providers and Minority Communities



While antiabortion-rights activists like to claim that most abortion providers are located in predominantly black or Hispanic neighborhoods -- supposedly because they "target" minority women for abortions -- the fact is that the majority of abortion providers are in areas where most residents are white, according to this infographic from the Guttmacher Institute.

Findings from Guttmacher's most recent census of abortion providers nationwide found that fewer than one in 10 abortion providers are located in majority-black neighborhoods, while about 13% are in majority-Hispanic neighborhoods. By contrast, six in 10 abortion providers are located in majority-white neighborhoods, Guttmacher found (Guttmacher release, June 2014).


TRAP Surge



Guttmacher's midyear report on state-level reproductive health care laws highlights a surge in targeted regulation of abortion providers, or TRAP, laws in recent years. Nationwide, nearly six in 10 women live in states with such laws, which include requirements such as mandating that abortion providers have admitting privileges at nearby hospitals (Guttmacher release, 7/8).


Ohio Democrats To Propose Bill Mandating Employers Cover Contraceptives

Thu, 07/24/2014 - 18:09

Ohio Democrats in the House and Senate plan to introduce a bill that would require small and mid-sized companies in the state to cover all FDA-approved contraceptives, the Columbus Dispatch reports.

Ohio Democrats To Propose Bill Mandating Employers Cover Contraceptives

July 24, 2014 — Ohio Democrats in the House and Senate plan to introduce a bill that would require small and mid-sized companies in the state to cover all FDA-approved contraceptives, the Columbus Dispatch reports.

According to the Dispatch, the bill comes in response to the Supreme Court's Hobby Lobby ruling (Siegel, Columbus Dispatch, 7/23). The high court said that closely held corporations cannot be required to provide contraceptive coverage to their employees if the corporations' owners have religious objections to contraception (Women's Health Policy Report, 6/30).

State Rep. Kathleen Clyde (D) said the legislation would prohibit companies from offering coverage that does not include all FDA-approved contraceptives. In addition, the measure would prohibit employers from firing workers based on their use of contraceptives or decision to have an abortion.

According to Clyde, 28 states already have passed similar measures.

Comments

Clyde said, "The steps you take to live your healthiest life shouldn't be anyone else's business but your own," adding that it is "discrimination to deny women this preventive care."

Similarly, state Sen. Charleta Tavares (D), who is sponsoring the Senate version of the bill, said that employees should not have to "fear losing their job because of a personal health-care decision they made with their families and doctors."

Meanwhile, Katherine McCann, spokesperson for Ohio Right to Life, said the measure "isn't going to go anywhere in a pro-life legislature." She said the bill is a "political tool that [Democrats are] going to use to cry 'war on women' later in the fall and continue to propagate that myth" (Columbus Dispatch, 7/23).


Study Evaluating Effects of Texas' HB 2 Shows 13% Drop in Abortions

Thu, 07/24/2014 - 18:08

The number of abortions in Texas has dropped by 13% since provisions of a state law (HB 2) took effect, according to a Texas Policy Evaluation Project study published in the journal Contraception, the Texas Tribune reports.

Study Evaluating Effects of Texas' HB 2 Shows 13% Drop in Abortions

July 24, 2014 — The number of abortions in Texas has dropped by 13% since provisions of a state law (HB 2) took effect, according to a Texas Policy Evaluation Project study published in the journal Contraception, the Texas Tribune reports (Edelman, Texas Tribune, 7/23).

The law includes four abortion regulations: a ban on abortion after 20 weeks of pregnancy unless a woman's life is in danger, a requirement that abortion clinics meet the standards of ambulatory surgical centers, a mandate that physicians administer medication abortion drugs in person and a requirement that physicians who perform abortions have admitting privileges at a hospital within 30 miles (Women's Health Policy Report, 7/30/13). Supporters of the law contended that it would make abortion safer, but opponents raised concerns that restricted access to the procedure would lead to more unintended pregnancies and self-induced abortions, the Tribune reports (Texas Tribune, 7/23).

Key Findings

For the study, researchers analyzed data from all licensed Texas abortion clinics between November 2012 and April 2014 (Grossman et al., Contraception, 7/22).

Overall, the researchers found that as the number of available clinics in the state dwindled, so did the number of abortions. However, the drop in abortions was not as large as the researchers expected, the Tribune reports.

The admitting privileges requirement contributed to a drop in the number of operating clinics, according to the Tribune. Before the law, 42 abortion clinics operated in Texas, and as of July 1, the number dropped to 20. The report estimates that the clinic closures increased the number of women of reproductive age who live farther than 100 miles from a reproductive health center from roughly 400,000 to 1.3 million (Texas Tribune, 7/23).

The researchers predicted that as abortion facilities are required to meet the standards of ambulatory surgical centers by September, about 752,000 women of reproductive age -- or 5.65% of all female Texans -- will live more than 200 miles away from a clinic. About 290,000 women live more than 200 miles from an abortion clinic now (Psencik, KVUE, 7/23). In addition, only six of the 20 clinics currently operating meet surgical center standards, according to the Tribune.

The report also found that the law's requirement limiting medication abortion to women who are seven or fewer weeks pregnant caused a 70% drop in such abortions.

Comments

Report co-author Daniel Grossman, a California physician, said, "There's no evidence that the safety of abortion has been increased by these restrictions," adding, "The provisions in this law were not based on any medical evidence."

He added that the reason why the decline in abortions was not steeper might be because the remaining abortion clinics are located in the state's population centers. Further, the report suggests that financial contributions and other support from abortion-rights groups helped blunt the law's impact.

However, Andrea Ferrigno of Whole Woman's Health said she is worried abortions will continue to decrease because reproductive rights groups might no longer be able to financially support clinics. "A lot of those organizations are out of funds already, and the full extent of the law hasn't even taken effect," she said (Texas Tribune, 7/23).


Opponents of Colorado 'Personhood' Amendment Launch Campaign Against Proposed Measure

Thu, 07/24/2014 - 18:07

Opponents of a proposed Colorado constitutional "personhood" amendment launched a campaign Tuesday, saying the ballot measure could further restrict abortion rights and limit some fertility treatments, the AP/CBS4 reports.

Opponents of Colorado 'Personhood' Amendment Launch Campaign Against Proposed Measure

July 24, 2014 — Opponents of a proposed Colorado constitutional "personhood" amendment launched a campaign Tuesday, saying the ballot measure could further restrict abortion rights and limit some fertility treatments, the AP/CBS4 reports. Members of Planned Parenthood of the Rocky Mountains and NARAL Pro-Choice Colorado attended a campaign kickoff rally at the state Capitol (AP/CBS4, 7/22).

The ballot initiative will ask voters whether the state's constitution should be amended to protect "pregnant women and unborn children by defining 'person' and 'child' in the Colorado criminal code and the Colorado wrongful death act to include unborn human beings."

Coloradans have rejected a personhood measure twice before (Women's Health Policy Report, 10/15/13).

Supporters of the measure say it is meant to protect pregnant women from assault, according to the Denver Post.

However, Nathan Woodliff-Stanley, executive director of the American Civil Liberties Union of Colorado, said, "If this were passed and the language added to the criminal code, it would be saying that life begins when an egg is fertilized -- in that case, you could bring murder or manslaughter charges up whenever a pregnancy didn't result in a live birth." He added, "If a woman had a miscarriage, there could be a criminal investigation into whether someone caused it or not" (Cotton, Denver Post, 7/23).


Mass. House Approves Bill Protecting Abortion Clinics

Thu, 07/24/2014 - 18:06

The Massachusetts House on Wednesday voted 116-35 to approve a bill that would bolster security around abortion clinics in the state, AP/MassLive reports.

Mass. House Approves Bill Protecting Abortion Clinics

July 24, 2014 — The Massachusetts House on Wednesday voted 116-35 to approve a bill that would bolster security around abortion clinics in the state, AP/MassLive reports.

Lawmakers developed the legislation in response to a recent Supreme Court ruling that struck down the state's "buffer zone" law, which had barred protests within 35 feet of clinic entrances. The measure -- approved by voice vote in the state Senate last week -- now has to be approved in a final vote in both chambers before proceeding to Gov. Deval Patrick (D) for his signature (AP/MassLive, 7/23). Patrick is expected to sign the legislation (Miller, Boston Globe, 7/23).

Legislation Details

The measure would give law enforcement personnel the authority to give dispersal orders if two or more protesters deliberately prevent patients or staff members from entering a clinic. Individuals who receive such orders would be required to stay at least 25 feet away from the clinic's entrance for up to eight hours.

The bill also would prohibit protesters from interfering with vehicles approaching or leaving the area, as well as intimidating or harming people accessing the clinic. In addition, victims of such intimidation would be allowed to seek damages through civil action (Women's Health Policy Report, 7/17).

The measure also would amend the state's current civil rights act to permit the state attorney general to pursue damages on behalf of individuals who have been blocked from accessing the clinics. The attorney general would be allowed to try to recover litigation costs and pursue civil penalties for individuals whose constitutional rights have been obstructed (AP/MassLive, 7/23).

Reaction

According to Reuters, opponents voiced concerns that the bill effectively chills free speech and gives abortion clinics unfair and unequal treatment (Barber, Reuters, 7/23). State Rep. Marc Lombardo (R) said the bill was a "retaliatory bill" that targeted abortion-rights opponents, while state Rep. James Lyons (R) said the measure is merely a reworking of the original buffer zone law and "is on the face of it unconstitutional."

Meanwhile, state Rep. Ann-Margaret Ferrante (D) said the bill was about public safety and not free speech. "There is a long, tragic history on this regard," she said, adding, "At some point in time there has to be a line drawn" (AP/MassLive, 7/23).

In a statement, Megan Amundson, executive director of NARAL Pro-Choice Massachusetts, said, "The Legislature's swift action will ensure that people can safely access reproductive health care in Massachusetts without fear of violence or intimidation."

Martha Walz, president and CEO of the Planned Parenthood League of Massachusetts, added, "There's clear recognition of the public safety concerns faced by the staff and patients at women's reproductive health care centers" (Boston Globe, 7/23).


Blogs Comment on Abortion Restrictions, Pregnancy and Fertility and More

Thu, 07/24/2014 - 17:40

We've compiled some of the most thought-provoking commentaries from around the Web. Catch up on the conversation with bloggers from "ThinkProgress," "The XX Factor" and more.

Blogs Comment on Abortion Restrictions, Pregnancy and Fertility and More

July 22, 2014 — We've compiled some of the most thought-provoking commentaries from around the Web. Catch up on the conversation with bloggers from "ThinkProgress," "The XX Factor" and more.

ABORTION RESTRICTIONS: "Half of Texas' Abortion Clinics Are Gone," Tara Culp-Ressler, Center for American Progress' "ThinkProgress": The number of abortion clinics in Texas "has been cut in half over the past year, dropping from 41 to just 20" under a "stringent package [HB 2] of abortion restrictions" that was approved in 2013, according to a report from Houston Public Media, Culp-Ressler writes. She writes that many of those clinics "were forced out of business because they can't comply with the new law, which requires doctors to obtain admitting privileges from local hospitals" and that just six clinics are expected to be able to comply with a provision of the law that takes effect in September, requiring clinics "to bring their facilities in line with the building codes for ambulatory surgical centers." The "crisis won't be contained within Texas' borders," Culp-Ressler writes, noting that "[o]ther anti-choice lawmakers have followed in Texas' footsteps and proposed the exact same type of laws in their own states" (Culp-Ressler, "ThinkProgress," Center for American Progress, 7/18).

What others are saying about abortion restrictions:

~ "The People of Color Activists Whose Voices Are Too Often Missing From Stories Abortion Texas' 'Orange Army,'" Shailey Gupta-Brietzke, RH Reality Check.

~ "A New Abortion Rights Bill Could Help Decide the Midterms," Robin Marty, Care2.

~ "The Women's Health Protection Act: Protecting Women's Right to Choose," Ashley Bender, NWLC blog.

~ "What The Abortion Fight Unfolding in Tennessee Means for the Rest of the Country," Culp-Ressler, Center for American Progress' "ThinkProgress."

PREGNANCY AND FERTILITY: "Hey Republicans, Here's How To Help Babies Who Haven't Been Born Yet," Culp-Ressler, Center for American Progress' "ThinkProgress": "Pro-life politicians talk a lot about unborn children," typically focusing on abortion policy and "efforts to dissuade women from ending their pregnancies," Culp-Ressler writes, noting that a new study shows there is a "different policy area that GOP lawmakers could be considering": Medicaid expansion. The study, supported by the Robert Wood Johnson Foundation, tracked states' varying levels of Medicaid expansion during the 1980s, finding that infants born after their mothers gained Medicaid coverage became healthier adults, having lower rates of obesity and BMI and fewer preventable hospital visits. Culp-Ressler notes that "more than 20 GOP-controlled states continue to resist implementing" the Affordable Care Act's (PL 111-148) Medicaid expansion, "leaving millions of low-income Americans without any access to affordable insurance whatsoever" (Culp-Ressler, "ThinkProgess," Center for American Progress, 7/18).

What others are saying about pregnancy and fertility:

~ "My Fertility Envy," Susie Meserve, Salon.

~ "Why Are Poor Women Having Healthier Babies?" Jessica Grose, Slate's "The XX Factor."

'BUFFER ZONE' LEGISLATION: "Repro Wrap: Massachusetts Gets Harsh With Abortion Protesters and Other News," Marty, Care2: "Massachusetts may have lost its buffer zone law thanks to a 9-0 decision by the Supreme Court, but the state, its governor, and its attorney general aren't willing to let that loss go quietly," writes Marty. She adds that the governor has proposed a new bill "to combat harassment at clinics" by "allowing police to have more power to disperse groups impeding an entrance way and forcing protesters to stay away longer once they have been accused of blocking a patient or a vehicle." Marty writes that while abortion-rights opponents might try to bring the proposed law to court if enacted, doing so will "make it clear that their intention was never about 'counseling'" but instead "to block the entry way and harass patients and staff." Marty also touches on similar legislative efforts in New York and New Hampshire, among other measures related to abortion rights (Marty, Care2, 7/18).

SUPPORTING WORKING FAMILIES: "Finally, Better Protections for Pregnant Workers," Ms. Magazine blog: "Many women nationwide ... are forced to take unpaid leave or leave their jobs altogether during pregnancy," Ms. Magazine writes, adding that "[p]regnancy discrimination complaints in the U.S. increased by 71 percent between 1992 and 2011." In response, the Equal Employment Opportunity Commission last week released new pregnancy discrimination guidelines. "[S]ome company managers claim that they're unsure how federal laws apply to their workers," the blog post notes, adding that the guidelines "make it clear that an employer cannot discriminate against a worker because she is pregnant or has recently given birth, and cannot force a pregnant woman to take early leave if she is still able to work." Overall, "[i]n updating its policies, the EEOC hopes to provide clarity" (Ms. Magazine blog, 7/18).

GENDER-BASED VIOLENCE: "Saying That a Killer 'Snapped' is not an Explanation for Domestic Violence," Libby Copeland, Washington Post's "She The People": Copeland writes that most "of the language the media uses to explain domestic homicides falls short -- or worse, makes the murders seem less shocking by rationalizing them," and she highlights various recent cases in which "reporters frame such murders in the language of romance." For example, it took only two days for an "Alaska TV station" to "gathe[r] the observations of childhood friends" of Ronald Lee Haskell, who was "accused of killing six members of his ex-wife's family in Texas this month," describing him "as funny, compassionate and religiously devout" and saying he "'must have snapped.'" Copeland notes that the manner in which the media "frame[s] such crimes affects how" the public comprehends them. She concludes, "Reporters don't do readers a service by painting a portrait of a normal, even-tempered guy who was like any one of us, until he wasn't." Instead, they should highlight that domestic violence is "not a crime of passion, but in many ways the opposite" (Copeland, "She The People," Washington Post, 7/21).

What others are saying about gender-based violence:

~ "Most Female Scientists Are Sexually Harassed on the Job," Kevin Mathews, Care2.


Fewer Low-Income Women Having Infants With Unhealthy Birthweights

Thu, 07/24/2014 - 17:18

Even though economic and health disparities persist, more low-income women are giving birth to infants with healthier birthweights than 25 years ago, the Washington Post reports.

Fewer Low-Income Women Having Infants With Unhealthy Birthweights

July 22, 2014 — Even though economic and health disparities persist, more low-income women are giving birth to infants with healthier birthweights than 25 years ago, the Washington Post reports.

A recent study by Princeton University economist Janet Currie and colleagues compared birthweights of infants born to women who were black, unmarried high school dropouts -- typically demographic indicators of being low-income -- with those of women who were white, married college graduates -- a group that tends to include individuals with higher incomes. According to the Post, many researchers use demographic information, such as race, marital status and education, as proxies for income information, which is not included on birth certificates.

The researchers found that one-sixth of infants born in 1989 to the lower-income group weighed under five-and-a-half pounds -- which doctors consider to be the lower bound of a healthy birthweight -- compared with one out of 32 infants born to the higher-income group.

About 20 years later, one-eighth of the infants born to the lower-income group had unhealthy birthweights, while the rate was largely unchanged for the higher-income group. The authors also found the same trends when they looked at the data after removing the factor of race.

Factors Influencing Birthweight

Other researchers have found that government policies such as food stamps, nutritional counseling and efforts to expand access to care have had a significant positive effect on birthweight. Further, other policy efforts and social trends -- such as regulations limiting pollution and auto emissions, and a decline in smoking rates -- also have played a role.

Meanwhile, studies have found several factors that continue to contribute to lower-income women giving birth to underweight infants at a higher rate, including pollution, stress and violence.

For example, researchers have found that women with annual incomes below $25,000 are two-and-a-half times more likely to be survivors of domestic violence. Further, women who have been sent to a hospital as the result of domestic violence tend to have infants who weigh five ounces less on average than women who have not (Goldfarb, Washington Post, 7/20).


Study Evaluating Effects of Texas' HB 2 Shows 13% Drop in Abortions

Thu, 07/24/2014 - 17:16

The number of abortions in Texas has dropped by 13% since provisions of a state law (HB 2) took effect, according to a Texas Policy Evaluation Project study published in the journal Contraception, the Texas Tribune reports.

Study Evaluating Effects of Texas' HB 2 Shows 13% Drop in Abortions

July 24, 2014 — The number of abortions in Texas has dropped by 13% since provisions of a state law (HB 2) took effect, according to a Texas Policy Evaluation Project study published in the journal Contraception, the Texas Tribune reports (Edelman, Texas Tribune, 7/23).

The law includes four abortion regulations: a ban on abortion after 20 weeks of pregnancy unless a woman's life is in danger, a requirement that abortion clinics meet the standards of ambulatory surgical centers, a mandate that physicians administer medication abortion drugs in person and a requirement that physicians who perform abortions have admitting privileges at a hospital within 30 miles (Women's Health Policy Report, 7/30/13). Supporters of the law contended that it would make abortion safer, but opponents raised concerns that restricted access to the procedure would lead to more unintended pregnancies and self-induced abortions, the Tribune reports (Texas Tribune, 7/23).

Key Findings

For the study, researchers analyzed data from all licensed Texas abortion clinics between November 2012 and April 2014 (Grossman et al., Contraception, 7/22).

Overall, the researchers found that as the number of available clinics in the state dwindled, so did the number of abortions. However, the drop in abortions was not as large as the researchers expected, the Tribune reports.

The admitting privileges requirement contributed to a drop in the number of operating clinics, according to the Tribune. Before the law, 42 abortion clinics operated in Texas, and as of July 1, the number dropped to 20. The report estimates that the clinic closures increased the number of women of reproductive age who live farther than 100 miles from a reproductive health center from roughly 400,000 to 1.3 million (Texas Tribune, 7/23).

The researchers predicted that as abortion facilities are required to meet the standards of ambulatory surgical centers by September, about 752,000 women of reproductive age -- or 5.65% of all female Texans -- will live more than 200 miles away from a clinic. About 290,000 women live more than 200 miles from an abortion clinic now (Psencik, KVUE, 7/23). In addition, only six of the 20 clinics currently operating meet surgical center standards, according to the Tribune.

The report also found that the law's requirement limiting medication abortion to women who are seven or fewer weeks pregnant caused a 70% drop in such abortions.

Comments

Report co-author Daniel Grossman, a California physician, said, "There's no evidence that the safety of abortion has been increased by these restrictions," adding, "The provisions in this law were not based on any medical evidence."

He added that the reason why the decline in abortions was not steeper might be because the remaining abortion clinics are located in the state's population centers. Further, the report suggests that financial contributions and other support from abortion-rights groups helped blunt the law's impact.

However, Andrea Ferrigno of Whole Woman's Health said she is worried abortions will continue to decrease because reproductive rights groups might no longer be able to financially support clinics. "A lot of those organizations are out of funds already, and the full extent of the law hasn't even taken effect," she said (Texas Tribune, 7/23).