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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Neb. Bill Seeks Medicaid Waiver To Expand Family Planning Services

Thu, 01/15/2015 - 18:05

A Nebraska lawmaker on Thursday proposed a bill (LB 77) that aims to make family planning and preventive health screening more accessible to low-income women in the state, the Lincoln Journal Star reports.

Neb. Bill Seeks Medicaid Waiver To Expand Family Planning Services

January 12, 2015 — A Nebraska lawmaker on Thursday proposed a bill (LB 77) that aims to make family planning and preventive health screening more accessible to low-income women in the state, the Lincoln Journal Star reports.

Bill Details

The measure, proposed by state Sen. Jeremy Nordquist, would allow Nebraska women with family incomes of up to 185% of the federal poverty level to access Medicaid services for family planning and health screenings. In addition, Nordquist's measure would allot about $500,000 in fiscal year 2015-2016 and FY 2016-2017 for outreach, education and preventive services for medically underserved women.

To implement the proposal, the state must submit a plan to CMS for approval. If the plan were approved, the federal government would cover 90% of the cost, according to Nordquist, who said other states have saved millions of dollars through similar arrangements (Young, Lincoln Journal Star, 1/8).

Twenty-nine states have federal approval for similar Medicaid family planning programs, WOWT News reports. If implemented, the Nebraska measure would save an estimated $4.17 for every dollar invested.

"We can improve the health of families in Nebraska by offering preventive health care services and empowering people to make healthier choices for themselves and their families," Nordquist said (WOWT News, 1/8).


Report Provides New Insights Into Role of Hormones, Interventions During Childbirth

Thu, 01/15/2015 - 18:04

High rates of interventions during maternity care can be detrimental to the health and safety of women and their infants, but many U.S. hospitals continue to overtreat such patients, according to a new report by Childbirth Connection, a program of the National Partnership for Women & Families, the New York Times' "Motherlode" reports.

Report Provides New Insights Into Role of Hormones, Interventions During Childbirth

January 14, 2015 — High rates of interventions during maternity care can be detrimental to the health and safety of women and their infants, but many U.S. hospitals continue to overtreat such patients, according to a new report by Childbirth Connection, a program of the National Partnership for Women & Families, the New York Times' "Motherlode" reports.

Report Findings

The report, based on a synthesis of research, found, "If overtreatment is defined as instances in which an individual may have fared as well or better with less or perhaps no intervention then modern obstetric care has landed in a deep quagmire. Navigating out of that territory will be challenging."

Report author Sarah Buckley provided several recommendations for hospitals, based on the approach that the hormonal processes at work during childbirth are best left undisrupted in most cases. The report found that these processes, which previously were not fully understood, help prepare the pregnant woman and her fetus for labor and birth.

Specifically, the report recommends that health care providers wait for labor to start on its own, advise women who labor at home while in early labor and be patient with women who are in labor in their facilities, instead of providing interventions to speed the process along. In addition, the report recommends that women "stay calm and relaxed" and practice patience as well.

Comments

Childbirth Connection Programs Director Carol Sakala said, "It's important for both clinicians and women to understand that common interventions, that we have come to view quite casually, are actually quite consequential."

She said that while "[o]ur current high rates of intervention are not serving women well ... the community is really moving in the right direction. Professional societies are breaking with the past."

For example, Sakala noted that professional societies are publicly discussing not allowing elective cesarean sections or inductions, as well as issues like the overuse of c-sections and fetal monitoring.

She added, "We are hopeful that the timing of this report will support that change" (Dell'Antonia, "Motherlode," New York Times, 1/13).


N.Y. Senate Passes Women's Equality Bills, Excludes Abortion-Rights Measure

Thu, 01/15/2015 - 18:03

The GOP-controlled New York Senate on Monday unanimously approved eight out of nine remaining bills in the package known as the Women's Equality Act but did not take up an abortion-rights measure, setting up another potential stalemate with the state Assembly, the AP/Auburn Citizen reports.

N.Y. Senate Passes Women's Equality Bills, Excludes Abortion-Rights Measure

January 13, 2015 — The GOP-controlled New York Senate on Monday unanimously approved eight out of nine remaining bills in the package known as the Women's Equality Act but did not take up an abortion-rights measure, setting up another potential stalemate with the state Assembly, the AP/Auburn Citizen reports (AP/Auburn Citizen, 1/12).

Background

The 10-point measure, which failed to pass in its entirety in previous sessions, includes bills covering issues such as human trafficking, sexual harassment, pay equity, protective orders for women and abortion access (Women's Health Policy Report, 1/7). A version of one of the 10 bills addressing penalties for domestic violence has already become law (Campbell, Binghamton Press & Sun-Bulletin, 1/12).

The state Senate last session passed some bills from the package, including measures that would have addressed employment and housing discrimination, equal pay and sexual harassment, but many state senators objected to the abortion-rights measure. Meanwhile, state Assembly Democrats wanted the package to be considered in its entirety and not as separate bills (Women's Health Policy Report, 1/7).

Supporters have said the abortion-rights measure in the package would bring state law in line with the Supreme Court's 1973 Roe v. Wade decision (Women's Health Policy Report, 6/12/14). However, opponents of abortion rights, including some conservative members of the New York state Senate, have referred to the measure as an "abortion expansion," the Albany Times Union reports.

Reaction, Next Steps

In a statement before the votes in his chamber, state Senate Majority Leader Dean Skelos (R) called on the state Assembly to follow suit and pass the eight bills. He said, "It is a new year and time to put progress over politics by passing effective measures that provide women with the protections they need and the opportunities they deserve. The Senate is making the passing of these bills an immediate priority because women need the politics to end so that New York can enact a Women's Equality Agenda without further delay."

State Senate Democratic Conference Leader Andrea Stewart-Cousins said that the votes were an example of Senate GOP lawmakers not being willing to support abortion rights. She said, "What they're saying yet again is here we are in 2015, and there's no Republican willing to even pass for New York state what is federal law" (Hamilton, Albany Times Union, 1/12).

Meanwhile, state Assembly Speaker Sheldon Silver (D) indicated that his chamber could again decide to only take up the Women's Equality Act as a whole (AP/Auburn Citizen, 1/12). He said, "I think what's important here is our conference will take up the issues, and what's really important is to pass all 10 points. A woman's right to choose is a fundamental right, and the Senate so far has not shown any (inclination) toward that."

According to the Albany Times Union, Gov. Andrew Cuomo (D) is expected to restate his support for the passage of the full Women's Equality Act when he delivers the State of the State address next week (Albany Times Union, 1/12).


Va. Gov., Women's Rights Coalition Outline Legislative Agendas

Thu, 01/15/2015 - 18:02

Virginia Gov. Terry McAuliffe (D) on Monday unveiled his Equal Opportunity legislative agenda, which includes legislative proposals that range from protections for abortion rights to addressing college sexual assaults and domestic violence, the Richmond Times-Dispatch reports.

Va. Gov., Women's Rights Coalition Outline Legislative Agendas

January 14, 2015 — Virginia Gov. Terry McAuliffe (D) on Monday unveiled his Equal Opportunity legislative agenda, which includes legislative proposals that range from protections for abortion rights to addressing college sexual assaults and domestic violence, the Richmond Times-Dispatch reports.

Agenda Details

McAuliffe said he will push to repeal a 2012 state law that requires a woman seeking an abortion to first undergo an ultrasound.

In addition, McAuliffe plans to propose a bill that would place restrictions on individuals' abilities to own a gun if they have been convicted of misdemeanor domestic violence charges and are subject to protective orders. McAuliffe also said he will propose legislation that requires employers to provide leave for any employees who are survivors of domestic violence, sexual assault or stalking so that the individuals may seek counseling and treatment.

Further, the governor proposed under the agenda that the Council for Higher Education for Virginia help update sexual assault policies for all public higher education institutions in the state. Under such policies, McAuliffe recommended that students' academic transcripts include any dismissals for violating a school's sexual misconduct code, code of conduct or honor code.

Comments

McAuliffe said during the announcement that the policies are not "partisan" or "political," and called them "common-sense things that move the commonwealth forward." He added that the agenda would put in place pledges he made "when [he] ran for governor" (Nolan, Richmond Times-Dispatch, 1/12). McAuliffe also said the policies would help the state to be more inclusive and welcoming in its efforts to diversify its economy.

Agenda Could Face Uphill Battle in State Legislature

According to the Virginian-Pilot, the governor's agenda could face an uphill battle in the state General Assembly (Hieatt, Virginian-Pilot, 1/13). For example, a Virginia House subcommittee last year rejected a bill (SB 617) that would have repealed the state's ultrasound requirements (Women's Health Policy Report, 2/19/14).

Meanwhile, conservative observers were quick to criticize the agenda. Republican Party of Virginia spokesperson Garren Shipley wrote in an email that the agenda shows "McAuliffe is focused on playing politics and waging divisive social battles under the guise of economic opportunity" (Virginian-Pilot, 1/13).

Virginia Women's Group Announces Agenda

In related news, a coalition of women's groups in Virginia on Thursday announced its legislative agenda for the state's 2015 legislative session, the Capital News Service/Southwest Times reports.

The coalition -- which includes ProgressVA, the Virginia Latina Advocacy Network and other women's rights and health groups -- is called the Women's Equality Coalition and has support from the Virginia chapters of the American Civil Liberties Union, the National Organization for Women and Planned Parenthood. Margie Del Castillo, a field coordinator for the Virginia Latina Advocacy Network, said the group will focus on "creat[ing] an environment in Virginia for all women to have the economic means, social capital and political power to make and exercise decisions about their own health, family and future."

According to the Capital News Service/Times, the group's main push will be for the state to ratify the Equal Rights Amendment, which Congress passed in 1972.

In addition, the group will advocate for the repeal of the state's ultrasound requirements and for passage of legislation that would provide unemployment benefits for survivors of domestic violence. The group also will support McAuliffe's efforts to expand the state's Medicaid program, among other initiatives (Mislowsky/Zirpolo, Capital News Service/Southwest Times, 1/12).


Blogs Comment on Catholic Hospitals, ACA Open Enrollment, More

Thu, 01/15/2015 - 18:02

Read the week's best commentaries from bloggers at Care2, the Huffington Post and more.

Blogs Comment on Catholic Hospitals, ACA Open Enrollment, More

January 13, 2015 — Read the week's best commentaries from bloggers at Care2, the Huffington Post and more.

ACCESS TO CARE: "As Catholic Hospitals Block Tubal Ligations, Women Lose Out," Robin Marty, Care2: "While the medical industry continues to collapse and consolidate, more hospitals are merging with Catholic based entities, and part of the price of partnership is an adherence to Catholic healthcare directives that claim that there is never a justifiable reason to allow a woman to have a tubal ligation," Marty writes. She notes that Catholic hospitals that had "previously turned a blind eye to the prohibition" and permitted women to obtain the procedure during cesarean sections are "now being forbidden to continue the practice." As a result, patients are left "with the options of either finding another hospital to perform a second surgery at least six weeks after birth ... or going with a less permanent method, in some cases leading to unwanted pregnancies and birth," Marty writes. The policy "stands counter to medical ethics, where Bishops are literally forbidding one type of care in order to stick to their religious beliefs, even though that decision could endanger that patient’s health down the road," Marty writes, adding, "When a person has decided she is no longer interested in having children, it should be up to her, not to the Catholic bishops writing medical directives" (Marty, Care2, 1/10).

AFFORDABLE CARE ACT: "Great Strides for Women's Health Under the Affordable Care Act," Valerie Jarrett, Huffington Post blogs: Jarrett, a senior adviser to President Obama and chair of the White House Council on Women and Girls, highlights the findings of an HHS report on "the important strides we have made in women's health as a result of the implementation of the Affordable Care Act" (PL 111-148). She notes that the report, released Friday, "outlines a significant 5.5 percentage point decline in the uninsured rate among women between the ages of 18 and 64 since 2013" and shows that "over 48 million women have benefited from ... expanded access to preventive care," such as for "mammograms, Pap smears, contraception, domestic violence screening, and other vital health services" now available "for no out-of-pocket cost." She adds that the report "also found that the ACA has been instrumental in providing maternity benefits" to 8.7 million U.S. women who bought marketplace coverage. She concludes by noting that although many women have enrolled in marketplace coverage, "there are still millions of women who have yet to sign up and gain access to these crucial services" and calls on individuals to do so prior to the Feb. 15 end of the open enrollment period (Jarrett, Huffington Post blogs, 1/9).

ABORTION RESTRICTIONS: "The GOP's Abortion-Obsessed First Day," Sally Kohn, Daily Beast: Kohn writes that despite GOP politicians' claims that they would focus on the economy in the new congressional session, conservative lawmakers "introduced no fewer than five restrictions on abortion on the first day of the new Republican-controlled Congress." She explains that the bills include a measure (HR 36) reintroduced by Reps. Marsha Blackburn (R-Tenn.) and Trent Franks (R-Ariz.) that would ban abortion after 20 weeks of pregnancy in most cases. Sen. David Vitter (R-La.) also introduced four antiabortion-rights bills: legislation to "bar Planned Parenthood from receiving federal funds for family planning work" (S 51); "require all abortion providers to have admitting privileges at a nearby hospital" (S 78); "allow hospitals, doctors and nurses to refuse to participate in abortion-related care even in cases of an emergency -- which makes that 'admitting privileges' bill entirely disingenuous" (S 50); and "ban 'sex-selective abortion,' which is purely a fictional boogieman invented by anti-abortion opponents" (S 48). Kohn writes, "Job creation, eh? The only jobs these bills will create are at advocacy organizations protesting these ridiculous infringements on reproductive freedom," adding, "This isn't what the American people voted for" (Kohn, Daily Beast, 1/13).

What others are saying about abortion restrictions:

~ "Your State's Probably 'Hostile' To Abortion, Says Scary Guttmacher Institute Report," Lauren Barbato, Bustle.

~ "Colorado Republicans Introduce 'Personhood' Bill After Ballot Measure Defeat," Jason Salzman, RH Reality Check.

~ "Tennessee Lawmaker Introduces Bill To Force Doctors To Provide Misleading Information," Teddy Wilson, RH Reality Check.

CONTRACEPTION: "The Group Behind America's Biggest Anti-Abortion March Now Says Birth Control Causes Abortions," Molly Redden, Mother Jones: The March for Life Education and Defense Fund, which organizes the annual antiabortion-rights protest against the Supreme Court's ruling in Roe v. Wade, is currently "fighting for an exemption from the Affordable Care Act (PL 111-148) mandate that all private employers provide contraception coverage," writes Redden. Specifically, she notes that the group has claimed in legal filings that hormonal birth control causes abortions, "a characterization with which most physicians strongly disagree." Further, Redden notes that "[p]olls consistently find that a majority of Americans who oppose abortion have no moral objections to birth control." She continues, "[m]ost of those planning to attend [this year's] march probably have no idea that March for Life views birth control as immoral" given that the organization "doesn't advertise its opinions on birth control in its promotional material for the protest" and "bills the march as a mass demonstration against 'legalized abortion on demand.'" Redden cites Joerg Dreweke, a Guttmacher Institute policy researcher, who said the organization's lawsuit "is part of a pattern of anti-abortion groups conflating contraception with abortion in a quiet effort to roll back both" (Redden, Mother Jones, 1/12).

What others are saying about contraception:

~ "The Birth Control Evangelists Who Want To Talk To You About Their IUDs," Tara Culp-Ressler, Center for American Progress' "ThinkProgress."

LGBTQ HEALTH AND RIGHTS: "DOJ Solidifies Protection for Transgender Rights," Ian Thompson, American Civil Liberties Union's "Blog of Rights": "While the American workplace is often notoriously inhospitable to transgender" individuals, the Department of Justice last month took an "important step forward in the ongoing fight for basic fairness and equal treatment under the law" by issuing a memorandum that "explicitly clarified that gender identity discrimination claims are covered under Title VII of the Civil Rights Act," Thompson writes. He shares the story of Diane Schroer, a 25-year Army veteran, who had a job offer at the Library of Congress rescinded after telling her future boss "that she was in the process of transitioning" from a man to a woman. After the ACLU filed a lawsuit against the Library of Congress on Schroer's behalf, the court "ruled that discriminating against someone for changing genders is sex discrimination and a violation of Title VII," Thompson writes. He adds that while DOJ "vigorously fought Diane's lawsuit" at the time, the department's "change in policy ... vindicates Diane's battle against workplace discrimination and provides protection for transgender Americans as they struggle for the respect and dignity they deserve" (Thompson, "Blog of Rights," ACLU, 1/12).


Groups Weigh In on Role of HPV Test for Cervical Cancer Screening

Thu, 01/15/2015 - 18:01

The American Society for Colposcopy and Cervical Pathology and the Society of Gynecological Oncology on Thursday issued an interim guidance report recommending that women be screened for cervical cancer starting at age 25 using the human papillomavirus test before potentially using Pap tests, Reuters reports.

Groups Weigh In on Role of HPV Test for Cervical Cancer Screening

January 9, 2015 — The American Society for Colposcopy and Cervical Pathology and the Society of Gynecological Oncology on Thursday issued an interim guidance report recommending that women be screened for cervical cancer starting at age 25 using the human papillomavirus test before potentially using Pap tests, Reuters reports.

Meanwhile, the American College of Obstetricians and Gynecologists said that it continues to support its current recommendations, which align with those issued by the U.S. Preventive Services Task Force and include Pap testing (Seaman, Reuters, 1/8).

The interim guidance was published in Gynecologic Oncology, the Journal of Lower Genital Tract Disease and Obstetrics and Gynecology (Preidt, HealthDay/U.S. News & World Report, 1/9). The recommendations were developed after a review of 11 studies (Reuters, 1/8).

Background

FDA in April 2014 approved the Cobas HPV test, the first alternative to the Pap test as a primary screening method for cervical cancer, despite opposition from some medical, consumer and women's groups.

The test screens cervical samples for the presence of HPV, which causes the majority of cervical cancer cases. By comparison, the Pap test involves examining a cervical sample under a microscope to look for abnormalities.

FDA approved the Cobas test in 2011 for use in conjunction with the Pap test. The latest approval permitted Roche to market Cobas for use on its own as a primary screening method for women ages 25 and older, with Pap tests only being necessary in certain cases as a follow up (Women's Health Policy Report, 4/25/14).

Interim Guidance Details

The interim guidance recommends that, starting at age 25, women should undergo screening for cervical cancer using the HPV test, which it says is an effective alternative to the Pap test or the two tests in combination.

If the HPV test is negative, the interim guidance says that women should not undergo a screening for an additional three years. If women test positive for HPV strains 16 and 18, which are the most likely types to cause cancer, ASCCP and SGO recommend that health care providers follow up with a colposcopy, a procedure to visually examine the cervix (HealthDay/U.S. News & World Report, 1/9). If the HPV test is positive for other strains, the interim guidance recommends that women undergo a Pap test.

The interim guidance recommends that women younger than age 25 follow USPSTF's current guidelines for cervical cancer screening.

ACOG Sticking to Current Recommendations

ACOG, which had a representative on the panel that developed the new guidance, said that it continues to support its current recommendation of a Pap test for women ages 21 through 65 every three years to screen for cervical cancer or a Pap test in combination with an HPV test every five years for women ages 30 to 65 (Reuters, 1/8).

ACOG said that it is not recommending an HPV test-only approach at this time because infection with HPV occurs often among younger women and frequently resolves on its own. Therefore, ACOG said that a positive result from an HPV test could lead to women undergo an unnecessary amount of follow-up tests.

ACOG said that while it might be the case that the HPV test could replace the Pap test as a first option for testing at age 25, there was not sufficient evidence to recommend that it "should" (HealthDay/U.S. News & World Report, 1/9).


Analysis Finds More Women Using LARC; Growth Expected To Continue

Thu, 01/15/2015 - 17:59

More women are using intrauterine devices and other long-acting reversible contraceptives, although use of the methods continues to lag behind that of other contraceptives, according to a Guttmacher Institute analysis of federal data, Kaiser Health News' "Insuring Your Health" reports.

Analysis Finds More Women Using LARC; Growth Expected To Continue

January 12, 2015 — More women are using intrauterine devices and other long-acting reversible contraceptives, although use of the methods continues to lag behind that of other contraceptives, according to a Guttmacher Institute analysis of federal data, Kaiser Health News' "Insuring Your Health" reports.

For the analysis, Guttmacher researchers examined data from the federal National Survey of Family Growth.

Looking at data from 2011 to 2013, the analysis found that almost 12% of women who used contraceptives during that time opted for IUDs or hormonal implants, making LARC the third most common method of reversible contraceptive. By contrast, 26% of women used birth control pills, the most popular option, and 15% used condoms.

The analysis also found that use of LARC steadily increased from 2.4% in 2002 to 8.5% in 2009.

Growth of LARC Use Expected To Continue

Megan Kavanaugh, a senior researcher at the Guttmacher Institute, said experts believe LARC use will continue to increase under the Affordable Care Act's (PL 111-148) contraceptive coverage rules, which require most health plans to cover all FDA approved contraceptives. She noted that because the mandate took effect in 2013, it likely did not have an effect on the study's findings.

According to "Insuring Your Health," LARCs are considered one of the most effective methods of contraception because they do not require women to remember to use them. However, women have often opted for shorter-term contraceptives because of LARC's high up-front costs (Andrews, "Insuring Your Health," 1/9).


Conservatives Pushing for Abortion Restrictions on Federal, State Level

Thu, 01/15/2015 - 17:59

Abortion-rights opponents are pushing more antiabortion restrictions this year after conservative lawmakers gained control of both chambers of Congress and two-thirds of state legislatures in last year's midterm election, Politico reports.

Conservatives Pushing for Abortion Restrictions on Federal, State Level

January 12, 2015 — Abortion-rights opponents are pushing more antiabortion restrictions this year after conservative lawmakers gained control of both chambers of Congress and two-thirds of state legislatures in last year's midterm election, Politico reports.

Push for Federal 20-Week Abortion Ban

Congressional Republicans have coalesced around legislation that would ban abortion after 20 weeks of pregnancy, based on the disputed notion that a fetus can feel pain at that point of development. The American College of Obstetricians and Gynecologists has said that there is no legitimate scientific evidence showing that fetuses are capable of feeling pain at 20 weeks.

The House is expected to vote on such a bill (HR 36) on Jan. 22, the 42nd anniversary of the Supreme Court's Roe v. Wade decision and the date of the antiabortion-rights March for Life. The bill would allow abortions after 20 weeks only in certain cases of rape and incest, and endangerment to a woman's life.

Meanwhile, Senator Majority Leader Mitch McConnell (R-Ky.) also plans to hold a vote on a 20-week ban sometime in the spring, according to aides and Republican senators.

While the bill is expected to pass the House, it likely will fall short of the necessary votes for passage in the Senate, according to Politico. While at least one Democrat, Sen. Joe Manchin (W.Va.), is likely to support the measure, several Senate Republicans could oppose it. Politico notes that Republican Sens. Susan Collins (Maine), Lisa Murkowski (Alaska), Dean Heller (Nev.) and Mark Kirk (Ill.) did not support the legislation during the last Congress.

Despite the measure's low chances of becoming law in the near future, abortion-rights opponents, including eight potential GOP presidential candidates, have largely united around the 20-week ban and believe the issue could help them politically.

Sen. John Thune (R-S.D.) said, "If you define these issues the right way, I think you get to a point where you really do have good, strong public support."

Supporters of abortion rights counter that conservatives' rhetoric on 20-week bans and fetal pain has been misleading. Terry O'Neill, president of the National Organization for Women, said that the legislation is equivalent to overturning "Roe v. Wade completely, period."

O'Neill added, "If you say 'viability,' that's the time where a fetus can live independently outside of the womb. That's 24 to 26 weeks. But most people don't know that. So when you just say, 'Oh, do you want to ban abortion at 20 weeks?' People go 'Yeah, that's really late!' No, it's not. And most people don't know that it's not late."

According to Politico, abortion-rights supporters plan to highlight the measure as an example of the GOP continuing to seek to limit women's rights and access to health care. Rep. Rosa DeLauro (D-Conn.) said, "The role of Congress should not be to deny women a medical procedure that they have decided with their physician is the right course of action. What Congress should be doing is working every day to reduce unintended pregnancies and keep women healthy" (Everett/French, Politico, 1/12).

Antiabortion-Rights Groups Pushing State Abortion Restrictions

In related news, antiabortion-rights groups are advocating for more state-level legislation that would ban abortion after 20 weeks of pregnancy, among other state abortion restrictions this year, the Wall Street Journal reports.

In the 2014 midterm election, GOP lawmakers took control of 11 legislative chambers that had been controlled by Democrats. Overall, Republicans now have control of 68 state legislative chambers, compared with 30 that are controlled by Democrats, according to the Journal (Campo-Flores/McWhirter, Wall Street Journal, 1/11). In addition, there are now 31 GOP governors (Politico, 1/12).

Specifically, National Right to Life Committee Director of State Legislation Mary Spaulding Balch said her group intends to advocate for 20-week bans in more states, including South Carolina and West Virginia (Wall Street Journal, 1/11). According to Politico, abortion-rights opponents are "bullish" that GOP lawmakers will also push for such bans in Wisconsin (Politico, 1/12).

In addition, Americans United for Life President Charmaine Yoest said her group, which drafts model antiabortion-rights bills for lawmakers, plans to support measures that would restrict the use of medication abortion, impose stricter regulations on clinics and require abortion providers to have admitting privileges at nearby hospitals.

Elizabeth Nash, state issues manager at the Guttmacher Institute, said that there have been antiabortion-rights measures filed in at least 10 states thus far and that more are expected. Such bills have included so-called "personhood" bans and legislation forcing physicians to show women seeking an abortion an ultrasound image of the fetus.

Jennifer Dalven, director of the American Civil Liberties Union's Reproductive Freedom Project, said that supporters of abortion rights "are definitely bracing for another round of attacks on women's ability" to choose to have an abortion (Wall Street Journal, 1/11).


Conservatives Leveraging State Legislation To Pass National Antiabortion-Rights Bills

Thu, 01/15/2015 - 17:49

Opponents of abortion rights are planning to highlight state antiabortion-rights laws to try to convince lawmakers to support similar measures in Congress, where abortion restrictions have often failed to garner enough votes to become law, National Journal reports.

Conservatives Leveraging State Legislation To Pass National Antiabortion-Rights Bills

January 15, 2015 — Opponents of abortion rights are planning to highlight state antiabortion-rights laws to try to convince lawmakers to support similar measures in Congress, where abortion restrictions have often failed to garner enough votes to become law, National Journal reports (Novack, National Journal, 1/14).

Background

States passed 231 antiabortion-rights laws from 2011 to 2014, during which time the number of states deemed "extremely hostile" to abortion rights increased more than threefold, according to a recent report by the Guttmacher Institute. The report found that 15 states passed a total of 26 antiabortion-rights laws in 2014, 70 abortion restrictions in 2013 and more than 80 in 2011 (Women's Health Policy Report, 1/6).

Meanwhile, national antiabortion-rights legislation "has not fared as well" for its supporters, according to National Journal. Stakeholders attribute the difference to state legislatures having shorter sessions and tending to have less gridlock. In addition, state lawmakers tend to be more conservative, with about 10% of state lawmakers supporting abortion rights, compared with 30% of governors and about 40% of congressional lawmakers, according to NARAL Pro-Choice America.

Abortion-Rights Opponents' Strategy

Abortion-rights opponents intend to spotlight the passage of state abortion restrictions to pressure lawmakers to support legislation that would ban abortion after 20 weeks of pregnancy, National Journal reports.

According to NARAL, 13 states have passed 20-week abortion bans, three of which have been blocked by courts from going into effect to date. More states are expected to consider such bans in 2015 (National Journal, 1/14).

The House is expected to vote on such a bill (HR 36) on Jan. 22, the 42nd anniversary of the Supreme Court's Roe v. Wade decision. The bill would allow abortions after 20 weeks only in certain cases of rape and incest, and endangerment to a woman's life.

While the bill is expected to pass the House, it likely will fall short of the necessary votes for passage in the Senate (Women's Health Policy Report, 1/12). According to a spokesperson for Sen. Lindsey Graham (R-S.C.), the senator will release a companion bill to the House measure soon (Davis, USA Today, 1/14). Meanwhile, President Obama has said he would veto such a measure.

Graham spokesperson Kevin Bishop said, "Everyone's realistic about its chance of being signed into law. The strategy is to take a baseline vote [in the Senate] to see where everyone stands ... The general thinking is, we'll have north of 50 votes, but not 60 ... From there, we'll continue to push the issue, continue to have states push it, and continue to add to the vote total."

Bishop added, "We've strongly supported states taking up and passing [these] laws. It helps build support in Congress and move the issue to the front burner" (National Journal, 1/14).

Planned Parenthood's Richards Lambasts 20-Week Abortion Bans

Planned Parenthood Action Fund President Cecile Richards at a press briefing on Wednesday said 20-week abortion bans "do nothing to advance women's health and do everything to chip away at the right to abortion, which has been legal in this country for many, many years" (Zanona, CQ Roll Call, 1/14). She said that conservative lawmakers were "out of touch" for repeatedly focusing on legislation to restrict abortion rights and focusing less on other issues as a result.

However, Richards said she "fully expects" the Senate to block a 20-week abortion ban from being passed, adding, "We definitely expect the president to stand with us and the women's health community on these kind of attacks on women."

Further, Richards noted that states have been introducing "a record number" of bills to expand abortion rights (Ferris, The Hill, 1/14). She said that despite ongoing efforts to restrict women's health access, she is "more confident than ever that this next generation of young women and men are not going to allow their rights to be taken away" (USA Today, 1/14).

Abortion-Rights Activists Pushing Back

Similarly, other supporters of abortion rights are pushing back against the 20-week abortion ban and other antiabortion-rights measures for lacking a scientific basis and being detrimental to women's health, MedPage Today's "The Gupta Guide" reports.

In a conference call on Wednesday, Planned Parenthood of Metropolitan Washington Medical Director Jamila Perritt said, "The political attacks waged on women's health at state capitals across the country have gotten out of hand." She said "there is no benefit" for patient safety in antiabortion-rights measures that would "mandate ... certain procedures that can be performed before women can have an abortion, or ... changing the qualifications that providers and patients would have to clear in order to have the procedure."

She added, "Studies regarding fetal pain are pretty clear. At 20 weeks [gestation] there's no indication the nerves are developed and it's not touted in any science" (Frieden, "The Gupta Guide," MedPage Today, 1/14).

Similarly, Hal Lawrence, executive vice president and CEO of the American Congress of Obstetricians and Gynecologists, said, "There is no evidence that there's any fetal pain until you get [past] the 23 or 24 week gestation" (Breitman, Politico Pro, 1/14).

Lawrence also noted that abortions after 20 weeks gestation can be necessary when a woman's life is at risk and that they account for less than 1% of all abortions. He said, "I don't think we want to take that therapeutic option away from physicians trying to save the life of the [woman]" ("The Gupta Guide," MedPage Today, 1/14).


Study: Episiotomy Rate Down by Nearly One-Third From 2006-2012

Thu, 01/15/2015 - 15:35

The percentage of vaginal deliveries in the U.S. involving an episiotomy dropped from 17% in 2006 to less than 12% in 2012, a study published Tuesday in the Journal of the American Medical Association had found, according to HealthDay/U.S. News & World Report.

Study: Episiotomy Rate Down by Nearly One-Third From 2006-2012

January 15, 2015 — The percentage of vaginal deliveries in the U.S. involving an episiotomy dropped from 17% in 2006 to less than 12% in 2012, a study published Tuesday in the Journal of the American Medical Association had found, according to HealthDay/U.S. News & World Report (Mozes, HealthDay/U.S. News & World Report, 1/13).

An episiotomy is an incision in the perineum to widen the vagina during childbirth (Pappas, Live Science, 1/13). According to the study's authors, episiotomies were performed during about 25% of all vaginal births as recently as 10 years ago. However, the procedure's prevalence has been declining since the 1990s because of concerns about its risks and benefits, according to HealthDay/U.S. News & World Report.

Study Details

For the study, Alexander Friedman and other researchers from the Columbia University College of Physicians and Surgeons looked at data on more than 2.2 million U.S. women who had vaginal deliveries between 2006 and 2012 at 510 facilities (HealthDay/U.S. News & World Report, 1/13).

The data were taken from an insurance database and excluded deliveries that involved fetal distress, fetal heartbeat abnormalities or shoulder dystocia because such occurrences could warrant an episiotomy, according to MedPage Today's "The Gupta Guide."

Key Findings

The researchers found that 14.4% of the women had an episiotomy between 2006 and 2012, with the overall prevalence of the procedure declining by nearly 32% over that time frame (Brown, "The Gupta Guide," MedPage Today, 1/13).

The researchers noted that some hospitals performed considerably more episiotomies than others during the study period, suggesting that "nonmedical factors are related" to the procedure's use. Specifically, episiotomies were performed in more than 34% of deliveries at the 10% of hospitals that performed the procedure most frequently, while it was used for only 2.5% of deliveries in the 10% of hospitals that used it the least (HealthDay/U.S. News & World Report, 1/13).

Further, the study found that white women, at 15.7%, were nearly two times more likely to undergo an episiotomy than black women, at 7.9%. In addition, women with private health plans underwent the procedure 17.2% of the time, compared with women with Medicaid coverage, who underwent the procedure 11.2% of the time ("The Gupta Guide," MedPage Today, 1/13).


Texas Lawmakers Propose Sex Education Bills

Wed, 01/14/2015 - 17:31

Two Texas lawmakers filed bills addressing sex education ahead of the first day of the state's legislative session on Tuesday, the San Antonio Current's "The Daily" reports.

Texas Lawmakers Propose Sex Education Bills

January 14, 2015 — Two Texas lawmakers filed bills addressing sex education ahead of the first day of the state's legislative session on Tuesday, the San Antonio Current's "The Daily" reports.

One of the bills (HB 78) would require public schools to offer sex education that is "medically accurate" and "age-appropriate," while the other (HB 205) would prohibit individuals or entities affiliated with abortion providers from providing sexual health and education materials for schools.

Existing Sex Education Programs

According to "The Daily," Texas public schools are only required to teach about abstinence but have the option to also have instruction about contraceptives. In each school district, a school health advisory committee, comprised of parents and other community members, has the authority to decide which sex education materials can be used by schools. In addition, parents can elect to remove their children from a particular sex education lesson.

Details of HB 78

HB 78, sponsored by state Rep. Mary Gonzalez (D), would define "medically accurate" as instruction that is "supported by peer-reviewed research conducted in compliance with accepted scientific methods and recognized as accurate by leading professional organizations and agencies with relevant experience, such as the American Medical Association."

Gonzalez's bill would "kee[p] the focus" of sex education programs mostly on abstinence, "The Daily" reports. However, the bill also would require school districts to include the effect that FDA-approved contraceptives have in preventing sexually transmitted infections and unplanned pregnancies.

The bill also would allow school districts to choose to distribute condoms, which is prohibited under current state law. In addition, the legislation would mandate that the state Board of Education develop a rule for public schools to incorporate instruction about communication and healthy relationship skills into their educational materials.

Details of HB 205

Meanwhile, state Rep. Jeff Leach's (R) bill would bar sexual education and health programs from using instruction materials that were created by "an entity or individual that performs abortions or an affiliate of an entity or individual that performs abortions." According to "The Daily," the legislation likely is meant to specifically block instruction materials provided by Planned Parenthood (Garcia-Ditta, "The Daily," San Antonio Current, 1/12).


Va. Gov., Women's Rights Coalition Outline Legislative Agendas

Wed, 01/14/2015 - 17:31

Virginia Gov. Terry McAuliffe (D) on Monday unveiled his Equal Opportunity legislative agenda, which includes legislative proposals that range from protections for abortion rights to addressing college sexual assaults and domestic violence, the Richmond Times-Dispatch reports.

Va. Gov., Women's Rights Coalition Outline Legislative Agendas

January 14, 2015 — Virginia Gov. Terry McAuliffe (D) on Monday unveiled his Equal Opportunity legislative agenda, which includes legislative proposals that range from protections for abortion rights to addressing college sexual assaults and domestic violence, the Richmond Times-Dispatch reports.

Agenda Details

McAuliffe said he will push to repeal a 2012 state law that requires a woman seeking an abortion to first undergo an ultrasound.

In addition, McAuliffe plans to propose a bill that would place restrictions on individuals' abilities to own a gun if they have been convicted of misdemeanor domestic violence charges and are subject to protective orders. McAuliffe also said he will propose legislation that requires employers to provide leave for any employees who are survivors of domestic violence, sexual assault or stalking so that the individuals may seek counseling and treatment.

Further, the governor proposed under the agenda that the Council for Higher Education for Virginia help update sexual assault policies for all public higher education institutions in the state. Under such policies, McAuliffe recommended that students' academic transcripts include any dismissals for violating a school's sexual misconduct code, code of conduct or honor code.

Comments

McAuliffe said during the announcement that the policies are not "partisan" or "political," and called them "common-sense things that move the commonwealth forward." He added that the agenda would put in place pledges he made "when [he] ran for governor" (Nolan, Richmond Times-Dispatch, 1/12). McAuliffe also said the policies would help the state to be more inclusive and welcoming in its efforts to diversify its economy.

Agenda Could Face Uphill Battle in State Legislature

According to the Virginian-Pilot, the governor's agenda could face an uphill battle in the state General Assembly (Hieatt, Virginian-Pilot, 1/13). For example, a Virginia House subcommittee last year rejected a bill (SB 617) that would have repealed the state's ultrasound requirements (Women's Health Policy Report, 2/19/14).

Meanwhile, conservative observers were quick to criticize the agenda. Republican Party of Virginia spokesperson Garren Shipley wrote in an email that the agenda shows "McAuliffe is focused on playing politics and waging divisive social battles under the guise of economic opportunity" (Virginian-Pilot, 1/13).

Virginia Women's Group Announces Agenda

In related news, a coalition of women's groups in Virginia on Thursday announced its legislative agenda for the state's 2015 legislative session, the Capital News Service/Southwest Times reports.

The coalition -- which includes ProgressVA, the Virginia Latina Advocacy Network and other women's rights and health groups -- is called the Women's Equality Coalition and has support from the Virginia chapters of the American Civil Liberties Union, the National Organization for Women and Planned Parenthood. Margie Del Castillo, a field coordinator for the Virginia Latina Advocacy Network, said the group will focus on "creat[ing] an environment in Virginia for all women to have the economic means, social capital and political power to make and exercise decisions about their own health, family and future."

According to the Capital News Service/Times, the group's main push will be for the state to ratify the Equal Rights Amendment, which Congress passed in 1972.

In addition, the group will advocate for the repeal of the state's ultrasound requirements and for passage of legislation that would provide unemployment benefits for survivors of domestic violence. The group also will support McAuliffe's efforts to expand the state's Medicaid program, among other initiatives (Mislowsky/Zirpolo, Capital News Service/Southwest Times, 1/12).


Appeals Court Hears Oral Arguments Over N.D., Ark. Early Abortion Bans

Wed, 01/14/2015 - 17:30

A three-judge panel of the 8th U.S. Circuit Court of Appeals heard back-to-back cases on Tuesday over the constitutionality of a North Dakota law (HB 1456) that banned abortions when a fetal heartbeat can be detected and an Arkansas law (Act 301) that banned the procedures at 12 weeks of pregnancy, the AP/Miami Herald reports.

Appeals Court Hears Oral Arguments Over N.D., Ark. Early Abortion Bans

January 14, 2015 — A three-judge panel of the 8th U.S. Circuit Court of Appeals heard back-to-back cases on Tuesday over the constitutionality of a North Dakota law (HB 1456) that banned abortions when a fetal heartbeat can be detected and an Arkansas law (Act 301) that banned the procedures at 12 weeks of pregnancy, the AP/Miami Herald reports (Scher Zagier, AP/Miami Herald, 1/13).

Background on Laws

The Center for Reproductive Rights filed a lawsuit against the North Dakota law, which bans abortions as early as six weeks of pregnancy, in June 2013 on behalf of the Red River Women's Clinic of Fargo (Women's Health Policy Report, 4/17/14). CRR and the American Civil Liberties Union filed suit in April 2013 against the Arkansas law, which prohibits abortions after 12 weeks if a fetal heartbeat is detectable, with exceptions in cases of rape, incest, to save a woman's life or when the fetus has a fatal disorder (Women's Health Policy Report, 3/17/14).

Federal judges placed temporary injunctions on both laws before they went into effect (Gambino, The Guardian, 1/13).

A federal judge in April 2014 struck down the North Dakota law as an "invalid and unconstitutional" measure that "cannot withstand a constitutional challenge" (Women's Health Policy Report, 4/17/14). Meanwhile, a federal judge struck down part of Arkansas' law in March 2014, ruling that restricting abortion based on fetal heartbeat rather than viability is unconstitutional. However, the judge left in place parts of the law that require physicians to perform an ultrasound and tell a woman if a fetal heartbeat can be detected (Women's Health Policy Report, 3/17/14).

States' Oral Arguments

Lawyers for both states argued that the 8th Circuit should not apply the viability standard set by the 1973 Supreme Court case Roe v. Wade, when the high court found that women have a constitutional right to abortion up to the point that a fetus is able to survive outside of the womb. According to Bloomberg, fetal viability is considered to be about 24 weeks (Harris/Whittington, Bloomberg, 1/13).

North Dakota is asking the court for a bench trial, at which it would present medical findings that a fetus could survive outside the womb for several days with medical help, even during the first trimester (McLure, Reuters, 1/13).

Daniel Gaustad, an attorney for North Dakota, told the judges, "The definition of viability occurs at the time of conception, based upon IVF technology, advances in medical science" (The Guardian, 1/13). He added, "The centuries old standard to show life is a heartbeat."

Judge Duane Benton asked in response, "Has the Supreme Court ever used or mentioned the term 'heartbeat' as a standard?"

Meanwhile, Arkansas Assistant Attorney General Colin Jorgensen argued that "[v]iability standards have changed" as the result of a 2007 Supreme Court ruling that upheld a federal law that banned certain abortion procedures performed later in pregnancy (Bloomberg, 1/13). He also cited Supreme Court rulings upholding mandatory 24-hour delays prior to an abortion and parental consent requirements, adding, "You can't look at those laws under Roe vs. Wade in a vacuum anymore" (AP/Miami Herald, 1/13).

Jorgensen also argued that Arkansas' law would protect women. He said, "All else being equal, it's undisputed it's better for a woman to have an abortion earlier than later. The state would prefer there be no abortions, but we're not allowed to do that at this time" (Reuters, 1/13).

Plaintiffs' Oral Arguments

Meanwhile, the plaintiffs argued in each case that the state laws are unconstitutional and that the Supreme Court had affirmed abortion rights in its post-Roe rulings.

Janet Crepps, senior counsel for CRR, told the panel, "There's a legal framework that's been established" (AP/Miami Herald, 1/13). She said, "What [the plaintiffs are] really simply expressing is they really don't like prior decisions and they'd like the Supreme Court to reconsider them" (Reuters, 1/13).

Crepps said, "The [S]upreme [C]ourt has said that it doesn't matter what reason states offer for wanting to ban abortions (before the point of viability), the court has said you can't." She added, "Legislatures may not like the law of the land, but there is just no room here for the states to act in the way they want to" (The Guardian, 1/13).

Attorneys for the North Dakota abortion clinic argued that the definition of viability should be that a fetus should be reasonably likely to survive for a sustained period outside the womb, regardless of artificial support.

In addition, ACLU attorney Talcott Camp in the hearing on the Arkansas law argued, "No fetus can be viable at 12 weeks."

U.S. Circuit Court Judge Bobby Shepherd said that "viability seems to be a scientific or medical decision, not one for judges to decide" (Bloomberg, 1/13).

The 8th Circuit judges did not indicate when they would rule on the two cases, according to Reuters (Reuters, 1/13).


Hundreds Rally in Nashville To Support Women's Rights

Wed, 01/14/2015 - 17:29

About 500 to 600 people rallied in Nashville on Tuesday in support of access to women's health services and against proposed abortion restrictions as the Tennessee Legislature convened for its 2015 session, the Knoxville News Sentinel reports.

Hundreds Rally in Nashville To Support Women's Rights

January 14, 2015 — About 500 to 600 people rallied in Nashville on Tuesday in support of access to women's health services and against proposed abortion restrictions as the Tennessee Legislature convened for its 2015 session, the Knoxville News Sentinel reports.

The Women's March on Nashville featured speakers and a march to the state Capitol. Both were peaceful, with no arrests, according to the News Sentinel (Locker, Knoxville News Sentinel, 1/13).

Background

Tennessee legislators have already proposed multiple bills that would restrict abortion, including a mandatory counseling bill (SB 13) and a bill (HB 2) that would require a physician to perform an ultrasound before an abortion, the Tennessean reports (Wadhwani, Tennessean, 1/13). HB 2 would also require that providers show the ultrasound image to the woman (Knoxville News Sentinel, 1/13).

An increased focus on abortion measures is expected in the Tennessee Legislature this session after voters approved a ballot initiative (Amendment 1) that specifies that there is no right to abortion in the state constitution (Women's Health Policy Report, 12/16/14).

The ballot effort was seen as a response from abortion-rights opponents to the 2000 state Supreme Court ruling, which found that "a woman's right to terminate her pregnancy is a vital part of the right to privacy" under Tennessee's state constitution and that any abortion restrictions should be subject to a "strict scrutiny" legal standard (Women's Health Policy Report, 1/13).


Report Provides New Insights Into Role of Hormones, Interventions During Childbirth

Wed, 01/14/2015 - 17:09

High rates of interventions during maternity care can be detrimental to the health and safety of women and their infants, but many U.S. hospitals continue to overtreat such patients, according to a new report by Childbirth Connection, a program of the National Partnership for Women & Families, the New York Times' "Motherlode" reports.

Report Provides New Insights Into Role of Hormones, Interventions During Childbirth

January 14, 2015 — High rates of interventions during maternity care can be detrimental to the health and safety of women and their infants, but many U.S. hospitals continue to overtreat such patients, according to a new report by Childbirth Connection, a program of the National Partnership for Women & Families, the New York Times' "Motherlode" reports.

Report Findings

The report, based on a synthesis of research, found, "If overtreatment is defined as instances in which an individual may have fared as well or better with less or perhaps no intervention then modern obstetric care has landed in a deep quagmire. Navigating out of that territory will be challenging."

Report author Sarah Buckley provided several recommendations for hospitals, based on the approach that the hormonal processes at work during childbirth are best left undisrupted in most cases. The report found that these processes, which previously were not fully understood, help prepare the pregnant woman and her fetus for labor and birth.

Specifically, the report recommends that health care providers wait for labor to start on its own, advise women who labor at home while in early labor and be patient with women who are in labor in their facilities, instead of providing interventions to speed the process along. In addition, the report recommends that women "stay calm and relaxed" and practice patience as well.

Comments

Childbirth Connection Programs Director Carol Sakala said, "It's important for both clinicians and women to understand that common interventions, that we have come to view quite casually, are actually quite consequential."

She said that while "[o]ur current high rates of intervention are not serving women well ... the community is really moving in the right direction. Professional societies are breaking with the past."

For example, Sakala noted that professional societies are publicly discussing not allowing elective cesarean sections or inductions, as well as issues like the overuse of c-sections and fetal monitoring.

She added, "We are hopeful that the timing of this report will support that change" (Dell'Antonia, "Motherlode," New York Times, 1/13).


Hundreds Rally in Nashville To Support Women's Rights

Wed, 01/14/2015 - 16:15

About 500 to 600 people rallied in Nashville on Tuesday in support of access to women's health services and against proposed abortion restrictions as the Tennessee Legislature convened for its 2015 session, the Knoxville News Sentinel reports.

Hundreds Rally in Nashville To Support Women's Rights

January 14, 2015 — About 500 to 600 people rallied in Nashville on Tuesday in support of access to women's health services and against proposed abortion restrictions as the Tennessee Legislature convened for its 2015 session, the Knoxville News Sentinel reports.

The Women's March on Nashville featured speakers and a march to the state Capitol. Both were peaceful, with no arrests, according to the News Sentinel (Locker, Knoxville News Sentinel, 1/13).

Background

Tennessee legislators have already proposed multiple bills that would restrict abortion, including a mandatory counseling bill (SB 13) and a bill (HB 2) that would require a physician to perform an ultrasound before an abortion, the Tennessean reports (Wadhwani, Tennessean, 1/13). HB 2 would also require that providers show the ultrasound image to the woman (Knoxville News Sentinel, 1/13).

An increased focus on abortion measures is expected in the Tennessee Legislature this session after voters approved a ballot initiative (Amendment 1) that specifies that there is no right to abortion in the state constitution (Women's Health Policy Report, 12/16/14).

The ballot effort was seen as a response from abortion-rights opponents to the 2000 state Supreme Court ruling, which found that "a woman's right to terminate her pregnancy is a vital part of the right to privacy" under Tennessee's state constitution and that any abortion restrictions should be subject to a "strict scrutiny" legal standard (Women's Health Policy Report, 1/13).


Appeals Court Hears Oral Arguments Over N.D., Ark. Early Abortion Bans

Wed, 01/14/2015 - 15:44

A three-judge panel of the 8th U.S. Circuit Court of Appeals heard back-to-back cases on Tuesday over the constitutionality of a North Dakota law (HB 1456) that banned abortions when a fetal heartbeat can be detected and an Arkansas law (Act 301) that banned the procedures at 12 weeks of pregnancy, the AP/Miami Herald reports.

Appeals Court Hears Oral Arguments Over N.D., Ark. Early Abortion Bans

January 14, 2015 — A three-judge panel of the 8th U.S. Circuit Court of Appeals heard back-to-back cases on Tuesday over the constitutionality of a North Dakota law (HB 1456) that banned abortions when a fetal heartbeat can be detected and an Arkansas law (Act 301) that banned the procedures at 12 weeks of pregnancy, the AP/Miami Herald reports (Scher Zagier, AP/Miami Herald, 1/13).

Background on Laws

The Center for Reproductive Rights filed a lawsuit against the North Dakota law, which bans abortions as early as six weeks of pregnancy, in June 2013 on behalf of the Red River Women's Clinic of Fargo (Women's Health Policy Report, 4/17/14). CRR and the American Civil Liberties Union filed suit in April 2013 against the Arkansas law, which prohibits abortions after 12 weeks if a fetal heartbeat is detectable, with exceptions in cases of rape, incest, to save a woman's life or when the fetus has a fatal disorder (Women's Health Policy Report, 3/17/14).

Federal judges placed temporary injunctions on both laws before they went into effect (Gambino, The Guardian, 1/13).

A federal judge in April 2014 struck down the North Dakota law as an "invalid and unconstitutional" measure that "cannot withstand a constitutional challenge" (Women's Health Policy Report, 4/17/14). Meanwhile, a federal judge struck down part of Arkansas' law in March 2014, ruling that restricting abortion based on fetal heartbeat rather than viability is unconstitutional. However, the judge left in place parts of the law that require physicians to perform an ultrasound and tell a woman if a fetal heartbeat can be detected (Women's Health Policy Report, 3/17/14).

States' Oral Arguments

Lawyers for both states argued that the 8th Circuit should not apply the viability standard set by the 1973 Supreme Court case Roe v. Wade, when the high court found that women have a constitutional right to abortion up to the point that a fetus is able to survive outside of the womb. According to Bloomberg, fetal viability is considered to be about 24 weeks (Harris/Whittington, Bloomberg, 1/13).

North Dakota is asking the court for a bench trial, at which it would present medical findings that a fetus could survive outside the womb for several days with medical help, even during the first trimester (McLure, Reuters, 1/13).

Daniel Gaustad, an attorney for North Dakota, told the judges, "The definition of viability occurs at the time of conception, based upon IVF technology, advances in medical science" (The Guardian, 1/13). He added, "The centuries old standard to show life is a heartbeat."

Judge Duane Benton asked in response, "Has the Supreme Court ever used or mentioned the term 'heartbeat' as a standard?"

Meanwhile, Arkansas Assistant Attorney General Colin Jorgensen argued that "[v]iability standards have changed" as the result of a 2007 Supreme Court ruling that upheld a federal law that banned certain abortion procedures performed later in pregnancy (Bloomberg, 1/13). He also cited Supreme Court rulings upholding mandatory 24-hour delays prior to an abortion and parental consent requirements, adding, "You can't look at those laws under Roe vs. Wade in a vacuum anymore" (AP/Miami Herald, 1/13).

Jorgensen also argued that Arkansas' law would protect women. He said, "All else being equal, it's undisputed it's better for a woman to have an abortion earlier than later. The state would prefer there be no abortions, but we're not allowed to do that at this time" (Reuters, 1/13).

Plaintiffs' Oral Arguments

Meanwhile, the plaintiffs argued in each case that the state laws are unconstitutional and that the Supreme Court had affirmed abortion rights in its post-Roe rulings.

Janet Crepps, senior counsel for CRR, told the panel, "There's a legal framework that's been established" (AP/Miami Herald, 1/13). She said, "What [the plaintiffs are] really simply expressing is they really don't like prior decisions and they'd like the Supreme Court to reconsider them" (Reuters, 1/13).

Crepps said, "The [S]upreme [C]ourt has said that it doesn't matter what reason states offer for wanting to ban abortions (before the point of viability), the court has said you can't." She added, "Legislatures may not like the law of the land, but there is just no room here for the states to act in the way they want to" (The Guardian, 1/13).

Attorneys for the North Dakota abortion clinic argued that the definition of viability should be that a fetus should be reasonably likely to survive for a sustained period outside the womb, regardless of artificial support.

In addition, ACLU attorney Talcott Camp in the hearing on the Arkansas law argued, "No fetus can be viable at 12 weeks."

U.S. Circuit Court Judge Bobby Shepherd said that "viability seems to be a scientific or medical decision, not one for judges to decide" (Bloomberg, 1/13).

The 8th Circuit judges did not indicate when they would rule on the two cases, according to Reuters (Reuters, 1/13).


Va. Gov., Women's Rights Coalition Outline Legislative Agendas

Wed, 01/14/2015 - 15:40

Virginia Gov. Terry McAuliffe (D) on Monday unveiled his Equal Opportunity legislative agenda, which includes legislative proposals that range from protections for abortion rights to addressing college sexual assaults and domestic violence, the Richmond Times-Dispatch reports.

Va. Gov., Women's Rights Coalition Outline Legislative Agendas

January 14, 2015 — Virginia Gov. Terry McAuliffe (D) on Monday unveiled his Equal Opportunity legislative agenda, which includes legislative proposals that range from protections for abortion rights to addressing college sexual assaults and domestic violence, the Richmond Times-Dispatch reports.

Agenda Details

McAuliffe said he will push to repeal a 2012 state law that requires a woman seeking an abortion to first undergo an ultrasound.

In addition, McAuliffe plans to propose a bill that would place restrictions on individuals' abilities to own a gun if they have been convicted of misdemeanor domestic violence charges and are subject to protective orders. McAuliffe also said he will propose legislation that requires employers to provide leave for any employees who are survivors of domestic violence, sexual assault or stalking so that the individuals may seek counseling and treatment.

Further, the governor proposed under the agenda that the Council for Higher Education for Virginia help update sexual assault policies for all public higher education institutions in the state. Under such policies, McAuliffe recommended that students' academic transcripts include any dismissals for violating a school's sexual misconduct code, code of conduct or honor code.

Comments

McAuliffe said during the announcement that the policies are not "partisan" or "political," and called them "common-sense things that move the commonwealth forward." He added that the agenda would put in place pledges he made "when [he] ran for governor" (Nolan, Richmond Times-Dispatch, 1/12). McAuliffe also said the policies would help the state to be more inclusive and welcoming in its efforts to diversify its economy.

Agenda Could Face Uphill Battle in State Legislature

According to the Virginian-Pilot, the governor's agenda could face an uphill battle in the state General Assembly (Hieatt, Virginian-Pilot, 1/13). For example, a Virginia House subcommittee last year rejected a bill (SB 617) that would have repealed the state's ultrasound requirements (Women's Health Policy Report, 2/19/14).

Meanwhile, conservative observers were quick to criticize the agenda. Republican Party of Virginia spokesperson Garren Shipley wrote in an email that the agenda shows "McAuliffe is focused on playing politics and waging divisive social battles under the guise of economic opportunity" (Virginian-Pilot, 1/13).

Virginia Women's Group Announces Agenda

In related news, a coalition of women's groups in Virginia on Thursday announced its legislative agenda for the state's 2015 legislative session, the Capital News Service/Southwest Times reports.

The coalition -- which includes ProgressVA, the Virginia Latina Advocacy Network and other women's rights and health groups -- is called the Women's Equality Coalition and has support from the Virginia chapters of the American Civil Liberties Union, the National Organization for Women and Planned Parenthood. Margie Del Castillo, a field coordinator for the Virginia Latina Advocacy Network, said the group will focus on "creat[ing] an environment in Virginia for all women to have the economic means, social capital and political power to make and exercise decisions about their own health, family and future."

According to the Capital News Service/Times, the group's main push will be for the state to ratify the Equal Rights Amendment, which Congress passed in 1972.

In addition, the group will advocate for the repeal of the state's ultrasound requirements and for passage of legislation that would provide unemployment benefits for survivors of domestic violence. The group also will support McAuliffe's efforts to expand the state's Medicaid program, among other initiatives (Mislowsky/Zirpolo, Capital News Service/Southwest Times, 1/12).


Texas Lawmakers Propose Sex Education Bills

Wed, 01/14/2015 - 15:37

Two Texas lawmakers filed bills addressing sex education ahead of the first day of the state's legislative session on Tuesday, the San Antonio Current's "The Daily" reports.

Texas Lawmakers Propose Sex Education Bills

January 14, 2015 — Two Texas lawmakers filed bills addressing sex education ahead of the first day of the state's legislative session on Tuesday, the San Antonio Current's "The Daily" reports.

One of the bills (HB 78) would require public schools to offer sex education that is "medically accurate" and "age-appropriate," while the other (HB 205) would prohibit individuals or entities affiliated with abortion providers from providing sexual health and education materials for schools.

Existing Sex Education Programs

According to "The Daily," Texas public schools are only required to teach about abstinence but have the option to also have instruction about contraceptives. In each school district, a school health advisory committee, comprised of parents and other community members, has the authority to decide which sex education materials can be used by schools. In addition, parents can elect to remove their children from a particular sex education lesson.

Details of HB 78

HB 78, sponsored by state Rep. Mary Gonzalez (D), would define "medically accurate" as instruction that is "supported by peer-reviewed research conducted in compliance with accepted scientific methods and recognized as accurate by leading professional organizations and agencies with relevant experience, such as the American Medical Association."

Gonzalez's bill would "kee[p] the focus" of sex education programs mostly on abstinence, "The Daily" reports. However, the bill also would require school districts to include the effect that FDA-approved contraceptives have in preventing sexually transmitted infections and unplanned pregnancies.

The bill also would allow school districts to choose to distribute condoms, which is prohibited under current state law. In addition, the legislation would mandate that the state Board of Education develop a rule for public schools to incorporate instruction about communication and healthy relationship skills into their educational materials.

Details of HB 205

Meanwhile, state Rep. Jeff Leach's (R) bill would bar sexual education and health programs from using instruction materials that were created by "an entity or individual that performs abortions or an affiliate of an entity or individual that performs abortions." According to "The Daily," the legislation likely is meant to specifically block instruction materials provided by Planned Parenthood (Garcia-Ditta, "The Daily," San Antonio Current, 1/12).


Kan. Medical Board Rules Not To Reinstate Medical License of Former Tiller Colleague

Tue, 01/13/2015 - 18:58

Kansas' medical board has decided not to reinstate the medical license of physician Ann Kristin Neuhaus after finding that she kept inadequate records while providing second opinions to the late George Tiller for abortion patients, KMBC reports.

Kan. Medical Board Rules Not To Reinstate Medical License of Former Tiller Colleague

January 13, 2015 — Kansas' medical board has decided not to reinstate the medical license of physician Ann Kristin Neuhaus after finding that she kept inadequate records while providing second opinions to the late George Tiller for abortion patients, KMBC reports (KMBC, 1/10).

Specifically, the board ruled on Friday that Neuhaus' inadequate record keeping was serious enough to justify the revocation of her medical license and that she should not be allowed to practice medicine (Hegeman/Hanna, AP/U-T San Diego, 1/9).

Background

Neuhaus' medical license was revoked in 2012 based on allegations that she conducted inadequate exams of abortion patients when providing second opinions for Tiller. Neuhaus conducted the exams to comply with a Kansas law that requires abortion providers to obtain an independent second opinion, concurring that patients seeking abortion care later in pregnancy would face significant and permanent harm if the pregnancy continued. Tiller -- one of a few physicians in the country who provided later abortions -- was shot and killed by an antiabortion-rights activist in 2009.

However, last year, a county judge overturned the Kansas Board of Healing Arts' decision to revoke Neuhaus' license and sent the case back to the medical board. However, the judge upheld the board's finding that she had kept inadequate records. Neuhaus currently has a license to provide charity care but was seeking to have her full medical license reinstated (Women's Health Policy Report, 12/4/14).

Reaction

Julie Burkhart -- CEO of Trust Women, an abortion-rights group, and owner of the South Wind Women's Center -- said Neuhaus had provided quality and necessary health services and called the legal measures taken against her "politically motivated." She added, "It is irresponsible, corrupt and immoral for the state of Kansas and the Kansas Board of Healing Arts to continue this witch-hunt to punish Dr. Neuhaus simply because she helped her patients access necessary reproductive health care."

Bob Eye, Neuhaus' attorney, said that he was reviewing the decision and would "make a determination soon about what to do next." He noted that Neuhaus could request a rehearing or appeal the decision to the district court.

Meanwhile, Cheryl Sullenger -- senior policy adviser for the antiabortion-rights group Operation Rescue, which brought the initial complaint against Neuhaus -- supported the board's decision and stated that she "is glad they revoked [Neuhaus'] license again" (AP/U-T San Diego, 1/9).