Daily Women's Health Policy Report

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Daily Women's Health Policy Report by the National Partnership for Women & Families
Updated: 40 min 17 sec ago

Washington Post's 'Storyline' Examines Colo. Policies for Pregnant Teens

Thu, 08/21/2014 - 17:44

The Washington Post's "Storyline" examines how Colorado's family planning policies have improved teens' access to long-acting reversible contraceptives and helped to lower its teen birth rates.

Washington Post's 'Storyline' Examines Colo. Policies for Pregnant Teens

August 21, 2014 — The Washington Post's "Storyline" examines how Colorado's family planning policies have improved teens' access to long-acting reversible contraceptives and helped to lower its teen birth rates.

"Between 2007 and 2012, Colorado saw the highest percentage drop in birth rates among teens 15 to 19 in the country," while "[a]bortion rates in the state among teens fell 35 percent between 2009 and 2012," according to "Storyline."

The Colorado Family Planning Initiative, which is supported by an anonymous donation, provides intrauterine devices and implants at family planning clinics in the state. A state analysis attributed three-quarters of state's decline in teen birth rates to the initiative. Another program -- called the Colorado Adolescent Maternity Program, or CAMP -- allows low-income teens who have just given birth to receive long-acting reversible contraceptives before leaving the hospital (Griego [1], "Storyline," Washington Post, 8/20).

In a separate piece, "Storyline" also profiles CAMP, which aims to achieve better pregnancy outcomes by focusing on pregnant teens' physical and mental health. The CAMP clinic is located at Children's Hospital Colorado and serves about 500 pregnant teens and women ages 14 to 22 annually. The state's Medicaid program covers the cost of the care (Griego [2], "Storyline," Washington Post, 8/20).


Ohio Clinic Stops Offering Abortions Amid State Restrictions

Thu, 08/21/2014 - 17:40

An abortion clinic near Cincinnati, Ohio, will stop offering surgical abortions, instead of continuing a dispute with the state over a requirement that it calls politically motivated, the Cincinnati Enquirer reports.

Ohio Clinic Stops Offering Abortions Amid State Restrictions

August 21, 2014 — An abortion clinic near Cincinnati, Ohio, will stop offering surgical abortions, instead of continuing a dispute with the state over a requirement that it calls politically motivated, the Cincinnati Enquirer reports (Thompson/Perry, Cincinnati Enquirer, 8/20).

The state requirement at issue mandates that abortion clinics secure a transfer agreement with nearby hospitals.

Ohio in 2013 became the first state to bar abortion clinics from arranging such agreements with public hospitals, meaning that, by default, they must arrange them with private hospitals. The Ohio Department of Health ordered Women's Med Center's Lebanon Road Surgery Center to close after it was unable to meet the requirement.

Hamilton County Judge Jerome Metz in January blocked the department's order, but he ruled last week that he did not have the jurisdiction to maintain the injunction. Women's Med Center said Friday that it would not appeal (Palmer, Reuters, 8/20).

Impact on Abortion Access

According to the Enquirer, the clinic's announcement leaves Ohio with 10 abortion clinics, down from 14 clinics before the new law took effect in 2013. Three of the remaining clinics are "in limbo" under the law, the Enquirer reports (Cincinnati Enquirer, 8/20).

The Lebanon Road Surgery Center was the only clinic within about 100 miles that provided abortions between 18 weeks and 22 weeks of pregnancy, according to Reuters (Reuters, 8/20).

The Cincinnati metropolitan region would become the largest metropolitan area in the U.S. without an abortion clinic if the two others in the area -- a Planned Parenthood in Mount Auburn and a Women's Med Center clinic in Dayton -- also have to stop offering abortion services because of the state law.

Mount Auburn Planned Parenthood spokesperson Rick Pender said the clinic is expecting an "influx of patients" as a result of Lebanon Road Surgery Center's announcement, adding that Planned Parenthood sees the overall situation "as wholly politically motivated and medically unnecessary."

Clinic Will Continue Other Services

The Lebanon Road Surgery Center will still see abortion patients for their required pre-abortion consultation, Women's Med Center officials said. The center will then send patients to the Dayton Women's Med Center for the abortion procedure (Cincinnati Enquirer, 8/20). The clinic will end surgical abortions on Friday.

Dorothea Langsam, an attorney for the clinic, added that it is considering offering medication abortion (Reuters, 8/20).

Langsam noted that many of the clinic's patients are low-income, meaning that "transportation to Dayton (and for an abortion) is difficult" (Cincinnati Enquirer, 8/20).


Antiabortion-Rights Protests Increase After Portland, Maine, Ends 'Buffer Zone'

Thu, 08/21/2014 - 17:12

Antiabortion-rights protests have increased "in number and activity" outside a Portland, Maine, Planned Parenthood clinic since the City Council repealed a "buffer zone" ordinance, the Bangor Daily News reports.

Antiabortion-Rights Protests Increase After Portland, Maine, Ends 'Buffer Zone'

August 18, 2014 — Antiabortion-rights protests have increased "in number and activity" outside a Portland, Maine, Planned Parenthood clinic since the City Council repealed a "buffer zone" ordinance, the Bangor Daily News reports (Koenig, Bangor Daily News, 8/15).

The Portland City Council in November unanimously approved an ordinance that created a 39-foot, protest-free zone around entrances to the clinic, which was facing regular demonstrations from abortion-rights opponents. However, the council voted 7-1 to repeal the ordinance less than two weeks after the Supreme Court struck down a similar Massachusetts law (Women's Health Policy Report, 7/8).

Increased Protests

Nicole Clegg, Planned Parenthood of Northern New England's vice president of public policy, said PPNNE had to request help from police on a recent weekend, when protesters blocked sidewalks near the clinic's entrance and screamed loud enough to result in a warning from a police officer on duty. She added that demonstrations have been "escalating" since the Supreme Court decision.

Portland Police Chief Michael Sauschuck confirmed that the number of protesters had increased and that some had received warnings, which they followed. He said, "Case law has shown that it is a civil rights violation if you can hear the protests from inside the examination room," which is "what Planned Parenthood reported was happening."

City of Portland spokesperson Jessica Grondin said city staff members are investigating alternatives to the buffer zone and expect to deliver recommendations at a City Council committee meeting on Sept. 9 (Bangor Daily News, 8/15).

Antiabortion-Rights Protesters Sue

Meanwhile, antiabortion-rights protesters continue to pursue a lawsuit they filed after the City Council initially approved the buffer zone last year, the Portland Press Herald reports.

A day after the City Council repealed the ordinance, the city filed a motion requesting that U.S. District Judge Nancy Torresen dismiss the case because "there is no longer a controversy here." The city on Tuesday filed a final legal brief in support of its dismissal request (Dolan, Portland Press Herald, 8/14).

However, the protesters have requested that the case go forward and want the judge to award them $1 in damages as a symbolic measure to demonstrate the "constitutional violations" and "harm" suffered by the plaintiffs. Erin Kuenzig, an attorney for the protesters, said a ruling in their favor would "set a precedent and would be persuasive authority for a judge to consider if Portland decides to enact a similar buffer zone ordinance" (Bangor Daily News, 8/15).


Judge Allows Ban on Iowa Telemedicine Abortion Program

Thu, 08/21/2014 - 17:12

An Iowa judge on Tuesday ruled that the state Board of Medicine has the authority to ban the administration of medication abortion drugs via a telemedicine system, Bloomberg reports.

Judge Allows Ban on Iowa Telemedicine Abortion Program

August 20, 2014 — An Iowa judge on Tuesday ruled that the state Board of Medicine has the authority to ban the administration of medication abortion drugs via a telemedicine system, Bloomberg reports.

Polk County Judge Jeffrey Farrell's decision upholds a board rule that requires a physician to be present and perform a physical examination before administering the medication (Harris, Bloomberg, 8/19). The judge's ruling is expected to take effect in 30 days (Leys, Des Moines Register, 8/19).

Planned Parenthood of the Heartland plans to appeal to the Iowa Supreme Court (Bloomberg, 8/19).

Background

Although the Iowa Board of Medicine in 2010 ruled that doctors at PPH could continue to dispense medication abortion drugs via its telemedicine system, Gov. Terry Brandstad (R) later replaced all of the board members, who then approved rules barring PPH from administering medication abortions through the system.

PPH sued, and a judge last November issued a temporary stay against the ban (Women's Health Policy Report, 6/18). PPH argued in the lawsuit that the board's rule was politically motivated and "promulgated solely for the purpose of preventing access to early abortion, and for no legitimate purpose relating to the health and well-being of Iowa women" (Women's Health Policy Report, 11/6/13).

Tuesday's Ruling

In his ruling, Farrell wrote, "There is no question that the board has the power to establish standards of practice for the medical profession."

He added that the board held public hearings, accepted written comments and, therefore, met the requirements for setting a rule. He said that banning the telemedicine system would not cause "undue hardship" for women who would need to travel to obtain the drugs if it were not in place.

However, Farrell also said that the board "invited scrutiny" through some of its actions, including by acting on the petition for rulemaking just three days after it was received and declining requests from physicians' groups to take more time to consider the matter.

Supporters, Opponents React

PPH Chief Operating Officer Penny Dickey said in a statement, "While the board of medicine claims it is acting to protect women's safety and health, its true purpose is to prevent women from receiving an abortion if and when they need one." She added that PPH will "continue to fight for evidence-based medicine and a woman's right to make her personal health care decisions."

Iowa Board of Medicine Executive Director Mark Bowden said the ruling showed the board acted appropriately, "carefully studied the issue and provided ample opportunity for public comment." He added, "The board considers a thorough medical history and physical examination to be the cornerstone of good medical care" (Des Moines Register, 8/19).


Women's Health Issues Key for Both Parties in Senate Campaigns

Thu, 08/21/2014 - 17:11

Republicans vying for Senate seats in the midterm election are working to rally abortion-rights opponents and "counterbalance" Democrats' criticism of GOP positions on women's health issues, The Hill reports.

Women's Health Issues Key for Both Parties in Senate Campaigns

August 20, 2014 — Republicans vying for Senate seats in the midterm election are working to rally abortion-rights opponents and "counterbalance" Democrats' criticism of GOP positions on women's health issues, The Hill reports.

Republicans would need to gain six Senate seats to win control of the chamber, according to The Hill.

The GOP strategy is built around a bill (S 1670) from Sen. Lindsey Graham (R-S.C.) that would prohibit abortion after 20 weeks of pregnancy. A conservative group called Women Speak Out PAC is targeting three Democratic senators who oppose Graham's bill: Sens. Mary Landrieu (La.), Mark Pryor (Ark.) and Kay Hagan (N.C.).

The group plans to spend between $8 million and $10 million this election cycle, fund several ad campaigns and set up field offices in key states. Another group called National Right to Life Victory Fund plans to spend $250,000 on advertising against Landrieu.

Democrats Target GOP's Stance on Birth Control

Meanwhile, the Planned Parenthood Action Fund, EMILY's List and other abortion-rights groups are backing Democratic candidates in federal and state races and highlighting Republicans' efforts to restrict birth control access, among other issues. The groups have "an enormous cash advantage" over their antiabortion-rights counterparts, according to The Hill (Viebeck, The Hill, 8/20).

EMILY's List President Stephanie Schriock argued that "momentum" is also on Democrats' side. "Democratic women have been at the forefront on every major issue and not only are Americans impressed, they are ready to send them reinforcements," she said.

Donors have contributed more than $46 million to candidates and political committees linked to EMILY's List, including nearly $6 million in July alone. The group is supporting senators such as Hagan and Sen. Jeanne Shaheen (D-N.H.), as well as several state-level Democratic candidates (Elliot, AP/San Francisco Chronicle, 8/20).

PPAF likely will spend up to $20 million during this election cycle, including $3 million in North Carolina (The Hill, 8/20).


NCAA Says Athletic Depts. Should Stop Oversight of Campus Sexual Assault Cases

Thu, 08/21/2014 - 17:10

College athletic departments should cooperate with investigations into sexual assault allegations against student athletes, but they should not oversee such cases, the National Collegiate Athletic Association's Executive Committee said in a resolution last week, the McClatchy/Miami Herald reports.

NCAA Says Athletic Depts. Should Stop Oversight of Campus Sexual Assault Cases

August 18, 2014 — College athletic departments should cooperate with investigations into sexual assault allegations against student athletes, but they should not oversee such cases, the National Collegiate Athletic Association's Executive Committee said in a resolution last week, the McClatchy/Miami Herald reports.

The Executive Committee -- NCAA's highest decision-making body -- unanimously approved the resolution in light of a recent survey that found that 22% of colleges let their athletic departments handle such investigations. Among Division I, II and III schools, 30% permit athletic departments to have oversight of the investigations (Schoof, McClatchy/Miami Herald, 8/14). Sen. Claire McCaskill's (D-Mo.) office conducted the survey to gauge how campuses and local law enforcement deal with sexual assault investigations (Women's Health Policy Report, 7/10).

McCaskill after a Senate hearing last month expressed surprise that NCAA President Mark Emmert, who testified at the hearing, was not aware that many schools allowed athletic department to oversee the investigations. "The fact [that] he didn't know [the statistics] until our survey is probably an indictment as to how serious [colleges] have been about this problem," McCaskill said.

Resolution Details

The resolution calls on collegiate athletic departments to "cooperate with but not manage, direct, control or interfere with college or university investigations into allegations of sexual violence ensuring that investigations involving student-athletes and athletics department staff are managed in the same manner as all other students and staff on campus."

The Executive Committee said the resolution "recognizes the importance of addressing the abhorrent societal issue of sexual violence," adding that it is the "collective responsibility" of NCAA members "to maintain campuses as safe places to learn, live, work and play" (McClatchy/Miami Herald, 8/14).


FDA Approves New Option for Late-Stage Cervical Cancer

Thu, 08/21/2014 - 17:09

FDA on Thursday approved Genentech's Avastin for the treatment of late-stage cervical cancer, in combination with chemotherapy drugs, the AP/New York Times reports.

FDA Approves New Option for Late-Stage Cervical Cancer

August 19, 2014 — FDA on Thursday approved Genentech's Avastin for the treatment of late-stage cervical cancer, in combination with chemotherapy drugs, the AP/New York Times reports (AP/New York Times, 8/15).

Avastin is the first drug approved for late-stage cervical cancer since 2006 and the first biologic agent approved to treat for disease, Richard Pazdur, FDA's director of hematology and oncology products, said.

Approval Details

FDA granted the new approval after reviewing results from a study involving 452 patients with late-stage, recurrent or persistent cervical cancer. The study found that participants who took Avastin in combination with paclitaxel and cisplatin or paclitaxel and topotecan had a median survival of 16.8 months, compared with 12.9 months among patients who used only paclitaxel and cisplatin or paclitaxel and topotecan (Bankhead, MedPage Today, 8/15).

FDA approved Avastin for use in combination with paclitaxel and cisplatin or paclitaxel and topotecan.

According to MedScape, Avastin was already approved to treat several other cancers, including forms of lung and colon cancer (Lowes, MedScape, 8/14). However, the agency in 2011 revoked its approval to treat advanced breast cancer after studies showed its benefits did not outweigh its risks (Women's Health Policy Report, 11/21/11).


Blogs Comment on Need for Better Family Leave Policies, Decriminalizing Sex Work, More

Thu, 08/21/2014 - 17:08

Read the week's best commentaries from bloggers at the Washington Post, "ThinkProgress" and more.

Blogs Comment on Need for Better Family Leave Policies, Decriminalizing Sex Work, More

August 15, 2014 — Read the week's best commentaries from bloggers at the Washington Post, "ThinkProgress" and more.

SUPPORTING WORKING FAMILIES: "A Tale of Two Maternity Leaves," Darlena Cunha, Washington Post's "On Parenting": Cunha compares the family leave options available to herself and other U.S. parents with leave that is available to families in Finland. She notes that only 11% of U.S. workers have access to paid family leave, while other families struggle financially to take unpaid leave or do not qualify for any leave at all under the Family Medical Leave Act (PL 103-3),which only applies to certain employers and workers. By contrast, Finnish families have access to "about four months maternity leave," 54 days of paternity leave, "parental leave" that can be taken by any parent at separate times from when a child is four months old to nine months old, and a small stipend for "home child care leave until the child is 3 years old" (Cunha, "On Parenting," Washington Post, 8/13).

CONTRACEPTION: "Our Safety Net is Failing the Impoverished Women Who Need Birth Control," Tara Culp-Ressler, Center for American Progress' "ThinkProgress": "As the number of low-income women who need government assistance to access family planning services has been on the rise, the number of patients served by publicly funded clinics has been falling, according to new data from the Guttmacher Institute," Culp-Ressler writes, adding that the findings "illustrate the widening gulf between poor women and wealthier women when it comes to their ability to use reproductive health services, a disparity driven partly by partisan attacks on abortion." She explains that in contrast to the "broad bipartisan support" of the past "for government funding to help impoverished women manage their reproductive health," conservatives today have "turned their attention to attacking Planned Parenthood," federal family planning programs have become "caught in the crossfires" of the abortion-rights debate and "GOP lawmakers have repeatedly cut family planning budgets" (Culp-Ressler, "ThinkProgress," Center for American Progress, 8/12).

What others are saying about contraception:

~ "How Colorado's Teen Birthrate Dropped 40% in Four Years," Gail Sullivan, Washington Post's "Morning Mix."

~ "Obama Administration To Issue New Rules for Religious Accommodation to Birth Control Benefit," Jessica Mason Pieklo, RH Reality Check.

HEALTH DISPARITIES: "Report: Racial Discrimination Severely Undermines Black Women’s Health," Elizabeth Dawes Gay, RH Reality Check: The Reproductive Health Technologies Project's Dawes Gay comments on a "new shadow report ... by the Center for Reproductive Rights, the National Latina Institute for Reproductive Health, and SisterSong Women of Color Reproductive Justice Collective" that "shares some alarming data on maternal health outcomes as well as disturbing firsthand accounts of the racial discrimination experienced by Black women." She notes, "The stories ... included in the report convey the gross under-education and discriminatory treatment of Black women living in the South, in particular, where sexual and reproductive health education is nonexistent and stigma is rampant." Dawes Gay adds, "Black women are victims of something much worse than stigma, judgment, and discrimination: We are victims of a system and society that abrogates our basic human rights, including the rights to health, life, and non-discrimination" (Dawes Gay, RH Reality Check, 8/13).

SEX WORK: "The Evidence is in: Decriminalizing Sex Work is Critical to Public Health," Anna Forbes/Sarah Elspeth Patterson, RH Reality Check: Forbes and Elspeth Patterson analyze why "the trend toward criminalizing populations involved in the sex trades [is] increasing in the United States," even as medical research and a growing number of public health organizations affirm "the decriminalization of sex work as vital to preventing the spread of [HIV] and [AIDS]" and improving overall public health. They explain the trend in relation to three factors: the conflation of sex work with trafficking, the lack of health care access among sex workers and how criminalization exacerbates violence toward sex workers. "We can't stop HIV in the United States without sustainable and long-term solutions to end the arrest, detention, and incarceration of sex workers in the [U.S.], as well as end the violations against sex workers within the correctional system," they write (Forbes/Elspeth Patterson, RH Reality Check, 8/13).

ADOLESCENT HEALTH: "California Parents Complain That Sex Ed Textbook is 'Equivalent To Pornography,'" Culp-Ressler, Center for American Progress' "ThinkProgress": "Comprehensive sex ed materials often spark controversy for being too sexually explicit," Culp-Ressler writes, noting that a California school district recently "agreed to temporarily shelve a ninth grade sex education textbook" after some parents "compared the book to porn." The district's superintendent said the textbook was picked "because it 'provides current, accurate, factual and relevant information our students need to make responsible decisions about their health,'" she adds. Culp-Ressler writes that "from a public health perspective, experts suggest that kids should actually learn accurate information about sexuality from a very early age," but "most teens don't receive" such information "until after they've already started having sex" (Culp-Ressler, "ThinkProgress," Center for American Progress, 8/12).


HPV Vaccine Studies Show Lasting Protection, Suggest Providers Need To Offer Shot Sooner

Thu, 08/21/2014 - 17:08

A new study in Pediatrics found that the human papillomavirus vaccine protects against HPV and its associated conditions and diseases for at least eight years, according to HealthDay/U.S. News & World Report.

HPV Vaccine Studies Show Lasting Protection, Suggest Providers Need To Offer Shot Sooner

August 20, 2014 — A new study in Pediatrics found that the human papillomavirus vaccine protects against HPV and its associated conditions and diseases for at least eight years, according to HealthDay/U.S. News & World Report.

For the study, researchers randomly assigned 1,781 sexually inactive boys and girls ages nine to 15 to receive a series of three HPV vaccine doses or placebo shots.

They found that that none of the participants who received the vaccine developed conditions or diseases associated with HPV, such as genital warts. In addition, participants had sustained levels of antibodies to protect against the disease at the end of the eight-year study.

Lead researcher Daron Ferris, director of Georgia Regents University's HPV epidemiology and prevention program, said the study affirms the vaccine's safety and efficacy, with no need for patients to receive a booster dose beyond the recommended three shots.

Survey Examines Why Girls Are Not Getting HPV Vaccine

In related news, a separate survey in Pediatrics found that physicians delayed administering the HPV vaccine to girls because they incorrectly believed that it should be given when girls are more likely to be sexually active. CDC recommends that children receive the vaccine at ages 11 or 12.

The researchers interviewed 37 providers and 124 parents. While most of the physicians and parents thought girls should be vaccinated, providers often delayed recommending the vaccine for girls ages 11 and 12 because they did not think the girls were sexually active. According to the survey, providers recommended delaying vaccination until the girls were older.

The study also found that physicians reported higher vaccination rates when they presented the vaccine as a routine part of the vaccination schedule and discussed it as a way to prevent cancer, rather than as a way to prevent sexually transmitted infections (Reinberg, HealthDay/U.S. News & World Report, 8/18).

NYT Op-Ed: HPV Vaccine is 'Not About Sex. It's About Cancer.'

In a related New York Times opinion piece, Paul Offit -- a professor of pediatrics in the division of infectious diseases and director of the Vaccine Education Center at the Children's Hospital of Philadelphia -- writes that a major reason physicians are not recommending the HPV vaccine is that "[d]octors don't want to talk about sex," but "[t]he good news is, they don't have to."

Offit reminds doctors that the need for the vaccine is "not about sex. It's about cancer." He also cites research that dispels the misconception that the vaccine might "increase sexual promiscuity."

Offit suggests several other reasons why HPV vaccination rates are lower than those for other vaccines. He writes that "[p]eople just don't understand how serious an infection HPV can be"; they don't know that the vaccine "would most likely prevent most cervical cancers" and provide immunity for a long time; and "some high-profile -- and highly irresponsible -- claims have been made that the vaccine is unsafe," despite medical evidence to the contrary.

Offit concludes, "Given current rates of immunization, somewhere around 2,000 adults every year whose parents had chosen not to give them the HPV vaccine will probably die from a preventable cancer. It's unconscionable. And doctors will have only themselves to blame" (Offit, New York Times, 8/19).


CDC: U.S. Teen Birth Rates Down Significantly Since 1950s

Thu, 08/21/2014 - 17:07

With a few exceptions, the U.S. teen birth rate has been generally declining for more than a half-century, according to a report from CDC's National Center for Health Statistics, USA Today reports.

CDC: U.S. Teen Birth Rates Down Significantly Since 1950s

August 21, 2014 — With a few exceptions, the U.S. teen birth rate has been generally declining for more than a half-century, according to a report from CDC's National Center for Health Statistics, USA Today reports.

Specifically, compared with a peak of 96.3 births per 1,000 teens in 1957, the rate had fallen to 26.6 births per 1,000 teens in 2013, based on preliminary data (Jayson, USA Today, 8/20).

The report analyzed trends in teen birth rates from 1940 through 2013, with a focus on the years since 1991 (Ventura et al., CDC report, 8/20).

According to CDC, declines in teen births between 1991 and 2013 can be attributed to less sexual activity among teens and increased use of contraception.

Rates Vary by Age, Race, State

The report also noted that trends varied among various groups and states.

For example, although birth rates declined across all teen age brackets from 1991 to 2013, the rate among girls ages 15 to 17 dropped the most, by 68%. By comparison, the rate decreased by 50% over the same time period among girls 18 to 19.

Similarly, rates among all racial groups decreased, with the greatest declines among Asian-Pacific Islanders -- 64% -- and non-Hispanic blacks -- 63%. Hispanic teens had the highest birth rate, but it has declined by 39% since 2007.

By state, birth rates were lowest in the Northeast and highest in the South. New Hampshire recorded the lowest rate at 13.8 births per 1,000 teens, and New Mexico had the highest at 47.5 per 1,000.

Implications

The U.S. teen birth rate ranks among the highest of developed countries, but the decline has resulted in four million fewer teen births since 1991, according to the report.

The lower rates also saved taxpayers about $12 billion in 2010, CDC said (Millman, "Wonkblog," Washington Post, 8/20).

Washington Post's 'Storyline' Examines Colo. Policies for Pregnant Teens

In related news, the Washington Post's "Storyline" examines how Colorado's family planning policies have improved teens' access to long-acting reversible contraceptives and helped to lower its teen birth rates.

"Between 2007 and 2012, Colorado saw the highest percentage drop in birth rates among teens 15 to 19 in the country," while "[a]bortion rates in the state among teens fell 35 percent between 2009 and 2012," according to "Storyline."

The Colorado Family Planning Initiative, which is supported by an anonymous donation, provides intrauterine devices and implants at family planning clinics in the state. A state analysis attributed three-quarters of state's decline in teen birth rates to the initiative. Another program -- called the Colorado Adolescent Maternity Program, or CAMP -- allows low-income teens who have just given birth to receive long-acting reversible contraceptives before leaving the hospital (Griego [1], "Storyline," Washington Post, 8/20).

In a separate piece, "Storyline" also profiles CAMP, which aims to achieve better pregnancy outcomes by focusing on pregnant teens' physical and mental health. The CAMP clinic is located at Children's Hospital Colorado and serves about 500 pregnant teens and women ages 14 to 22 annually. The state's Medicaid program covers the cost of the care (Griego [2], "Storyline," Washington Post, 8/20).


NYT Editorial: 'Deception' Behind State Abortion Restrictions Revealed in Texas Cases

Thu, 08/21/2014 - 17:06

Texas' defense of an antiabortion-rights law (HB 2) underscores "[t]he deception behind the wave of state-level abortion restrictions now threatening women's access to safe and legal abortions," according to a New York Times editorial.

NYT Editorial: 'Deception' Behind State Abortion Restrictions Revealed in Texas Cases

August 21, 2014 — Texas' defense of an antiabortion-rights law (HB 2) underscores "[t]he deception behind the wave of state-level abortion restrictions now threatening women's access to safe and legal abortions," according to a New York Times editorial.

The Times focuses on reproductive-rights advocates' lawsuit challenging two provisions in the law: one that requires doctors who provide abortions to have admitting privileges at nearby hospitals and another that requires abortion clinics to meet the same standards as ambulatory surgical centers.

The admitting privileges requirement is "already in place" and "has severely limited access to safe and legal care in Texas," while the "unnecessary and prohibitively costly" ambulatory surgical center requirement is scheduled to take effect on Sept. 1, unless the court intervenes, the editorial explains.

The plaintiffs have "presented compelling evidence of the destructive consequences of the two rules and the emptiness of the claim that they are necessary to protect women's health and safety," the editorial argues.

"By contrast, the state's defense of the rules was a bizarre and unconvincing show," including the use of testimony "crafted by Vincent Rue, an opponent of women's reproductive freedom best known for promoting kooky claims, like the existence of an abortion-related mental illness he calls 'post-abortive syndrome,'" the editorial continues. It urges the judge in the case to "call out Texas' dishonest bid to crush a fundamental right" (New York Times, 8/20).


Poll: Most Voters Say Government Should Not Restrict Abortion Access

Thu, 08/21/2014 - 17:05

Almost 70% of registered voters say the government should not limit access to abortion, according to a new poll from NARAL Pro-Choice America, Politico Pro reports.

Poll: Most Voters Say Government Should Not Restrict Abortion Access

August 18, 2014 — Almost 70% of registered voters say the government should not limit access to abortion, according to a new poll from NARAL Pro-Choice America, Politico Pro reports.

The poll marks the first time NARAL asked respondents to distinguish between the morality and legality of abortion, an approach that allows respondents to voice personal objections to abortion but still support access to it. The poll did not include questions about restricting abortion based on the stage of pregnancy or other factors.

Greenberg Quinlan Rosner pollster Drew Lieberman said polls that do not make the distinction between morality and legality force people "into artificial categories." He added, "Almost half the population is in the gray area" of having moral objections to abortion while supporting legal access, which is a "pro-choice position."

Key Findings

For the poll, GQR researchers surveyed 800 registered voters.

The poll found that 23% of respondents believe abortion is "morally acceptable and should be legal," while 45% said they are personally against it but believe the government should not restrict access to it. About 25% of respondents said abortion should be illegal.

In addition, the poll found that the majority of Democrats, Republicans and independents do not support government restrictions on abortion. Specifically, 84% of Democrats said the government should not limit access, while 53% of Republicans and 66% of independents said the same.

NARAL: Poll Shows Disconnect Among Lawmakers

NARAL Political Director Erika West said the poll's findings show that elected officials are not representing voters' views. Only four in 10 representatives in the House fit NARAL's definition of abortion-rights supporters, she noted.

"People ask why are we losing ground on reproductive freedom, and it's because our elected representatives don't represent our values," she said (Haberkorn, Politico Pro, 8/18).


Ohio Clinic Stops Offering Abortions Amid State Restrictions

Thu, 08/21/2014 - 15:21

An abortion clinic near Cincinnati, Ohio, will stop offering surgical abortions, instead of continuing a dispute with the state over a requirement that it calls politically motivated, the Cincinnati Enquirer reports.

Ohio Clinic Stops Offering Abortions Amid State Restrictions

August 21, 2014 — An abortion clinic near Cincinnati, Ohio, will stop offering surgical abortions, instead of continuing a dispute with the state over a requirement that it calls politically motivated, the Cincinnati Enquirer reports (Thompson/Perry, Cincinnati Enquirer, 8/20).

The state requirement at issue mandates that abortion clinics secure a transfer agreement with nearby hospitals.

Ohio in 2013 became the first state to bar abortion clinics from arranging such agreements with public hospitals, meaning that, by default, they must arrange them with private hospitals. The Ohio Department of Health ordered Women's Med Center's Lebanon Road Surgery Center to close after it was unable to meet the requirement.

Hamilton County Judge Jerome Metz in January blocked the department's order, but he ruled last week that he did not have the jurisdiction to maintain the injunction. Women's Med Center said Friday that it would not appeal (Palmer, Reuters, 8/20).

Impact on Abortion Access

According to the Enquirer, the clinic's announcement leaves Ohio with 10 abortion clinics, down from 14 clinics before the new law took effect in 2013. Three of the remaining clinics are "in limbo" under the law, the Enquirer reports (Cincinnati Enquirer, 8/20).

The Lebanon Road Surgery Center was the only clinic within about 100 miles that provided abortions between 18 weeks and 22 weeks of pregnancy, according to Reuters (Reuters, 8/20).

The Cincinnati metropolitan region would become the largest metropolitan area in the U.S. without an abortion clinic if the two others in the area -- a Planned Parenthood in Mount Auburn and a Women's Med Center clinic in Dayton -- also have to stop offering abortion services because of the state law.

Mount Auburn Planned Parenthood spokesperson Rick Pender said the clinic is expecting an "influx of patients" as a result of Lebanon Road Surgery Center's announcement, adding that Planned Parenthood sees the overall situation "as wholly politically motivated and medically unnecessary."

Clinic Will Continue Other Services

The Lebanon Road Surgery Center will still see abortion patients for their required pre-abortion consultation, Women's Med Center officials said. The center will then send patients to the Dayton Women's Med Center for the abortion procedure (Cincinnati Enquirer, 8/20). The clinic will end surgical abortions on Friday.

Dorothea Langsam, an attorney for the clinic, added that it is considering offering medication abortion (Reuters, 8/20).

Langsam noted that many of the clinic's patients are low-income, meaning that "transportation to Dayton (and for an abortion) is difficult" (Cincinnati Enquirer, 8/20).


CDC: U.S. Teen Birth Rates Down Significantly Since 1950s

Thu, 08/21/2014 - 15:19

With a few exceptions, the U.S. teen birth rate has been generally declining for more than a half-century, according to a report from CDC's National Center for Health Statistics, USA Today reports.

CDC: U.S. Teen Birth Rates Down Significantly Since 1950s

August 21, 2014 — With a few exceptions, the U.S. teen birth rate has been generally declining for more than a half-century, according to a report from CDC's National Center for Health Statistics, USA Today reports.

Specifically, compared with a peak of 96.3 births per 1,000 teens in 1957, the rate had fallen to 26.6 births per 1,000 teens in 2013, based on preliminary data (Jayson, USA Today, 8/20).

The report analyzed trends in teen birth rates from 1940 through 2013, with a focus on the years since 1991 (Ventura et al., CDC report, 8/20).

According to CDC, declines in teen births between 1991 and 2013 can be attributed to less sexual activity among teens and increased use of contraception.

Rates Vary by Age, Race, State

The report also noted that trends varied among various groups and states.

For example, although birth rates declined across all teen age brackets from 1991 to 2013, the rate among girls ages 15 to 17 dropped the most, by 68%. By comparison, the rate decreased by 50% over the same time period among girls 18 to 19.

Similarly, rates among all racial groups decreased, with the greatest declines among Asian-Pacific Islanders -- 64% -- and non-Hispanic blacks -- 63%. Hispanic teens had the highest birth rate, but it has declined by 39% since 2007.

By state, birth rates were lowest in the Northeast and highest in the South. New Hampshire recorded the lowest rate at 13.8 births per 1,000 teens, and New Mexico had the highest at 47.5 per 1,000.

Implications

The U.S. teen birth rate ranks among the highest of developed countries, but the decline has resulted in four million fewer teen births since 1991, according to the report.

The lower rates also saved taxpayers about $12 billion in 2010, CDC said (Millman, "Wonkblog," Washington Post, 8/20).

Washington Post's 'Storyline' Examines Colo. Policies for Pregnant Teens

In related news, the Washington Post's "Storyline" examines how Colorado's family planning policies have improved teens' access to long-acting reversible contraceptives and helped to lower its teen birth rates.

"Between 2007 and 2012, Colorado saw the highest percentage drop in birth rates among teens 15 to 19 in the country," while "[a]bortion rates in the state among teens fell 35 percent between 2009 and 2012," according to "Storyline."

The Colorado Family Planning Initiative, which is supported by an anonymous donation, provides intrauterine devices and implants at family planning clinics in the state. A state analysis attributed three-quarters of state's decline in teen birth rates to the initiative. Another program -- called the Colorado Adolescent Maternity Program, or CAMP -- allows low-income teens who have just given birth to receive long-acting reversible contraceptives before leaving the hospital (Griego [1], "Storyline," Washington Post, 8/20).

In a separate piece, "Storyline" also profiles CAMP, which aims to achieve better pregnancy outcomes by focusing on pregnant teens' physical and mental health. The CAMP clinic is located at Children's Hospital Colorado and serves about 500 pregnant teens and women ages 14 to 22 annually. The state's Medicaid program covers the cost of the care (Griego [2], "Storyline," Washington Post, 8/20).


NYT Editorial: 'Deception' Behind State Abortion Restrictions Revealed in Texas Cases

Thu, 08/21/2014 - 14:57

Texas' defense of an antiabortion-rights law (HB 2) underscores "[t]he deception behind the wave of state-level abortion restrictions now threatening women's access to safe and legal abortions," according to a New York Times editorial.

NYT Editorial: 'Deception' Behind State Abortion Restrictions Revealed in Texas Cases

August 21, 2014 — Texas' defense of an antiabortion-rights law (HB 2) underscores "[t]he deception behind the wave of state-level abortion restrictions now threatening women's access to safe and legal abortions," according to a New York Times editorial.

The Times focuses on reproductive-rights advocates' lawsuit challenging two provisions in the law: one that requires doctors who provide abortions to have admitting privileges at nearby hospitals and another that requires abortion clinics to meet the same standards as ambulatory surgical centers.

The admitting privileges requirement is "already in place" and "has severely limited access to safe and legal care in Texas," while the "unnecessary and prohibitively costly" ambulatory surgical center requirement is scheduled to take effect on Sept. 1, unless the court intervenes, the editorial explains.

The plaintiffs have "presented compelling evidence of the destructive consequences of the two rules and the emptiness of the claim that they are necessary to protect women's health and safety," the editorial argues.

"By contrast, the state's defense of the rules was a bizarre and unconvincing show," including the use of testimony "crafted by Vincent Rue, an opponent of women's reproductive freedom best known for promoting kooky claims, like the existence of an abortion-related mental illness he calls 'post-abortive syndrome,'" the editorial continues. It urges the judge in the case to "call out Texas' dishonest bid to crush a fundamental right" (New York Times, 8/20).


ACOG Says All Pregnant Women Should Receive Flu Vaccine

Thu, 08/21/2014 - 14:54

The latest research affirms recommendations that all pregnant women receive a flu vaccination, the American College of Obstetricians and Gynecologists said in updated guidelines on flu shots during pregnancy, Medscape reports.

ACOG Says All Pregnant Women Should Receive Flu Vaccine

August 21, 2014 — The latest research affirms recommendations that all pregnant women receive a flu vaccination, the American College of Obstetricians and Gynecologists said in updated guidelines on flu shots during pregnancy, Medscape reports.

The ACOG committee opinion, published in the September issue of Obstetrics & Gynecology, calls on ob-gyns, health care providers and groups, and public health officials to work to increase flu vaccination rates among pregnant women.

Although ACOG has long supported CDC's recommendation that all pregnant women receive the inactivated form of the flu vaccine, the new guidelines encompass the latest research and strengthen the group's endorsement, according to Medscape.

"The flu virus is highly infectious and can be particularly dangerous to pregnant women, as it can cause pneumonia, premature labor, and other complications," Laura Riley, chair of the ACOG Immunization Expert Work Group, said in a release (Pullen, Medscape, 8/20).

Details of Committee Opinion

According to ACOG, various studies released over the last few years have confirmed the safety and effectiveness of the inactivated flu vaccine for use in pregnant women. About half of pregnant women received the vaccination during the 2009 to 2010 flu season, but the rates could be higher, the group said.

ACOG's guidelines noted that pregnant women should not be given the live attenuated version of the vaccine, which is packaged as a nasal mist.

Breastfeeding women and those who have just given birth should also be vaccinated against the flu, according to ACOG (Preidt, HealthDay/U.S. News & World Report, 8/19). The nasal spray is safe for women in the postpartum period, the guidelines said (ACOG committee opinion, September 2014).

ACOG recommended that pregnant women be vaccinated as early in the flu season as possible. The flu season usually lasts from October to May (HealthDay/U.S. News & World Report, 8/19).


Ind. Asks Federal Court To Let Medication Abortion Restrictions Take Effect

Thu, 08/21/2014 - 14:28

The Indiana attorney general's office on Monday requested summary judgment in a federal court case challenging a state law (SB 371) that would impose additional building requirements on health clinics offering medication abortion, the AP/Lafayette Journal & Courier reports.

Ind. Asks Federal Court To Let Medication Abortion Restrictions Take Effect

August 21, 2014 — The Indiana attorney general's office on Monday requested summary judgment in a federal court case challenging a state law (SB 371) that would impose additional building requirements on health clinics offering medication abortion, the AP/Lafayette Journal & Courier reports (Wilson, AP/Lafayette Journal & Courier, 8/19).

The law requires clinics that offer only medication abortions to adhere to the same building and equipment standards as facilities that perform the surgical procedure. It would affect just one clinic, a Planned Parenthood of Indiana and Kentucky facility in Lafayette, Ind.

The American Civil Liberties Union of Indiana in August 2013 filed suit against the law, which was scheduled to take effect on Jan. 1, 2014. In November, U.S. District Judge Jane Magnus-Stinson issued a temporary injunction to block the law (Women's Health Policy Report, 1/31).

State's Arguments

The state on Monday argued that ACLU of Indiana did not prove in its court filings that the law would prevent women from obtaining abortions.

State attorneys acknowledged that the law might require women to travel farther for an abortion, but they said that imposition was not illegal and that women would still be able to access abortion. "The Supreme Court has never held that a woman is entitled to the abortion method of her choice," they wrote.

If the law took effect, women in Lafayette would have to travel more than an hour to obtain medication abortion in either Indianapolis or Merrillville, according to PPINK CEO Betty Cockrum.

The state's filing also disputed ACLU's claims that the law violates a constitutional guarantee of equal protection.

ACLU made the equal protection argument based on the fact that the law does not require doctors' offices that offer medication abortion to meet the building requirements if medication abortion is not the offices' primary source of business. The state countered that lawmakers have the constitutional authority to treat doctors' offices and abortion clinics differently (AP/ Lafayette Journal & Courier, 8/19).


Judge Allows Ban on Iowa Telemedicine Abortion Program

Wed, 08/20/2014 - 15:44

An Iowa judge on Tuesday ruled that the state Board of Medicine has the authority to ban the administration of medication abortion drugs via a telemedicine system, Bloomberg reports.

Judge Allows Ban on Iowa Telemedicine Abortion Program

August 20, 2014 — An Iowa judge on Tuesday ruled that the state Board of Medicine has the authority to ban the administration of medication abortion drugs via a telemedicine system, Bloomberg reports.

Polk County Judge Jeffrey Farrell's decision upholds a board rule that requires a physician to be present and perform a physical examination before administering the medication (Harris, Bloomberg, 8/19). The judge's ruling is expected to take effect in 30 days (Leys, Des Moines Register, 8/19).

Planned Parenthood of the Heartland plans to appeal to the Iowa Supreme Court (Bloomberg, 8/19).

Background

Although the Iowa Board of Medicine in 2010 ruled that doctors at PPH could continue to dispense medication abortion drugs via its telemedicine system, Gov. Terry Brandstad (R) later replaced all of the board members, who then approved rules barring PPH from administering medication abortions through the system.

PPH sued, and a judge last November issued a temporary stay against the ban (Women's Health Policy Report, 6/18). PPH argued in the lawsuit that the board's rule was politically motivated and "promulgated solely for the purpose of preventing access to early abortion, and for no legitimate purpose relating to the health and well-being of Iowa women" (Women's Health Policy Report, 11/6/13).

Tuesday's Ruling

In his ruling, Farrell wrote, "There is no question that the board has the power to establish standards of practice for the medical profession."

He added that the board held public hearings, accepted written comments and, therefore, met the requirements for setting a rule. He said that banning the telemedicine system would not cause "undue hardship" for women who would need to travel to obtain the drugs if it were not in place.

However, Farrell also said that the board "invited scrutiny" through some of its actions, including by acting on the petition for rulemaking just three days after it was received and declining requests from physicians' groups to take more time to consider the matter.

Supporters, Opponents React

PPH Chief Operating Officer Penny Dickey said in a statement, "While the board of medicine claims it is acting to protect women's safety and health, its true purpose is to prevent women from receiving an abortion if and when they need one." She added that PPH will "continue to fight for evidence-based medicine and a woman's right to make her personal health care decisions."

Iowa Board of Medicine Executive Director Mark Bowden said the ruling showed the board acted appropriately, "carefully studied the issue and provided ample opportunity for public comment." He added, "The board considers a thorough medical history and physical examination to be the cornerstone of good medical care" (Des Moines Register, 8/19).


HPV Vaccine Studies Show Lasting Protection, Suggest Providers Need To Offer Shot Sooner

Wed, 08/20/2014 - 14:40

A new study in Pediatrics found that the human papillomavirus vaccine protects against HPV and its associated conditions and diseases for at least eight years, according to HealthDay/U.S. News & World Report.

HPV Vaccine Studies Show Lasting Protection, Suggest Providers Need To Offer Shot Sooner

August 20, 2014 — A new study in Pediatrics found that the human papillomavirus vaccine protects against HPV and its associated conditions and diseases for at least eight years, according to HealthDay/U.S. News & World Report.

For the study, researchers randomly assigned 1,781 sexually inactive boys and girls ages nine to 15 to receive a series of three HPV vaccine doses or placebo shots.

They found that that none of the participants who received the vaccine developed conditions or diseases associated with HPV, such as genital warts. In addition, participants had sustained levels of antibodies to protect against the disease at the end of the eight-year study.

Lead researcher Daron Ferris, director of Georgia Regents University's HPV epidemiology and prevention program, said the study affirms the vaccine's safety and efficacy, with no need for patients to receive a booster dose beyond the recommended three shots.

Survey Examines Why Girls Are Not Getting HPV Vaccine

In related news, a separate survey in Pediatrics found that physicians delayed administering the HPV vaccine to girls because they incorrectly believed that it should be given when girls are more likely to be sexually active. CDC recommends that children receive the vaccine at ages 11 or 12.

The researchers interviewed 37 providers and 124 parents. While most of the physicians and parents thought girls should be vaccinated, providers often delayed recommending the vaccine for girls ages 11 and 12 because they did not think the girls were sexually active. According to the survey, providers recommended delaying vaccination until the girls were older.

The study also found that physicians reported higher vaccination rates when they presented the vaccine as a routine part of the vaccination schedule and discussed it as a way to prevent cancer, rather than as a way to prevent sexually transmitted infections (Reinberg, HealthDay/U.S. News & World Report, 8/18).

NYT Op-Ed: HPV Vaccine is 'Not About Sex. It's About Cancer.'

In a related New York Times opinion piece, Paul Offit -- a professor of pediatrics in the division of infectious diseases and director of the Vaccine Education Center at the Children's Hospital of Philadelphia -- writes that a major reason physicians are not recommending the HPV vaccine is that "[d]octors don't want to talk about sex," but "[t]he good news is, they don't have to."

Offit reminds doctors that the need for the vaccine is "not about sex. It's about cancer." He also cites research that dispels the misconception that the vaccine might "increase sexual promiscuity."

Offit suggests several other reasons why HPV vaccination rates are lower than those for other vaccines. He writes that "[p]eople just don't understand how serious an infection HPV can be"; they don't know that the vaccine "would most likely prevent most cervical cancers" and provide immunity for a long time; and "some high-profile -- and highly irresponsible -- claims have been made that the vaccine is unsafe," despite medical evidence to the contrary.

Offit concludes, "Given current rates of immunization, somewhere around 2,000 adults every year whose parents had chosen not to give them the HPV vaccine will probably die from a preventable cancer. It's unconscionable. And doctors will have only themselves to blame" (Offit, New York Times, 8/19).


Women's Health Issues Key for Both Parties in Senate Campaigns

Wed, 08/20/2014 - 14:30

Republicans vying for Senate seats in the midterm election are working to rally abortion-rights opponents and "counterbalance" Democrats' criticism of GOP positions on women's health issues, The Hill reports.

Women's Health Issues Key for Both Parties in Senate Campaigns

August 20, 2014 — Republicans vying for Senate seats in the midterm election are working to rally abortion-rights opponents and "counterbalance" Democrats' criticism of GOP positions on women's health issues, The Hill reports.

Republicans would need to gain six Senate seats to win control of the chamber, according to The Hill.

The GOP strategy is built around a bill (S 1670) from Sen. Lindsey Graham (R-S.C.) that would prohibit abortion after 20 weeks of pregnancy. A conservative group called Women Speak Out PAC is targeting three Democratic senators who oppose Graham's bill: Sens. Mary Landrieu (La.), Mark Pryor (Ark.) and Kay Hagan (N.C.).

The group plans to spend between $8 million and $10 million this election cycle, fund several ad campaigns and set up field offices in key states. Another group called National Right to Life Victory Fund plans to spend $250,000 on advertising against Landrieu.

Democrats Target GOP's Stance on Birth Control

Meanwhile, the Planned Parenthood Action Fund, EMILY's List and other abortion-rights groups are backing Democratic candidates in federal and state races and highlighting Republicans' efforts to restrict birth control access, among other issues. The groups have "an enormous cash advantage" over their antiabortion-rights counterparts, according to The Hill (Viebeck, The Hill, 8/20).

EMILY's List President Stephanie Schriock argued that "momentum" is also on Democrats' side. "Democratic women have been at the forefront on every major issue and not only are Americans impressed, they are ready to send them reinforcements," she said.

Donors have contributed more than $46 million to candidates and political committees linked to EMILY's List, including nearly $6 million in July alone. The group is supporting senators such as Hagan and Sen. Jeanne Shaheen (D-N.H.), as well as several state-level Democratic candidates (Elliot, AP/San Francisco Chronicle, 8/20).

PPAF likely will spend up to $20 million during this election cycle, including $3 million in North Carolina (The Hill, 8/20).