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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Abortion-Rights Supporters Look to New Efforts To Protect Clinic Access

Fri, 06/27/2014 - 20:17

Abortion-rights supporters pledged to find alternative ways to ensure women's safe access to abortion services after the Supreme Court's ruling on Thursday that struck down a Massachusetts "buffer zone" law, The Hill reports.

Abortion-Rights Supporters Look to New Efforts To Protect Clinic Access

June 27, 2014 — Abortion-rights supporters pledged to find alternative ways to ensure women's safe access to abortion services after the Supreme Court's ruling on Thursday that struck down a Massachusetts "buffer zone" law, The Hill reports (Al-Faruque, The Hill, 6/26).

The Massachusetts law, enacted in 2007, only permitted people to enter a 35-foot zone around abortion clinics to access the facility itself or reach another destination. Supreme Court Chief Justice John Roberts wrote in Thursday's majority opinion that "buffer zones burden substantially more speech than necessary to achieve [Massachusetts'] asserted interests."

Roberts said the only way for the state to meet the requirement that free-speech restrictions be "narrowly tailored" would be to "demonstrate that alternative measures that burden substantially less speech would fail to achieve the government's interests, not simply that the chosen route is easier" (Women's Health Policy Report, 6/26).

Other states and municipalities -- such as Colorado; Chicago, Ill.; and Portland, Maine -- have similar buffer zone laws (Novack, National Journal, 6/26).

Mass. Weighs Options

Massachusetts Attorney General Martha Coakley (D) said Thursday that she had spoken with Gov. Deval Patrick (D) and Boston Mayor Marty Walsh about how the state can protect women's access to abortion services in light of the ruling.

Coakley said that the state would work with law enforcement and seek court injunctions or other actions against protesters who threaten patients' safe access to abortion clinics. Her office is reviewing the Supreme Court ruling to determine what strategies are permissible (Villacorta, Politico Pro, 6/26).

"We ... vowed to make sure that we will continue here in Massachusetts to provide for the protections the decision still leaves and ... to work with our legislatures and others to find what other tools will be available to us moving forward," said Coakley, who is also running for governor.

Planned Parenthood League of Massachusetts CEO Marty Walz echoed Coakley's statements, adding that the clinic would use additional escorts to help patients and employees enter its clinics.

Separately, Reps. Diana DeGette (D-Colo.) and Louise Slaughter (D-N.Y.) urged the state to quickly write new laws protecting women's abortion access that comply with the Supreme Court's ruling. "While the Supreme Court ... overturned this large fixed buffer zone in Massachusetts, it's important to note it left the opening for Massachusetts to re-write its laws," they said (The Hill, 6/26).

White House Voices Support for 'Buffer Zone' Laws, Abortion Access

White House press secretary Josh Earnest on Thursday said the White House believes that the Massachusetts buffer zone law was a "commonsense" way to balance abortion access and protesters' freedom of speech. In the wake of the ruling, the administration remains committed to ensuring safe abortion access, he said.

Earnest added that the administration is pleased that the high court "recognized the possibility of alternative approaches, such as the federal law (PL 103-259) protecting a woman's right to access reproductive health clinics." He said that the White House would support Massachusetts' efforts to enact new legislation in compliance with the high court's "very narrow concerns" (Kenen, Politico Pro, 6/26).


Featured Blog

Fri, 06/27/2014 - 17:48

"What Today's Supreme Court Ruling Means for Other Laws That Protect Clinic Patients," (Flatow, "ThinkProgress," Center for American Progress, 6/26).

June 27, 2014

FEATURED BLOG

"What Today's Supreme Court Ruling Means for Other Laws That Protect Clinic Patients," Nicole Flatow, Center for American Progress' "ThinkProgress": Flatow notes that in striking down Massachusetts' "buffer zone" law on Thursday, five of the justices reasoned that the law, "among the nation's broadest," was unconstitutional because the state "could not punish such a broad swath of conduct." Although other buffer zone laws could be challenged in wake of the ruling, it is possible that many of them, especially Colorado's and others that are "more specific about the types of conduct they prohibit," might "very well survive the Supreme Court's new test," she writes (Flatow, "ThinkProgress," Center for American Progress, 6/26).

What others are saying about buffer zones:

~ "What is Left of Hill v. Colorado?" Kevin Russell, SCOTUSblog.

Pa. Asks Planned Parenthood for Admitting Privileges Information

Fri, 06/27/2014 - 17:41

Three of Planned Parenthood's Pennsylvania affiliates were mistakenly asked to provide the state with information on their providers' admitting privileges at hospitals, the AP/Washington Times reports.

Pa. Asks Planned Parenthood for Admitting Privileges Information

June 27, 2014 — Three of Planned Parenthood's Pennsylvania affiliates were mistakenly asked to provide the state with information on their providers' admitting privileges at hospitals, the AP/Washington Times reports.

Planned Parenthood operates 10 abortion clinics in the state and has never been asked for such information before, according to Planned Parenthood spokesperson Meghan Roach.

A 2011 state law requires abortion providers to have either admitting privileges or a transfer agreement with a nearby hospital. However, Pennsylvania does not require all abortion clinics to have physicians with admitting privileges, as several other states do.

Department's Explanation

According to Pennsylvania Department of Health spokesperson Aimee Tysarczyk, the department did not intend to inquire about the physician admitting privileges, but an employee asked Planned Parenthood's state affiliates for the information "without receiving directive to do so."

Roach accepted the department's explanation and said Planned Parenthood has a good working relationship with PDH.

However, she spoke out against legislation (HB 1762) pending in the state House Judiciary Committee that would require abortion providers to have admitting privileges at nearby hospitals that offer obstetrical or gynecological services.

"As we've seen in other states, these proposed regulations are not supported by the medical community and are driven by misguided politicians," she said (Levy, AP/Washington Times, 6/25).


Datapoints: Paid Leave Worldwide, Contraceptive Counseling Priorities & Global Midwifery

Fri, 06/27/2014 - 16:11

Our monthly snapshot of women's health graphics features a global overview of paid maternity leave, plus a chart contrasting women's and health care providers' contraceptive priorities and a look at midwifery worldwide.

Datapoints: Paid Leave Worldwide, Contraceptive Counseling Priorities & Global Midwifery

June 27, 2014 — Our monthly snapshot of women's health graphics features a global overview of paid maternity leave, plus a chart contrasting women's and health care providers' contraceptive priorities and a look at midwifery worldwide.

Paid Leave



The lack of a national paid leave policy for mothers of infants in the U.S. makes the nation a global outlier, as depicted in this map from the World Policy Forum. Worldwide, many nations offer at least 14 weeks of paid leave, either in the form of maternity leave, which is exclusively for mothers, or parental leave, which can be used by either parent (World Policy Forum, accessed June 2014).


Contraceptive Counseling



Women and their health care providers often diverge in which issues they prioritize during consultations about contraceptives, according to results of a study summarized in this chart from NPR's "Shots."

The study surveyed women and providers about which information they thought was most important to include in such consultations. Overall, women thought that safety-related issues were the most important, while providers felt that talking to women about how a method is used should be the top priority (Singh, "Shots," NPR, 6/10).


Global Midwifery



This infographic encapsulates key challenges identified in the 2014 edition of the United Nations Population Fund's "State of the World's Midwifery" report. Although the report depicts progress since UNFPA's inaugural midwifery report in 2011, it shows that the 73 nations included in the report account for the vast majority of global maternal and neonatal deaths.

Additional infographics summarizing the report's findings on the impact of midwives and key actions to ensure more effective midwifery care are available online (UNFPA, June 2014).


Editorials, Columns React to Supreme Court Ruling on Mass. 'Buffer Zone' Law

Fri, 06/27/2014 - 15:59

Several newspapers published editorials and opinion pieces reacting to the Supreme Court's ruling on Thursday that Massachusetts' "buffer zone" law is unconstitutional.

Editorials, Columns React to Supreme Court Ruling on Mass. 'Buffer Zone' Law

June 27, 2014 — Several newspapers published editorials and opinion pieces reacting to the Supreme Court's ruling on Thursday that Massachusetts' "buffer zone" law is unconstitutional.

~ New York Times: The court's ruling "ignores what actually happens on the ground" at reproductive health clinics, which have "endured a long and sometimes violent history of protest," a Times editorial states. It explains, "As both opponents and defenders of abortion rights have converged on the clinics over the years, initially peaceful protests have escalated into shoving matches, with women caught in the middle." The Massachusetts law was "a considered response to a decades-long threat to public safety, largely in the form of harassment, physical intimidation and worse by people opposed to abortion," the Times adds (New York Times, 6/26).

~ Chicago Tribune: A Tribune editorial comments that the ruling "refined the First Amendment rights of abortion opponents who want to talk with prospective patients outside abortion clinics" by giving "new guidelines to states and cities ... that seek to regulate the opponents outside clinics." The editorial notes that even though the ruling was unanimous, "the justices [were] divided," with four of the justices arguing that Chief Justice John Roberts' majority opinion "didn't go far enough to protect abortion opponents' right to free speech" (Chicago Tribune, 6/27).

~ Los Angeles Times: The court "got the balance wrong" when "weighing one person's right to free speech against another's right to be protected from harassment," ultimately placing women and clinic staff members at risk, a Times editorial argues. "As important as the 1st Amendment is, courts have long recognized that it may be restricted, within limits," it adds, concluding, "Americans may protest, plead, hector and even offend, but they have no inalienable right to falsely shout 'fire' in a crowded theater, play obscene movies on Main Street or intimidate or bully others going about their lawful business" (Los Angeles Times, 6/26).

~ Robin Abcarian, Los Angeles Times: According to Times columnist Abcarian, the ruling "sidestep[s]" reports of "the appalling acts of violence that anti-abortion extremists have unleashed on doctors, staffers and patients" at reproductive health centers over the years. While Abcarian "can appreciate the court's decision" from "a strictly free-speech point of view," she argues that the ruling "relegates women seeking abortions, and those who work at abortion clinics, to a kind of second-class constitutional status" (Abcarian, Los Angeles Times, 6/26).

~ Laurence Tribe, New York Times: In a Times opinion piece, Tribe, a Harvard University constitutional law professor, writes that even though he is "a committed supporter of a woman's -- increasingly imperiled -- right to choose, [he] must acknowledge that the Supreme Court got it right on Thursday." Tribe argues, "The great virtue of our First Amendment is that it protects speech we hate just as vigorously as it protects speech we support," adding that "all nine justices united to reaffirm our nation's commitment to allowing diverse views in our public spaces" (Tribe, New York Times, 6/26).

~ USA Today: While it may have been "inevitable that a law designed to protect women seeking abortions against aggressive, sometimes violent protesters would finally fall," the Supreme Court's decision "is likely to embolden anti-abortion protesters, and prompt clinics to create their own buffer zones by locating farther away from public sidewalks," according to a USA Today editorial. At the same time, the court's suggestion that state authorities explore "more narrowly tailored options" to protect clinic access gives officials "a chance to experiment, with the knowledge that even if the justices found that Massachusetts created a buffer too big, at least they left reasonable latitude to find a fair balance between conflicting rights" (USA Today, 6/26).

~ Carrie Campbell Severino, USA Today: In an opinion piece opposing the USA Today editorial, Campbell Severino, chief counsel and policy director at the Judicial Crisis Network, argues that the court "rightly insisted that Massachusetts enforce existing laws barring harassment and violence instead of creating new ones that literally draw lines on the ground to criminalize speech." She notes that the "case isn't really about abortion at all," but "whether the government can restrict speech it dislikes." She concludes, "The Bill of Rights answers that question unequivocally: of course not" (Campbell Severino, USA Today, 6/26).


Columnist: Why the U.S. Lacks Paid Maternity Leave

Fri, 06/27/2014 - 15:34

President Obama during a White House conference on working families "lamented the fact that the United States was the one developed nation that doesn't provide paid maternity leave," Washington Post columnist Harold Meyerson writes.

Columnist: Why the U.S. Lacks Paid Maternity Leave

June 27, 2014 — President Obama during a White House conference on working families "lamented the fact that the United States was the one developed nation that doesn't provide paid maternity leave," Washington Post columnist Harold Meyerson writes.

Meyerson ascribes the lack of paid maternity leave in the U.S. to two factors. He argues that the first issue is the power imbalance between how "the wealthiest 10 percent of Americans, who increasingly dominate our politics, have no trouble affording quality child care" and how "the rest of the population ... suffers from a problem of agency: The collapse of the union movement (which was slow to prioritize this issue) has left no way for workers to bargain with their bosses for paid leave."

Second, he writes that the "mass entry of women into the workforce has coincided not only with unions' disappearance but also with the rise of a near-fanatical anti-tax, anti-government right wing that keeps Republicans from supporting the most basic programs ... if they're funded through taxes."

For example, Republicans have yet to support legislation (S 1810, HR 3712) proposed by Sen. Kirsten Gillibrand (D-N.Y.) and Rep. Rosa DeLauro (D-Conn.) that would provide up to 12 weeks of paid family and medical leave through employer and employee payroll contributions of 0.2% of wages, Meyerson writes. Meyerson also highlights strong public support for such a program, citing a poll conducted for the National Partnership for Women & Families that found that 86% of U.S. residents supported paid parental leave, including 73% of Republicans (Meyerson, Washington Post, 6/25).


Blogs Comment on 'Buffer Zone' Ruling, Gun Violence, More

Fri, 06/27/2014 - 15:19

We've compiled some of the most thought-provoking commentaries from around the Web. Catch up on the conversation with bloggers from the Center for American Progress, Care2 and more.

Blogs Comment on 'Buffer Zone' Ruling, Gun Violence, More

June 27, 2014 — We've compiled some of the most thought-provoking commentaries from around the Web. Catch up on the conversation with bloggers from the Center for American Progress, Care2 and more.

BUFFER ZONES: "What Today's Supreme Court Ruling Means for Other Laws That Protect Clinic Patients," Nicole Flatow, Center for American Progress' "ThinkProgress": Flatow notes that in striking down Massachusetts' "buffer zone" law on Thursday, five of the justices reasoned that the law, "among the nation's broadest," was unconstitutional because the state "could not punish such a broad swath of conduct." Although other buffer zone laws could be challenged in wake of the ruling, it is possible that many of them, especially Colorado's and others that are "more specific about the types of conduct they prohibit," might "very well survive the Supreme Court's new test," she writes (Flatow, "ThinkProgress," Center for American Progress, 6/26).

What others are saying about buffer zones:

~ "What is Left of Hill v. Colorado?" Kevin Russell, SCOTUSblog.

GENDER-BASED AND PARTNER VIOLENCE: "NRA Thinks Same-Sex Domestic Violence is No Big Deal," Mindy Townsend, Care2: Townsend takes issue with the National Rifle Association's opposition to Sen. Amy Klobuchar's (D-Minn.) bill (S 1290) "that would make it harder" for convicted stalkers and "people who abuse their partners but don't live together or have children together to buy guns" because the restrictions could apply to same-sex couples. She argues that the "loophole" that allows certain abusers "to get their hands on weapons" is "something that has to be corrected." It is "shameful [of NRA] to use cultural misunderstandings to keep those loopholes in place," she says, adding, "Gay men and lesbians need these protections just as much as heterosexual women do" (Townsend, Care2, 6/26).

GLOBAL ISSUES: "Why #BringBackOurGirls Isn't Enough," Zak Newman, American Civil Liberties Union's "Washington Markup": Despite the popularity of widespread social media campaigns like #BringBackOurGirls, the U.S. government "cannot combat gender-based violence and sex discrimination from the convenience of a Twitter handle," Newman argues, referring to the hashtag used in response to the kidnapping of girls in Nigeria. Instead, "we must commit ourselves to global efforts to eliminate gender-based violence," by passing and ratifying measures such as the International Violence Against Women Act (S 2307) and the Women's Equality Treaty. Supporting both measures "will help us move from words of condemnation to a system of comprehensive action," he argues (Newman, "Washington Markup," ACLU, 6/26).

What others are saying about global issues:

~ "Lucy Liu: Child Trafficking Must End Now," Lucy Liu, Daily Beast.

~ "She The People's Guide to the International Women's Rights Treaty You Have Never Heard Of," Jackie Kucinich, Washington Post's "She The People."

~ "The Clock's Ticking: Can We Still Meet U.N. Goals for Maternal and Child Health?" James Hildebrand, Ms. Magazine blog.

~ "Why We Must Act When Women in Iraq Document Rape," Clare Winterton, Huffington Post blogs.

WORKING FAMILIES: "What Do Working Families Need? The White House Has the Answer," Robin Marty, Care2: President Obama at the White House Summit on Working Families proposed several "basic, simple steps to make sure that more people [can] give birth, house and feed their children," including paid family leave and "living wage[s]" for families, among other issues, Marty writes. However, she adds that while the Obama administration "can work on policies to address federal workplaces, getting real reforms that will help families across the country still seem doomed for as long as the Republican party controls Congress." Marty writes that the GOP, which "presents itself as the party of family values," should "step up and join the Democrats and the White House and promote real laws that make all families stronger" (Marty, Care2, 6/24).

What others are saying about working families:

~ "What was Achieved at the White House Summit on Working Families?" Emily Shugerman, Ms. Magazine blog.

BREASTFEEDING: "Creating a Space for (Talking About) Breastfeeding in Public," Amanda Barnes Cook, Our Bodies Ourselves' "Our Bodies, Our Blog": Barnes Cook, a student teacher at the University of North Carolina-Chapel Hill, discusses the "injustice ... that the real struggles of women's lives cannot be discussed in a public forum" when it comes to breastfeeding "because this issue makes people uncomfortable." In particular, she comments on the role of college faculty in helping to "normalize breastfeeding." She writes, "College professors are in a unique position to do this, since breastfeeding can be discussed in many different departments and used as an example for so many different issues," adding, "Let's remind students, during what may very well be the height of their objectification of women and of their glorification of frivolous sex, that breasts have a purpose, and that sex produces hungry babies" (Barnes Cook, "Our Bodies, Our Blog," Our Bodies Ourselves, 6/24).

What others are saying about breastfeeding:

~ "Facebook No Longer Treats Breastfeeding Photos Like They're Obscene," Tara Culp-Ressler, Center for American Progress' "ThinkProgress."

PEACE CORPS: "Following Senate's Lead, House Appropriations Committee Lifts Peace Corps Abortion Restriction," Emily Crockett, RH Reality Check: The House Appropriations Committee voted to "lift a discriminatory, decades-old restriction" and allow abortion coverage for Peace Corps volunteers in cases of rape, incest or threats to a woman's life, "indicating bipartisan support for a measure that the Senate Appropriations Committee" previously passed, Crockett writes. "Under current law, Peace Corps volunteers, who typically make about $300 per month, cannot receive insurance coverage for abortion care under any circumstance," she explains. She cites a recent report that found that "97 percent of returning volunteers surveyed thought the policy should be changed" (Crockett, RH Reality Check, 6/24).


Abortion-Rights Supporters Look to New Efforts To Protect Clinic Access

Fri, 06/27/2014 - 14:05

Abortion-rights supporters pledged to find alternative ways to ensure women's safe access to abortion services after the Supreme Court's ruling on Thursday that struck down a Massachusetts "buffer zone" law, The Hill reports.

Abortion-Rights Supporters Look to New Efforts To Protect Clinic Access

June 27, 2014 — Abortion-rights supporters pledged to find alternative ways to ensure women's safe access to abortion services after the Supreme Court's ruling on Thursday that struck down a Massachusetts "buffer zone" law, The Hill reports (Al-Faruque, The Hill, 6/26).

The Massachusetts law, enacted in 2007, only permitted people to enter a 35-foot zone around abortion clinics to access the facility itself or reach another destination. Supreme Court Chief Justice John Roberts wrote in Thursday's majority opinion that "buffer zones burden substantially more speech than necessary to achieve [Massachusetts'] asserted interests."

Roberts said the only way for the state to meet the requirement that free-speech restrictions be "narrowly tailored" would be to "demonstrate that alternative measures that burden substantially less speech would fail to achieve the government's interests, not simply that the chosen route is easier" (Women's Health Policy Report, 6/26).

Other states and municipalities -- such as Colorado; Chicago, Ill.; and Portland, Maine -- have similar buffer zone laws (Novack, National Journal, 6/26).

Mass. Weighs Options

Massachusetts Attorney General Martha Coakley (D) said Thursday that she had spoken with Gov. Deval Patrick (D) and Boston Mayor Marty Walsh about how the state can protect women's access to abortion services in light of the ruling.

Coakley said that the state would work with law enforcement and seek court injunctions or other actions against protesters who threaten patients' safe access to abortion clinics. Her office is reviewing the Supreme Court ruling to determine what strategies are permissible (Villacorta, Politico Pro, 6/26).

"We ... vowed to make sure that we will continue here in Massachusetts to provide for the protections the decision still leaves and ... to work with our legislatures and others to find what other tools will be available to us moving forward," said Coakley, who is also running for governor.

Planned Parenthood League of Massachusetts CEO Marty Walz echoed Coakley's statements, adding that the clinic would use additional escorts to help patients and employees enter its clinics.

Separately, Reps. Diana DeGette (D-Colo.) and Louise Slaughter (D-N.Y.) urged the state to quickly write new laws protecting women's abortion access that comply with the Supreme Court's ruling. "While the Supreme Court ... overturned this large fixed buffer zone in Massachusetts, it's important to note it left the opening for Massachusetts to re-write its laws," they said (The Hill, 6/26).

White House Voices Support for 'Buffer Zone' Laws, Abortion Access

White House press secretary Josh Earnest on Thursday said the White House believes that the Massachusetts buffer zone law was a "commonsense" way to balance abortion access and protesters' freedom of speech. In the wake of the ruling, the administration remains committed to ensuring safe abortion access, he said.

Earnest added that the administration is pleased that the high court "recognized the possibility of alternative approaches, such as the federal law (PL 103-259) protecting a woman's right to access reproductive health clinics." He said that the White House would support Massachusetts' efforts to enact new legislation in compliance with the high court's "very narrow concerns" (Kenen, Politico Pro, 6/26).


Ob-Gyns Lack Tools, Training To Warn Women About Environmental Toxins, Study Finds

Fri, 06/27/2014 - 14:01

Obstetricians and gynecologists feel unprepared to explain the risks of environmental toxins such as heavy metals, solvents and pesticides to pregnant women, according to a recent study published in the journal PLOS ONE, Reuters reports.

Ob-Gyns Lack Tools, Training To Warn Women About Environmental Toxins, Study Finds

June 27, 2014 — Obstetricians and gynecologists feel unprepared to explain the risks of environmental toxins such as heavy metals, solvents and pesticides to pregnant women, according to a recent study published in the journal PLOS ONE, Reuters reports.

For the study, researchers sent a 64-question survey to fellows of the American Congress of Obstetrics and Gynecologists in 2011. More than 2,500 ob-gyns responded. Researchers also conducted three focus groups with 22 ob-gyns.

The survey included questions about doctors' levels of training, knowledge of the effect of environmental exposure, how often they took their patients' environmental histories and whether physicians had a trusted source on the topic, among other topics.

Key Findings

The researchers found that only one in 15 ob-gyns have some form of training on the topic of environmental hazards. In addition, 50% said they rarely asked about their patients' exposure to environmental hazards, even though most respondents -- 78% -- said that talking to patients about the topic could reduce their exposure (Lehman, Reuters, 6/25).

The study also found that ob-gyns were reluctant to discuss environmental risks with their patients because of a lack of training and evidence. In addition, respondents said they did not want to cause anxiety.

They said they especially did not want to worry low-income patients -- who tend to have higher exposure than women with higher socioeconomic status -- about hazards that they had no control over, according to the findings. Respondents perceived low-income patients as having more-immediate problems, such as obesity, poor nutrition and chronic medical conditions, the study found (Manke, "Shots," NPR, 6/25).


Pa. Asks Planned Parenthood for Admitting Privileges Information

Fri, 06/27/2014 - 13:58

Three of Planned Parenthood's Pennsylvania affiliates were mistakenly asked to provide the state with information on their providers' admitting privileges at hospitals, the AP/Washington Times reports.

Pa. Asks Planned Parenthood for Admitting Privileges Information

June 27, 2014 — Three of Planned Parenthood's Pennsylvania affiliates were mistakenly asked to provide the state with information on their providers' admitting privileges at hospitals, the AP/Washington Times reports.

Planned Parenthood operates 10 abortion clinics in the state and has never been asked for such information before, according to Planned Parenthood spokesperson Meghan Roach.

A 2011 state law requires abortion providers to have either admitting privileges or a transfer agreement with a nearby hospital. However, Pennsylvania does not require all abortion clinics to have physicians with admitting privileges, as several other states do.

Department's Explanation

According to Pennsylvania Department of Health spokesperson Aimee Tysarczyk, the department did not intend to inquire about the physician admitting privileges, but an employee asked Planned Parenthood's state affiliates for the information "without receiving directive to do so."

Roach accepted the department's explanation and said Planned Parenthood has a good working relationship with PDH.

However, she spoke out against legislation (HB 1762) pending in the state House Judiciary Committee that would require abortion providers to have admitting privileges at nearby hospitals that offer obstetrical or gynecological services.

"As we've seen in other states, these proposed regulations are not supported by the medical community and are driven by misguided politicians," she said (Levy, AP/Washington Times, 6/25).


Supreme Court Strikes Down Mass. 'Buffer Zone' Law

Thu, 06/26/2014 - 19:17

The Supreme Court unanimously ruled on Thursday that a Massachusetts "buffer zone" law prohibiting protests within 35 feet of abortion clinics violates the First Amendment's right to free speech, the Boston Globe reports.

Supreme Court Strikes Down Mass. 'Buffer Zone' Law

June 26, 2014 — The Supreme Court unanimously ruled on Thursday that a Massachusetts "buffer zone" law prohibiting protests within 35 feet of abortion clinics violates the First Amendment's right to free speech, the Boston Globe reports.

The majority opinion, by Chief Justice John Roberts, said, "[B]uffer zones burden substantially more speech than necessary to achieve [Massachusetts'] asserted interests" (Valencia et al., Boston Globe, 6/26).

Justices Ruth Bader Ginsburg, Stephen Breyer, Sonia Sotomayor and Elena Kagan joined Roberts' opinion, agreeing that the law is unconstitutional because it is not narrowly tailored. The other justices concurred that the law is unconstitutional but said it was because the statute only targets the views of abortion-rights opponents (Haberkorn, Politico Pro, 6/26).

Case Background

The Massachusetts law, enacted in 2007, only permitted people to enter a 35-foot zone around abortion clinics to access the facility itself or reach another destination (Women's Health Policy Report, 1/16).

The lead plaintiff in the case is an abortion-rights opponent who regularly protests outside a Massachusetts Planned Parenthood clinic (Politico Pro, 6/26). Plaintiffs' attorneys argued that the law is unconstitutional because it violates their clients' free-speech rights and favors one side of the abortion-rights debate by allowing clinic employees to enter the buffer zone.

Attorneys for the state argued that the law is necessary to prevent protesters from interfering with access to abortion clinics, particularly given the history of violence at abortion clinics in Massachusetts. The state, joined by the federal government, also argued that there is no constitutional guarantee to conversing with someone in close proximity (Women's Health Policy Report, 1/16).

Roberts' Opinion

Roberts wrote that the state pursued its interest in public safety through "the extreme step of closing a substantial portion of a traditional public forum to all speakers" (Politico Pro, 6/26).

He added that while the state has "undeniably significant interests in maintaining public safety on those same streets and sidewalks," it implemented the buffer zone law without first "seriously addressing the problem through alternatives that leave the forum open for its time-honored purposes."

Roberts said the only way for the state to meet the requirement that free-speech restrictions be "narrowly tailored" would be to "demonstrate that alternative measures that burden substantially less speech would fail to achieve the government's interests, not simply that the chosen route is easier."

For example, traffic ordinances could be used to address the issue of obstructing clinic driveways, while laws barring large groups from congregating for long periods in front of clinics could protect access to entrances, the court said (Boston Globe, 6/26).

Early Reaction

NARAL Pro-Choice America President Ilyse Hogue said in a statement that the group is "deeply disappointed" in the court's decision to strike down the law, which "was supported by public safety officials whose goal is to protect women, doctors, and clinic workers from the relentless harassment and intimidation that they face daily." She added that the antiabortion-rights "movement has a long history of violence and has committed eight murders and 17 attempted murders since 1991."

While the justices "acknowledged that these laws play an important role in protecting women and doctors," they "made it more difficult for states to protect their citizens," Hogue said (NARAL release, 6/26).

Separately, Judith Lichtman, senior advisor at the National Partnership for Women & Families, said in a statement, "Instead of allowing Massachusetts to take this reasonable step to protect women accessing essential health care services, the Court is giving extremists freer rein to intimidate and harass women."

"Violence at clinics is real and constant," she said, adding, "The imperative to ensure that these health centers are safe is as urgent as ever" (National Partnership for Women & Families release, 6/26).


Study Examines Associations Between Sexual Assault, Childlessness Among Female Veterans

Thu, 06/26/2014 - 19:02

In this study, researchers assessed relationships between experiencing attempted or completed sexual assault and voluntary and involuntary childlessness among female veterans. They interviewed more than 1,000 women and found associations between history of sexual assault and childlessness, as well as between sexual assault and increased rates of abortion, post-traumatic stress disorder and infertility, among other issues. The researchers urge women's health care providers to ask veterans about their service and recognize the complex ways it might affect their reproductive health.

Study Examines Associations Between Sexual Assault, Childlessness Among Female Veterans

June 26, 2014 — Summary of "Voluntary and Involuntary Childlessness in Female Veterans: Associations with Sexual Assault," Ryan et al., Fertility and Sterility, May 26, 2014.

"[M]ilitary service presents female service members with high sexual assault" risk and, as more women become eligible for combat roles, "increasing combat-related trauma risks, not to mention deployment-related family disruptions," which can "impact veterans' overall health, as well as reproductive health, choices and outcomes," according to Ginny Ryan of the University of Iowa's Carver College of Medicine and colleagues.

The researchers aimed to follow up on a 1999 study that found associations between sexual assault among female military service members and reproductive and mental health issues, and to "further investigate associations between lifetime attempted or completed sexual assault (LSA) and voluntary and involuntary childlessness and related care seeking in female veterans."

Methods

The researchers interviewed pre-menopausal women enrolled in one of two Midwestern Veterans Affairs Medical Centers or affiliated clinics during the study period (July 2005 to August 2008) or the five years prior.

Participants completed a telephone interview that included questions about attempted and completed LSA, pregnancy and abortion history, postpartum mental health, sexually transmitted infections, and post-traumatic stress disorder. The researchers also collected demographic information.

The researchers then analyzed participants' "histor[ies] of self-reported pregnancy termination(s), infertility, and infertility treatment among three categories of sexual assault: [1] no LSA; [2] attempted only LSA; [3] at least one completed LSA." They also compared those factors "between participants who experienced sexual assault during military service and those who experienced sexual assault outside military service."

In addition, the researchers examined relationships between LSA and various demographic and clinical variables, such as race, marital status and mental health, among others.

Results

A total of 1,004 women from an initial sample of 2,414 participated in the study. Participants ranged from ages 20 to 52, and most were white (80%), heterosexual (94%), insured (84%) and had completed at least some college (85%). Seventy percent of participants had sought gynecological care at a VA clinic.

LSA Data

The researchers found that 62% of participants said they had experienced LSA, with 41% reporting an assault in childhood, 15% in adulthood before the military, 33% in the military and 13% after the military. The researchers noted that the categories were not mutually exclusive. Fifty-one percent of participants reported a completed LSA.

According to the study, 19% of participants who said they were never assaulted reported having an abortion, compared with 29% of those who experienced attempted LSA and 31% of those who experienced completed LSA. In addition, 12% of those who had not experienced LSA said they have experienced infertility, compared with 20% who experienced attempted LSA and 24% who experienced completed LSA.

LSA and Military Service

The study found that "women sexually assaulted in childhood, in military, or in postmilitary adulthood (not mutually exclusive) were more likely to self-report having ever terminated a pregnancy compared with those women without LSA exposure." These populations also were more likely to report infertility. However, "[w]hen all time periods were included, only women sexually assaulted in childhood and/or in military service were more likely to report infertility," the study found.

LSA and PTSD

The researchers found that about one-quarter of participants self-reported a PTSD diagnosis, and about one-quarter "screened positive for probable PTSD." The percentages were higher among women who had experienced LSA (32% and 33%, respectively) and lower among women who had not experienced LSA (10% and 10%, respectively).

Sociodemographic Factors

Veterans who reported LSA "tended to be older (39.5 vs. 36.4 years), more likely to seek gynecologic care at the VA (76% vs. 62%), and less likely to endorse a current sexual preference for men (92% vs. 97%) than veterans who had not experienced LSA."

LSA and Health Outcomes

The researchers found that LSA was "significantly associated with past diagnosis of sexually transmitted infection (42% vs. 27%), earlier age at first pregnancy (21.5 vs. 22.8 years), and a greater number of pregnancies (2.9 vs. 2.5)."

Overall, 31% of the women who experienced LSA and had ever been pregnant had terminated a pregnancy in their lifetimes, a rate that was "significantly higher" than the 19% of veterans who had not experienced LSA, had ever been pregnant and had terminated a pregnancy.

In addition, veterans who reported LSA "were almost twice as likely to self-report infertility (23% vs. 12%) though significantly less likely to be evaluated for infertility once identified (48% vs. 64%)." They were also more likely to report postpartum depression (62% vs. 44%) and to have been diagnosed with PTSD (32% vs. 10%).

Further, 23% of women who reported completed LSA said they delayed or forwent pregnancy "'as a result of the rape.'"

Discussion

"The study confirms the disturbingly high rate of lifetime sexual assault trauma in female veterans (both during military service and before or after military service) found by other studies," as well as the "associations between sexual assault history and certain reproductive outcomes," such as abortion, infertility and "voluntary and involuntary childlessness," the researchers wrote.

They added that while the rate of women who have had an abortion (31%) and the rate of pregnancies that ended in abortion among veterans (19%) were not substantively different than rates in the general population rates (33% and 22%, respectively), "it is remarkable to note the differences in veteran abortion rates based on [LSA] and to see the number of abortions these women have undergone as a direct result of a sexual assault."

Similarly, they wrote that the level of lifetime infertility found in the study (23%) was not very different from available data on infertility in the general population (21.2%), but it is "again intriguing to see the differences in these self-reported infertility rates within [the] veteran population based on sexual assault history."

In the same manner, "it is the significant increase in [PTSD and maternal mental health] symptoms in veterans with a sexual assault history rather than the absolute numbers (although these are certainly alarming) that are highlighted by this study," the researchers added.

They noted, "[I]t is important that all women's health providers ask their patients about military service and understand how female veterans' reproductive health may have been affected in complicated ways by this service," especially as many female veterans "will primarily seek gynecologic care in the civilian system."


Providers, Patients Differ in Priorities for Contraceptive Decision-Making

Thu, 06/26/2014 - 19:02

Researchers from Dartmouth College surveyed women about how they prioritize 34 questions about information they might consider when selecting a contraceptive method. They also asked providers about their priorities in counseling women about the same information. While women and providers placed similar levels of importance on 18 of the 34 questions, they differed in the questions that they felt were most important overall.

Providers, Patients Differ in Priorities for Contraceptive Decision-Making

June 26, 2014 — Summary of "What Matters Most? The Content and Concordance of Patients' and Providers' Information Priorities for Contraceptive Decision Making," Donnelly et al., Contraception, May 1, 2014.

While imperfect contraceptive use is often "framed as failure on the part of the user," it could also "be viewed as a predictable consequence of poor alignment between a woman's unique needs, preferences and circumstances and her chosen contraceptive method," according to Kyla Donnelly of the Dartmouth Institute for Health Policy and Clinical Practice and colleagues from Dartmouth College.

The need to reduce "poor-quality contraceptive decision making ... is particularly salient given the significant expansions in access to contraceptive care and methods recently enabled by the Affordable Care Act [PL 111-148]," the researchers wrote.

They developed a study to assess and compare women's priorities for contraceptive decision-making and providers' priorities in contraceptive counseling.

Methods

The researchers developed an online survey for women ages 15 through 45 and one for health care providers. They recruited respondents through email invitations and social media postings by reproductive health groups, as well as through other email distribution lists, print publications and professional association mailing lists.

The surveys included a list of 34 common questions that might be considered in discussions between women and providers about choosing a contraceptive method. Women were asked how important the questions were to them in choosing a method, while providers were asked how important answering the questions was to them in discussing contraception with a patient.

Respondents were given six response options, including ranking the importance of the question on a scale from "not important at all" to "very important" or stating that they did not "know what this means." They also were allowed to write in as many as three of their own questions and rate their importance. Finally, respondents were asked to rank the questions they identified as "important" or "very important" in order of importance.

For each question, the researchers calculated a "mean importance rating," ranging "from 0 (not important at all) to 4 (very important)," for patients' and providers' responses. They excluded answers in which respondents said they did not understand the question.

They then determined the proportion of respondents who ranked each question among their three most important. The researchers also identified the eight questions that were most frequently ranked among respondents' top three selections.

Results

The final sample included 417 women and 188 providers. Both groups were mostly white and not Hispanic or Latino. Most of the women had a bachelor's or higher degree (74.8%) and were trying to avoid pregnancy (76.1%). Nearly all of the providers were female (97.3%), and they were most commonly trained as nurse-practitioners (27.3%) or physicians (20.3%).

For 18 of the 34 questions, women's and providers' average importance rating was about the same. The largest areas of discordance in importance ratings were that providers rated religious acceptability, concealability of the method and method documentation on health insurance as more important than women did.

For women, "How does it work to prevent pregnancy?" was the most important question overall, while providers equally rated "How often does a patient need to remember to use it?" and "How is it used?" as most important.

"Is it safe?" was the question that appeared most frequently among women's top three questions, while "How is it used?" was most common for providers.

The eight questions that respondents most frequently selected in their top three "were related to the safety of the method, mechanism of action, mode of use, side effects, effectiveness with typical and perfect use, frequency of administration and when it begins to prevent pregnancy," the researchers found.

Discussion

The study "found considerable concordance in women's and providers' information priorities, which is promising given efforts to promote shared contraceptive decision making," the researchers wrote.

However, the discordance in some areas has "important implications for patient-centered counseling practices," they added. For example, women were more likely than providers to prioritize side effects, which is noteworthy "[c]onsidering that side effects are a major cause of method discontinuation," the researchers wrote.

They noted that their "findings are particularly timely given that the [ACA] has served both to significantly expand women's access to contraceptive counseling and methods without out-of-pocket costs and to promote shared decision making and the use of decision support tools in health care more broadly."


Maternal Depression, Pregnancy Intentions Tied to Return to Paid Work for New Moms

Thu, 06/26/2014 - 19:01

Researchers from the University of Maryland-College Park examined the relationships between maternal depression, whether a pregnancy was intended and return to paid work among women who had recently given birth. "Mothers who were not depressed and did not intend the pregnancy ... returned to paid work the soonest," whereas having an intended pregnancy and being depressed decreased the likelihood of return to paid work, the researchers found.

Maternal Depression, Pregnancy Intentions Tied to Return to Paid Work for New Moms

June 26, 2014 — Summary of "Maternal Depression, Pregnancy Intention, and Return to Paid Work After Childbirth," Dagher et al., Women's Health Issues, May/June 2014.

Maternal depression affects about 13% of mothers in the first year after childbirth, making it the most common serious mental health condition during that time period, according to Rada Dagher, Sandra Hofferth and Yoonjoo Lee of the University of Maryland-College Park's School of Public Health.

The majority (61%) of U.S. mothers with infants under age three participate in the workforce, they added, noting that U.S. mothers' higher rate of workforce participation compared with their European counterparts could be tied to the fact that the U.S. lacks a "national policy of paid maternity leave." In addition to financial concerns, factors such as personal values, maternal depression and pregnancy intention can affect a woman's decisions on whether and when to return to paid work after giving birth, past studies suggest.

The researchers devised a study to examine the relationships between return to paid work, maternal depression and pregnancy intention. They hypothesized that lack of depressive symptoms and unintended pregnancy would be associated with a quicker return to paid work. The researchers also predicted that "[t]he association between maternal depression and return to paid work [would] depend on pregnancy intention."

Methods

The researchers examined data from the Listening to Mothers II Survey, which was conducted from Jan. 20, 2006, to Feb. 21, 2006, via telephone and online interviews. Participants in the survey were women ages 18 through 45 who spoke English and delivered a live, singleton infant at a U.S. hospital in 2005. For the study, the researchers focused on data from women who worked for an employer during their pregnancies, resulting in a sample size of 882 women.

Women were asked whether they had returned to work at the time of the interview and, if so, how many weeks had passed since they gave birth when they went back to work. The researchers also measured maternal depression symptoms, using a screening tool.

Results

Participants' average age was 29, 63% were white, 66% were college educated and 70% were married.

Women were interviewed, on average, at 33.26 weeks after giving birth, and 68% of them had returned to paid work at the time of the interview. On average, participants had stopped working 3.8 weeks before delivery. Forty-one percent of participants had paid maternity leave after birth, 59% experienced an intended pregnancy and 62% reported experiencing depressive symptoms.

At one month after delivery, 91.6% of women in the sample had not returned to work, which decreased to 40.9% at three months after delivery, 31% at six months and 18% at 12 months.

"[T]here was no difference" in the likelihood of returning to paid work among depressed and non-depressed mothers when depression was the only variable considered, the researchers found.

However, there was "a significant difference in the probability of returning to paid work among mothers with an intended pregnancy and those with unintended pregnancy." Specifically, mothers who experienced an intended pregnancy returned to work later than those who had an unintended pregnancy.

The researchers found "no difference in return to paid work patterns" among depressed and non-depressed mothers with intended pregnancies.

Overall, "[m]others who were not depressed and did not intend the pregnancy (the reference group) returned to paid work the soonest," the researchers wrote, adding that time of return to paid work was similar to the reference group for mothers who were depressed and did not intend the pregnancy.

Mothers who were depressed and intended the pregnancy were significantly less likely than the reference group to return to work, while those who were not depressed and intended the pregnancy had the lowest likelihood of returning to work.

There was no association between depression and return to work among mothers with unintended pregnancies. Among mothers with intended pregnancies, depression was associated with returning to work sooner.

Assessment of Hypotheses

Sixty-two percent of participants had some depressive symptoms, suggesting that "such symptoms may be common among new mothers," the researchers wrote, adding that this finding possibly explains why their first hypothesis -- that mothers with fewer depressive symptoms would return to work more quickly than depressed mothers -- was not supported.

The researchers were correct in hypothesizing that women who experienced unintended pregnancies would return to work more quickly than those with intended pregnancies. "The lack of preparation for a period of time at home for mothers with unintended pregnancies possibly increased the cost of remaining out of the workforce," they wrote, adding that additional analyses showed that paid maternity leave was less common among women with unintended pregnancies than those with intended pregnancies.

The data also supported the researchers' "third hypothesis of an interaction between depression and pregnancy intention." They "found that pregnancy intention is more important than depressive symptoms but also that, among those with an intended pregnancy, depressed mothers return to paid work more quickly than nondepressed mothers."

Conclusions

While it is generally accepted "that leave after childbirth provides mothers time for emotional recovery and for bonding with the baby, and returning to paid work sooner than desired may worsen depressive symptoms," it is alarming "that women with an intended pregnancy who are depressed return to the workplace sooner than those who are not depressed," the researchers wrote.

If future studies produce similar findings, "primary care and occupational health providers may want to advise women on the optimal amount of leave after childbirth given their mental health states," the researchers suggested. In addition, providers should "ensure that women have access to the most appropriate methods for delaying pregnancy until a woman is ready to have a baby and to delay additional childbearing as desired," they wrote.

Their "findings underscore the need for considering paid leave legislation at the national level, such as the recently introduced Family and Medical Insurance [Leave] Act [S 1810, HR 3712], to ensure more equitable access to these benefits," they added.


Ob-Gyns Describe Frustration With Catholic Hospitals' Restrictions on Tubal Ligation

Thu, 06/26/2014 - 19:00

Tubal ligation is one of the most commonly requested contraceptive methods in the U.S., but it is prohibited under the Roman Catholic Church's religious directives for health care facilities. University of Chicago researchers interviewed ob-gyns to assess their opinions and experiences related to requests for the procedure in Catholic hospitals. The ob-gyns expressed frustration with Catholic hospital policies that they felt put patients at unnecessary risk and increased barriers to care, especially for patients with financial or insurance restrictions.

Ob-Gyns Describe Frustration With Catholic Hospitals' Restrictions on Tubal Ligation

June 26, 2014 — Summary of "Tubal Ligation in Catholic Hospitals: A Qualitative Study of Ob-Gyns' Experiences," Stulberg et al., Contraception, May 5, 2014.

Female sterilization is the second most common contraceptive method among U.S. women, but "tubal sterilization is not always available to women," often because of "system-level barriers," such as Catholic hospital policies that prohibit the procedure, according to a study led by Debra Stulberg of the University of Chicago's MacLean Center for Clinical Medical Ethics and departments of family medicine and obstetrics and gynecology. About half of the roughly 700,000 female sterilizations performed annually in the U.S. occur within 48 hours postpartum, they noted.

Meanwhile, the Roman Catholic Church has become "a large and growing stakeholder in the United States health care system," with one in six U.S. patients receiving care at a Catholic institution, the researchers wrote.

Although the church's directives for health care services prohibit sterilization at Catholic facilities, hospitals vary in how they interpret this order. Some Catholic hospitals permit sterilizations in limited circumstances or have created arrangements to allow patients to access otherwise prohibited services. The researchers developed a study to examine ob-gyns' experiences when patients seek sterilization services at Catholic hospitals.

Methods

The researchers contacted ob-gyns who worked in Catholic hospitals and participated in a previous survey on reproductive health care. They also recruited some ob-gyns from non-Catholic hospitals for comparison.

A qualitatively trained sociologist conducted 45-60 minute interviews that included guided but open-ended questions on topics such as the ob-gyns' likes and dislikes about their hospital; how their values aligned with those of their employers and peers; and clinical issues related to abortion, infertility and sterilization. The interviews were transcribed and thematically analyzed.

The researchers also collected respondents' demographic and religious characteristics.

Results

The final sample included 31 ob-gyns -- 27 of whom had worked in Catholic hospitals -- from all regions of the U.S. Only one of the ob-gyns had never trained or worked in a non-Catholic hospital.

None of the respondents expressed moral objections to sterilization. They held diverse beliefs on abortion and religion, the study found.

The analysis of the interviews revealed two major themes, which the researchers summarized as "risk of harm to women" and "when workarounds don't work."

'Risk of Harm to Women'

The "risk of harm to women" theme included ob-gyns' concern "that their inability to provide tubal sterilization to women, due to the Catholic Directives, sometimes posed a risk of harm to those patients." For example, some patients had a contraindication to future pregnancy, or they were undergoing a medically necessary cesarean section and the ob-gyn was concerned that not performing "a concurrent tubal ligation would expose the patient to unnecessary risk with a second surgery," the researchers wrote.

Ob-gyns also expressed frustration with not being able to provide their patients with what they considered to be the standard of care and discomfort over denying sterilizations that they felt were in a patient's best interest.

'When Workarounds Do Not Work'

The other major theme -- "when workarounds do not work" -- encompassed ob-gyns' descriptions of "scenarios in which workarounds [to Catholic hospital bans on sterilization] were insufficient," the researchers wrote.

They noted that while ob-gyns cited some cases in which they were about to circumvent the bans, there were three types of circumstances in which those efforts were typically inadequate: "partial workarounds that did not apply to all women; workarounds that were narrowed due to changes in enforcement and workarounds subject to a patient's insurance or ability to pay."

The insufficient workarounds often involved sales of hospitals or parts of hospitals to Catholic entities, or increased involvement or stricter enforcement by local bishops. "[I]n some hospitals, physicians who had come to rely on workarounds, or who had been told they would be able to bypass the sterilization ban in specific scenarios, found these options no longer available for their patients," the researchers wrote.

Ob-gyns also described situations in which patients' insurance coverage only included a Catholic hospital, meaning that patients could not obtain tubal sterilization unless they secured special permission from the insurer to cover it at another hospital.

Discussion

On the whole, the respondents "disagreed with strict Catholic hospital prohibitions on sterilization, especially when the patient faced increased medical risk from a future pregnancy or when she was undergoing cesarean delivery," the researchers wrote.

They noted various implications for health care providers, including the "repeated examples of tightening enforcement under new hospital management or a new bishop." The researchers advised health care providers seeking employment or privileges at Catholic hospitals to be wary of "any upfront assurance that sterilization" will be allowed in some cases. They also called for officials at non-Catholic hospital to "carefully consider" how a new Catholic affiliation could affect women's health care.

The researchers also highlighted the added barriers for women with insurance and financial limitations. In addition, they noted that their "findings have important implications for patient autonomy and outcomes." They note that women typically do not have the necessary information "to make an informed choice about whether to seek care in a Catholic hospital" and likely do not "choose their hospital based upon its religious affiliation."

Thus, "women should be encouraged to ask questions in advance to maximize their opportunities for receiving desired sterilization," the researchers wrote. They concluded that as Catholic involvement in the U.S. health care system continues to expand, "policymakers should address whether public funding of medical care should be subject to religious directives that may not be in the patient's best interest."


N.C. Efforts Address Improper Sterilizations

Thu, 06/26/2014 - 18:04

Advocates in North Carolina are urging the state Legislature to extend the deadline for a program designed to compensate survivors of the state's former eugenics program, which forcibly sterilized thousands of residents, Reuters reports.

N.C. Efforts Address Improper Sterilizations

June 26, 2014 — Advocates in North Carolina are urging the state Legislature to extend the deadline for a program designed to compensate survivors of the state's former eugenics program, which forcibly sterilized thousands of residents, Reuters reports.

The $10 million program was authorized last year and currently has a deadline of Monday for claims to be filed. However, advocates said more time is needed to find people who are eligible for compensation, particularly because the state did little outreach to publicize the program (Jenkins, Reuters, 6/24).


Calif. Efforts Address Improper Sterilizations

Thu, 06/26/2014 - 18:03

A California Assembly committee on Tuesday unanimously advanced a bill (SB 1135) that would prohibit sterilization surgeries on the state's inmates, Reuters reports.

Calif. Efforts Address Improper Sterilizations

June 26, 2014 — A California Assembly committee on Tuesday unanimously advanced a bill (SB 1135) that would prohibit sterilization surgeries on the state's inmates, Reuters reports.

The action came after an audit of the state's prisons found that prison officials did not properly obtain informed consent to perform sterilization procedures on 39 female inmates. State Sen. Hannah-Beth Jackson (D), the bill's sponsor and commissioner of the audit, said the bill is necessary to ensure "that women are not coerced into procedures they don't want and [are] truly informed about risks and side effects should they be deemed necessary" (Chaussee, Reuters, 6/24).



State Law Prompts Ala. Abortion Clinic To Relocate

Thu, 06/26/2014 - 18:00

The only abortion clinic in northern Alabama plans to voluntarily surrender its license and close by June 30 because it does not comply with building standards required under a new law (HB 57), Alabama Media Group reports.

State Law Prompts Ala. Abortion Clinic To Relocate

June 26, 2014 — The only abortion clinic in northern Alabama plans to voluntarily surrender its license and close by June 30 because it does not comply with building standards required under a new law (HB 57), Alabama Media Group reports.

The administrator of Alabama Women's Center for Reproductive Alternatives has already notified the state of plans to relocate to another building in the area.

HB 57, which was signed into law by Gov. Robert Bentley (R) in 2013 and takes effect July 1, requires abortion clinics to meet the same standards as ambulatory surgical centers, with doors and hallways wide enough for gurneys, among other requirements (Doyle, Alabama Media Group, 6/25). The clinic's current building, which it has used since 2001, does not meet the standards.

Dalton Johnson, the clinic's administrator, said closing "will be a sad day ... because it means women of North Alabama will no longer have access to the multiple health care services we provide, not just abortions."

Clinic officials have already provided the health department with blueprints for a new location. The department has not approved them yet because it is waiting for some small changes from the architect, a department spokesperson said (Gray, WTVM, 6/24). If approved, the clinic will have to apply for new licensing.

There are three other clinics that offer abortion services in Alabama: Planned Parenthood - Mobile Center, West Alabama Women's Center and Reproductive Health Services (Alabama Media Group, 6/25).


Ohio Abortion Clinic Fights To Stay Open

Thu, 06/26/2014 - 17:58

Toledo's only abortion clinic is fighting a ruling by a state hearing officer that it does not have a valid hospital-transfer agreement and should close, the Toledo Blade reports.

Ohio Abortion Clinic Fights To Stay Open

June 26, 2014 — Toledo's only abortion clinic is fighting a ruling by a state hearing officer that it does not have a valid hospital-transfer agreement and should close, the Toledo Blade reports.

The decision on whether to revoke Capital Care Network's license for failing to have such an agreement is before Ohio Department of Health Acting Director Lance Himes (Provance, Toledo Blade, 6/24). The only other clinic in Toledo closed last year after it could not obtain a transfer agreement.

State Requirement

Ohio law requires that ambulatory surgical facilities -- including abortion clinics -- have transfer agreements with local hospitals in the case of emergencies. In September, provisions in the state budget took effect that require abortion clinics to secure the transfer agreements with private hospitals and prohibit them from making such arrangements with public hospitals, among other restrictions.

The clinic in January secured a hospital-transfer agreement with the University of Michigan Health System, which is about 53 miles from the clinic, after no other private hospital in the region was willing to form an agreement.

However, earlier this month, hearing examiner William Kepko ruled that the pact did not meet the legal requirement for a "local" hospital and did "not specify an appropriate procedure for the safe and immediate transfer of patients from the facility to a local hospital when medical care, beyond the care that can be provided at the ambulatory-care facility, is necessary, including when emergency situations occur or medical complications arise" (Women's Health Policy Report, 6/17).

Clinic's Arguments

In a filing released Tuesday by the health department, Capital Care Network attorney Jennifer Branch argued that the department's determination that a local hospital must be within 30 minutes of an abortion clinic is arbitrary and that the requirement to specify a patient transportation procedure was not consistent with most other state transfer agreements.

Branch also stated that, contrary to the hearing examiner's ruling, the department did have jurisdiction to consider the constitutionality of the relevant state law.

If Himes orders the clinic to close, Capital Care Network is expected to challenge the decision in court, according to the Blade (Toledo Blade, 6/24).


Datapoints: Paid Leave Worldwide, Contraceptive Counseling Priorities & Global Midwifery

Thu, 06/26/2014 - 17:52

Our monthly snapshot of women's health graphics features a global overview of paid maternity leave, plus a chart contrasting women's and health care providers' contraceptive priorities and a look at midwifery worldwide.

Datapoints: Paid Leave Worldwide, Contraceptive Counseling Priorities & Global Midwifery

June 26, 2014 — Our monthly snapshot of women's health graphics features a global overview of paid maternity leave, plus a chart contrasting women's and health care providers' contraceptive priorities and a look at midwifery worldwide.

Paid Leave



The lack of a national paid leave policy for mothers of infants in the U.S. makes the nation a global outlier, as depicted in this map from the World Policy Forum. Worldwide, many nations offer at least 14 weeks of paid leave, either in the form of maternity leave, which is exclusively for mothers, or parental leave, which can be used by either parent (World Policy Forum, accessed June 2014).


Contraceptive Counseling



Women and their health care providers often diverge in which issues they prioritize during consultations about contraceptives, according to results of a study summarized in this chart from NPR's "Shots."

The study surveyed women and providers about which information they thought was most important to include in such consultations. Overall, women thought that safety-related issues were the most important, while providers felt that talking to women about how a method is used should be the top priority (Singh, "Shots," NPR, 6/10).


Global Midwifery



This infographic encapsulates key challenges identified in the 2014 edition of the United Nations Population Fund's "State of the World's Midwifery" report. Although the report depicts progress since UNFPA's inaugural midwifery report in 2011, it shows that the 73 nations included in the report account for the vast majority of global maternal and neonatal deaths.

Additional infographics summarizing the report's findings on the impact of midwives and key actions to ensure more effective midwifery care are available online (UNFPA, June 2014).