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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Justice Ruth Bader Ginsburg Discusses Future of Roe v. Wade, Much More in New Republic Interview

Thu, 10/02/2014 - 17:02

In a wide-ranging interview with the New Republic's Jeffrey Rosen, Supreme Court Justice Ruth Bader Ginsburg explains why she believes Roe v. Wade will remain "the law of the land," her thoughts on states' increasing restrictions on abortion rights and her dissent in Burwell v. Hobby Lobby, among other topics.

Justice Ruth Bader Ginsburg Discusses Future of Roe v. Wade, Much More in New Republic Interview

September 30, 2014 — In a wide-ranging interview with the New Republic's Jeffrey Rosen, Supreme Court Justice Ruth Bader Ginsburg explains why she believes Roe v. Wade will remain "the law of the land," her thoughts on states' increasing restrictions on abortion rights and her dissent in Burwell v. Hobby Lobby, among other topics.

On Roe v. Wade

Ginsburg does not believe that the Supreme Court will overturn Roe v. Wade anytime soon, even if a Republican is elected president. She noted that the "Court had an opportunity" to overturn Roe in Planned Parenthood v. Casey and did not, with Justices Sandra Day O'Connor, David Souter and Anthony Kennedy issuing a "strong opinion" that reaffirmed Roe. She added that if the justices continue to follow the logic of respecting Roe as precedent, "there will be no overruling and it won't matter whether it's a Democratic president or a Republican president."

When asked what the consequences would be if Roe were overturned, Ginsburg said, "It would be bad for non-affluent women," adding, "It doesn't matter what Congress or the state legislatures do, there will be other states that provide this facility, and women will have access to it if they can pay for it. Women who can't pay are the only women who would be affected."

On States, Courts 'Moving in the Wrong Direction'

Responding to questions about protecting low-income women's access to reproductive health services and whether "legislatures [can] be trusted or ... courts [must] remain vigilant" to do so, Ginsburg said that both the courts and state legislatures "have been moving in the wrong direction."

She asked, "How could you trust legislatures in view of the [abortion] restrictions states are imposing?" She cited "Texas legislation [HB 2] that would put most clinics out of business" as an example, adding that in light of the Supreme Court's Gonzales v. Carhart decision -- which upheld a federal law banning a procedure used in late abortions -- and rulings denying Medicaid coverage for abortion, "[t]he courts can't be trusted either."

She continued, "The irony and tragedy is any woman of means can have a safe abortion somewhere in the United States. But women lacking the wherewithal to travel can't. There is no big constituency out there concerned about access restrictions on poor women." She noted, "It must start with the people. Legislatures are not going to move without that kind of propulsion."

On Hobby Lobby

Ginsburg explained that while Justices Stephen Breyer and Elena Kagan disagreed with some details of her dissent in Hobby Lobby, they "all agreed on what was most important," which was that "no one who is in business for profit can foist his or her beliefs on a workforce that includes many people who do not share those beliefs." She stressed that none of the justices doubted the sincerity of Hobby Lobby's owners' beliefs, but "[t]he simple point is, we have the right to speak freely, to exercise religion freely, with this key limit."

On the Carhart Decision

Ginsburg called the court's decision in Carhart "way out of line," adding that she is particularly troubled by the majority's "attitude" of "looking at the woman as not really an adult individual" and stating in its opinion "that the woman would live to regret her choice." She continued, "Adult women are able to make decisions about their own lives' course no less than men are," and Carhart "was a new form of 'Big Brother must protect the woman against her own weakness and immature misjudgment'" (Rosen, New Republic, 9/28).


Calif. Enacts 'Affirmative Consent' Standard for Campus Sexual Assault, Anti-Trafficking Bills

Thu, 10/02/2014 - 17:01

California Gov. Jerry Brown (D) on Sunday signed a bill (SB 967) into law that will require colleges and universities that receive state funds to determine whether active consent occurred when investigating or adjudicating alleged sexual assaults, the New York Times reports.

Calif. Enacts 'Affirmative Consent' Standard for Campus Sexual Assault, Anti-Trafficking Bills

September 30, 2014 — California Gov. Jerry Brown (D) on Sunday signed a bill (SB 967) into law that will require colleges and universities that receive state funds to determine whether active consent occurred when investigating or adjudicating alleged sexual assaults, the New York Times reports.

In adopting the measure, California became the first state to have an affirmative consent standard, according to the Times (Lovett, New York Times, 9/28).

About 'Affirmative Consent'

Affirmative consent is defined as an "affirmative, unambiguous and conscious decision" by sexual partners to consent to sexual activity. The consent must be "ongoing" and could be "revoked at any time."

The measure specifies that silence or the lack of physical resistance does not constitute consent, nor can consent be given in a situation in which a person is asleep, drugged, drunk or unconscious. However, the legislation does note that consent can be nonverbal.

The legislation also establishes policies aimed at improving protections and services for sexual assault survivors, as well as on-campus education and intervention efforts (Women's Health Policy Report, 8/12). For example, the law requires colleges and universities to offer on-campus survivors' advocates, prohibits survivors who report sexual assaults from being disciplined for underage drinking, and mandates that schools provide sexual assault and consent education during freshman orientation (New York Times, 9/28).

Gov. Brown Signs Human Trafficking Bills

In related news, Brown on Sunday also signed seven bills into law that aim to reduce human trafficking, the AP/San Francisco Chronicle reports.

The new laws include measures that authorize courts to expunge individuals' prostitution convictions if they are found to have been victims of human trafficking, strengthen contractor hiring standards for some foreign-born workers and increase penalties for the solicitation of child prostitutes (AP/San Francisco Chronicle, 9/28).


More Details Released on Birth Control Copay Errors at CVS

Thu, 10/02/2014 - 17:00

A price-coding error that resulted in about 11,000 women being improperly charged copayments for birth control at CVS Health affected people in only one health insurance plan, according to a CVS spokesperson, Kaiser Health News' "Capsules" reports.

More Details Released on Birth Control Copay Errors at CVS

September 30, 2014 — A price-coding error that resulted in about 11,000 women being improperly charged copayments for birth control at CVS Health affected people in only one health insurance plan, according to a CVS spokesperson, Kaiser Health News' "Capsules" reports.

Rep. Jackie Speier (D-Calif.) said that the improper charges affected people enrolled in a plan offered by CareFirst BlueCross BlueShield, which provides coverage in Maryland, Virginia and Washington, D.C. (Luthra, "Capsules," Kaiser Health News, 9/26).

Background

Under federal guidance on the Affordable Care Act's (PL 111-148) contraceptive coverage rules, insurers must cover the full range of contraceptive methods without cost-sharing.

However, after a staff member was charged a $20 copay for generic birth control, Speier sent a letter to CVS Health CEO Larry Merlo stating, "Although my staff member's issue was eventually resolved a week and numerous phone calls and pharmacy visits later, I am concerned that most women who are likely not familiar with their rights under the ACA may go without this essential family planning service that is supposed to be guaranteed to them under law."

Following the inquiry, CVS said the issue stemmed from a price-coding error that would be fixed by Sept. 26. A CVS spokesperson said the pharmacy chain was already working to fix the error prior to receiving Speier's letter. CVS also said it will reimburse women who were improperly charged (Women's Health Policy Report, 9/25).

The affected customers should receive their refunds by the beginning of October, according to "Capsules."

Additional Improper Copayments

It is not known if other customers were affected by the glitch, but Speier's office has received reports of women in her district being charged copayments, according to "Capsules."

CVS has not verified the additional complaints. Speier's office is continuing to collect such reports ("Capsules," Kaiser Health News, 9/26).


NPR Examines Relationship Between Abortion Restrictions, Unsafe Procedures

Thu, 10/02/2014 - 17:00

Advocates on both sides of the abortion-rights debate agree on the need to reduce unsafe abortions, but the factors that lead to these procedures and the best ways to stop them are points of contention, NPR's "Goats and Soda" reports.

NPR Examines Relationship Between Abortion Restrictions, Unsafe Procedures

September 30, 2014 — Advocates on both sides of the abortion-rights debate agree on the need to reduce unsafe abortions, but the factors that lead to these procedures and the best ways to stop them are points of contention, NPR's "Goats and Soda" reports.

Nearly 50,000 women worldwide die from unsafe abortions annually, while an additional five million are admitted to hospitals because of complications following abortion procedures, according to "Goats and Soda."

Research on Impact of Abortion Laws

Some governments have outlawed abortions to try to stop them, but evidence has found that the strategy does not reduce abortion rates.

For example, a Guttmacher Institute and World Health Organization study published in The Lancet in 2012 found that outlawing abortion is linked to slightly higher abortion rates and that the majority of the clandestine procedures are dangerous for women. Specifically, in 18 regions throughout the world, 44 million pregnancies ended in abortion in 2008. On average, abortion rates were about 10% higher in regions with broad abortion restrictions, compared with those with more liberal laws.

In addition, other research has shown that the number of maternal deaths decreases when countries ease abortion restrictions, likely because of a decline in the number of unsafe procedures.

Meanwhile, reports of abortions in the U.S. increased by almost 70% during the six years following the Roe v. Wade Supreme Court decision, which ended pre-viability bans on the procedure nationwide. According to CDC, 750,000 abortions were reported in the country in 1974. By 1980, that number had increased to nearly 1.3 million.

Experts' Explanation

Ana Langer, a reproductive health researcher at the Harvard School of Public Health, said, "Once a procedure becomes illegal, the need is still there." She added, "Women will look for services, safe or unsafe, to terminate their pregnancy."

Legalizing abortion alone is not enough to stop unsafe abortions, said Gilda Sedgh, a researcher at the Guttmacher Institute who was the lead author of the study in The Lancet. It is also important that women are aware of new laws, that the providers are trained to offer safe abortion care and that supplies are in place, she said.

Further, Sedgh and Langer noted that improving access to contraception, in order to reduce unwanted pregnancies, is an effective strategy to reduce the need for abortion.

Meanwhile, Michael New of the antiabortion-rights Charlotte Lozier Institute said the Guttmacher and WHO study's findings are misleading. He said, "Many of the countries where abortion is legally restricted tend to have high poverty rates and a variety of other social pathologies that increase the demand for abortions. This clouds some of the findings and makes them less reliable than one would like" (Doucleff, "Goats and Soda," NPR, 9/28).


Reported Complaints Do Not Reflect Full Scope of Pregnancy Discrimination Incidents

Thu, 10/02/2014 - 16:59

Although more women are filing pregnancy discrimination claims with the Equal Employment Opportunity Commission, some remain hesitant to report pregnancy discrimination and face challenges when trying to prove the claims in court, according to The Atlantic.

Reported Complaints Do Not Reflect Full Scope of Pregnancy Discrimination Incidents

September 26, 2014 — Although more women are filing pregnancy discrimination claims with the Equal Employment Opportunity Commission, some remain hesitant to report pregnancy discrimination and face challenges when trying to prove the claims in court, according to The Atlantic (Cunha, The Atlantic, 9/24).

Overall, pregnancy-related complaints to EEOC increased by 46% from 1997 through 2011, according to the agency's most recent data. In response, EEOC in July released new enforcement guidelines reminding employers that they are prohibited from discriminating against workers based on past, future or current pregnancies (Women's Health Policy Report, 7/16).

According to The Atlantic, some pregnant workers who experience discrimination fear retribution from current or former employers if they report the incidents.

Colorado-based attorney Brian Stutheit said, "The law clearly states the employer can't retaliate against a woman speaking up for her rights, but many employers do it anyway. They just find another reason down the road." Often employees will be treated well for a period of time after the complaint was filed and then fired months later for an unrelated reason, he said.

Similarly, employment attorney Diane King said, "There are many more women discriminated against in the workplace due to pregnancy, family, and gender than will ever come forward to file a claim." She noted that some women might avoid filing claims for fear of receiving a bad reference, adding, "In some businesses, a simple wink and nod can ruin your chances of getting the next job."

Stutheit said women who do sue their employers can face challenges proving the discrimination in court. According to The Atlantic, filming inappropriate behavior in the workplace often violates privacy laws, so most evidence in the cases is considered circumstantial unless there is a documented paper trail. Stutheit added that it can be difficult to convince eyewitnesses to testify because they fear that they will jeopardize their own job (The Atlantic, 9/24).


Blogs Comment on First Birth Center 'Inside an Abortion Clinic,' EC Access, Sharing 'Nuanced' Abortion Stories, More

Thu, 10/02/2014 - 16:58

Read the week's best commentaries from bloggers at RH Reality Check, Salon and more.

Blogs Comment on First Birth Center 'Inside an Abortion Clinic,' EC Access, Sharing 'Nuanced' Abortion Stories, More

September 26, 2014 — Read the week's best commentaries from bloggers at RH Reality Check, Salon and more.

ABORTION PROVIDERS: "Buffalo Clinic First in the Nation To Offer Both Abortion and Birthing Services," Eleanor Bader, RH Reality Check: This spring, "Buffalo Womenservices, a 31-year-old reproductive health facility in" Buffalo, N.Y., "opened the nation's first birth center to be located inside an abortion clinic," Bader writes. She notes that although the center has "rais[ed] eyebrows among some members of the Buffalo community who have bristled at putting birth and abortion care in one facility, the model has provoked interest elsewhere." According to Bader, "clinics in Kansas, Ohio, and Tennessee are exploring the feasibility of adding a birth center to their repertoire of services" (Bader, RH Reality Check, 9/25).

CONTRACEPTION: "Sen. Murray Introduces Legislation To Improve Emergency Contraception Education, Access," Emily Crockett, RH Reality Check: Crockett comments on Sen. Patty Murray's (D-Wash.) introduction of a bill (S 2876) that "would require any hospital that receives federal funding under Medicare or Medicaid ... to both inform sexual assault survivors who come to the emergency room about emergency contraception and to offer it to them regardless of their ability to pay." The bill would also "launch an education campaign on the drug and its uses" to be carried out through HHS, she adds. Crockett writes that Murray has introduced the same bill each year "for over a decade," adding that the senator would have to reintroduce the bill during the next legislative session if Congress does not consider it before the end of this year (Crockett, RH Reality Check, 9/24).

What others are saying about contraception:

~ "CVS Illegally Charged 11,000 Women Contraceptive Co-Pay," Crockett, RH Reality Check.

ABORTION-RIGHTS MOVEMENT: "Abortion Beyond 'Good' and 'Bad': Why It's So Important To Share Nuanced Stories," Katie McDonough, Salon: Sharing abortion stories "is an important and necessary thing," but because "[w]omen who speak out are still targeted for harassment and other threats," it can be difficult "to talk about the full range of experiences that people seeking abortion go through," McDonough writes. The Center for Reproductive Rights has launched a campaign "featuring women and men telling stories related to their own reproductive healthcare choices," she adds, noting that they "are important stories because they're real stories." McDonough also recounts a time she interviewed a woman who recorded her abortion to illustrate how such stories can "challenge stigma around the procedure and demystify the process for people who only think about abortion as an abstract political concept" (McDonough, Salon, 9/25).

What others are saying about the abortion-rights movement:

~ "Rush Limbaugh Inadvertently Donated To an Abortion Fund," Jenny Kutner, Salon.

SUPREME COURT: "Ruth Bader Ginsburg: '50 Years From Now, People Will Not Be Able To Understand Hobby Lobby,'" Kutner, Salon: Supreme Court Justice Ruth Bader Ginsburg, who "has already (artfully) made clear that she disagrees with the Hobby Lobby decision," is "convinced future generations will not only feel the same way, but that they won't even understand the Supreme Court's ruling in the first place," Kutner writes. In an interview with Elle, Ginsburg also stated that "'one of the reasons ... that there's not so much pro-choice activity'" today is because "'young women ... have grown up in a world where they know if they need an abortion, they can get it,'" Kutner notes. Kutner adds that "[w]hen asked if she believes that the court will swing further to the right over abortion rights, Ginsburg answered optimistically, adding that she thinks the court has 'gotten about as conservative as it will get'" (Kutner, Salon, 9/23).

FEMINISM: "We Need #YesAllWomen Now More Than Ever Before," Madeline Wahl, Huffington Post blogs: In the face of continued violence and harassment against women and "the inadequate way people are coping with the spreading popularity of feminism and idea of equality ... we need #YesAllWomen now more than ever before," Wahl writes, reflecting, in part, on reaction to a speech about feminism by actress Emma Watson before the United Nations. She urges women to use the Twitter hashtag "to continue raising awareness on what women have faced and continue to face ... to share our voices and stop the violence." Wahl continues, "We need to tell each other our experiences of sexual assault, of being catcalled, of body shaming and victim shaming and all other kinds of shaming that should not be tolerated. We have to tell each other that 'no means no' and any unwanted contact, even under the guise of a prank, is not appropriate and not allowed." She adds, "We have to tell the men and women in our lives that equality can be achieved, that peace is within our grasp, that we should actually be proud to be feminists" (Wahl, Huffington Post blogs, 9/24).

What others are saying about feminism:

~ "This Is Why I'm Not a Reluctant Feminist," Jean-Paul Bedard, Huffington Post blogs.


U.S. Infant Mortality Rate Improves, Still Lags Behind Many Developed Countries, CDC Finds

Thu, 10/02/2014 - 16:58

The U.S. infant mortality rate has improved but was still the fourth highest among 29 developed nations included in a CDC report released on Wednesday, the Los Angeles Times' "Science Now" reports.

U.S. Infant Mortality Rate Improves, Still Lags Behind Many Developed Countries, CDC Finds

September 26, 2014 — The U.S. infant mortality rate has improved but was still the fourth highest among 29 developed nations included in a CDC report released on Wednesday, the Los Angeles Times' "Science Now" reports (Kaplan, "Science Now," Los Angeles Times, 9/24).

For the report, the infant mortality rate was defined as the percentage of infants who were born alive but died prior to their first birthdays. The researchers compared 2010 U.S. infant mortality rates with European countries, as well Australia, Korea, Israel, Japan and New Zealand.

Key Findings

CDC found that the U.S. infant mortality rate had declined from 6.87 infant deaths per 1,000 live births in 2005 to a rate of 6.1 in 2010 (Haelle, HealthDay/U.S. News & World Report, 9/24). By comparison, the lowest 2010 rates identified in the study were 2.3 in Finland and Japan and 2.5 in Portugal and Sweden.

However, some countries did not report infant mortality rates for premature infants born at 22 or 23 weeks of gestation ("Science Now," Los Angeles Times, 9/24). When excluding such infant deaths from the data, researchers found that the U.S. infant mortality rank was 4.2 deaths per 1,000 live births, the ninth highest rate among countries that supplied infant mortality data for infants born at 22 or 23 weeks and about double the rates for Denmark, Finland and Sweden (Adams, CQ HealthBeat, 9/23).

Overall, the U.S. had the fifth-lowest rate for infants born after 24 to 27 weeks, the second-highest rate for infants born after 32 to 36 weeks, and the highest rate for infants born after at least 37 weeks, with 2.2 deaths per 1,000 live births.

Rates in Perspective

The researchers said that if the U.S. could reduce its mortality rate for infants born after at least 37 weeks to Sweden's rate of 1.1, the country's overall infant mortality rate could decline to 3.2, which would be equivalent to 4,100 fewer infant deaths annually.

In addition, CDC said that if the percentage of all births in the U.S. involving infants born preterm -- before 37 weeks -- declined from 9.8% to Sweden's rate of 5.8%, the U.S. infant mortality rate would decline to 3.4, which would be equivalent to 3,200 fewer infant deaths annually ("Science Now," Los Angeles Times, 9/24).

Contributors to U.S. Rates

Lead author Marian MacDorman said that while the researchers expected the U.S. to have a high preterm birth rate, the "higher infant mortality rate for full-term, big babies who should have really good survival prospects is not what we expected."

While noting that the report did not provide a reason for the findings, MacDorman suggested that they were the result of "social factors, such as [sudden infant death syndrome] and injuries," adding, "I don't think it's so much about health care but about the environment and raising a child."

Deborah Campbell -- a professor of clinical pediatrics at Albert Einstein College of Medicine who was not involved in the study -- said the relatively high infant mortality rate in the U.S. is the result of "significant gaps in access to and utilization of prenatal and preconception care." She added that black women and their infants, in particular, have had a higher risk of mortality as the result of issues such as discrimination, malnutrition and a lack of access to quality care (HealthDay/U.S. News & World Report, 9/24).


Report: States' Abortion Restrictions Tied to Worse Health Outcomes for Women, Children

Thu, 10/02/2014 - 16:57

States that have enacted more abortion restrictions tend to fare worse on women and children's health outcomes and have fewer policies in place that support their health and well-being, according to a report released Wednesday by Ibis Reproductive Health and the Center for Reproductive Rights, the Huffington Post reports.

Report: States' Abortion Restrictions Tied to Worse Health Outcomes for Women, Children

October 2, 2014 — States that have enacted more abortion restrictions tend to fare worse on women and children's health outcomes and have fewer policies in place that support their health and well-being, according to a report released Wednesday by Ibis Reproductive Health and the Center for Reproductive Rights, the Huffington Post reports (Bassett, Huffington Post, 10/1).

Report Details

For the report, researchers tracked which states implemented 14 types of abortion restrictions, including laws imposing mandatory counseling and ultrasounds (Walters, Texas Tribune, 10/1). The researchers then compared the number of abortion restrictions in each state with wellness scores for women and children based on several health indicators, such as how many adult women had received Pap tests, rates of domestic violence, and the percentages of dental coverage and mental health care among children.

In addition, the researchers compared the number of abortion restrictions in each state with the number of policies enacted that support the health and well-being of women and children, such as whether the state expanded Medicaid or requires that pregnant workers receive reasonable accommodations.

According to the report, Kansas, Mississippi and Oklahoma have implemented 14 of the abortion restrictions examined; 22 states have implemented between 11 and 13; and only Vermont has not implemented any of the 14 abortion restrictions.

Key Findings

Overall, researchers found that states with more abortion restrictions performed worse on health indicators for women and children. For example Vermont, New Hampshire and Iowa -- which respectively have zero, two and six of the abortion restrictions in place -- scored the best on those indicators.

By contrast, most of the states with more than 10 abortion restrictions performed poorly on health indicators for women and children. According to the report, such states included Arkansas, Alabama, Arizona, Florida, Indiana, Louisiana, Mississippi, Missouri, Oklahoma and Texas.

While the report did not adjust for income, it found that the percentage of low-income residents did not fully explain differing health results between states. For example, the report noted that Arizona and Texas are middle-income states, but have some of the highest levels of abortion restrictions and scored poorly on health indicators. Meanwhile, certain lower-income states -- including Montana, New Mexico and West Virginia -- fared better on health indicators compared with other states in that income range that had more abortion restrictions (Huffington Post, 10/1).

The researchers also found that states with more abortion restrictions had implemented fewer policies to help the health and well-being of children. In addition, the report found that states with more conservative leadership tended to have more abortion restrictions, fewer state-funded health policies and worse health outcomes (Texas Tribune, 10/1).

CRR President and CEO Nancy Northup said in a statement, "This report exposes the flimsy claims of politicians who have been shutting down women's health care providers under the patently false pretext of protecting women's health" (Huffington Post, 10/1).


American Academy of Pediatrics Recommends IUDs, Hormonal Implants for Adolescents

Thu, 10/02/2014 - 16:56

The American Academy of Pediatrics for the first time has recommended that long-acting reversible contraceptives be considered as a first choice for adolescents seeking contraceptives, according to a policy statement published in Pediatrics, the Pittsburgh Post-Gazette reports.

American Academy of Pediatrics Recommends IUDs, Hormonal Implants for Adolescents

September 29, 2014 — The American Academy of Pediatrics for the first time has recommended that long-acting reversible contraceptives be considered as a first choice for adolescents seeking contraceptives, according to a policy statement published in Pediatrics, the Pittsburgh Post-Gazette reports (Carpenter, Pittsburgh Post-Gazette, 9/29).

The guidance updates AAP's birth control policy from 2007, which did not recommend any specific contraceptive methods besides using condoms. It also brings AAP's position in line with recommendations issued in 2012 by the American College of Obstetricians and Gynecologists.

Benefits of LARC

AAP said that LARC, including intrauterine devices and hormonal implants, are safe, easy to use and nearly 100% effective, with lower failure rates than oral contraceptives, patches, injections and condoms used alone. IUDs are effective for three to 10 years post-insertion, while hormonal implants typically work for three years.

Although IUDs and implants can have higher upfront costs than other methods -- in part because they must be inserted at a doctor's office -- they are more cost-effective in the long run than birth control pills or condoms, according to Mary Ott, lead author of the AAP policy statement and an adolescent medicine specialist and associate pediatrics professor at Indiana University (Tanner, AP/Sacramento Bee, 9/29).

Federal guidance on the contraceptive coverage rules under the Affordable Care Act (PL 111-148) states that insurers must cover the full range of FDA-approved methods without cost sharing (Women's Health Policy Report, 9/19). However, out-of-pocket costs for those without insurance can be $800, according to the Post-Gazette.

Details of AAP Policy, Other Recommendations

The policy said, "The past decade has demonstrated that LARCs ... are safe for adolescents. Pediatricians should be familiar with counseling, insertion and/or referral for LARCs" (Pittsburgh Post-Gazette, 9/29). It added, "Given the efficacy, safety, and ease of use, LARC methods should be considered first-line contraceptive choices for adolescents" (AAP policy statement, 9/24).

AAP recommended that sexually active adolescents also use condoms to protect against sexually transmitted infections and further reduce the chance of pregnancy.

In addition, AAP noted that abstinence is 100% effective at preventing STIs and pregnancy and that pediatricians should counsel adolescents to wait to be sexually active "until they are ready." However, the group noted that many teens will not remain abstinent, so pediatricians should provide adolescents with contraceptive information.

Ott said, "All methods of hormonal birth control," including injections, patches and oral contraceptives, "are safer than pregnancy."

AAP also provided additional information to pediatricians for discussing contraceptive options with obese adolescents, noting that hormonal patches might be less effective in girls who weigh more than 198 pounds and that obese women have a higher likelihood of gaining weight with hormonal injections than with oral contraceptives (AP/Sacramento Bee, 9/29).

Reaction

Guttmacher Institute Director of Public Policy Heather Boonstra said, "The AAP's recommendations will be a great help," adding, "This is about trying to change the minds of the provider community, more of who are recognizing that adolescents are appropriate users for the IUD."

Ana Radovic -- a physician at the Center for Adolescent and Young Adult Health, a family planning clinic -- added that the new policy "will give primary care physicians and pediatricians the much needed information that this is a safe procedure, even for young girls who have never had intercourse" (Pittsburgh Post-Gazette, 9/29).


Report: States' Abortion Restrictions Tied to Worse Health Outcomes for Women, Children

Thu, 10/02/2014 - 16:27

States that have enacted more abortion restrictions tend to fare worse on women and children's health outcomes and have fewer policies in place that support their health and well-being, according to a report released Wednesday by Ibis Reproductive Health and the Center for Reproductive Rights, the Huffington Post reports.

Report: States' Abortion Restrictions Tied to Worse Health Outcomes for Women, Children

October 2, 2014 — States that have enacted more abortion restrictions tend to fare worse on women and children's health outcomes and have fewer policies in place that support their health and well-being, according to a report released Wednesday by Ibis Reproductive Health and the Center for Reproductive Rights, the Huffington Post reports (Bassett, Huffington Post, 10/1).

Report Details

For the report, researchers tracked which states implemented 14 types of abortion restrictions, including laws imposing mandatory counseling and ultrasounds (Walters, Texas Tribune, 10/1). The researchers then compared the number of abortion restrictions in each state with wellness scores for women and children based on several health indicators, such as how many adult women had received Pap tests, rates of domestic violence, and the percentages of dental coverage and mental health care among children.

In addition, the researchers compared the number of abortion restrictions in each state with the number of policies enacted that support the health and well-being of women and children, such as whether the state expanded Medicaid or requires that pregnant workers receive reasonable accommodations.

According to the report, Kansas, Mississippi and Oklahoma have implemented 14 of the abortion restrictions examined; 22 states have implemented between 11 and 13; and only Vermont has not implemented any of the 14 abortion restrictions.

Key Findings

Overall, researchers found that states with more abortion restrictions performed worse on health indicators for women and children. For example Vermont, New Hampshire and Iowa -- which respectively have zero, two and six of the abortion restrictions in place -- scored the best on those indicators.

By contrast, most of the states with more than 10 abortion restrictions performed poorly on health indicators for women and children. According to the report, such states included Arkansas, Alabama, Arizona, Florida, Indiana, Louisiana, Mississippi, Missouri, Oklahoma and Texas.

While the report did not adjust for income, it found that the percentage of low-income residents did not fully explain differing health results between states. For example, the report noted that Arizona and Texas are middle-income states, but have some of the highest levels of abortion restrictions and scored poorly on health indicators. Meanwhile, certain lower-income states -- including Montana, New Mexico and West Virginia -- fared better on health indicators compared with other states in that income range that had more abortion restrictions (Huffington Post, 10/1).

The researchers also found that states with more abortion restrictions had implemented fewer policies to help the health and well-being of children. In addition, the report found that states with more conservative leadership tended to have more abortion restrictions, fewer state-funded health policies and worse health outcomes (Texas Tribune, 10/1).

CRR President and CEO Nancy Northup said in a statement, "This report exposes the flimsy claims of politicians who have been shutting down women's health care providers under the patently false pretext of protecting women's health" (Huffington Post, 10/1).


Va. Health Commissioner Recommends Overhaul of Abortion Clinic Restrictions

Thu, 10/02/2014 - 15:37

Virginia Health Commissioner Marissa Levine on Wednesday suggested that the state overhaul the abortion clinic regulations passed under former Gov. Bob McDonnell (R), the Washington Post's "Virginia Politics" reports.

Va. Health Commissioner Recommends Overhaul of Abortion Clinic Restrictions

October 2, 2014 — Virginia Health Commissioner Marissa Levine on Wednesday suggested that the state overhaul the abortion clinic regulations passed under former Gov. Bob McDonnell (R), the Washington Post's "Virginia Politics" reports (Portnoy, "Virginia Politics," Washington Post, 10/1).

Background

Virginia's rules specify various building standards -- such as exam room size, hallway width and ceiling height -- and create new requirements for inspections, recordkeeping and medical procedures. The rules were written to specifically apply to health centers that provide abortion services.

In May, Gov. Terry McAuliffe (D) appointed five abortion-rights supporters to the state Board of Health and ordered the board to conduct a review, which began in June with a 45-day public comment period (Women's Health Policy Report, 7/31).

Recommendations

Levine in a letter to McAuliffe said that the regulations received more than 14,000 comments, the majority of which called for the repeal of the rules (AP/Sacramento Bee, 10/1). However, Levine wrote that the board does not have the authority to repeal the rules.

Levine instead recommended that the state modify provisions regarding clinic construction and design, better align rules for storing and dispensing drugs with state code, and clarify rules requiring parental consent for abortion. She also said standards for medical testing, lab services, emergencies and anesthesia should be improved.

According to "Virginia Politics," the board will vote on the recommendations on Dec. 4 ("Virginia Politics," Washington Post, 10/1).

Reaction

Tarina Keene, executive director of NARAL Pro-Choice Virginia, said her organization is "thrilled with Commissioner Levine's decision today to put medicine before politics and amend these dangerous restrictions" (AP/Sacramento Bee, 10/1).

Meanwhile, Family Foundation of Virginia President Victoria Cobb said, "We look forward to the Board of Health strengthening the standards in the areas the commissioner has [said] have proven to be seriously deficient in nearly every abortion center in Virginia" ("Virginia Politics," Washington Post, 10/1).


Human Rights Commission To Hear First Case of Forced Sterilization Related to HIV Status

Thu, 10/02/2014 - 14:42

The Inter-American Commission on Human Rights has agreed to hear a forced sterilization case involving a person living with HIV in Latin America, according to the Center for Reproductive Rights, Reuters reports.

Human Rights Commission To Hear First Case of Forced Sterilization Related to HIV Status

October 2, 2014 — The Inter-American Commission on Human Rights has agreed to hear a forced sterilization case involving a person living with HIV in Latin America, according to the Center for Reproductive Rights, Reuters reports.

While the commission has ruled on forced sterilization before, this is the first case it will consider in which an individual was forcibly sterilized because of his or her HIV status.

Case Details

The case involves a Chilean woman who said she was forcibly sterilized because of her HIV-positive status during a cesarean section in 2002. The woman filed a criminal complaint against the Chilean physicians in March 2007, saying she had no knowledge of the sterilization and did not give her consent.

According to CRR, the public prosecutor working on the case conducted a "substandard police investigation," leading to the case's dismissal on the basis that the woman had given verbal consent to the sterilization.

CRR and Vivo Positivo, an HIV/AIDS rights group in Chile, petitioned the commission over the case in 2009. They called for the Chilean government to provide financial compensation to the woman and levy criminal sanctions on the parties responsible for the sterilization. In addition, the groups urged changes to Chilean law to better protect the reproductive and sexual rights of people living with HIV/AIDS and ensure that forcible or coercive sterilizations do not occur in the future.

Prospects

Lilian Sepulveda, head of CRR's global legal program, said it could be several years until the commission considers the case. She noted that the commission could issue non-binding suggestions to the Chilean government and take the role of an intermediary if Chilean officials try to settle the matter out of court.

CRR President Nancy Northup said in a statement that the commission "is making history in taking [the] case and must send a clear message that no country can ever ignore human rights violations or allow discrimination as horrific as forced sterilization" (Moloney, Reuters, 9/30).


Settlement Reached for Legal Claims Over Vaginal Mesh Injuries

Thu, 10/02/2014 - 14:40

Endo International has reached agreements to settle most legal claims related to alleged harm from vaginal mesh products sold by one of its units, the Wall Street Journal reports.

Settlement Reached for Legal Claims Over Vaginal Mesh Injuries

October 2, 2014 — Endo International has reached agreements to settle most legal claims related to alleged harm from vaginal mesh products sold by one of its units, the Wall Street Journal reports.

According to the Journal, Endo in April announced it would pay around $830 million pre-tax to settle a "substantial majority" of legal complaints claiming that its vaginal mesh inserts, which are used to treat urinary incontinence and pelvic organ prolapse, caused injuries. The company previously created a pre-tax product liability fund of around $1.2 billion, which is expected to grow to about $1.6 billion with the latest settlements.

In addition, Endo said American Medical Systems Holding -- the unit that sells the mesh inserts -- will continue investing in educational campaigns to urge physicians and patients to discuss potential risks and benefits related to surgical mesh.

Endo said the settlement agreements are not an admission of fault or liability (Beckerman, Wall Street Journal, 9/30).


Columns: Conservative Writer's Desire To Punish Women for Abortions Not Rare Among Abortion-Rights Opponents

Wed, 10/01/2014 - 17:15

Two writers who support reproductive rights recently responded to comments by National Review's Kevin Williamson, who said that women who have abortions -- and those who help them do so -- should be put to death.

Columns: Conservative Writer's Desire To Punish Women for Abortions Not Rare Among Abortion-Rights Opponents

October 1, 2014 — Two writers who support reproductive rights recently responded to comments by National Review's Kevin Williamson, who said that women who have abortions -- and those who help them do so -- should be put to death.

~ Robin Abcarian, Los Angeles Times: Columnist Abcarian writes that the view that women should face criminal penalties for obtaining abortions is "not as rare as [people] might think" among abortion-rights opponents. In her experience reporting on the abortion-rights debate in the U.S., Abcarian has "interviewed many abortion opponents who believe that terminating a pregnancy under any circumstance is murder and a violation of God's will" and has learned that "there are people in this country who would like nothing better than to see women who have abortions be punished with prison terms. Or worse." She cites the case of Jennifer Whalen, a Pennsylvania mother sentenced to prison for obtaining medication abortion drugs online for her daughter, as an example of the real-life implications of this approach. It is "important to know that people like [Williamson] are out there" and "influenc[ing] the conversation around abortion," she adds (Abcarian, Los Angeles Times, 9/30).

~ Amanda Marcotte, USA Today: Marcotte, a feminism and politics blogger, writes that "anti-abortion activists try to have it both ways, arguing that abortion should be banned because it's 'murder' and that women getting an abortion should be 'protected.'" She suggests that Williamson deserves "[k]udos ... for telling the truth and abandoning the futile effort to ignore the contradiction." Marcotte writes that the American Congress of Obstetricians and Gynecologists has noted that laws supposedly protecting women's health "aren't, in reality, making abortion safer or protecting women at all," adding that such "laws are more consistent with a desire to punish women than with the desire to protect them" (Marcotte, USA Today, 9/30).


Lawsuit Challenges Okla. Medication Abortion Restrictions

Wed, 10/01/2014 - 17:14

Oklahoma women's health care providers on Tuesday filed a lawsuit challenging a state law (SB 1848) that would require physicians to administer medication abortion drugs according to FDA protocol and ban the method after 49 days of pregnancy, which goes against common medical practice, the Oklahoman reports.

Lawsuit Challenges Okla. Medication Abortion Restrictions

October 1, 2014 — Oklahoma women's health care providers on Tuesday filed a lawsuit challenging a state law (SB 1848) that would require physicians to administer medication abortion drugs according to FDA protocol and ban the method after 49 days of pregnancy, which goes against common medical practice, the Oklahoman reports (Green, Oklahoman, 9/30).

Similar Law Struck Down

The legislation was written in direct response to a state Supreme Court decision that struck down a similar state law as unconstitutional because it effectively banned all medication abortions in the state. The state's high court also said in the ruling that 96% of medication abortions are prescribed in a regimen that differs from FDA's protocol, noting that "medical research and advances do not stop upon a particular drug's approval by the FDA" (Women's Health Policy Report, 7/28).

The new law is schedule to take effect Nov. 1.

Lawsuit Details

The lawsuit was filed in Oklahoma County District Court by Nova Health Systems and the Oklahoma Coalition for Reproductive Justice, both represented by the Center for Reproductive Rights.

In their brief, the plaintiffs argued that the law is "an unconstitutional intrusion on women's reproductive rights that will harm women's health and well-being."

CRR in a statement added that requiring clinics to adhere to FDA protocol would prevent clinics from administering the drugs in ways that make medication abortion safer, faster and less costly, with fewer complications (Oklahoman, 9/30).

Comments

Bill author state Rep. Randy Grau (R) expressed confidence the law would be upheld. He said that state lawmakers have "fixed the issues that the court had" when it overturned the previous law. Grau added that the bill is meant to protect women (Murphy, AP/Sacramento Bee, 9/30).

However, CRR President and CEO Nancy Northup said, "The true intent and effect of this law is to deny women an important option for ending a pregnancy safely and legally in the earliest stages," adding, "That is plainly unconstitutional, and we are confident that the court, as it has so many times before, will stop it from ever going into effect" (Oklahoman, 9/30).


Lawsuit Challenges Okla. Medication Abortion Restrictions

Wed, 10/01/2014 - 16:50

Oklahoma women's health care providers on Tuesday filed a lawsuit challenging a state law (SB 1848) that would require physicians to administer medication abortion drugs according to FDA protocol and ban the method after 49 days of pregnancy, which goes against common medical practice, the Oklahoman reports.

Lawsuit Challenges Okla. Medication Abortion Restrictions

October 1, 2014 — Oklahoma women's health care providers on Tuesday filed a lawsuit challenging a state law (SB 1848) that would require physicians to administer medication abortion drugs according to FDA protocol and ban the method after 49 days of pregnancy, which goes against common medical practice, the Oklahoman reports (Green, Oklahoman, 9/30).

Similar Law Struck Down

The legislation was written in direct response to a state Supreme Court decision that struck down a similar state law as unconstitutional because it effectively banned all medication abortions in the state. The state's high court also said in the ruling that 96% of medication abortions are prescribed in a regimen that differs from FDA's protocol, noting that "medical research and advances do not stop upon a particular drug's approval by the FDA" (Women's Health Policy Report, 7/28).

The new law is schedule to take effect Nov. 1.

Lawsuit Details

The lawsuit was filed in Oklahoma County District Court by Nova Health Systems and the Oklahoma Coalition for Reproductive Justice, both represented by the Center for Reproductive Rights.

In their brief, the plaintiffs argued that the law is "an unconstitutional intrusion on women's reproductive rights that will harm women's health and well-being."

CRR in a statement added that requiring clinics to adhere to FDA protocol would prevent clinics from administering the drugs in ways that make medication abortion safer, faster and less costly, with fewer complications (Oklahoman, 9/30).

Comments

Bill author state Rep. Randy Grau (R) expressed confidence the law would be upheld. He said that state lawmakers have "fixed the issues that the court had" when it overturned the previous law. Grau added that the bill is meant to protect women (Murphy, AP/Sacramento Bee, 9/30).

However, CRR President and CEO Nancy Northup said, "The true intent and effect of this law is to deny women an important option for ending a pregnancy safely and legally in the earliest stages," adding, "That is plainly unconstitutional, and we are confident that the court, as it has so many times before, will stop it from ever going into effect" (Oklahoman, 9/30).


Columns: Conservative Writer's Desire To Punish Women for Abortions Not Rare Among Abortion-Rights Opponents

Wed, 10/01/2014 - 14:51

Two writers who support reproductive rights recently responded to comments by National Review's Kevin Williamson, who said that women who have abortions -- and those who help them do so -- should be put to death.

Columns: Conservative Writer's Desire To Punish Women for Abortions Not Rare Among Abortion-Rights Opponents

October 1, 2014 — Two writers who support reproductive rights recently responded to comments by National Review's Kevin Williamson, who said that women who have abortions -- and those who help them do so -- should be put to death.

~ Robin Abcarian, Los Angeles Times: Columnist Abcarian writes that the view that women should face criminal penalties for obtaining abortions is "not as rare as [people] might think" among abortion-rights opponents. In her experience reporting on the abortion-rights debate in the U.S., Abcarian has "interviewed many abortion opponents who believe that terminating a pregnancy under any circumstance is murder and a violation of God's will" and has learned that "there are people in this country who would like nothing better than to see women who have abortions be punished with prison terms. Or worse." She cites the case of Jennifer Whalen, a Pennsylvania mother sentenced to prison for obtaining medication abortion drugs online for her daughter, as an example of the real-life implications of this approach. It is "important to know that people like [Williamson] are out there" and "influenc[ing] the conversation around abortion," she adds (Abcarian, Los Angeles Times, 9/30).

~ Amanda Marcotte, USA Today: Marcotte, a feminism and politics blogger, writes that "anti-abortion activists try to have it both ways, arguing that abortion should be banned because it's 'murder' and that women getting an abortion should be 'protected.'" She suggests that Williamson deserves "[k]udos ... for telling the truth and abandoning the futile effort to ignore the contradiction." Marcotte writes that the American Congress of Obstetricians and Gynecologists has noted that laws supposedly protecting women's health "aren't, in reality, making abortion safer or protecting women at all," adding that such "laws are more consistent with a desire to punish women than with the desire to protect them" (Marcotte, USA Today, 9/30).


Calif. Gov. Signs Legislation To Protect Farm Workers From Sexual Assault

Wed, 10/01/2014 - 14:48

California Gov. Jerry Brown (D) on Sunday signed a bill (SB 1087) into law to help protect agricultural workers from sexual harassment and assault, the Center for Investigative Reporting reports.

Calif. Gov. Signs Legislation To Protect Farm Workers From Sexual Assault

October 1, 2014 — California Gov. Jerry Brown (D) on Sunday signed a bill (SB 1087) into law to help protect agricultural workers from sexual harassment and assault, the Center for Investigative Reporting reports.

According to CIR, state Sen. Bill Monning (D) authored the bill in response to an investigation called Rape in the Fields, which found broad sexual abuse of immigrant women who work on farms.

The new law requires labor contractors, supervisors and all farm employees to complete two hours of sexual harassment training every other year. Previously, only agricultural employers with at least 50 employees were required to provide such training.

In addition, the law requires that licensing exams for labor contractors include questions related to sexual harassment. It also allows the state to revoke the license of any contractor who has harassed a worker or who has hired a supervisor who committed harassment within the last three years (Yeung, Center for Investigative Reporting, 9/29).


Study: Breast Cancer Drug Significantly Extends Survival

Wed, 10/01/2014 - 14:46

Women with an aggressive form of breast cancer that has spread to other parts of the body lived 15.7 months longer if their treatment regimen included a Roche drug called Perjeta, according to a study supported by the drugmaker, the Wall Street Journal reports.

Study: Breast Cancer Drug Significantly Extends Survival

October 1, 2014 — Women with an aggressive form of breast cancer that has spread to other parts of the body lived 15.7 months longer if their treatment regimen included a Roche drug called Perjeta, according to a study supported by the drugmaker, the Wall Street Journal reports (Morse, Wall Street Journal, 9/28).

The 15.7-month survival extension is the longest ever recorded for a drug being studied in women with metastatic breast cancer, according to Reuters (Hirschler, Reuters, 9/28).

The study was conducted among 800 patients with HER2-positive metastatic breast cancers. The study participants either took Herceptin -- another Roche drug -- and underwent chemotherapy, or they took Perjeta in addition to Herceptin and chemotherapy.

Both Herceptin and Perjeta are developed from organisms and "work by blocking the HER2 protein," the Journal reports (Wall Street Journal, 9/28).

Key Findings

Women who took Perjeta along with Herceptin and chemotherapy lived for a median of 56.5 months, compared with 40.8 months among women who did not take Perjeta.

Further, the results mean that the risk of dying was reduced by 32% for women who took Perjeta, compared with those who received Herceptin and chemotherapy alone (Reuters, 9/28). The study was presented at the European Society for Medical Oncology annual meeting.

Implications

According to the New York Times, the findings could lead to increased use of Perjeta, which FDA approved in 2012.

The drug already is considered to be the standard of care in the U.S. However, only about 50% of eligible women are treated with it in the U.S., according to a Roche spokesperson (Pollack, New York Times, 9/28).


Calif. Enacts 'Affirmative Consent' Standard for Campus Sexual Assault, Anti-Trafficking Bills

Tue, 09/30/2014 - 17:22

California Gov. Jerry Brown (D) on Sunday signed a bill (SB 967) into law that will require colleges and universities that receive state funds to determine whether active consent occurred when investigating or adjudicating alleged sexual assaults, the New York Times reports.

Calif. Enacts 'Affirmative Consent' Standard for Campus Sexual Assault, Anti-Trafficking Bills

September 30, 2014 — California Gov. Jerry Brown (D) on Sunday signed a bill (SB 967) into law that will require colleges and universities that receive state funds to determine whether active consent occurred when investigating or adjudicating alleged sexual assaults, the New York Times reports.

In adopting the measure, California became the first state to have an affirmative consent standard, according to the Times (Lovett, New York Times, 9/28).

About 'Affirmative Consent'

Affirmative consent is defined as an "affirmative, unambiguous and conscious decision" by sexual partners to consent to sexual activity. The consent must be "ongoing" and could be "revoked at any time."

The measure specifies that silence or the lack of physical resistance does not constitute consent, nor can consent be given in a situation in which a person is asleep, drugged, drunk or unconscious. However, the legislation does note that consent can be nonverbal.

The legislation also establishes policies aimed at improving protections and services for sexual assault survivors, as well as on-campus education and intervention efforts (Women's Health Policy Report, 8/12). For example, the law requires colleges and universities to offer on-campus survivors' advocates, prohibits survivors who report sexual assaults from being disciplined for underage drinking, and mandates that schools provide sexual assault and consent education during freshman orientation (New York Times, 9/28).

Gov. Brown Signs Human Trafficking Bills

In related news, Brown on Sunday also signed seven bills into law that aim to reduce human trafficking, the AP/San Francisco Chronicle reports.

The new laws include measures that authorize courts to expunge individuals' prostitution convictions if they are found to have been victims of human trafficking, strengthen contractor hiring standards for some foreign-born workers and increase penalties for the solicitation of child prostitutes (AP/San Francisco Chronicle, 9/28).