Friday, August 18, 2017
Washington's Top News (August 12, 2017): Texas set to restrict insurance coverage for abortion, by The Associated Press
A bill that would require women to purchase separate insurance for abortions that are not medical emergencies has passed the Texas state House after hours of debate. The next step is the Texas Senate which could pass the bill as early as tonight. After that the bill would be sent to the Texas Governor, Greg Abbottt. If signed into law Texas would follow in the footsteps of several other states that have laws which restrict health insurance coverage of abortion.
Supporter of the bill Republican Rep. John Smithee states that the proposed law, "applies only to 'elective' abortions and promotes 'economic freedom' by not forcing Texas policyholders who object to abortion to 'subsidize' insurance coverage for women undergoing the procedure". Democrats however argue that this move is purely political since most insurance companies only cover medically necessary abortions. Democrat Rep. Chris Turner states that this law would essentially require women to purchase "rape insurance" since the law would not have a rape or incest exception.
Elizabeth Nash of the Guttmacher Institute states, "my sense is that there isn't any identifiable impact of these restrictions since most women pay out of pocket already". According to the Guttmacher Institute about 60 percent of insured abortion recipients pay out of pocket. The insurance ban has also been condemned by the American College of Obstetricians and Gynecologists which says that abortion procedures should be compared to other essential health care procedures.
Thursday, August 17, 2017
Chicago Tribune (August 16, 2017): Federal court: Arkansas can block Planned Parenthood money, by Andrew DeMillo:
On Wednesday, the 8th Circuit vacated a preliminary injunction prohibiting Arkansas from suspending Medicaid payments to Planned Parenthood. The district court initially enjoined Arkansas from suspending Medicaid payments under a Medicaid provision that provides a right to Medicaid recipients to choose any qualified provider. Four other circuits reached the same conclusion as the district court and prohibited states from disqualifying Planned Parenthood from receiving Medicaid payments.
However, in a 2 to 1 decision, the Eighth Circuit held that the "choice of provider" provision does not create a cause of action for individual plaintiffs (here the Medicaid recipients who received services from Planned Parenthood). Arkansas governor Asa Hutchinson claimed that the state ended Planned Parenthood's contract because of videos purporting to show Planned Parenthood staff discussing fetal tissue sales, which have been deemed false by multiple investigations. The decision does not reach the question of whether the videos constitute an appropriate grounds to terminate Medicaid payments to Planned Parenthood.
Planned Parenthood has indicated that it is "evaluating all options to ensure our patients receive uninterrupted care."
Chicago Tribune (August 9, 2017): Abortion rights group starts advocacy campaign aimed at men, by Rick Pearson
In an effort to engage men, an abortion rights group in Illinois has started a campaign which is named "CallBullS***" or "CallBS". The goal of the campaign is to show men that they do not face the same type of restrictions on their reproductive health as do women. The group hopes to promote awareness of a bill in the state legislature that would expand abortion rights, but that the governor, Bruce Rauner, says he will veto.
The digital media campaign will feature men supporting abortion rights. The campaign will be spread using various social media platforms. The co-founder and executive director of Men4Choice, Oren Jacobson, says that the name is how the campaign first evolved. The name he says it how most men react when they hear about possible restrictions to their reproductive health and Jacobson believes the name will strongly speak to men.
Personal PAC CEO, Terry Cosgrove, one of the organizations leading this campaign, says that this is not just about abortion, but about all reproductive health services and access to birth control. He says the idea was created organically, simply by asking men how they would feel about needing to travel to other states to receive Viagra or a vasectomy. "We decided to give men a space to get involved and take action".
The legislative effort is being conducted by the Democrat-controlled General Assembly in Illinois as a way to ensure abortion remains legal in the state if Roe v. Wade is overturned. The bill would also remove restrictions on using state funding for elective abortions for women on Medicaid and to provide abortion coverage to Illinois state employees. Lawmakers however are hesitant to send Governor Rauner the bill as they are unsure of his position and whether or not he veto it.
Friday, August 4, 2017
WBUR 90.9 (Aug. 1, 2017): States With More Abortion Restrictions Score Worse On Women's Health, Study Finds, by Eojin Choi
A newly released report by Ibis Reproductive Health and the Center for Reproductive Rights found that the the twenty-six states with more than ten abortion restrictions had poorer health outcomes for women than the twenty-four states with fewer than ten restrictions.
Titled Evaluating Priorities: Measuring Women's and Children's Health and Well-being Against Abortion Restrictions in the States, the report's findings challenge anti-choice politicians' claims of passing abortion restrictions under the guise of protecting women's health and safety.
Some examples of positive, supportive policies include Medicaid expansion, expanded family and medical leave, mandated evidence-based sex education, maternal mortality review boards, and contraceptive parity laws. The study found that many states with more abortion restrictions lack these supportive policies.
The report was first published in 2014 and is updated for 2017. You can read the full report here.
Thursday, August 3, 2017
Winston-Salem Journal/Associated Press (Jul. 30, 2017): Judge blocks Arkansas from enforcing four abortion restrictions, by Andrew DeMillo
A federal judge in Arkansas blocked four new abortion restrictions from taking effect, including a ban on dilation & evacuation (D&E, the safest and most common second-trimester procedure), a sex-selection ban, and a fetal-remains restriction that would have effectively required a partner's consent prior to having an abortion. The ruling came down from U.S. District Court Judge Kristine Baker. The Center for Reproductive Rights and the American Civil Liberties Union filed the case on behalf of Little Rock, Arkansas provider Dr. Frederick Hopkins.
D&E bans are currently in effect in Mississippi and West Virginia and are blocked in Alabama, Kansas, Louisiana, and Oklahoma. This year, Texas passed an identical ban that is slated to become effective in September but is being challenged in court.
The sex-selection ban included a provision requiring that a doctor performing the abortion first request records related to the entire pregnancy history of the woman. Judge Baker struck down the restriction, noting that the provision "will cause women to forgo abortion in Arkansas rather than risk disclosure to medical providers who they know oppose abortion or who are family friends or neighbors."
The fourth struck-down law required physicians performing abortions on minors under 17 years of age to preserve embryonic or fetal tissue and notify police where the minor resides. Arkansas currently enforces such a requirement for minors under 14 years of age.
Wednesday, August 2, 2017
The Texas Tribune (July 20, 2017): Abortion rights groups sue Texas over procedure ban, by Marissa Evans
The Center for Reproductive Rights and Planned Parenthood announced last week their decision to sue the state of Texas for a provision in Texas' Senate Bill 8 which is set to go into effect this September. This bill will ban dilation and evacuation abortions, a procedure in which doctors use instruments to remove fetal tissue. The procedure would only be permitted if the fetus is already dead.
Medical professionals state that the dilation and evacuation technique is the safest way to perform an abortion. However, abortion opponents argue that the procedure is inhumane. Similar laws in other states have already been stopped by the courts. This will be the third time this year that Texas will have to defend its abortion laws in court.
Despite the Supreme Court's decision in Whole Woman's Health v. Hellerstedt which last year held multiple Texas abortion policies unconstitutional, Texas continues to pass anti-abortion bills. The Texas governor, Greg Abbott, has put several abortion bills on the docket for the special session which started on July 18th.
Tuesday, August 1, 2017
Huffington Post (July 17, 2017): Investing In Women's Reproductive Health: The Value of $8, by Seema Jalan
New research from the Guttmacher Institute reveals that the need for contraceptives, quality maternal care, and new born health care could be met with only $8.39 per person in the developing world . However, this need is going unmet for millions of women. The research showed that 214 million women in developing countries want to avoid pregnancy but cannot do so using modern contraceptives for numerous reasons. These 214 million women make up approximately 84% of unintended pregnancies in developing regions.
The study also shows that the need for contraceptives, maternal care, and newborn health care are all connected. When all three are provided alongside the others it is the "greatest return on investment...a 130% return." In addition to being economical, it will also save lives. This year alone more than 300,000 women in the developing world will die from pregnancy-related causes, and 2.7 million babies will die in their first month of life. If women had the ability to plan for and space out their pregnancies in combination with receiving quality maternal and new born health care, those numbers would be dramatically reduced. Not only would it reduce deaths; it would also allow women to stay in school and break the cycle of poverty. In order to eliminate the gap and provide quality reproductive health care to women and families in the developing world, investments need to be made by governments, individuals, and civil society.
Thursday, July 20, 2017
Al Jazeera (Jul. 19, 2017): Chile Moves to Ease Strict Abortion Laws, by AFP News Agency:
In 1989, the dictatorial regime of Augusto Pinochet Ugarte outlawed abortion in Chile in all cases. Almost 30 years later, the law remains unchanged.
In 2015, Chilean President Michelle Bachelet advanced a proposal to decriminalize abortion at up to 12 weeks if the pregnant person's physical health was at risk, if the fetus would not survive the pregnancy, or in cases of rape. The reform also included an 18-week window for pregnant individuals under the age of 14. President Bachelet urged Chilean lawmakers to take up the legislation before the country's elections are held in November. The government's lower house, the Chamber of Deputies, has already approved the reforms and the issue now lies before the Senate, which began consideration on Monday, July 17th.
Consideration in the Senate did not come without hurdles. Senate President Andres Zaldivar advanced a proposal arguing that abortion when the mother's life is at risk should not legally be considered an abortion. That measure failed by just one vote following five hours of debate. The legislation finally passed the Senate in the early hours of Wednesday after a 17-hour session, and is now under reconsideration by the Chamber of Deputies. Should the law pass the lower chamber, it will head to President Bachelet for final approval.
Chile is one of just six countries in the world where individuals can be prosecuted for seeking an abortion irrespective of circumstances.
Tuesday, July 18, 2017
Nashville Public Radio (Jul. 17, 2017): Why Women Still Must See A Doctor For The Pill, A Year After Tennessee Law Changed, by Chas Sisk
Early last year, Democrats and Republicans in the Tennessee Legislature co-sponsored and passed legislation that would allow pharmacists to prescribe birth control. Over a year later, pharmacists in Tennessee are still waiting on finalized rules from the Tennessee Department of Health.
State health officials say that final rule drafting has been "complicated." Originally scheduled to be published this summer, the Department has struggled to balance federal regulations with existing law.
The bill had widespread bipartisan support in Tennessee and the backing of major medical associations, pharmacist groups, and reproductive rights organizations. In the face of federal inaction on the issue and the FDA's resistance to over-the-counter birth control, Tennessee took matters into its own hands.
Under the law, women will still have to answer questions about their health before they can receive birth control pills at the pharmacy, and they'll have to be warned of potential side effects. Pharmacists are also required to write out the prescriptions, primarily for record-keeping purposes.
Tennessee will be just the fourth state to allow pharmacists to prescribe birth control, after California, Oregon, and Colorado. California's law spent 18 months in the rulemaking process, and Tennessee officials now expect the same for their own law.
Thursday, July 13, 2017
Human Rights Watch (July 10, 2017): Contraception is Lifesaving but Often Out of Reach, by Nisha Varia
This week, the Family Planning Summit met in London. The goal of this annual meeting is to bring governments, donors, and civil society together to discuss progress and future goals in expanding access to modern contraception for millions of women globally.
Family planning and effective contraception saves lives.
Complications from pregnancy and childbirth are the second leading cause of death for adolescents ages 15 to 19 globally and cause 800 women and girls to die each day. The World Health Organization estimates that at least 22,000 women die from abortion-related complications each year.
This year, many lobbied for the Summit to include conversations on the effects of the Trump administration's reimplementation of the "Global Gag Rule." The controversial policy prohibits foreign nongovernmental organizations from receiving any U.S. health funding if they use funds from any source to provide information about abortions, advocate for or provide abortions.
The policy affects $8.8 billion of foreign assistance. The anticipated consequences of the Gag Rule include increases in unplanned pregnancies and dangerous abortions as well as a higher maternal death rate.
Vox (Jun. 29, 2017): California decided it was tired of women bleeding to death in childbirth, by Julia Belluz:
At the same time the global maternal death rate fell by nearly 44 percent, between 2000 and 2014, the United States watched its maternal mortality rate skyrocket 27 percent. Maternal mortality refers to "the death of a mother from pregnancy-related complications while she's carrying or within 42 days after birth." Childbirth is more dangerous in the U.S. than any other wealthy nation. The reason? The U.S. does not value its women.
The United States is in the company of only 12 other countries whose maternal mortality rates have actually increased in recent years, including North Korea and Zimbabwe.
Researchers and health care advocates argue that a high maternal death rate is a reflection of how that culture views its women.
[In the U.S.,] policies and funding dollars tend to focus on babies, not the women who bring them into the world. For example, Medicaid, the government health insurance program for low-income Americans, will only cover women during and shortly after pregnancy.
Texas, having rejected Medicaid expansion and closed the majority of its Planned Parenthood clinics, has the highest maternal mortality rate in the developed world. California, however, has proven to be an exception within the nation. The California maternal mortality rate has steadily decreased over the same time that the rest of the nation's has risen, thanks in large part to the California Maternal Quality Care Collaborative (CMQCC).
60% of maternal deaths are preventable and the complications that cause them should be anticipated. The CMQCC finds that even within an imperfect health care system, death from childbirth need not be an inevitability. Maternal deaths in the U.S. often result from common complications like hemorrhaging and preeclampsia. The CMQCC has enacted simple, lifesaving procedures over the last decade to reduce the number of unnecessary maternal deaths. And, they're working.
First, they aimed to lower the number of unnecessary C-sections performed. Cesarian sections are often prematurely offered by obstetricians who are short on time. The procedure can leave mothers with internal scar tissue that ultimately makes future pregnancies more dangerous by increasing the mother's risk of hemorrhaging.
As many maternal deaths are a result of hemorrhaging--a mother can bleed to death within five minutes--doctors set out to prepare every delivery room in hospitals participating in their program with a "hemorrhage cart," equipped with everything necessary to handle a bleeding problem the moment it begins.
In a recent study, researchers found a 21 percent reduction in severe complications related to hemorrhages in the hospitals participating in CMQCC's program. Hospitals not participating in the program saw only a one percent reduction.
California has demonstrated that even in our messy and imperfect health care system, progress is possible. They’ve shown the rest of the country what happens when people care about and organize around women’s health. Policymakers owe it to the 4 million babies born in the US each year, and their mothers, to figure out how to bring that success to families across the country.
How the current health care debate and the resulting volatility of the insurance market will affect the United States' maternal mortality rate going forward remains to be seen.
Tuesday, July 11, 2017
ABA Journal (July 7, 2017): Supreme Court allows Wisconsin to enforced fetal protection law pending appeal, by Debra Cassens Weiss:
Last week, the Supreme Court stayed a district court injunction of a Wisconsin fetal protection law. The challenged law gave courts jurisdiction over pregnant women who “habitually lack self-control” in the use of alcohol and drugs “to a severe degree,” creating a substantial risk to the health of the child. Justices Sotomayor and Ginsburg indicated that they would not have granted the stay.
The case was brought by Tamara Loertscher who was held in contempt and jailed for 18 days without prenatal care when she refused to report to a residential drug treatment center. Once Loertscher finally obtained a lawyer, she was able to negotiate an agreement that allowed her to stay at home if she agreed to undergo out patient drug treatment and testing. The subsequent tests were negative, and she gave birth to a health baby boy.
The district court found the statute unconstitutionally vague because the concepts "habitual lack of self-control" and "substantial risk to the physical health of the unborn child" are not "amenable to reasonably precise interpretation." An appeal to the 7th Circuit is pending with briefs due later this month.
Sunday, July 9, 2017
Vox (July 6, 2017): The White House's gender pay gap has more than tripled under Trump, by German Lopez
In recent weeks, news outlets had been reporting that in Trump's White House women are making 80 cents for every dollar a man makes there. However, a new report for the conservative think tank American Enterprise Institute (AEI) explains that it is even worse. Women in Trump's White House are actually making 63.2 cents for every dollar a man makes there. The difference is credited to the way the gender pay gap is calculated. During President Obama's last year in office, women in his White House made 89.25 cents to every dollar a man made there. The AEI disputes the idea that the gender pay gap is due to discrimination, but rather other factors. Despite Trump's daughter Ivanka Trump's effort to speak out against the gender pay gap, so far the Trump administration has not made any strides to change policy.
Washington Post (July 7, 2017): Groups condemn El Salvador's jailing woman after miscarriage, by Associated Press
Human rights organizations around the world are condemning the latest sentencing of a woman in El Salvador. Evelyn Beatriz Hernandez Cruz, a 19 year old, was recently sentenced to 30 years in prison for aggravated homicide. Hernandez Cruz says she was raped and out of fear did not report the incident. She was unaware that she had become pregnant. In April of 2016 she experienced abdominal pain and "was taken to a hospital and treated for vaginal bleeding from an out-of-hospital delivery," but there was no fetus. Authorities decided to pursue a case against Hernandez Cruz and initially charged her with having caused an abortion after finding the fetus. Abortions are illegal in El Salvador with no exceptions. Later, authorities changed the charge against Hernandez Cruz to aggravated homicide. Hernandez Cruz has been in jail since the incident.
Friday, July 7, 2017
Romper (July 5, 2017): Oregon Takes A Monumental Step To Protect Abortion Rights, Because It's Health Care, by Jen McGuire
Oregon, the only state that currently does not enforce any regulations on abortion access, is on the brink of passing more legislation to protect abortion rights. If signed by Governor Kate Brown, this law would provide free abortions and postnatal care to all women in the state of Oregon including undocumented immigrant women. State Representative Julie Fahey sponsored this bill to ensure that a women's right to an abortion and access to health care will not be affected in Oregon regardless of any laws passed or repealed at the federal level. Currently, Senate Republicans are working on a health care bill that could potentially allow states to opt out of requiring insurance companies to pay for certain essential health care benefits. Oregon would be the fifth state to pass legislation protection abortion access as a precautionary measure if the Supreme Court were to overturn Roe v. Wade.
Governor Brown is expected to review the bill soon, but could face opposition from state Republicans. Jonathan Lockwood, the spokesperson for the Oregon Senate Republican Conference, was quoted explaining how he does not believe that Oregonians are okay with funding "late-term, sex-selective abortions" and that this bill is "nothing more than a political gift card to Planned Parenthood." McGuire noted, however, that neither of these statements is true; 99 percent of abortions occur before 21 weeks and sex-selective abortions simply do not happen.
Tuesday, July 4, 2017
Saint Louis Post-Dispatch (Jun. 29, 2017): Planned Parenthood: Judge's Ruling a Victory for Young Women, by Rick Callahan (AP):
A federal judge in Indiana Thursday blocked part of a new law that would have required a judge to determine whether a pregnant minor's parents should be notified if she sought an abortion. Republican Governor Holcomb of Indiana, who signed the law in April, frames it as a "parental rights issue."
Reagan-nominated U.S. District Judge Sarah Evans Barker who enjoined the provision also blocked two additional provisions--one requiring physicians to verify the relationship between a minor and her parents or guardians and another that would have prevented anyone assisting an un-emancipated minor seeking an abortion.
Attorney General Curtis Hill has not yet decided if he will appeal the Judge Barker's decision to the 7th Circuit Court of Appeals in Chicago.
Friday, June 30, 2017
The U.S. Feminist Judgments Project seeks contributors of rewritten judicial opinions and commentaries for an edited collection tentatively titled, Feminist Judgments: Rewritten Family Law Opinions. This edited volume is part of a collaborative project among law professors and others to rewrite, from a feminist perspective, key judicial decisions in the United States. The initial volume, Feminist Judgments: Rewritten Opinions of the United States Supreme Court, edited by Kathryn M. Stanchi, Linda L. Berger, and Bridget J. Crawford, was published in 2016 by Cambridge University Press. Subsequent volumes in the series will focus on different areas of law and will be under review by Cambridge.
Volume editor Rachel Rebouché seeks prospective authors for twelve to fifteen rewritten family law opinions covering a range of topics. With the assistance of an advisory panel of distinguished family law scholars, the editor has selected decisions that have not appeared in other Feminist Judgment volumes. Potential authors are welcome to suggest other opinions, but given certain constraints, the list of cases will likely remain the same. The list of selected cases, a description of the process of selecting decisions, and the opinions considered but not included, are on the application website (https://goo.gl/forms/9JYv7GtR2gJMDVbY2).
Proposals must be to either 1. rewrite an opinion (subject to a 10,000-word limit) or 2. comment on a rewritten opinion (4,000-word limit). Rewritten decisions may be majority opinions, dissents, or concurrences. Authors of rewritten opinions should abide by the law and precedent in effect at the time of the original decision. Commentators should explain the original court decision, how the feminist judgment differs from the original judgment, and what difference a feminist judgment might have made. The volume editor conceives of feminism broadly and invites applications that seek to advance, complicate, or critique feminist ideas and advocacy.
Those who are interested in rewriting an opinion or providing commentary should complete the form found here:
Applications are due no later than Friday, July 21, 2017. The editor will notify accepted authors and commentators by Monday, July 31, 2017.
First drafts of rewritten opinions will be due on Friday, February 2, 2018. First drafts of commentaries will be due on Friday, March 9, 2018.
If you have any questions, please contact Rachel Rebouché at email@example.com.
Wednesday, June 28, 2017
Romper (Jun. 23, 2017): This New Hampshire Law Accidentally Let Pregnant Women Get Away With Murder, by Kenza Moller
New Hampshire lawmakers recently passed a bill defining a fetus of 20 weeks or older as a human with full rights, exposing anyone who causes the death of such a fetus to the risk of being charged with a homicide.
Senate Bill 66 is soon-to-be one of about 38 fetal homicide laws currently on the books throughout the country. Supporters generally think of fetal homicide laws as providing an avenue for women to press charges if their unborn children are killed in an incident such as a car crash or violent assault. Opponents, however, criticize such legislation, citing it as an attack on women's reproductive rights. Fetal homicide laws, they argue, can be construed to punish women who miscarry or are suspected of inducing an abortion.
Republican lawmakers here, though, added a clause to the bill intended to assuage pro-choice fears, but the initial wording implied possible scandalous results.
The bill read that "any act committed by the pregnant woman" or her doctor wouldn't apply in any second-degree murder, manslaughter, or negligent homicide cases, according to Slate. The fine print there, of course, is that "any act" could include far more than just an abortion.
Technically, that would make physician-assisted suicide and murder A-OK for pregnant ladies. Whoops. Once lawmakers noticed the fairly serious loophole, however, they quickly fixed it on Thursday in a legislative move (called an "enrolled bills process") usually reserved for correcting spelling or grammatical errors.
New Hampshire Governor Chris Sununu is expected to sign the bill into law--without granting pregnant women the right to murder--going into effect January 1, 2018.
Saturday, June 24, 2017
TIME (Jun. 22, 2017): 4 Ways the Senate Health Care Bill Would Hurt Women, by Amanda MacMillan
The newly unveiled Senate health care bill intended to repeal the Affordable Care Act has a name: the Better Care Reconciliation Act of 2017. The Senate bill looks very similar to the American Health Care Act passed by the House of Representatives earlier this year, with a few changes. What hasn't changed much is the debilitating effects the legislation could have on women and families, and especially low-income Americans and those with pre-existing conditions.
Under the Senate plan, women could lose essential benefits like cervical cancer screenings, breast pumps, contraception, and domestic violence screening and counseling, and prescription drug coverage could be severely limited. The bill also slashes Medicaid, which currently funds half of all childbirths in the United States, and includes language that allows states to impose employment requirements for Medicaid eligibility.
The Senate plan eliminates Medicaid reimbursements to Planned Parenthood for one year, which would further limit access to essential services like well-woman visits, cancer screenings, and STI testing. Finally, the Republican plan repeals the individual mandate and the requirement that employers with 50 or more employees provide health coverage. Without these requirements, many women will lose their health insurance and face unique challenges, particularly regarding childbirth. With the U.S.'s maternal mortality rate already the highest among the developed world, both the House and Senate bills are likely to make a bad problem worse.
Friday, June 23, 2017
Ms. Magazine (Jun. 21, 2017): Calling on Congress to Support Black Women's Maternal Health, by Meliss Arteaga:
Last week, members of the Black Mamas Matter Alliance (BMMA), a maternal health advocacy committee organized by SisterSong, briefed members of Congress and non-profit groups on Capitol Hill about the state of black maternal health in the United States. BMMA called on Congress to "improve policies that impact the health of pregnant black women and stressed that access to affordable contraception and abortion is a human rights issue."
The U.S. maternal mortality rate has risen by more than fifty percent between 1990 and 2016. According to the Centers for Disease Control (CDC), black women are four times more likely to die during pregnancy, childbirth, and the year following childbirth than white women, and black women also experience more pregnancy complications than white women.
What is causing this significant discrepancy between black and white women? A combination of poverty-driven health disparities, systemic racism in healthcare, and lack of access to care lead to poorer health outcomes for black families.
"Racial discrimination is very real in the health care system," said SisterSong Executive Director Monica Simpson. "We need to listen to pregnant women, talk to pregnant women and love pregnant women. That includes ensuring that programs and policies support the health and the needs of pregnant women."