Friday, September 14, 2018
Slate (Sept. 12, 2018): Planned Parenthood’s Next President: An Immigrant Doctor of Color Who Grew Up on Medicaid, by Christina Cauterucci:
Planned Parenthood announced in September that its new president, Leana Wen, will start in November. Wen currently serves as Baltimore's health commissioner and is also an emergency room physician. She will be the second doctor to head the organization and the first one to do so in 50 years.
"In both her career and her lived experience, Wen is a near-perfect embodiment of the organization’s core concerns, client base, and trajectory." Wen left China for the United States as a political asylum-seeker when she was eight years old. Growing up in poverty in California, she relied on Medicaid and Planned Parenthood for her health care, and gave back as a medical student by volunteering with Planned Parenthood as well.
In her current role as health commissioner of Baltimore, Wen has contributed both to reducing infant mortality and to fighting against disparate racial treatment in the health care system.
After 10 years of leadership focusing on the political side of the organization under Cecile Richards, Wen is expected to emphasize the legitimacy of the medical branch of Planned Parenthood while also continuing to bolster PP's political activism.
While the majority of Americans support Planned Parenthood, it's often considered a political body and branch of the Democratic party above all else. "Wen will be well-positioned to make the medical case for practices like telemedicine abortions," among other services Planned Parenthood offers and causes it supports.
That Planned Parenthood chose as its next leader a young immigrant woman of color who grew up on Medicaid and has worked to combat health inequities is a testament to the organization’s semi-recent rebranding as one committed to not only reproductive choice but reproductive justice, an ethos that prioritizes equal access to care and includes related issues like mass incarceration and poverty. The organization came under fire in 2014 when several reproductive justice advocacy groups accused it of engaging in “the co-optation and erasure” of work done by women of color in the field by claiming the mantle of reproductive justice without crediting those who’d pioneered the framework. It has been working to shake that reputation ever since.
In hiring Wen, the organization seems to hope to cement their relevancy in the reproductive justice world, re-focusing on intersectionality in the movement as well as making the case for the medical necessity of Planned Parenthood in a country facing growing threats to reproductive rights.
Saturday, September 8, 2018
The New York Times (Sept. 6, 2018): India Strikes Down Colonial-Era Ban on Gay Sex, by Jeffrey Gettleman, Kai Schultz, and Suhasini Raj:
India's Supreme Court unanimously struck down a ban on consensual gay sex, a remnant of the country's colonial past and one of the oldest bans of its kind. The Court called the law "irrational, indefensible and manifestly arbitrary."
The Court's decision came after weeks of deliberation, years of legal arguments, and decades of activism. Human rights advocates in India and around the world celebrated as India joined the growing list of countries granting full rights to gay-identifying people. Similar laws have been overturned in the United States, Canada, England, and Nepal, among others.
In 2009, a court in New Delhi had ruled that the law could not be applied to consensual sex, but religious resistance to this decision followed by an appeal led to the restoration of the full law in 2013. The court deferred at that point to the Parliament and claimed the law only applied to a "minuscule fraction of the country."
In 2016, activists rallied five brave plaintiffs identifying as gay and lesbian Indians who alleged their rights to equality and liberty were violated under the law (Section 377). Eventually, more than two dozen additional Indians joined the case while it was pending before the Supreme Court.
The September 2018 decision struck down the prohibition against gay sex, and the Court also made illegal all discrimination based on sexuality, extending "all constitutional protections under Indian law" to gay people.
The law was written in the mid-19th century and applied to "unnatural sexual acts." The law, which criminalized people who engaged in "intercourse against the order of nature," remains on the books to apply to cases of bestiality, for example, but now no longer can be used against consensual sex. “'History owes an apology to members of the community for the delay in ensuring their rights,' Justice Indu Malhotra said."
Menaka Guruswamy was one of the lead attorneys representing the petitioners. This decision is a "huge win" she said. The lawyers' arguments centered on the legal issues but also embraced pleas to the Justices to recognize the humanity of those who have been affected by Section 377 for decades.
The law is notably a vestige of British colonialism. Hinduism, the dominant religion in India, is generally permissive of same-sex relationships, but levels of tolerance were eviscerated under British rule. The British leaders implemented Section 377, which imposed a life sentence on those in violation. While the law has been greatly limited, India remains a conservative country in many ways, and fundamentalist groups across religions--Hindu, Muslim, and Christian--protested the decision.
In recent years, though, many more Indians have come out, identifying publicly as gay, lesbian, and transgender. Now that these lifestyles are no longer criminalized, Indian activists hope that many more Indians will come out and be embraced by their country.
Tuesday, August 28, 2018
Moms throughout country under investigation while Utah's 'free-range parenting' law said to be first in the nation
The Washington Post (Mar.28, 2018): Utah's 'free-range parenting' law said to be first in the nation, by Meagan Flynn:
Lenore Skenazy reinvigorated debates about best parenting practices when she decided to let her 9-year-old ride the New York City subway alone (with a map, MetroCard, and cash) to instill in him independence in 2008. After the court of public opinion contested whether she was a terrible or great parent, Skenazy wrote a book on her philosophies and coined the term "free-range parenting."
The idea was to let her child engage in "various activities without stifling supervision." Unforunately, many parents who subscribe consciously or not to Skenazy's "free-range" style have encountered the scary side-effects of leaving their children without supervision: interference from child services or the police.
A mother in Chicago allowed her 8-year-old to walk their dog around the block. After the girl arrived safely home, the police stopped at their home upon receiving an anonymous tip about a child walking alone. The investigations that ensue in these scenarios are looking for child neglect. And even if the parents under investigation are cleared by officials (whether child services or the police), they have to endure "invasive and stressful" investigations that can not only be humiliating but are often considered a waste of time and resources. "Experts say that the problem stems from vague laws that often ensnare well-meaning parents who are trying to give their children freedom or responsibility."
A sociology professor at the Univesity of Illinois at Chicago, Barbara Risman, also notes that the expectation that mothers keep "a constant eye on their children" doesn't often extend to fathers:
This shaming mechanism underlies the cultural logic that women should spend all their time making sure their children are never alone. The opposite is true of dads. No one presumes fathers have a moral responsibility to take care of (their children). When they do, they get praise and positive reinforcement.
Child abuse and neglect laws can be vague, defining neglect, for example, as leaving a child under 14 "without supervision for an unreasonable period of time without regard for the mental or physical health, safety, or welfare of that minor." Those charged with investigating a report of neglect generally find it important to thoroughly explore every allegation.
Society is pushing back, though, against what it considers unreasonable surveillance of reasonable parenting. The free-range parenting concept has now translated into law in Utah. State Senator Lincoln Fillmore (R) sponsored the measure, which exempts a range of activities children of a "sufficient age" can do without supervision from the definition of child neglect. These activities include walking, running, or biking to and from school or recreational facilities as well as playing outside or staying inside at home unattended. While the bill was in committee earlier this year, Fillmore told Fox 13:
As a society, we’ve kind of erred, as our pendulum has swung for children’s safety, a little bit too much to the side of helicopter parenting, right? We want kids to be able to learn how to navigate the world so when they’re adults they’re fully prepared to handle things on their own.
Skenazy, too, has remained involved in the conversation. Arkansas attempted to pass a similar bill last year. It failed in committee from fears of child abduction. Skenazy wrote: “Why give kids freedom — why give parents freedom — when you can take it away so easily and say you’re championing safety in the process?”
Saturday, August 25, 2018
Bustle (Aug. 22, 2018): A California Abortion Pill Law Would Require Colleges To Offer Them, Thanks to These Activists, by Lani Seelinger:
California could require medication abortion pills to be available across all of the state's public college campuses if a bill that originated through student activism passes by the end of the month. Activists at the University of California-Berkeley were already focusing on promoting reproductive health care when they realized that expanding that care to include access to medication abortions on campus in particular would improve many student lives.
"Medication abortion is the process by which a woman can terminate her pregnancy by taking a series of pills within the first 10 weeks of her pregnancy." These procedures are considered very safe and efficient, and activists recognize that campus access could alleviate the logistical issues of accessing the medication. Often the stress of accessing a medication abortion can harm a student's emotional, academic, and financial well-being. Over 500 students a month on University of California (UC) and California State University (CSU) campuses seek medication abortions.
The Women's Foundation of California--which fights for racial, economic, and gender justice--partnered with the students and alumni promoting the cause, and from there the effort spread from Berkeley throughout the state. California Senator Connie Leyva introduced the bill in the Senate earlier this year. It passed. Next, the bill must pass in the Assembly before August 31 in order to land on Governor Jerry Brown's desk.
The activists spearheading the campaign for the bill (SB320) are driven by the greater mission of de-stigmatizing abortion.
August 25, 2018 in Abortion, Contraception, Culture, Current Affairs, Politics, Pro-Choice Movement, Public Opinion, Reproductive Health & Safety, State and Local News, State Legislatures, Women, General | Permalink | Comments (0)
Wednesday, August 22, 2018
Aug. 8, 2018 (The New Republic): The Glaring Exception in the Coming Battle Over Reproductive Rights, by Emma Scornavacchi:
Justice Kennedy's retirement announcement earlier this summer immediately sparked discussion and concern over the fate of Roe v. Wade, abortion rights, and reproductive rights in general. Conservative and anti-abortion activists now feel that, depending on Trump's SCOTUS nominee, making abortion illegal in the United States is a real possibility. Further, "an emboldened anti-abortion campaign could lead to consequences for women’s health care and reproductive rights that range far beyond abortion restrictions. Contraceptive devices, such as IUDs or even the pill, could cease to be covered by insurance."
Notably, though, in-vitro fertilization (IVF), tends to be left out of the reproductive rights debate.
A leader of the Pro-Life Action League cited that it can be too difficult to explain what is "objectionable" about IVF as a reason for focusing conservative efforts on abortion alone--despite the fact that the typical IVF cycle results in the disposal of many fertilized embryos. "IVF poses a puzzling challenge for conservative groups: How do organizations that liken embryos to people reckon with a technology that creates babies for families, but destroys embryos along the way?"
In the United States, the success rate for IVF in women under 35 hovers around 42%. To achieve that success, though, IVF cycles may produce anywhere from 3 - 25 embryos at a time. Many of the unused embryos remain frozen, some may be donated to research or to another family, and some may be "thawed" right away (that is, disposed of).
Usually, anti-abortion arguments pertain to the right to life of unborn embryos, who do not get a say in the termination of life. "Unborn" embryos are being terminated by "thawing" across the country, as well, however, with no general outcry from conservative anti-abortion activists. "'There’s a disconnect between how public policy treats women who undergo IVF and women who have abortions,' says Margo Kaplan, a Rutgers law professor." Kaplan herself underwent IVF, and she and her husband chose to donate their unused embryos to medical research. Such research contributes to developments in treatments and cures for diseases like Parkinson's, yet Planned Parenthood was harshly targeted for participating in embryonic research partnerships.
Women who undergo IVF and choose to donate embryos do not have to read any mandated material or sit out a waiting period, both of which are required of women in many states who choose to get an abortion. “Nobody ever questioned my ability to make my own decision. And we don’t assume that women have the same ability to do that when they have an abortion,” Kaplan says.
Anti-abortion activists are hesitant to focus on the IVF issue when they see the opportunity to at least make strides criminalizing abortion, especially in light of today's Supreme Court opening. Kaplan also posits that activists are hesitant to focus on IVF as problematic, because it's a procedure that values and supports a woman's desire to be a mother, while abortion tends to implicate women who are pregnant but do not want motherhood.
Patriarchal values combine with the stigma around abortion to explain the dichotomy in how conservatives are choosing to respond to abortion versus IVF. Further, IVF is steeped in privilege--the costs to undergo IVF cycles can exceed $20,000 and the treatments are out of reach for many people who would otherwise avail themselves of it. As such, IVF is often enjoyed exclusively by well-educated, wealthy, and white women. If it continues to thrive--even amidst anti-abortion attacks on other forms of reproductive rights--its privilege will likely bolster its continued growth and support.
Sunday, August 12, 2018
Aug. 9, 2018 (New York Times): Argentina's Senate Narrowly Rejects Legalizing Abortion, by Daniel Politi and Ernesto Londoño:
After 16 hours of deliberation, Argentina’s Senate narrowly rejected a bill to legalize abortion on Thursday, dealing a painful defeat to a vocal grass-roots movement that pushed reproductive rights to the top of Argentina's legislative agenda and galvanized abortion rights activist groups throughout Latin America, including in Brazil and Chile.
As legislators debated the bill into the early hours of Thursday morning, thousands waited outside the Congress Building in Buenos Aires, weathering the winter cold.
Supporters of the legislation, which would have legalized abortion care during the first 14 weeks of pregnancy, had hoped Argentina would begin a sea change in reproductive rights in a largely Catholic region where 97 percent of women live in countries that ban abortion or allow it only in rare instances.
In the end, 38 legislators voted against legalization, 31 voted in favor, and 2 legislators abstained.
Opposition in Argentina hardened as Catholic Church leaders spoke out forcefully against abortion from the pulpit and senators from conservative provinces came under intense pressure to stand against legalization.
While the bill's failure is considered a major setback for the activists who backed it, analysts said the abortion rights movement has already brought change to Central and South America in ways that would have been impossible just years ago.
On Wednesday, demonstrators rallied in support of the Argentine bill in Uruguay, Mexico, Peru, and Chile, where they gathered in front of the Argentine Embassy in Santiago, chanting and wearing the green handkerchiefs that became the symbol of Argentina’s abortion rights movement.
Recently, activists in Argentina scored a victory with the passage of a law that seeks to have an equal number of male and female lawmakers.
"If we make a list of the things we’ve gained and the things we’ve lost, the list of things we’ve gained is much bigger,” said Edurne Cárdenas, a lawyer at the Center for Legal and Social Studies, a human rights group in Argentina that favors legalized abortion. “Sooner or later, this will be law.”
In the region, only Uruguay, Cuba, Guyana and Mexico City allow any woman to have an early-term abortion.
For Argentina, the debate over abortion has tugged at the country’s sense of self. It is the birthplace of Pope Francis, the leader of the world’s Catholics, who recently denounced abortion as the “white glove” equivalent of the Nazi-era eugenics program. Recently, though, the country has begun shifting away from its conservative Catholic roots. In 2010, Argentina became the first country in Latin America to allow gay couples to wed. Francis, then the archbishop of Buenos Aires, called that bill a “destructive attack on God’s plan.”
The organized movement that pushed the failed bill started in 2015 with the brutal murder of a pregnant 14-year-old girl by her teenage boyfriend. Her mother claimed the boyfriend’s family didn’t want her to have the baby. As debates about violence against women on social media grew into wider conversations about women’s rights, young female lawmakers gave a fresh push to an abortion bill that had been presented repeatedly in the past without going anywhere.
In June, the lower house of the Argentine Congress narrowly approved a bill allowing women to terminate pregnancy in the first 14 weeks. Current law allows abortions only in cases of rape or when a mother’s life is in danger. While the measure failed in the Senate this week, it made some inroads: among the senators who voted for it was Cristina Fernández de Kirchner, who as president had opposed legalizing abortion.
“Society as a whole has moved forward on this issue,” said Claudia Piñeiro, a writer and abortion-rights activist in Argentina. “Church and state are supposed to be separate, but we’re coming to realize that is far from the case,” Ms. Piñeiro said as it became clearer that the push for legalization would lose.
“That will be the next battle.”
Thursday, July 26, 2018
The Department of Health and Human Services (HHS) announced the opening of a new division in January of this year: The Office of Civil Rights (OCR). The OCR's primary mandate is to enforce refusal of care laws.
Refusal of care laws essentially empower medical providers to deny care to patients if they disagree with the ethics of a particular procedure based on their religious grounds. The purported goal of these laws is to protect a healthcare provider from being forced into providing care that "violates their conscience."
This is an Executive-ordered decision that does not require legislative or judicial approval to go into effect or to implement its new rules and regulations.
Critics of refusal of care laws express concern that these requirements do not simply "protect" health care providers consciences, but can instead seriously harm patients. These laws may lead to a pharmacist refusing to fill a birth control prescription, a doctor refusing hormone therapy to a transgender patient, limitations placed on services to LGBTQ persons and partners, and of course abortion services may also become more limited.
HHS does not require providers who refuse treatment to refer patients to other providers or provide any information at all on other providers.
The OCR further has authority to initiate compliance reviews of any organization receiving federal funding to ensure conformity to the new rules.
Earlier this month, the Center for Reproductive Rights (CRR) and the National Women's Law Center (NWLC) filed a lawsuit against HHS for refusing to release records pertaining to the creation of the OCR. The organizations initially requested these records via a FOIA request in January 2018. The CRR and NWLC seek knowledge of why the new division was needed, how the OCR operates, allocates funding, and may be influenced by outside groups.
"We’re filing this lawsuit to force the Trump-Pence administration to justify why it’s using resources to fund discrimination, rather than to protect patients," said Gretchen Borchelt, NWLC Vice President for Reproductive Rights and Health.
HHS's new Office of Civil Rights follows additional moves by the Trump administration to limit equitable access to reproductive health care, including promoting the "Global Gag Rule," its domestic counterpart, and establishing regulations aimed at severely limiting funding to Title X programs.
July 26, 2018 in Abortion, Anti-Choice Movement, Contraception, Culture, Current Affairs, In the Media, Mandatory Delay/Biased Information Laws, Medical News, Politics, President/Executive Branch, Religion, Religion and Reproductive Rights, Reproductive Health & Safety, Sexuality | Permalink | Comments (0)
Wednesday, July 18, 2018
The Washington Post (Jul. 17, 2018): Who gets the embryos? Whoever wants to make them into babies, new law says, by Ariana Eunjung Cha:
New court cases cases are grappling with the decision of what to do with frozen embryos created during a marriage that later dissolves. In many cases that Cha reports on, the couples chose to create and freeze several embryos in the wake of a cancer diagnosis and treatment schedule that threatened later fertility.
When these same couples faced divorce, there were bitter divides over what should be done with the embryos: one party wanted to maintain "ownership" of the embryos for a future chance at children while the other wanted the embryos destroyed, fearing unwanted future financial or relationship obligations.
With the number of frozen embryos in the United States soaring into the millions, disputes over who owns them are also on the rise. Judges have often — but not always — ruled in favor of the person who does not want the embryos used, sometimes ordering them destroyed, following the theory that no one should be forced to become a parent.
In Arizona, though, a "first-in-the-nation law" went into effect on July 1 that states "custody of disputed embryos must be given to the party who intends to help them 'develop to birth.'"
The legislation represents for some lawmakers the idea that frozen embryos have their own right to life, and many imagine that the implications could eventually include a delineation of when life begins and a claim to a separate set of embryonic rights of their own as human beings (rather than the discussion being centered on who "owns" the embryos).
Some groups, like the anti-abortion Thomas More Society, advocate for that embryos to be considered "children" in the legal sense, asking judges to make decisions on disputes based on the best interest of the "child."
Debates to extend personhood to unborn embryos and fetuses abound in anti-abortion work. Abortion rights advocates are concerned that these discussions could further disintegrate the right to abortion in the United States. "If a days-old embryo in a freezer has a right to life, why not a days-old embryo in utero?"
While judges have historically ordered disputed embryos destroyed based on the wishes of the party who does not want a child, an Arizona judge chose to balance one party's "probable inability to have a child without the embryos" against the other party's "desire to not be a father" a different way.
Maricopa County Superior Court Judge Ronee Korbin Steiner held that Ruby Torres, who wanted the embryos in order to have biological children one day, had no right to them. The judge did not order them destroyed, though, and instead ordered that they go up for donation.
Torres appealed the decision and expects a new ruling any day.
The new Arizona law that states embryos shall be given to the party who intends to develop them to birth was written in response to this case to "help" people in Torres' situation. It also attempts to recognize the rights of those who do not want the embryos used by providing that those parties would not be liable for child support in the future.
Both the judicial decisions and the legislation continue to prove extremely controversial:
The Center for Arizona Policy, a conservative lobbying group that has successfully pushed antiabortion legislation in the state, supported the measure, saying the bill would “lead to more consistent rulings.”
The American Society for Reproductive Medicine, which represents doctors, nurses and other professionals who work on fertility issues, opposed the measure, arguing that it would have a profound impact on reproductive medicine.
Medical professionals foresee profound complications to stem-cell research in particular, which relies on embryos donated to science. Such research is believed essential in developing treatments for many diseases and conditions like Parkinson's and Alzheimer's. The treatment and storage of embryos as a result of the new legislation will likely make embryonic stem cells much more scarce.
In a friend-of-the-court brief in Torres' pending appellate case, the Academy of Adoption and Assisted Reproduction Attorneys urged judges in the Arizona Court of Appeals to balance the interest of each former spouse. They argue that the parties claims are not equal and that "the constitutional protection against compulsory parenthood is [generally] greater than any procreative interest in pre-embryos."
Time will tell both if the appellate judges affirm Judge Steiner's controversial ruling (likely leading to further appeals) while we also wait for the inevitable challenges to Arizona's new embryo law.
July 18, 2018 in Abortion, Assisted Reproduction, Bioethics, Culture, Current Affairs, Fertility, Fetal Rights, In the Courts, Medical News, Parenthood, Politics, Public Opinion, Scholarship and Research, State and Local News, State Legislatures, Stem Cell Research | Permalink | Comments (0)
Friday, June 29, 2018
Washington Post (Jun. 27, 2018): Students sue University of Notre Dame for restricting access to some birth control, by Erin B. Logan:
A Notre Dame alumna and three current student sued the university on Tuesday in the wake of Notre Dame's February 2018 announcement that it would deny access to "abortion-inducing" contraceptives. The lawsuit alleges violations of federal law and the First and Fifth Amendments. In addition to the university, the suit names the departments of Health and Human Services, Labor, and Treasury.
These health-care policy changes to Notre Dame's plan will affect undergraduate and graduate students as well as university employees and their dependents. The policy will go into effect on July 1 for employees and in August for students.
The roll-back of coverage by the university is a response to the U.S. Department of Health and Human Services' fall 2017 announcement that it would rescind the Obama-era rule mandating free contraceptive coverage in health plans. This requirement currently remains in effect, though, due to judicial injunctions. Notre Dame, however, carved out an exception for itself with the federal government after a 2013 suit against the mandate claimed a violation of its moral and religious convictions.
Thursday, June 14, 2018
Rewire.News (Jun. 8, 2018): New York GOP Lawmakers Quash Contraception, Abortion Protections—For Now, by Auditi Guha:
The Reproductive Health Act (RHA), or S 2796, was drafted four years ago and recently passed by the Democratic-majority New York Assembly. The RHA is intended to rectify some of the shortcomings of local abortion law. The bill "repeals criminal abortion statutes, permits abortion after 24 weeks when the pregnant person’s health is at risk or when the fetus is not viable, and expands current law so that nurse practitioners and physicians’ assistants can provide abortion services."
The Comprehensive Contraception Coverage Act (S 3668), also passed by the Assembly, "would expand contraceptive coverage to include all forms of FDA-approved contraception (including vasectomies), authorize pharmacists to dispense emergency contraception, and add coverage for contraceptive education and counseling."
Gov. Andrew Cuomo (D) supported incorporating the RHA’s changes into state law in his budget proposal this year, but it’s been a hard push in a state where Republicans decide what bills get to be voted on. Procedural glitches made the fight tougher this week for both the RHA and the Comprehensive Contraception Coverage Act as the senate ground to a halt, the New York Daily News reported.
Senate Democrats last week again tried to bring both the RHA and the CCCA to the floor for a vote, but Republican leadership ended the session without action.
“Both these bills are supported by the governor and have passed the Assembly," Sen. Krueger said in a statement. "The Senate Republicans should stop using procedural maneuvers to block these bills which would ensure that individuals would have control of their own reproductive health decisions.”
The president and CEO of Planned Parenthood Empire State Acts, Robin Chappelle Golston, told Rewire.News: “Obviously legislation as simple as making access to contraception widely available was too much for the majority of the Senate...And I think the best answer for that is that people need to go out and vote this fall.”
Wednesday, May 2, 2018
The New York Times (April 26, 2018): Supporters of El Salvador’s Abortion Ban Foil Efforts to Soften It, by Elisabeth Malkin:
El Salvador remains one of six Latin American countries with a total ban on abortion after the Legislative Assembly failed to debate and vote on a measure that would have relaxed the ban in two circumstances: when the mother's life is in danger and in the case of a minor becoming pregnant as a result of rape.
In El Salvador, abortion is criminalized and punishable by up to eight years in prison for both doctor and patient. Human rights groups around the world have a lobbied for a change in the harsh policies that sometimes criminalize women who have late-term miscarriages. These women have historically been charged with abortion or even aggravated homicide.
Advocates aiming to soften the total ban had been lobbying for months, but their efforts were unsuccessful when the former, left-wing-led national legislature adjourned last week without voting on the proposals. A new Legislative Assembly convenes this month, dominated by conservatives who are not expected to revive the debate or offer reform proposals.
Thursday, April 19, 2018
The New York Times Magazine (April 11, 2018): Why America’s Black Mothers and Babies Are in a Life-or-Death Crisis, by Linda Villarosa:
Villarosa of The New York Times Magazine profiles several black mothers and their pregnancy, child birth, and health care stories while exploring the extraordinarily wide disparity in care that black women receive compared to white women.
The U.S. is one of only 12 countries whose maternal mortality rates have actually increased in recent years and now has a mortality rate worse than 25 years ago. Maternal mortality refers to "the death of a woman related to pregnancy or childbirth up to a year after the end of pregnancy." Women of color are three to four times more likely to die from pregnancy-related causes as white women.
Moms are not the only ones facing the consequences of underdeveloped care.
Black infants in America are now more than twice as likely to die as white infants — 11.3 per 1,000 black babies, compared with 4.9 per 1,000 white babies, according to the most recent government data — a racial disparity that is actually wider than in 1850, 15 years before the end of slavery, when most black women were considered chattel.
In the past, many explanations for the disparity turned to poverty, assuming that it was poor and uneducated black women and their babies that suffered the most. But the crisis does not consider class lines, it turns out. "In fact, a black woman with an advanced degree is more likely to lose her baby than a white woman with less than an eighth-grade education."
In 2014, Monica Simpson--the executive director of SisterSong, an organization dedicated to reproductive justice for women of color, and a member of advocacy group Black Mamas Matter Alliance-- testified before the United Nations Committee on the Elimination of Racial Discrimination. She called on the United States to “eliminate racial disparities in the field of sexual and reproductive health and standardize the data-collection system on maternal and infant deaths in all states to effectively identify and address the causes of disparities in maternal- and infant-mortality rates.” That the United States has not done so is a violation of the international human rights treaty, she says.
This is important for many reasons, one of which is the dramatic effect that society and systemic racism have on a pregnant person's "toxic physiological stress levels." This stress increases the chances for hypertension, pre-eclampsia, and other dangerous pregnancy complications, and it is exacerbated by the pervasive, systemic racial bias embedded in the United States' health care system. Racial bias, discrimination, and the toll it takes on women of color throughout their lives and pregnancy contributes to increased maternal complications across all class and education levels.
Even when controlling for income and education, African-American women had the highest allostatic load scores — an algorithmic measurement of stress-associated body chemicals and their cumulative effect on the body’s systems — higher than white women and black men. ...Though it seemed radical 25 years ago, few in the field now dispute that the black-white disparity in the deaths of babies is related not to the genetics of race but to the lived experience of race in this country.
Community care systems that incorporate the medical and personal support of doulas and midwives have proven to increase black women's chances at a healthy pregnancy, delivery, and postpartum experience.
"One of the most important roles that doulas play is as an advocate in the medical system for their clients." A doula may sometimes be the only person consistently present with the mom-to-be during her birth experience, too. One study of 2,400 women found that "more than a quarter of black women meet their birth attendants for the first time during childbirth, compared with 18 percent of white women."
Doulas “are a critical piece of the puzzle in the crisis of premature birth, infant and maternal mortality in black women.”
Rachel Zaslow, a midwife and doula in Charlottesville, Virginia established Sisters Keeper--a collective of 45 black and Latina doulas in Charlottesville. They offer free birthing services to women of color.
'The doula model is very similar to the community health worker model that’s being used a lot, and successfully, throughout the global South,' Zaslow says. 'For me, when it comes to maternal health, the answer is almost always some form of community health worker.' Since 2015, the Sisters Keeper doulas have attended about 300 births — with no maternal deaths and only one infant death among them.
An analysis of a similar program in New York City showed that, over a five-year period, moms receiving the support of the doula program experience half as many preterm and low-weight babies compared to other community members.
Tuesday, April 10, 2018
John Oliver takes aim at crisis pregnancy centers and anti-abortion activists 'controlling women's behavior'
The Guardian (Apr. 9, 2018): John Oliver takes aim at anti-abortion activists 'controlling women's behavior', by Guardian staff
John Oliver examined crisis pregnancy centers (CPCs) designed to prevent abortions on this past Sunday's episode of HBO's Last Week Tonight, criticizing their “disingenuous and predatory” tactics and explaining how their "primary purpose is to talk women out of terminating a pregnancy.”
There are 2,752 CPCs in the United States, compared with 1,671 abortion providers. Many CPCs use the word "choice" in their names and give out advice that is medically inaccurate. They often pretend to be abortion clinics on the exterior to fool women to enter. “Normally, the strategy ‘pretend you’re an abortion clinic’ is not actually a great marketing stunt, although I am pretty sure that Radio Shack would have tried it if they’d thought of it,” Oliver said.
Oliver also discussed how CPCs discourage the use of contraception. There are claims from within CPCs that condoms are ineffective at preventing pregnancy. “For all the lengths that CPCs will go to to prevent abortions, many of them don’t do a key thing that would help that and that’s give women access to birth control,” he said. “The fact is if you want fewer abortions, you should love birth control."
Oliver said that the real goal of CPCs is “controlling women’s sexual behavior”, as many of them are affiliated with religious figures and organizations.
Watch the segment below:
Saturday, March 10, 2018
Baltimore to join lawsuit against U.S. health agency over cuts to programs that help prevent teen pregnancy
The Baltimore Sun (Mar. 7, 2018): Baltimore to join lawsuit against U.S. health agency over cuts to programs that help prevent teen pregnancy, by Ian Duncan:
The city of Baltimore intends to join a lawsuit against President Trump filed last month by the nonprofit Healthy Teen Network. The suit was filed in U.S. District Court in Baltimore after Healthy Teen Network's federal grant--given to develop and fund the study of an app providing sex education--was significantly reduced.
Baltimore’s health department received an $8.5 million federal grant to help provide sex education for about 20,000 students over five years. Last year, the federal health agency told Baltimore that the program would be severed from its funding after three years instead, leading to a loss of $3.5 million.
The lawsuit alleges that Trump’s appointee to a senior position in the U.S. Department of Health and Human Services has reduced federal grants for programs that do not match the official’s belief that people should not have sex until they are married.
While the lawsuit by Healthy Teen Network states they did not receive a clear explanation for the funding cut, the lawyers claim that the cut in funding is directly related to the appointment of abstinence-only advocate Valerie Huber, who was appointed Chief of Staff for the Office of the Assistant Secretary of Health at the U. S. Department of Health and Human Services in June 2017.
"Dr. Leana Wen, the city’s health commissioner, said the reduction would greatly harm the department’s ability to provide services."
“We have made significant progress to reduce teen birth rates, and the last thing that should happen is to roll back the gains that have been made.”
March 10, 2018 in Culture, Current Affairs, In the Media, Politics, President/Executive Branch, Religion and Reproductive Rights, Sexuality Education, State and Local News, Teenagers and Children | Permalink | Comments (0)
Tuesday, February 27, 2018
ProPublica (Feb. 22, 2018): A Larger Role for Midwives Could Improve Deficient U.S. Care for Mothers and Babies, by Nina Martin:
The results of a five-year study, conducted by researchers in both the U.S. and Canada, on the effects of midwifery on maternal and infant health are in. The study was published in the peer-reviewed journal PLOS ONE; it analyzes hundreds of laws throughout the United States that dictate what a midwife can and cannot do when it comes to prenatal care and the birthing process.
'We have been able to establish that midwifery care is strongly associated with lower interventions, cost-effectiveness and improved outcomes,' said lead researcher Saraswathi Vedam, an associate professor of midwifery who heads the Birth Place Lab at the University of British Columbia.
The midwife model emphasizes community-based maternal and infant care along with avoiding any unnecessary, and potentially dangerous, interventions. Midwives have long been widely embraced in Europe as a positive component of maternal care. In the U.S., though, midwives often represent a "culture war that encompasses gender, race, class, economic competition, professional and personal autonomy, risk versus safety, and philosophical differences."
The title "midwife" can have multiple meanings, ranging from "certified nurse-midwives," to "direct-entry midwives," to "lay midwives." Depending on the title and the state in which the midwife works, the midwife will have a different level of training and may or may not be licensed or regulated by the state.
This new study indicates, though, that midwives may be part of the answer to the U.S.'s problematic infant and maternal mortality rates. Severe maternal complications have sharply risen over the past 20 years, and maternal care is seriously sparse in certain areas of the country. "Nearly half of U.S. counties don't have a single practicing obstetrician-gynecologist."
While midwife regulations vary widely among states, the study shows that states that have more fully integrated midwifery systems within their health care have significantly better outcomes for mothers and babies. States with restrictive midwife regulations--like Alabama, Ohio, and Mississippi--regularly score much lower on tests of maternal and neonatal well-being.
Alabama, which has the worst infant mortality rate in the country, has long had strict midwife regulations, "reflecting attitudes that wiped out the state's once-rich tradition of black birth attendants." Alabama lawmakers, though, recently passed a bill legalizing certified professional midwives, taking one small step toward the process of greater midwife integration, and, hopefully, improved maternal and infant health care across racial and economic lines.
Access to midwifery is often split among racial lines, as many of the states with the worst outcomes (and higher levels of opposition to midwives), including Alabama, have large black populations. The study suggests a correlation between improved access to midwifery and reduced racial disparities in the maternal health care field.
Jennie Joseph, a British-trained midwife who runs the Florida birthing center and nonprofit Commonsense Childbirth affirms this:
“It’s a model that somewhat mitigates the impact of any systemic racial bias. You listen. You’re compassionate. There’s such a depth of racism that’s intermingled with [medical] systems. If you’re practicing in [the midwifery] model you’re mitigating this without even realizing it.”
The study, though, does not conclude that better midwife access will directly lead to better outcomes or vice versa. It acknowledges that many other factors also affect maternal and infant health among states, including access to preventative care, insurance, and rates of chronic disease.
Nonetheless, maternal health advocates have long recognized the benefits of midwifery and this is not the only study to highlight the positive effects of supporting midwives. A 2014 study found that integrating midwives into health care could prevent more than 80 percent of maternal and infant fatalities worldwide, in both low and high-resource communities. Even in the U.S., organizations such as the American Congress of Obstetricians and Gynecologists have begun embracing nurse-midwives despite lingering skepticism by many.
Friday, February 23, 2018
Futurism (Feb. 2, 2018): Advanced Reproductive Technology is Here. But Who Decides Who Gets Access?, by Claudia Geib:
Reproductive technology has expanded and improved immensely over the years. The accessibility of assisted reproduction, fertility treatments, and even adoption, though, is highly limited, particularly in the United States. All of these processes can be prohibitively expensive, and, often, insurance does not cover them or organizations can arbitrarily choose not to provide them.
As reproductive technology is largely unregulated in the U.S., private organizations that manage processes such as embryo donations have full discretion when choosing who can participate in their programs. The National Embryo Donation Center (NEDC) states in its policies that they will only provide embryos to heterosexual, married couples, for example. The NEDC is founded in the Judeo-Christian worldview, and they explicitly exercise this viewpoint--or their perspective of it, at least--when selecting eligible couples for their services.
Jeffrey Keenan, the NEDC's medical director, says that their policy is to operate based on the "biological reality" of a family and God's intention for conception.
As much as you see gay people having children, you have noticed that none of them do it on their own. It is physically and scientifically impossible for gay people to have a child. So why just because we can have someone act as a surrogate, or because we can donate into a [gay] woman, why does that make it right? It doesn’t, not in and of itself.
Civil rights communities, LGBT groups, and, increasingly, the courts oppose these views. What many consider illegal discrimination, though, endures under the protection of U.S. law since such procedures are not generally considered "medically necessary."
Basic fertility treatments are rarely covered by U.S. insurance policies, and when they are, the insurance company may first require proof and documentation of a medical reason preventing "natural" pregnancy.
This is not the case in many other developed countries, where formal regulations, ethical requirements, and even entire administrative departments preside over reproductive technology. The United Kingdom's Human Fertilisation and Embryology Authority, for example, is solely committed to the regulation of fertility treatments and embryonic research in the U.K.
In the U.S., there is simply "no equality of access" to reproducing, says Antonio Gargiulo, an obstetrician-gynecologist and director of robotic surgery at the Brigham and Women's Hospital in Boston. As it stands, Boston residents do have access to fertility treatments under insurance, though; Massachusetts was the first state to pass laws requiring treatments be covered by insurance back in 1987. Just last year, New York also began requiring insurance companies to provide infertility treatments to those seeking, including homosexual couples and single women.
Many medical professionals, though, are skeptical that the federal government--particularly under the anti-regulation Trump administration--will make any moves toward ensuring fertility treatments and reproductive technology are uniformly covered by insurance and accessible to all Americans.
Wednesday, February 21, 2018
ThinkProgress (Jan. 25, 2018): It’s now easier for trans people to update birth certificates in Russia than in many U.S. states, by Zack Ford:
Last month, Russia established new procedures to allow transgender persons to obtain gender-affirming medical documentation without undergoing surgery. Previously, the only way for a trans person to officially change their gender identity was through the submission of a "medical certificate on gender/sex change" to a civil registry office where individual civil servants would determine whether or not to change the applicant's listed identity. The Russian Ministry of Health signed the new order in January, and it went into effect on February 2, 2018.
Although Russia is regularly condemned for its anti-LGBTQ reputation, this new procedure is considered more progressive than those in the United States, which often require transgender patients to undergo surgery before their gender identity will be officially recognized.
The U.S. does not have uniform procedures on how to update gender on a birth certificate or other official documentation. "According to the Transgender Law Center...there are only 17 states that offer clear policies for changing birth certificates and do not require surgeries for recognition." 18 states have policies specifically mandating surgical requirements as a prerequisite to the paperwork. Governor Chris Christie twice vetoed bills in New Jersey that would have eliminated such requirements. The U.S. courts have so far produced inconsistent and unpredictable results for trans persons seeking policy changes.
Russia is not the only country making gender identity documentation more accessible. India and Nepal recognize transgender persons by issuing papers that identify them as a "third gender." Sweden, which practiced forced sterilization well into the 20th century, eliminated its surgical requirement for transgender people in 2013.
Gender reassignment surgery, meant to align a person's gender with their reproductive organs, often results in the patient losing their reproductive ability. Requiring surgery to recognize a trans person's gender is increasingly considered an unacceptable and illegal form of forced sterilization throughout the world. Furthermore, such procedures are often financially prohibitive, making gender alignment surgery, and thus--in the U.S. at least--obtaining legal documentation that recognizes one's gender, inaccessible.
Last year, the European Court of Human Rights ruled against surgical requirements in a French case. The Court cited Article VIII of the European Convention on Human Rights, which gives everyone the right to respect for "his private and family life."
Although Russia still faces intense discrimination against its LGBTQ community, Tatiana Glushkova of the Transgender Legal Defense Project is optimistic that the new procedures eliminating the need for surgery before trans persons can obtain proper medical certificates will “significantly improve the situation of trans people in Russia."
Wednesday, February 7, 2018
Rewire (Jan. 25, 2018): For Nonbinary Parents, Giving Birth Can Be Especially Fraught, by S.E. Smith
Pregnancy and childbirth are vulnerable times in any parent's life. Add to that the highly gendered-status of both pregnancy and birth, and trans and non-binary parents are finding it difficult to locate an inclusive community with educated medical staff as they, too, enter childrearing chapters.
With the trans community, conversations about birth and parenting are few and far between and often fraught with discomfort. Now, though, more parents-to-be identify as trans men or somewhere else on the non-binary spectrum of gender identity. And the medical community has not yet caught up. "And, as in any area of reproductive health-care services, this isn’t simply a matter of gender: Race, class, and geography can play a huge role in whether non-binary people are able to access inclusive, affirming birth care."
Gender-affirming care--including asking for a patient's pronouns with their name, using gender-affirming language, and regularly seeking consent before performing examinations, particularly those that require a medical professional to touch the patient's genitalia--is important. When it is absent, patients report both physical and psychological trauma.
Many in the trans and non-binary communities are increasingly seeking home births with gender-affirming midwives in order to create the most comfortable environments for themselves. Midwifery can be prohibitively expensive though, and insurance rarely covers it. So for others, a hospital may be the safest or the only choice. Advocates say that hospitals and birth collectives would do well to invest in specialized training for medical providers "to ensure that everyone at a facility is trans-competent, or working on getting there."
This issue is likely to amplify in coming years with a more visible nonbinary community, as well as a more active movement to reframe the way we look at pregnancy and birthing. Trans people—binary and otherwise—are some of the biggest stakeholders in the conversation, and they’re contributing with inclusive birthing classes and provider training in addition to working as care providers themselves.
The trans and non-binary communities call on leaders within the medical community to initiate changes from the inside, including re-training initiatives and reframing core educational documents for inclusivity.
Thursday, November 30, 2017
Mother Jones (Nov. 29, 2017): Internal Emails Reveal How the Trump Administration Blocks Abortions for Migrant Teens, by Hannah Levintova and Pema Levy:
Jane Doe isn't the only teenage immigrant the Trump administration has tried to prevent from obtaining an abortion.
While the ACLU represented Doe in her ultimately successfully case to get an abortion, they continue to fight a class-action for other similarly-situation teens. These teens are pregnant and in government custody with the Office of Refugee Resettlement (ORR) within the Department of Health and Human Services. The ORR contracts with local shelters to house the minors.
The director of the ORR, Scott Lloyd, is an anti-abortion activist who has "changed ORR policy to prevent pregnant teens at these shelters from obtaining abortions."
As part of the ongoing lawsuit, the ACLU has obtained government emails showing the lengths to which the current administration will go to prevent an unaccompanied minor from seeking an abortion.
For example, ORR temporarily halted a medication abortion for one pregnant minor halfway through the procedure. In another case, ORR suggested that a pregnant minor scheduled for discharge from the shelter not be released until she had been counseled against receiving an abortion.
The ACLU says the government's efforts amount to a violation of the minors' Constitutional rights and defy Supreme Court precedent such as Roe v. Wade, which states the government cannot ban abortion. "They are effectively banning abortion for Jane Doe. I am still in shock that this is happening,” says Brigitte Amiri, a lead attorney for the ACLU.
One of the emails, published here, includes a redacted sender questioning whether the ORR's methods of approving (or not approving) a minor's pursuit of a judicial bypass are legal. A judicial bypass allows a minor who would otherwise need a guardian's permission for an abortion to get a court's approval to seek and receive an abortion without such parental or guardian permission.
The redacted email sender says:
My understanding is that the judicial bypass was created specifically so that the young lady does not need approval from her guardian (in our case the Director of ORR) to move forward with a term of pregnancy. Has this policy been vetted by your legal department? I anticipate there would be legal challenges to this policy.
Minors represented in this case have received judicial bypasses for their abortions from the courts, however the emails show that ORR nevertheless instructed the shelters not to allow it. It's unclear how those situations were resolved.
The release of these emails makes the government's targeted policies very clear, as the ACLU continues to fight for the Constitutional rights of unaccompanied and undocumented minors.
Friday, November 17, 2017
The New York Times (Nov. 10, 2017): Facebook is Ignoring Anti-Abortion Fake News, by Rossalyn Warren
As Facebook addresses the role of "fake news" on its platform, largely in relation to the 2016 election and Russian political propaganda, another potentially more difficult concern arises. The spread of false reproductive rights and health news is widespread and often harder for Facebook to spot (and manage).
Facebook’s current initiatives to crack down on fake news can, theoretically, be applicable to misinformation on other issues. However, there are several human and technical barriers that prevent misinformation about reproductive rights from being identified, checked and removed at the same — already slow — rate as other misleading stories.
Identifying a fake news sources is not always straightforward. The social media giant says it often targets "spoof" sites that mimic legitimate news sources. But misleading anti-abortion sites can be hazier to identify. They generally publish original pieces, but often alongside inaccurate facts or with poor sourcing, which "helps blur the line between what’s considered a news blog and 'fake news.'"
Facebook aims to limit fake news by making it more difficult for these sources to buy ads or generate spam. "Most false news is financially motivated," Facebook says. This is not often the case with anti-abortion advocates, though, who are overwhelmingly driven by strong religious or political beliefs. The goal isn't profit but persuasion.
Many are concerned that misinformation regarding reproductive rights and abortion in particular may detrimentally affect current political movements. Ireland plans to hold a referendum next year regarding whether to lessen the country's strict abortion regulations. Pro-choice advocates are worried that the rapid spread of abortion-related misinformation on Facebook (like a purported causal link between abortion and breast cancer) may affect the vote.
Facebook has yet, though, to directly address concerns over this type of scientific misinformation in the same way they have begun to address fake news about last year's election.
November 17, 2017 in Abortion, Anti-Choice Movement, Culture, Current Affairs, In the Media, Politics, Pro-Choice Movement, Religion, Religion and Reproductive Rights, Web/Tech | Permalink | Comments (0)