Friday, September 20, 2019

‘We Are Headed Toward a Public Health Crisis’: Title X Clinics Grapple With Trump’s ‘Gag Rule’

Sept. 11, 2019 (Rewire.News):‘We Are Headed Toward a Public Health Crisis’: Title X Clinics Grapple With Trump’s ‘Gag Rule’, by Erin Heger:

The Trump administration recently introduced a 'gag rule' on recipients of Title X funding, which provides federal money for family planning services to low income individuals hroughout the country. The new rule prohibits clinics receiving Title X funding from referring their patients for abortion care. Clinics that provide abortion services will also have to physically separate abortion and Title X-approved services.

HHS Office of Population Affairs operates Title X by funding “grantees” (health care organizations, state health departments, or non-profits) that oversee the distribution of Title X funds to safety-net clinics and other sites to provide family planning services to low-income, uninsured, and underserved clients.

Because of the recently introduced restrictions, health care organizations and some states are choosing to opt out of receiving Title X funding altogether rather than attempt to comply. The most notable of rejections may be from Planned Parenthood, which announced last month that it was rejecting funding under the new guidelines. The organization's clinics serve 40 percent of the country's Title X patients, and there are concerns that other providers will struggle to take on the resulting predicted increase in patients. According to Guttmacher Institute, there will need to be an estimated 70 percent expansion in clinics' caseloads in order to make up for Planned Parenthood's absence.

Seven states have also opted out, but other states and health care organizations have decided to stay, for fear that clinics they fund will not be able to afford to stay open without the Title X money. Providers in Missouri, for example, are in large part continuing to accept funding.  With previous restrictions on abortions leaving the state with only one abortion clinic, access to reproductive health care is extremely limited as is. "For the majority of Title X patients, their Title X provider is their only source of health care, particularly in small and rural communities," Audrey Sandusky of the National Family Planning and Reproductive Health Association told Rewire.News.

The second part of the gag rule requires that clinics somehow separate out their abortion services from their other functions. This is set to go into effect this coming March, but it's yet to be determined what hoops clinics will have to jump through to remain safely in compliance under these new standards. Many of the providers' plans submitted to the U.S. Department of Health and Human Services have not been approved as of yet. The largest of the Title X administrators, Essential Access Health, has had their plan approved, but its details have not been released.

Sandusky pointed out how low-income individuals already face serious barriers in their lives, and this new restriction makes it even more likely that they will go without care if they cannot go to a Title X provider. "That means they go without cancer screenings, STD testing and treatment, and HIV services. Given the uncertainty that exists across the country, we are headed toward a public health crisis." This certainly seems to be the case.

September 20, 2019 in Abortion, Anti-Choice Movement, Current Affairs, Poverty, Targeted Regulation of Abortion Providers (TRAP) | Permalink | Comments (0)

Thursday, September 19, 2019

Nearly seven percent of U.S. women say first sexual experience was forced

Sept. 16, 2019 (AP News): Many U.S. women say first sexual experience was forced in teens, by Lindsey Tanner: 

A new study published in JAMA Internal Medicine reports that "the first sexual experience for 1 in 16 U.S. women was forced or coerced intercourse in their early teens"--and often perpetrated by persons nearly a decade senior to the survivors.

The national survey conducted for the study did not use the term rape when asking participants about forced sexual experiences but identified a first sexual intercourse experience as "involuntary." Almost half of the participants who reported involuntary intercourse were physically held down during the experience, while just over half of the same respondents described being "verbally pressured to have sex against their will." 

The lead author of the study, Dr. Laura Hawks, affirms that “any sexual encounter (with penetration) that occurs against somebody’s will is rape. If somebody is verbally pressured into having sex, it’s just as much rape."

The study goes on to show that persons whose first sexual intercourse experiences amounted to rape reported "fair or poor health" twice as often as other women. The same women also "had more sex partners, unwanted pregnancies and abortions, and more reproductive health problems including pelvic pain and menstrual irregularities than women whose first sexual experience wasn’t forced."

The new study adds to the findings of prior research that identified a range of long-term effects of sexual assault, including "social isolation, feelings of powerlessness, stigmatization, poor self-image and risky behavior, which all may increase risks for depression and other mental health problems"

An editorial in this issue of the Journal "notes that the study lacks information on women’s health and any abuse before their first sexual encounter." It also doesn't include data on sexual violence after the women's first encounters, which, the editorial notes, may further "contribute to health problems."

The Journal calls for further research to fully understand and address the "range and consequences," particularly as related to long-term health outcomes, of sexual assault on survivors. 

Sex education specialists have responded emphasizing the need for inclusive education in U.S. schools that teaches children about consent among other healthy sexual practices. 

September 19, 2019 in Culture, Medical News, Reproductive Health & Safety, Scholarship and Research, Sexual Assault, Sexuality Education, Teenagers and Children, Women, General | Permalink | Comments (0)

Tuesday, September 17, 2019

Austin City Budget Includes Funding for Women to Overcome Barriers to Abortion Access

September 10, 2019 (NBC News): It just got a Little Easier for Low-Income Women in Texas City to Access Abortion Care, by Adam Edelman:

Last week, City Counsel members in Austin, Texas voted to include funding for low-income women to access abortion. This creative measure supports abortion access through funding services like travel to and from abortion clinics, lodging, and child care for women who need abortion procedures.

A Texas state bill enacted earlier this year, SB22, bans any Texas municipality from allocating public funding to groups that provide abortion care. However, the City Counsel's funding does not actually fund the procedure, sidestepping the restrictive legislation. 

'Advocates of the funding told NBC News it would not violate any of Texas’ restrictive abortion laws. Rather, they explained, the bill would merely help low-income women who need abortion care navigate a complicated landscape.'

Current Texas law imposes a number of barriers that make obtaining an abortion more time consuming and costly. Texas law bans abortion after 20 weeks post fertilization and requires pregnant women in Texas to visit an abortion clinic twice, first to undergo a sonogram and then, after a 24 hour wait,  to actually have the procedure. Additionally, all such costs must be paid out of pocket, as Texas law also prohibits private insurance from covering abortion care. The Austin law helps women pay some of the additional costs imposed on them by Texas law.

New York City Council recently approved a similar funding measure that allocated $250,000 to fund abortions for poor women who live in, or have traveled to New York City from the procedure. 

Advocates of the Austin measure hope that this action can provide an example for blue cities in red states to creatively advance abortion rights in their own cities. 

September 17, 2019 in Abortion, Current Affairs, Poverty, Pro-Choice Movement, State and Local News, Women, General | Permalink | Comments (0)

Thursday, September 12, 2019

Medication abortion reversal is "devoid of scientific support," judge rules in North Dakota

Sept. 10, 2019 (CBS News): Medication abortion reversal is "devoid of scientific support," judge rules in North Dakota, by Kate Smith: 

Legislators in North Dakota recently mandated physicians tell patients who are receiving medication abortions that the procedure may be reversed. North Dakota House Bill 1336 bases its text "on a pair of studies that have been contested by The American Medical Association and the American College of Obstetrics and Gynecology." 

Judge Daniel Hovland, on Tuesday, September 10, issued a 24-page decision granting an injunction against the bill, which he said is "devoid of scientific support, misleading, and untrue." Further elaborating that:

'State legislatures should not be mandating unproven medical treatments, or requiring physicians to provide patients with misleading and inaccurate information...The provisions of [Bill 1336] violate a physician's right not to speak and go far beyond any informed consent laws addressed by the United States Supreme Court, the Eighth Circuit Court of Appeals, or other courts to date.'

The lawsuit against the Bill was filed by the American Medical Association and Red River Women's Clinic. Red River is North Dakota's only legal abortion provider. According to research conducted by the Guttmacher Institute, people seeking abortions in the state must, in addition to very likely traveling long distances to reach the clinic, "undergo a state-mandated 24-hour waiting period." Minors may not receive an abortion in North Dakota without notifying their parents, and the state limits the ways a private insurance provider may cover the procedure. 

A separate North Dakota state law "requires physicians to tell patients that abortion terminates 'the life of a whole, separate, unique, living human being.'" The AMA and Red River suit also challenges this law, but the court has not yet addressed this claim, thus far only issuing the preliminary injunction against House Bill 1336.

September 12, 2019 in Abortion, Abortion Bans, Anti-Choice Movement, Fetal Rights, In the Courts, Mandatory Delay/Biased Information Laws, Medical News, Politics, State and Local News, State Legislatures, Targeted Regulation of Abortion Providers (TRAP) | Permalink | Comments (0)

Thursday, September 5, 2019

A woman gave birth alone in a jail cell after her cries for help were ignored

Aug. 29, 2019 (The Washington Post): 'Nobody cared': A woman gave birth alone in a jail cell after her cries for help were ignored, lawsuit says, by Allyson Chiu: 

Diana Sanchez was booked into Denver County Jail just three weeks ahead of her due date in July 2018. Early in the morning on July 31, Sanchez's contractions began. Her water broke and labor progressed without any help from prison or medical personnel. Sanchez gave birth to a baby boy alone in her jail cell, on top of a single absorbent pad--the only item provided to her despite her persistent cries for help. Immediately after the birth of Sanchez's son, a man wearing surgical gloves entered her cell to apparently examine the baby; however it wasn't until over 30 minutes post-birth that Sanchez and her new baby were transferred to the hospital.

Sanchez's birth experience was captured in full on surveillance footage of her cell. In the footage, Sanchez is seen unfolding the square pad deputies provided her and placing it on her bed. The video also shows her labor in full, including her water breaking, her shouts for help, her frantic efforts to remove her pants and underwear as the baby was coming. In August, Sanchez told KDVR: "They put my son's life at risk. When I got to the hospital, they said I could have bled to death." 

The U.S. has the worst maternal mortality rates in the developed world across the board, but for women of color and incarcerated women, the rates rise significantly.

Sanchez has filed a lawsuit against the city and county of Denver, Denver Health Medical Center, and six individuals after the internal investigation found no wrongdoing. Mari Newman, Sanchez's attorney, says she hopes to "achieve some measure of accountability and to force wrongdoers to change their behavior.”

The suit mentions several past incidents in which inmates under the supervision of the city and county of Denver and Denver Health Medical Center personnel allegedly did not receive adequate care. One case, which was settled about 10 years ago, resulted in an agreement that jail staff are required to report medical emergencies up the chain of command and if no action is taken, to call 911 themselves, Newman said. Had that commitment been followed, Sanchez’s experience might have been avoided, she said.

A spokesperson with the Denver Sheriff Department asserted that deputies took appropriate action and "followed the relevant policies and procedures," adding that the Department has updated its policies to "ensure that pregnant inmates who are in any stage of labor are now transported immediately to the hospital." 

September 5, 2019 in Incarcerated Women, Pregnancy & Childbirth | Permalink | Comments (0)

Wednesday, September 4, 2019

How many steps it takes to get an abortion in each state

August 24, 2019 (Axios): How many steps it takes to get an abortion in each state, Orion Rummler, Aida Amer:

Each year states devise and pass more and more restrictions on access to abortion -- from mandatory waiting periods to required viewing of an ultra sound.  While legislatures consider each new restriction on its own, people who need abortion care experience the collective impacts of multiple restrictions. And, collectively these restrictions can create an undue burden to abortion access, as delay, travel time and cost, days off from work, childcare all add up.

To illustrate the barriers placed in the path of a person seeking abortion care, Axios has published piece showing how many steps it takes to get an abortion in each state.

Women and transgender men must take 5-8 steps to get an abortion in the most heavily regulated states. They often have to wait at least 24 hours after seeking an abortion, attend counseling against the decision and take at least 2 trips to a facility — and in 6 states, only 1 such facility is available.

Based on statistics from Guttmacher Institute, Axion charts restrictions in each state to conclude that

 

  • Virginia is the most restrictive state in the U.S. for minors under 18, who must take 8 steps to have an abortion by obtaining parental notification and parental consent.
  • Arizona, Indiana, Louisiana, Mississippi, Ohio, Wisconsin and Virginia are the most restrictive states for adults over 18.

In addition,

  • Utah, South Dakota, Oklahoma, North Carolina and Missouri have the longest wait times before one can undergo the procedure, clocking in at 72 hours.

 

 

September 4, 2019 | Permalink | Comments (0)

Tuesday, September 3, 2019

HHS Threatens to Defund UVM Medical Center for Allegedly Failing to Protect Conscience Rights of Nurse Who Opposes Abortions

August 29, 2019 (Rewire News): HHS Launches Another Attach on Abortion Providers Under Guise of 'Conscience Rights," by Dennis Carter:

Rewire News reports that the Office of Civil Rights in the Department of Health and Human Services has accused the University of Vermont Medical Center of “intentionally, unnecessarily, and knowingly” scheduling nurses to assist with abortions “against their religious or moral objections." HHS Head Roger Severino claims that these alleged actions violate the Church Amendments, laws from the 1970s that protect the conscience rights of individuals to object to performing or assisting in abortion or sterilization procedures if it is contrary to their religious or moral beliefs.  HHS has given the center 30 days to change its religious freedom policies or lose federal funding. 

 
According to Severino, the nurse who filed the claim feared she would lose her job if she opted out of assisting with the abortion. A medical center spokesperson stated that UVM has “robust, formal protections that safeguard both our employees’ religious, ethical and cultural beliefs, and our patients’ right to access safe and legal abortion” and that “employees are protected from discrimination based on any decision they make to opt out of procedures for treatments.”  She also stated that UVM promptly investigated the allegations when they were first made and determined that they were unsupported. 
 
Despite UVM’s ongoing discussions with HHS, Severino opted to issue the public statement. This action appears reflective of the direction of the Civil Rights Office, which has prioritized discrimination and religious claims of health care providers rather than discrimination faced by people who seek to access health care services.  According to Rewire: 
 
Since Trump entered the White House, OCR officials have transformed the office into a powerful political entity centered on so-called religious freedom. In 2018 Severino launched a health-care discrimination wing of OCR, known as the Conscience and Religious Freedom Division, to defend health-care providers who oppose abortion and do not want to treat LGBTQ people. This case marks the third enforcement action the division has taken to protect “conscience rights,” and it’s first action in defense of an individual health-care worker who objects to participating in abortion care.

September 3, 2019 in Abortion, Abortion Bans, Religion and Reproductive Rights | Permalink | Comments (0)

Monday, September 2, 2019

Racial Disparities Persist for Breastfeeding Moms

August 24, 2019 (PBS News Hour): Racial Disparities Persist for Breastfeeding Moms, by Laura Santhanam:

A recent study released by the CDC indicates that while 83 percent of mothers report breastfeeding babies at birth, substantial racial disparities exist with 85% of white mothers and 69% of black mothers reporting that they breastfed.  Several factors appear to contribute to the difference, including lack of support for breastfeeding in maternity wards and lack of community support including maternity leave.  PBS News Hour explains:

Previous research shows hospital maternity wards that serve larger black populations are less likely to help black women initiate breastfeeding after giving birth or offer lactation support following delivery, according to the CDC study. Often, staff in these facilities instead offer black babies formula.

Another serious barrier against breastfeeding for some black mothers is the need to return to work shortly after giving birth, according to previous studies the CDC cited. Black women are more likely than others to need to return to work earlier than 12 weeks, and tend to be confronted with “inflexible work hours” that make consistently nursing and expressing milk difficult, the study authors wrote.

Differences in breastfeeding rates are significant because breastfeeding can improve the health of mothers and their babies.  In the United States, the maternal mortality rate of black women is 3-4 times that of white women and the infant mortality rate of black babies is more than twice that of white babies.

The U.S. has one of the lowest breast-feeding initiation rates in the industrialized world and is the only developed nation that does not mandate paid maternity leave.  "In July 2018, the Trump administration drew criticism when they rejected a policy that supported breastfeeding at the World Health Organization, under pressure from the infant formula industry."  In 2010, Congress required that large employers provide reasonable break times for nursing mothers for up to one year as part of the Affordable Care Act.  However, despite the law, breastfeeding remains difficult for women in low wage jobs and jobs that lack flexibility.

September 2, 2019 | Permalink | Comments (0)