By Charles Ornstein ProPublica This story was co-published with the Washington Post.
A few years back, Jonathan Bloedow filed a series of requests under Washington state’s Public Records Act asking for details on pregnancies terminated at abortion clinics around the state.
For every abortion, he wanted information on the woman’s age and race, where she lived, how long she had been pregnant and how past pregnancies had ended. He also wanted to know about any complications, but he didn’t ask for names.
What has been your experience with patient privacy? Do you think your medical information was shared by your doctor or health-care provider? Do you think it was involved in a breach? Tell us your story.
Bloedow, 43, isn’t a public health researcher, a traditional journalist or a clinic owner. He’s an anti-abortion activist who had previously sued Planned Parenthood, accusing the group of overcharging the government for contraception. Continue reading →
The undercover videos purporting to show officials of Planned Parenthood bargaining over the sale of fetal tissue have made the promise to defund the organization one of the most popular refrains on the Republican presidential campaign trail.
It’s actually a much easier promise to make than to fulfill. But that’s not slowing down the candidates.
“There is no reason in the world to have Planned Parenthood other than abortion,” said Sen. Rand Paul, R-Ky. “We should stop all funding for Planned Parenthood.”
Carly Fiorina, former CEO of Hewlett-Packard, echoed many of her fellow candidates by vowing that “we should shut down the government” rather than allow further funding of the organization. Many Republicans – though far from all – have been advocating a fight over Planned Parenthood funding this fall when it comes time to keep the federal government operating.
Candidates that are or were governors have gone even further – saying they have already eliminated funding for the organization in their states.
“I defunded Planned Parenthood more than four years ago, long before any of these videos came out,” said Gov. Scott Walker, R-Wis., in the recent Fox News debate.
“As governor of Florida I defunded Planned Parenthood,” said Jeb Bush, who served from 1999 to 2007, at the same debate. “I created a culture of life in our state.”
Next year, the military will officially lift restrictions on women in combat, the end of a process that may open up as many as 245,000 jobs that have been off limits to women.
But women who deploy overseas may continue to face obstacles in another area that can have a critical impact on their military experience: contraception.
It’s not a minor issue. Rates of unintended pregnancy among women in the military are 50 percent higher than those of women in the general population. And because of strict federal rules, their insurance does not generally cover abortion.
Rates of unintended pregnancy among women in the military are 50 percent higher than those of women in the general population.
Tricare, the health care plan for more than 9 million active and retired members of the military, covers most contraceptive methods approved by the Food and Drug Administration. Active-duty service members pay nothing out of pocket. Spouses and dependents of service members may face copayments in some instances.
But all methods aren’t necessarily available at every military hospital and clinic, and overseas, for example, women may have difficulty getting refills of their specific type of birth control pill.
Nancy Duff Campbell, co-president of the National Women’s Law Center, says, “It is unfortunate that here we have the military, that has one of the best health care systems in the country, and where we still have a gap is in contraception.”
Fifteen percent of active duty service members are women, and 97 percent of them are of childbearing age.
In a 2013 study, based on more than 28,000 responses to the 2008 Department of Defense health-related behaviors survey, researchers found that after adjusting for the larger concentration of young women in the military, the rate of unintended pregnancy among military women was 7.8 percent, compared with 5.2 percent among women in the general population.
“It’s critically important to address unintended pregnancy in the military, because it can be particularly damaging to women’s careers, and it’s hard to access abortion care,” says Dr. Daniel Grossman, a study co-author who is vice president for research at Ibis Reproductive Health, a research and advocacy group.
Abortion is available at a military facility or covered by military health care only if a woman’s life is in danger or if the pregnancy is a result of incest or rape. Women who want an abortion in other circumstances must use a non-military health care provider and pay for the procedure out of pocket, according to Department of Defense health officials.
Coverage for emergency contraception, meanwhile, has recently been expanded to all active duty service women and female beneficiaries without cost sharing.
It can be challenging to use contraceptives while deployed overseas for many reasons. There is the problem of trying to schedule a daily birth control pill when traveling across time zones, and desert conditions may make a contraceptive patch fall off. Although women are allowed a 180-day supply of contraceptives before deploying, obtaining refills of the same pill is sometimes difficult, some women reported in a 2012 study published in Contraception about access to contraception during deployment that was based on survey of 281 servicewomen.
Women also reported that they were told that contraceptives were unnecessary because having sex during deployment was forbidden or that they couldn’t receive an intrauterine device because they hadn’t yet given birth. Neither of those claims is true.
The majority of women surveyed also noted that they weren’t counseled about using contraception for either pregnancy prevention or menstrual suppression before deploying.
Pre-deployment counseling that specifically addresses women’s contraceptive needs could help counter confusion and ensure women have access to birth control methods that meet their needs. According to military health system officials, contraceptive and reproductive counseling is a covered benefit under Tricare and is an expected component of good clinical practice.
The House and Senate versions of the Pentagon’s spending bill for the fiscal year that begins in October contain measures that would affect contraception coverage in the military.
The Senate version of the bill would guarantee family planning education and counseling, while the House version would make available a broad range of FDA-approved contraceptives at military treatment facilities and ensure that women servicemembers have enough contraceptives to last for the duration of their deployment. A congressional conference committee is working to write a compromise between those two bills.
Defense Department officials said they had no comment on the pending legislation.
Kaiser Health News is an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communication organization not affiliated with Kaiser Permanente.
Pregnancy: A Touchy Subject In Employee Wellness Assessments
“Are you pregnant?”
By Julie Appleby KHN
It’s a topic employers generally avoid, since the Pregnancy Discrimination Act of 1978 prohibited sex discrimination on the basis of pregnancy.
But women’s advocates fear these long-standing protections could be undermined by some workplace wellness programs.
That question and “How old were you when you first became pregnant?” are both included in a health risk assessment offered to some clients of Audax Health, a wellness firm.
“How old were you when you first became pregnant?”
Similar queries are posed in health risk assessments offered by other wellness programs, say consumer groups, including the National Women’s Law Center.
“These are questions they should not ask,” because of the potential for discrimination, said Emily Martin, vice president and senior counsel for the NWLC, in a letter to the Obama administration asking for a ban on such questions in wellness programs. Continue reading →
Republican calls to defund Planned Parenthood over its alleged handling of fetal tissue for research are louder than ever. But they are just the latest in a decades-long drive to halt federal support for the group.
This round of attacks aims squarely at the collection of fetal tissue, an issue that had been mostly settled — with broad bipartisan support — in the early 1990s. Among those who voted to allow federal funding for fetal tissue research was now-Senate Majority Leader Mitch McConnell, R-Ky.
McConnell made no mention of his previous position when he announced that the Senate would take up a bill to cut off Planned Parenthood’s access to federal funds before leaving for its summer break. The first vote on the bill is expected as soon as Monday. Continue reading →
One in seven women experience depression during pregnancy or the first year after giving birth, yet many may not realize it or report their concerns to clinicians.
A new proposal by the U.S. Preventive Services Task Force could help change that. It recommends that all women who are pregnant or within a year of giving birth be screened for perinatal depression, as it’s called.
The screening proposal is included as part of a broader recommendation to screen all adults for depression that the task force released this week for public comment.
One in seven women experience depression during pregnancy or the first year after giving birth.
The task force proposal would update the current guidelines, adopted in 2009, which recommend depression screening in all adults if clinicians are available to address depression care.
In the 2009 document, the task force didn’t review depression in pregnant and postpartum women and made no screening recommendation for them. Continue reading →
Hospital costs for women who had no maternal or obstetric risk factors to complicate childbirth ranged from less than $2,000 to nearly $12,000, the analysis of discharge data found. The wide variation in cost means that for expectant parents, it can pay to shop around. Continue reading →
California and Oregon will be the first states in the nation to allow women to get birth control pills and other hormonal contraceptives directly from their pharmacists – without a doctor’s prescription.
As California officials were busy finalizing regulations on a state law passed in 2013, Oregon’s governor Kate Brown signed a similar bill into law last week.
The two measures were hailed by women’s health advocates. They noted that men have long had an easier time getting birth control, simply purchasing condoms over the counter.
Ken Thai, part-owner and manager of the El Monte Pharmacy Group, says he is excited about the new regulation that will allow him to directly prescribe birth control in his pharmacies in California (Photo by Heidi de Marco/KHN).
“We support efforts like these that remove barriers to women gaining access to birth control and other reproductive health care,” said Kathy Kneer, President and CEO of Planned Parenthood Affiliates of California, in a written statement.
She added that hormonal contraception has been widely studied and shown to be safe – “so safe that the American College of Obstetricians and Gynecologists has recommended that it be available over the counter.“
The contraceptives won’t be available like cough drops or antacids, however. In California, pharmacists can only dispense them after providing a health screening to women and taking their blood pressure. Oregon will also require a health screening, but the state’s specific rules haven’t been developed. Continue reading →
Women are saving a lot of money as a result of a health law requirement that insurance cover most forms of prescription contraceptives with no additional out-of-pocket costs, according to a study released Tuesday.
But the amount of those savings and the speed with which those savings occurred surprised researchers.
The study, in the July issue of the policy journal Health Affairs, found that the average birth control pill user saved $255 in the year after the requirement took effect.
The average user of an intrauterine device (IUD) saved $248. Those savings represented a significant percentage of average out-of-pocket costs.
“These are healthy women and this on average is their No. 1 need from the health care system,” said Nora Becker, an MD-PhD candidate at the University of Pennsylvania and lead author of the study. “On average, these women were spending about 30 to 44 percent of their total out of pocket (health) spending just on birth control.” Continue reading →