Category Archives: Women’s Health

7 Reproductive rights issues to watch in 2015

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By Nina Martin ProPublica

Abortion Knoxville-march-for-life-2013-3To say abortion opponents are feeling fired up in 2015 would be a massive understatement.

In their first week back at work, congressional Republicans introduced a sweeping prohibition on abortions after 20 weeks of pregnancy (H.R. 36, the Pain-Capable Unborn Child Protection Act), as well as bills that would ban sex-selective abortions, target funding for groups like Planned Parenthood, require abortion providers to have hospital admitting privileges, and let doctors and nurses opt out of providing abortion care, even in emergencies.

In the states, where the 2014 elections gave Republicans control of two-thirds of state legislative chambers, incoming lawmakers also have supersized their abortion agendas.

But abortion is just one issue on the minds of activists focused on reproductive rights. There’s also birth control, conscience clauses and personhood. Here are seven key trends and themes to watch for this year.

1. A New Wave of Abortion Restrictions

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Intrauterine devices and other long-acting contraceptives gaining popularity

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A diagram showing a hormonal IUD in the uterusBy Michelle Andrews
KHN

Though they continue to be overshadowed by less expensive, less effective birth control methods, long-acting reversible contraceptives such as intrauterine devices are gaining ground, according to an analysis of recently released federal data.

Nearly 12 percent of women who used contraceptives between 2011 and 2013 used IUDs or hormonal implants, according to a Guttmacher Institute analysis of data from the federal National Survey of Family Growth.

That made these long-acting products the third most popular form of reversible contraception, behind birth control pills (26 percent) and condoms (15 percent).

The use of long-acting forms of contraception has been increasing steadily, from 2.4 percent in 2002 to 8.5 percent in 2009, according to Guttmacher.

Long-acting contraceptives don’t require women to remember to use birth control every day or whenever they have sex.

That makes them one of the most effective forms of contraception, preventing pregnancy in more than 99 percent of cases. IUDs last for up to 12 years, depending on the type, while hormonal implants protect against pregnancy for up to three years. Continue reading

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States going beyond federal law to protect pregnant workers

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Blue Pregnant BellyMany states are approving new protections for pregnant workers, requiring employers to give them more or longer bathroom breaks, rest periods, light duty, job transfers, leave time or other accommodations.

By Marsha Mercer
Stateline

Decades after a federal law banned discrimination against pregnant women in the workplace, some states are providing additional protections to pregnant workers who want to stay on the job.

After Congress passed the Pregnancy Discrimination Act in 1978, many state legislators thought the problem had been solved.

“Women should not have to choose between being a mother and having a job.”

But as the number of women in the workforce has increased—and more of them have stayed on the job through their pregnancies—they have encountered obstacles not covered by the federal law.

Recent federal court rulings that have sided with employers who support a narrow interpretation of the law have added fuel to efforts in state capitals.

“Women should not have to choose between being a mother and having a job,” outgoing Democratic Gov. Pat Quinn of Illinois said in August when he signed that state’s Pregnant Workers Fairness Act.

As of Jan. 1, employers in Illinois must provide pregnant workers who request them more or longer bathroom breaks, rest periods, light duty, job transfers, leave time or other accommodations, unless doing so creates an undue hardship for the employer.

“These are women who are healthy and want to continue working,” said Democratic state Sen. Toi Hutchinson, a sponsor of the Illinois bill. “They’re not looking to get out of work. What they want is a temporary accommodation.”

Eleven other states also have passed laws requiring employers to provide reasonable accommodations to pregnant workers. In 2014, laws took effect in Delaware, Minnesota, West Virginia and the District of Columbia. Since 2011, Alaska, Connecticut, Maryland and New Jersey also have approved laws. Continue reading

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US bishops take aim at sterilization

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US catholic bishops-LogoBy Nina Martin
ProPublica

The Vatican has an absolute prohibition on sterilization for the purposes of birth control. The U.S. Catholic bishops consider the procedure “intrinsically immoral,” on par with abortion.

Yet for years, Genesys Health System, a Catholic medical center near Flint, Mich., allowed doctors delivering babies there to tie the tubes of new mothers who wanted to ensure they never got pregnant again.

A toughening of Catholic medical directives could include enforcing a ban on tubal ligations.

Genesys’s policy wasn’t hard to fathom: Performing a tubal ligation immediately after childbirth is the long-established standard of care, especially if a woman is having a cesarean section.

“She’s already cut open — her tubes are right there,” said Sarah Ward Prager, an associate professor in obstetrics and gynecology and director of family planning at the University of Washington Medical School.

Subjecting a new mother to a second surgery carries “unnecessary risk,” Prager said. “It is simply unethical to say, ‘I’m going to make you come back to a different hospital to have another surgery in six weeks because the bishop says I can’t tie your tubes right now.”

Then, seemingly out of the blue, Genesys reversed course. Starting November 1, sterilization with the “direct” aim of preventing pregnancy — as opposed to for some other medical (“indirect”) reason — was banned.

Patients who had planned to have the procedure after childbirth were left scrambling; their irate doctors were, too.

Genesys won’t say why it allowed sterilizations to go on for so long or why it has forbidden them now. In a statement to ProPublica, the hospital acknowledged only that it had “updated its policy on tubal ligations to comply with current Church teaching.”

But this much is clear: The Genesys decision is almost certainly a sign of things to come. Continue reading

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Good enough to pass: Washington gets a C+ Women’s Health Report Card – Puget Sound Business Journal

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C plus gradeThe state gets a C+ and comes in at No. 22 on the 2014 Women’s Health Report Card, a list from the Alliance for a Just Society, a Seattle-based national network of economic justice organizations including the Washington Community Action Network.

via Good enough to pass: Washington gets a C+ Women’s Health Report Card – Puget Sound Business Journal.

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Despite health law, long-acting contraceptives still often not free for women

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New research suggests that teenagers are more likely to choose long-acting contraceptives when cost is removed from the equation. And free coverage of such methods is required by the health law.

But now, a study has found that free coverage of such methods too often still falls short.

Why is free coverage of long-acting contraceptives—which can prevent pregnancy from three months up to 10 years—still lacking for roughly 40 percent of women?

The study, published in the journal Contraception by the Guttmacher Institute, found that insurance coverage of contraceptives without cost sharing has improved markedly since the health law’s requirement became effective for most women in 2013.

But gaps in coverage remain. The Guttmacher researchers analyzed the experiences of 892 privately insured women who used prescription contraceptives between the fall of 2012, before the law’s provisions took effect for most women, and the spring of 2014.

It found that the proportion of women who paid nothing for their intrauterine devices increased from 45 percent to 62 percent during that time.

The proportion of women who had no cost sharing for injectable contraceptives grew from 27 percent to 59 percent. (There weren’t enough women using hormonal implants to include in the study.)

Some long-acting contraceptives such as IUDS can cost hundreds of dollars up front, putting them out of reach financially for some women unless insurance covers the cost. Continue reading

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Low-cost, long-acting contraceptives cut teen pregnancy, abortion rates

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A diagram showing a hormonal IUD in the uterusBy Lisa Gillespie
KHN / OCTOBER 1ST, 2014

Teenage girls who are given access to long-acting contraceptives such as IUDs or hormonal implants at no cost are less likely to become pregnant, according to a study in the New England Journal of Medicine released Wednesday.

The findings come just two days after the American Academy of Pediatrics recommended that health providers should consider IUDs and implants first when discussing contraception choices with teen girls.

Young women with access to these methods at no cost were almost five times less likely to get pregnant, five times less likely to give birth and four times less likely to have an abortion.

Although there are not as many teenage pregnancies as there once were — rates have been cut by more than half since 1991 — they still pose serious public health issues because of the costs associated with child birth and public assistance for young mothers.

These pregnancies can also stunt education and income opportunities for teenage moms.

Each year, 750,000 teenage girls become pregnant, and 80 percent of those pregnancies are unintended. Continue reading

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Many women receiving unnecessary Pap tests

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Cytological specimen showing cervical cancer specifically squamous cell carcinoma in the cervix. Tissue is stained with Pap stain and magnified x200. PHOTO courtesy of NCIBy Stephanie Stephens,
Health Behavior News Service

As many as half to two-thirds of women who’ve undergone hysterectomies or are older than 65 years in the United States report receiving  Pap tests for cervical cancer.

This prevalence is surprising in light of the 2003 U.S. Preventive Services Taskforce guidelines recommending that women discontinue Pap testing if they have received a total hysterectomy without a history of cervical cancer and if they are over age 65 years with ongoing and recent normal Pap test results.

Performing these unnecessary tests can result in stress for the patient, increased costs, and inefficient use of both provider and patient time, concludes a new study in the American Journal of Preventive Medicine.

“During this time of health care reform, we could probably use our resources more wisely,” said corresponding author Deanna Kepka, Ph.D., M.P.H., assistant professor at the University of Utah’s College of Nursing and Huntsman Cancer Institute. Continue reading

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Pressure from providers leads some women to have C-sections, inductions

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Blue Pregnant BellyBy Christen Brownlee
Health Behavior News Service

Pregnant women who felt pressured to have a labor induction or cesarean section by their obstetrical care providers were significantly more likely to have these procedures, even if there was no medical need for them, suggests a new study in the journal Health Services Research.

Both cesarean deliveries and labor inductions continue to rise, accounting for about a third of births in the U.S.

While both procedures can be life saving for mothers and babies, previous studies have found that they can also increase the risk of poor health outcomes, such as respiratory problems for newborns and infections and death for mothers, as well as significantly increasing health care costs. Continue reading

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Women’s groups challenge GOP candidates on OTC birth control

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birth control contraceptionBy Julie Rovner
SEPTEMBER 10TH, 2014

Women’s health groups are launching a counterattack against suggestions by several Republican Senate candidates that making birth control pills available without a prescription is the answer to the dispute over contraceptive coverage rules in the health law.

At least four Republicans running for the U.S. Senate have proposed over-the-counter pills in recent weeks, including Ed Gillespie in Virginia, Cory Gardner in Colorado, Thom Tillis in North Carolina and Mike McFadden in Minnesota.

All four have advocated the repeal of the Affordable Care Act and its requirement that most insurance plans cover all FDA-approved contraceptives for women.

“I think over-the-counter, oral by contraception (sic), should be available without a prescription,” Tillis said in a debate with Sen. Kay Hagan, D-N.C., last week. “If you do those kinds of things, you will actually increase the access and reduce the barriers for having more options for women for contraception.”

Women’s health groups, however, strongly disagree. Continue reading

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Women’s health – week 52: Vulvodynia

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From the Office of Research on Women’s Health

tacuin womenVulvodynia is chronic (long-term) pain or discomfort of the vulva. The vulva is the area of the female genitals surrounding the vaginal opening and includes the labia, the vestibule, and the perineum.

Some women refer to it as “the pain down there” or as “feminine pain.”

Women with vulvodynia often experience burning, stinging, irritation, rawness, or stabbing pain in their genitals, with no apparent explanation.

As many as 18 percent of women will experience symptoms consistent with vulvodynia.

The pain or discomfort can be chronic or intermittent, and generalized or localized to one area
of the vulva. Some women also report itching.

For many women, sexual intercourse, inserting tampons, or wearing clothes are very uncomfortable or painful. Continue reading

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Infertility patients finding creative financing help

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IVF egg thumbBy Michelle Andrews
KHN

Infertility treatment is a numbers game in some respects: How many treatments will it take to conceive a child? And how much can you afford?

Even as insurance plans are modestly improving their coverage of such treatments, clinics and others are coming up with creative ways to cover the costs to help would-be parents reduce their risk  for procedures that can run tens of thousands of dollars.

Some even offer a money-back guarantee if patients don’t conceive. Continue reading

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Women’s health – Week 51: Traumatic Brain Injury

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tacuin womenFrom the Office of Research on Women’s Health

Traumatic brain injury (TBI), a form of acquired brain injury, occurs when a sudden force, such as from an explosive blast or an automobile accident, causes damage to the brain.

TBI can result when the head suddenly and violently hits an object, or when an object pierces the skull and enters brain tissue.

In most of these cases, the skull remains intact and the damage is believed to be caused by a pressure wave of the explosion’s concussive force passing through the brain.

Symptoms of a TBI can be mild, moderate, or severe, depending on the extent of the damage to the brain. Continue reading

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Federal judge blocks Texas restriction on abortion clinics

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200px-Flag-map_of_TexasBy Carrie Feibel, KUHF
AUGUST 30TH, 2014, 10:18 AM

This story is part of a partnership that includes Houston Public MediaNPR and Kaiser Health News.

In a highly anticipated ruling, a federal judge in Austin struck down part of a Texas law that would have required all abortion clinics in the state to meet the same standards as outpatient surgical centers.

The regulation, which was set to go into effect Monday, would have shuttered about a dozen abortion clinics, leaving only eight places in Texas to get a legal abortion — all in major cities.

. . . state’s regulation was unconstitutional and would have placed an undue burden on women, particularly on poor and rural women.”

The regulation, which was set to go into effect Monday, would have shuttered about a dozen abortion clinics, leaving only eight places in Texas to get a legal abortion — all in major cities.

Judge Lee Yeakel ruled late Friday afternoon that the state’s regulation was unconstitutional and would have placed an undue burden on women, particularly on poor and rural women living in west Texas and the Rio Grande Valley. Continue reading

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FAQ: Administration’s new contraception rules explained

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Photo: Matthew Bowden

Photo: Matthew Bowden

The Obama administration has released new rules they say will give employees of  religiously affiliated organizations a way to obtain contraceptive services as part of their health insurance coverage while respecting the religious beliefs of their employers.

The announcement follows a controversy that has dogged the administration as religiously affiliated employers objected to efforts to expand contraceptive options for women under the health law.

Under the accommodation, an eligible organization does not have to contract, arrange, pay or refer for contraceptive coverage

.The latest regulations seek to satisfy complaints about earlier guidance on contraception coverage that instructed these employers to notify their insurers or third-party administrators if they did not want to comply with the law’s contraception coverage based on religious objections.

The regulations unveiled Friday would allow religiously affiliated employers to notify the government – rather than their insurer – of their objections to the law’s coverage of birth control.

The government will then notify the insurer to provide the contraception coverage. Continue reading

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