Category Archives: Women’s Health

States urged to reduce pregnancy-related deaths


Blue Pregnant BellyBy Michael Ollove

The relatively high percentage of American women who die as a result of pregnancy, which exceeds that of other developed nations, is prompting a new national prevention campaign that is relying on the states to take a leading role.

The key element in that effort is to encourage all states to go beyond the information provided on a typical death certificate by having mortality review panels investigate the causes behind every maternal death that occurs during pregnancy or in the year after delivery.

The hope is the investigations will reveal systemic causes for at least some of the deaths and lead to preventive measures to save the lives of more would-be or new mothers.

The death rate is significantly higher in the U.S. than in other developed countries. 

A number of studies suggest that one in three maternal deaths is preventable.

“It’s hard to do anything about a problem if you don’t have the problem fully defined,” said Cynthia Shellhaas, an associate professor in the division of maternal-fetal medicine at the Ohio State University Wexner Medical Center. Continue reading


Ovarian cancer mutations found in healthy women, UW study finds


From the University of Washington

In a study of 36 women – 16 diagnosed with ovarian cancer and a control group of 20 with no cancer diagnosis – nearly all of the women were found to carry cancer-associated gene mutations.

“Cancer mutations are supposed to indicate the presence of cancer. This study suggests that if we sequence deeply enough, we will find cancer mutations in nearly everyone,” said Rosana Risques, a UW assistant professor of pathology, who led the study with Jeff Krimmel, a medical student.

This study suggests that if we sequence deeply enough, we will find cancer mutations in nearly everyone.

The study is a caution for scientists and clinicians trying to detect cancer based on mutations, said Michael Schmitt, a co-author of the study and co-inventor of duplex sequencing. He is an oncology fellow at UW Medicine and Fred Hutch Cancer Research Center.

Among cells stained for the P53 mutation, the brown dots are nuclei of high-grade serous ovarian cancer cells. The blue represents normal Fallopian tube epithelial cells. Photo: Courtesy of Rosana Risques

Among cells stained for the P53 mutation, the brown dots are nuclei of high-grade serous ovarian cancer cells. The blue represents normal Fallopian tube epithelial cells. Photo: Courtesy of Rosana Risques

“Because healthy tissue frequently carries low-frequency cancer-like mutations, we need exquisitely sensitive technologies to accurately define the mutational load and differentiate between truly cancerous changes versus age-associated mutations,” he said.

The study was an early test of the power of DNA duplex sequencing, a technology developed at the University of Washington. Duplex sequencing independently tags molecules along both strands of DNA. In terms of a prospective diagnostic, its accuracy is thought to be unmatched.

This research, marking the technology’s first published application in human cancer detection, was posted online today by the Proceedings of the National Academy of SciencesContinue reading


Even as birth rates fall, teens say they are getting less sex education


By Michelle Andrews
Kaiser Health News

Teenage girls are catching up to teenage boys in one way that does no one any good: lack of sex education, according to a recent report.

The proportion of teenage girls between the ages of 15 and 19 who were taught about birth control methods declined from 70 to 60 percent over two time periods, from 2006-2010 and 2011-2013, the analysis of federal data found.

Meanwhile, the percentage of teenage boys in the same age group who were taught about birth control also declined, from 61 to 55 percent.


“Historically there’s been a disparity between men and women in the receipt of sex education,” said Isaac Maddow-Zimet, a coauthor of the study and a research associate at the Guttmacher Institute, a reproductive health research and advocacy group. “It’s now narrowing, but in the worst way.”

The study, which was published online in the Journal of Adolescent Health in March, analyzed responses during the two time periods from the Centers for Disease Control and Prevention’s National Survey for Family Growth, a continuous national household survey of women and men between the ages of 15 and 44.

In addition to questions about birth control methods, the study asked teens whether they had received formal instruction at their schools, churches, community centers or elsewhere about sexually transmitted diseases (STDs), how to say no to sex or how to prevent HIV/AIDS.

Overall, 43 percent of teenage girls and 57 percent of teenage boys said in the most recent time frame that they hadn’t received any information about birth control before they had sex for the first time. Continue reading


Pregnant and addicted: the tough road to a healthy family

Amanda Hensley holds her daughter Valencia

Amanda Hensley holds her daughter Valencia

By Sarah Jane Tribble, WCPN
Kaiser Health News

Amanda Hensley started abusing prescription painkillers when she was just a teenager. For years, she managed to function and hold down jobs. She even quit opioids for a while when she was pregnant with her now 4-year-old son. But she relapsed.

Hensley says she preferred drugs like Percocet and morphine, but opted for heroin when short on cash.

By the time she discovered she was pregnant last year, she couldn’t quit.

“It was just one thing after another, you know — I was sick with morning sickness or sick from using,” said Hensley, who is 25 and lives in Cleveland. “Either I was puking from morning sickness or I was puking from being high. That’s kind of how I was able to hide it for a while.”

Hensley said she was ashamed and hurt, and she wanted to stop using but didn’t know how. She had friends who would help her find drugs — even after they found out she was pregnant. But finding help to get sober and protect her child proved much more difficult, though.

The number of people dependent on opioids is increasing and that includes women of child-bearing age, like Hensley. Researchers estimated that every 25 minutes a baby was born dependent on opioids in 2012, the most recent year for which data are available.

By the time Hensley was about six months pregnant, she was living on couches, estranged from her mother and her baby’s father, Tyrell Shepherd. Her son went to live with her mother.

That’s when Hensley reached out for help. One moment, she dialed to get her fix. The next, she called hospitals and clinics.

“Nobody wants to touch a pregnant woman with an addiction issue,” she said.

Shepherd wasn’t happy when he realized Hensley was taking opioids while pregnant. “If you don’t care about yourself,” he said, “have enough common decency to care about the baby you’re carrying. Be adult. Own up to what it is you’re doing and take care of business. Regardless of how bad you’re going to feel, there’s a baby that didn’t ask to be there.”

After being rejected by two hospitals and several clinics, Hensley let herself go into withdrawal and then went to the emergency department of MetroHealth System, Cleveland’s safety-net hospital. Continue reading


Court asks from more information in birth control case


U.S. Supreme CourtBy Julie Rovner
Kaiser Health News

An apparently deadlocked Supreme Court is asking lawyers in a closely watched health law case to provide more information on how women working for religious employers might be able to get insurance coverage for contraception without violating the rights of their bosses.

The order also included a request for information about a scenario that might be a possible compromise in the case.

At issue in Zubik v. Burwell is an “accommodation” created by the Obama administration to a provision of the Affordable Care Act that otherwise requires most employers to provide female workers access to coverage of FDA-approved contraception with no copay.

Houses of worship are exempt from the requirement to provide contraceptive coverage, but religiously affiliated organizations (such as hospitals, universities and social service agencies) are required to submit information to their insurer or the government stating their religious objection. The insurer is then required to provide the coverage, under the accommodation.

The religious organizations that are suing, however, claim that the act of notifying the government or their insurance companies facilitates the coverage being provided, making them “complicit” in what they consider sinful.

The eight Supreme Court justices at last week’s oral arguments appeared evenly divided over whether the requirement represented a “substantial burden” on the organizations’ religious freedoms. (All but one lower court said it did not.)

A 4-4 tie in the case (the seat of the late Justice Antonin Scalia remains vacant) would leave the lower court rulings intact unless the court opts to take up the issue after Scalia’s seat is filled.

It also would create an unusual situation in which the rules would be enforced in most areas of the country, but not all.

The order issued Tuesday asked lawyers on both sides of the case to “file supplemental briefs that address whether and how contraceptive coverage may be obtained by petitioners’ employees through petitioners’ insurance companies, but in a way that does not require any involvement of petitioners beyond their own decision to provide health insurance without contraceptive coverage to their employees.” The final deadline for the new briefs is April 20. Continue reading


Demand surges for addiction treatment during pregnancy



BOSTON — As soon as the home pregnancy test strip turned blue, Susan Bellone packed a few things and headed straight for Boston Medical Center’s emergency room. She’d been using heroin and knew she needed medical help to protect her baby.

“I felt so guilty. I still do,” said Bellone, a petite, energetic woman. At 32, and six years into her heroin addiction, having a baby was the last thing on her mind. “I was not in the right place to start a family,” she said. “But once it was happening, it was happening, so I couldn’t turn back.”

Nationwide, the number of pregnant women using heroin, prescription opioids or medications used to treat opioid addiction has increased more than five-fold and it’s expected to keep rising. With increased opioid and heroin use, the number of babies born with severe opioid withdrawal symptoms has also spiraled, leaving hospitals scrambling to find better ways to care for the burgeoning population of mothers and newborns.

Among the most important principles is that expectant mothers who are addicts should not try to quit cold turkey because doing so could cause a miscarriage. Trying to quit opioids without the help of medications also presents a high risk of relapse and fatal overdose.


Until the opioid epidemic took hold about eight years ago, most hospitals saw only one or two cases a year of what is known as neonatal abstinence syndrome. Now, a baby is born suffering from opioid withdrawal every 25 minutes in the U.S., according to the National Institute on Drug Abuse. Continue reading


Combatants in Texas abortion case using new playbook


U.S. Supreme CourtBy Julie Rovner
Kaiser Health News

The fate of the controversial Texas abortion law is in the hands of the Supreme Court, and a decision is not expected before June.

But exactly how this particular law reached the high court and how its opponents are gathering evidence to strike it down represent fresh twists in an acrimonious national debate stretching back to the 1970s.

Many of the provisions of the 2013 Texas law, known as HB 2, are based on model laws created by the anti-abortion group Americans United for Life, which has been working for years to get a carefully crafted state bill on health and safety provisions surrounding abortion to the Supreme Court. And abortion-rights forces have been fighting the law with data from rigorous, university-based research on how the law is affecting women’s access to abortion.

The court is looking at two provisions of the law that require doctors who perform abortions to have admitting privileges at a hospital no more than 30 miles from the abortion clinic and abortion facilities to meet the same standards as “ambulatory surgical centers” that perform more complicated procedures than the typical first-trimester abortion. Continue reading


The most important abortion case you never heart about


U.S. Supreme Courtby Nina Martin ProPublica, Feb. 29, 2016, 6 a.m.

Everyone considers Roe v. Wade, the 1973 decision that established a woman’s right to an abortion, to be the most important ruling ever on the issue by the Supreme Court.

But this year, a lesser-known progeny of Roe occupies center stage in potentially the most momentous abortion case confronting the justices in a generation.

After Roe established abortion rights, Planned Parenthood v. Casey reined them in, creating a new legal standard that gave states greater leeway to regulate the procedure.

Many conservative legislatures took advantage to enact a series of increasingly tough laws that reproductive rights advocates argue have made it more difficult 2014 and sometimes impossible 2014 for women to obtain abortions,

One of those states was Texas, which in 2013 enacted H.B. 2, an omnibus bill whose multiple provisions include restrictions, known as TRAP laws, targeting abortion providers.

Now the Supreme Court is being asked to decide the constitutionality of two of these laws 2014 one requiring clinics to meet the same building codes as other types of outpatient surgical centers, the other requiring abortion doctors to have admitting privileges at a hospital within 30 miles 2014 that have already shut down more than half of the state’s 41 clinics and could close 8 more. Continue reading


Most young men don’t know about emergency contraception


planb-thumbBy Michelle Andrews

Less than half of young men have heard of emergency contraception, a recent study found, even though it’s available over the counter at drug stores and is effective at preventing pregnancy after sex.

The study, published in the March Journal of Adolescent Health, analyzed survey responses by 93 men between the ages of 13 and 24 who visited the adolescent medicine clinic at Children’s Hospital Colorado in Aurora for a physical exam, illness or injury between August and October 2014.

Although 84% said they believed avoiding pregnancy was very or somewhat important, only 42% had heard of emergency contraception.

Most had been sexually active. The computerized survey asked patients about their knowledge of contraceptives, and whether they had talked about birth control with their partners or health care providers.

Although 84 percent of the teenage boys and young men said they believed avoiding pregnancy was very or somewhat important, only 42 percent had heard of emergency contraception, according to the study.

Those who knew about emergency contraception, also called the morning-after pill, were more likely to have talked with a health care provider about birth control in the past. Continue reading


Study Finds HPV Vaccine Has Lowered Number Of Women With Disease


The HPV vaccine has lowered the number of women with HPV, a sexually transmitted disease that can lead to cancer, according to a study in the journal Pediatrics. NPR’s Audie Cornish talks to Dr. Joseph Bocchini from Louisiana State University to get his read on the results.


Struggling rural hospitals opt to close labor and delivery units


Newborn preemie baby hand NICUBy Michelle Andrews

A few years ago, when a young woman delivered her baby at Alleghany Memorial Hospital in Sparta, North Carolina, it was in the middle of a Valentine’s Day ice storm and the mountain roads out of town were impassable. The delivery was routine, but the baby girl had trouble breathing because her lungs weren’t fully developed.

Dr. Maureen Murphy, the family physician who delivered her that night, stayed in touch with the neonatal intensive care unit at Wake Forest Baptist Medical Center in Winston-Salem, a 90-minute drive away, to consult on treatment for the infant.

“It was kind of scary for a while,” Murphy remembered. But with Murphy and two other family physicians trained in obstetrics as well as experienced nurses staffing the 25-bed hospital’s labor and delivery unit, the situation was manageable, and both mother and baby were fine.

Things are different now. Alleghany hospital — like a growing number of rural hospitals — has shuttered its labor and delivery unit, and pregnant women have to travel either to Winston-Salem or to Galax, Virginia, about 30 minutes away by car, weather permitting.

“It’s a long drive for prenatal care visits, and if they have a fast labor” it could be problematic, said Murphy, who teaches at the Cabarrus Family Medicine Residency Program in Concord, North Carolina. (Although not essential, women typically see the physician they expect will handle their delivery for prenatal care.) Continue reading


States start to let pharmacists prescribe birth control pills


Photo: Matthew Bowden

By Sarah Breitenbach

Since January, Charley McGrady has been doling out hormonal contraceptive pills and patches to women who come to her Eugene, Oregon, pharmacy without a doctor’s prescription for birth control.

A new state law allows McGrady to consult women about pregnancy prevention and write prescriptions for contraceptives that previously required a doctor’s signature.

Oregon’s move to pharmacist-prescribed birth control is an attempt to increase access to the drugs and reduce unintended pregnancies, which make up more than half of all pregnancies in the United States. It also is part of a movement toward team-based medical care, in which doctors and other medical professionals together oversee patients’ care.

California pharmacists will begin writing their own prescriptions for birth control next month, and lawmakers in HawaiiMissouriSouth CarolinaTennessee and Washington are considering legislation that would give pharmacists the power to prescribe contraceptives.

Pharmacists in several states already can prescribe certain drugs under the supervision of a physician, but laws like those in Oregon and California give them autonomy to prescribe contraceptives on their own after completing a training course.

Photo: Matthew Bowden Continue reading


Supreme Court vacancy creates muddle for future of reproductive rights


U.S. Supreme CourtBy Julie Rovner

The sudden death of Associate Justice Antonin Scalia has complicated the fate of many major cases before the Supreme Court this term. But few issues face as much turmoil going forward as women’s reproductive rights.

In March the court is scheduled to hear two separate cases; one on abortion and one on contraceptive insurance coverage. And the absence of Scalia means predictions of what may be the state of the law come the end of the court’s term this June are being turned, if not on their heads, at least sideways.

The abortion case, which originated in Texas, is considered the more significant of the two. Whole Women’s Health v Hellerstedt asks whether the state’s law imposing a series of restrictions on abortion clinics amounts to an “undue burden” on a woman’s right to have the procedure.

Prior to Justice Scalia’s death, it was considered likely that the court would uphold a Texas law that limits access to abortion, thus giving the nod not just to Texas, but to a broad array of state laws to scale back abortion access.

With only part of the law in effect, about half of the state’s 40 abortion clinics have closed. If the rest of the law is allowed to take full effect, abortion providers estimate that only around 10 would remain open.

The contraceptive case, Zubik v Burwell, is actually seven separate cases that have been bundled together. All the plaintiffs are religious-affiliated institutions that claim the Obama administration’s “accommodation” to allow them not to offer contraceptive coverage as part of their health plans still interferes with their religious freedom.

The administration’s rules specify that religious hospitals or schools do not have to “contract, arrange, pay, or refer a person for contraceptive coverage.” But it does require those entities to tell the federal government who its insurer is, so the government may make arrangements for the coverage to be provided. That, argue the plaintiffs, makes them “complicit in sin” through the act of providing coverage.

Prior to Scalia’s death, it was considered likely that the court would uphold the Texas law, thus giving the nod not just to Texas, but to a broad array of state laws to scale back abortion access by, among other things, requiring doctors who perform abortions to have admitting privileges at a nearby hospital and requiring abortion clinics to meet the same health and safety standards as “ambulatory surgical centers” that do much more complicated procedures. Continue reading