Women's Health News

Just a reminder that we've moved

2009-06-14T11:58:00.002-06:00

I continue to keep this blog up for various reasons (it still turns up in internet searches, and some posts at the new place link back here), but if you want to see the new content, please come over to the WordPress location. From time to time I may post links over here, but my ability to do that has been very limited as of late.

Visit Women's Health News at its new home - http://womenshealthnews.wordpress.com

No, Seriously

2009-01-18T09:12:00.000-06:00

Visit Women's Health News at its new home - http://womenshealthnews.wordpress.com

Head on Over...

2008-08-01T08:46:00.001-06:00

I know people are still finding me via this site, so come along to the new location.

Visit Women's Health News at its new home - http://womenshealthnews.wordpress.com

Women's Health News Update, 2/2/07

2008-02-02T10:41:00.000-06:00

Posts from January, at the new place.

Saturday News Round-Up, 2/2/08

Ridiculous Lawmaker of the Day: Mayhall Wants to Ban Obese from Eating

On Sushi, Mercury, and Women’s Health: Can’t See the Pollution for the Fish

I’m Cranky, and These Labor Nurses Aren’t Helping

Learn About Organ Donation

The Bedtime Chronicles, Vol. 4

*Blushes*

Labor’Lert: A Stopwatch for Your Uterus

Check Out the Sex Ed Video Contest Winners!

Reproductive Health and the Catholic Hospital Conundrum

Another Lost Tampon Story

Prophylactics, Propaganda, and Posters, Oh My!

Friday News Round-Up

Best Cities to Have a Baby

Are Women Really Requesting C-Sections?

Blog for Choice Day 2008

Hand in a Box

Caffeine and Increased Miscarriage Risk - A Portion Problem?

Newsweek Gets “Gay” MRSA Story Right, CWA Gets it Oh So Wrong

Contraceptive Patch Label Updated to Address Blood Clot Risks

Birth Control Sabotage - Submit Your Stories

WIC Program (Barely) Increasing Access to Fruits & Veggies

Heather Corinna Writes the Best Rants

Go Do Your Thing

International Carnival of Pozitivities

Health Disparities A-Go-Go

WTF, Underwear?

Randomized Birth Studies and Ethical Questions

Education of the Pregnant Teen

Spanish Abortion Providers on Strike

The Bedtime Chronicles, Vol. 3

Oh, Tennessee

The Ethical Concerns of Paid Surrogacy

This Just Seems Mean-Spirited

Update on Problems at Afghan Maternity Hospital

Mandatory HIV Testing of Pregnant Women?

One Thing to Hate About the New Year

Headlines of 2008 Meme

Happy New Year!

Pretty Bird Woman House Fundraising Drive a Success!

Inaugural Pro-Choice Blog Carnival

The Year in Review, 2007

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Women's Health News Update, 12/27/07

2007-12-27T08:03:00.000-06:00

Visit Women's Health News at its new home - http://womenshealthnews.wordpress.com

A roundup of recent posts:

Science vs. Spin: Reactions to New Research on Sex Ed and Abortion

CDC Releases Data on the Pre-Pregnant

Pretty Bird Woman House Needs Your Help - Help fund a safe shelter for abuse victims on the Standing Rock Reservation

New Warnings on Nonoxynol-9, and Spermicide in Your Hair Dye? - Nonoxynol-9 is not for HIV or STD prevention.

What, Y’all Didn’t Know I’m a Robot? - Your blogger gets a funny mention in a Bay Area newspaper

Shameless Bloggy Begging - Vote for me!

ACOG’s “Conscience” Statement on Refusing Care Due to Religious Beliefs

Grooming for the Gyno? Not Necessary - Seriously, nobody cares about your hair.

Fetal Mortality Rates by Race/Ethnicity - Still no explanation for the disparities

Foreign Rectal Bodies

Seriously? On HIV and Isolation

Huckabee, HIV/AIDS, Travel, and Bigotry - Huckabee got it wrong

Prisons and Reproductive Rights or the lack thereof

Waxman Calls for Investigation into Conditions at Kabul Maternity Hospital

Sunday Morning Linkage - Health Discussions, Forced Sterilization, and More

Making Your Holiday Donations Count for Women - A list of good causes

CDC Releases New Birth Data - Lots of interesting things in this new report

Bloody Baby Pictures Banned by MySpace - It happened to a friend of mine - MySpace thinks slutty underage pics are fine, newborns are gruesome

News Round-Up, 12/7/07

More Anti-Choice Ballot Initiatives Proposed for 2008 - You are registered to vote, aren't you?

Get the Machine That Goes “Ping!” - Monty Python takes on hospital birth

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Women's Health News Update, 12/1/07

2007-12-01T11:22:00.000-06:00

Please note that comments here are moderated very infrequently, if at all. Old posts have been migrated over as well, so please come on over if you have a comment.

Review: The Business of Being Born - This is an awesome documentary. Come find out why.

Websites and Eating Disorders

Home Sick - This woman's health, plus congrats to another blogger.

C-Section Rates by Hospital for Multiple States - Reliable info on this topic is extremely difficult to find.

The Book of Vice - Who wants to buy me a present?

To Sleep, Perchance to Chew My Hand Off - Something very strange happened while I was sleeping.

News Round-Up, 11/24/07 - Assorted goodies.

Updates on Fertilized Egg Personhood and Campus Contraception Prices

Welcome Writer Magazine Readers - Shameless self-promotion.

35th Carnival Against Sexual Violence - Lots of good posts on this topic.

News Round-Up, 11/17/07

More “Fertilized Egg as Person” Initiatives

Things You Don't Hear About Every Day - Because you know you want to read more about anal cancer.

Fertilized Egg as a Person, and Increasing STI Rates

Send a Sex Toy - to a frustrateding Attorney General.

Oh, Good Grief - More women's health blogger health woes.

Assorted Goodies - Another round-up.

Will a New Female Condom Catch On? - I'm guessing it won't.

Geeks and Vaginas - The best of both worlds.

Sin Tetas No Hay Paraíso - No, I don't expect I'd like a show called "Without Breasts There Is No Paradise."

Your Yucky Body - An awesome cartoon on the "mommy makeover" from Mikhaela.

Oral Contraceptives and Cervical Cancer

Diabulimia Discussion

Jezebel Can Suck It (But Can’t Breastfeed) - Why I have a love/hate relationship with Jezebel.

I Love Technology, Placentas Love Cloaking Devices - Why it's like a weird spy thriller up in your uterus.

Driving Me Crazy - Please Help! - A reader comes through with the name of a blog for a woman who was accused of child abuse.

Medical Concern, or Bad Attitude? - I report, you decide.

47th Carnival of Feminists

Quote of the Day, Understatement of the Year - On teens and abstinence.

Universal Orlando Staff Harrasses Breastfeeding Mama - They need to read a copy of Florida law, stat.

The Hospital Birth, The Hospital Rules - Can you really have a normal birth in a hospital?

The Perils of Librarianship - On plastic wrap, oral sex, and librarianship.

Vajapocalypse: I Say Vagina, You Say “This is what happened on Tyra” - Complete with fun clip from The Soup.

Bill Introduced to Reduce Campus Contraception Prices - Contact your legislator.

Miscarriage and Infertility Blogs - Lots of links.

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Women's Health News Update, 11/4/07

2007-11-04T09:04:00.000-06:00

It looks like we're on a monthly schedule now for pointing you over to the new place. Please note that comments here are moderated very infrequently. Old posts have been migrated over as well, so please come on over if you have a comment.

Posts since the last update (from oldest to newest):

Farewell, Mr. Otto - I lost my poor (20ish) baby kitty at the end of September. I still miss my furry little friend.

On the New Acting Surgeon General’s Plan B Holdup - More politicization of women's health. In a two-for-one, you get links to my posts at Our Bodies Ourselves as well.

Supreme Court Refuses to Hear Sex Toy Case, Sales Effectively Banned in Alabama - Causing women everywhere to utter the phrase "underground dildo railroad."

New Study on Risks of Birth After a C-Section - Talkin' 'bout the uterine rupture bogeyman.

Is the “Mommy Makeover” Really Necessary? - "Necessary" was a stupid word for these folks to use, because the answer is "no."

“there would be more abortions performed in this country if Planned Parenthood didn’t exist” - What a med student learned from a stint at Planned Parenthood.

A Long Way To Go On Sexual Assault Issues - Some folks don't think wives can be raped by their husbands. Those people are jerks.

F-Cup Cookies - Better living through junk food? Probably not.

Ina May Gaskin, Marsden Wagner Speak Out on Cytotec Induction of Birth - You know, if both the FDA and the drug manufacturer say, "Dudes, don't use this drug in pregnant women," maybe you should listen.

Pump and Type: Katie Allison Granju Talks About Working While Breastfeeding - The challenges of working while breastfeeding, and the privilege inherent in being able to do so.

Two New Posts at OBOS - Breast Cancer, Violence in the Congo - Come on over and find out more.

Sex Ed Digital Video Contest - You still have until Dec 31st to enter your brilliant sex ed video in this contest.

New Figures on Worldwide Maternal Mortality - The U.S. is still lagging behind numerous other countries in taking care of birthing women.

Argh - Susan Orr Appointed to Head National Family Planning Program - Call me crazy, but I think that if you don't at all believe in the mission of an agency, you shouldn't be in charge of it.

Pervy Dentist Makes up Total BS - Boob fondling is not an approved treatment for TMJ.

Student Denied a Rape Kit at Several Hospitals? - This is outrageous. Read it for yourself.

Report Card on Women’s Health - FAIL!

Enema, Schmenema

Don’t Work on Crime, Just Be a Vending Machine - Just hope your would-be attacker doesn't get thirsty.

Out Sick - I was ill, but still linked you to my post at OBOS on a postpartum depression bill that passed in the House (but not without political BS).

Rates of Elective Double Mastectomy Rise - When we focus on cancer prevention, we apparently focus on boob removal.

Australian Miners to Learn About Woman-Caves - Will better sex with their menopausal wives lead to happier workers?

HIV Vaccine Trial Gone Wrong - FYI - vaccines are supposed to prevent disease, not make it more likely that you'll get sick.

Arguments for Normal Birth - Bloggy goodness from some smart women.

Oral Herpes is Awesome - Not so much when you have to talk to strangers for 6 hours.

What to Ask Before Surgery, and What to Expect - A friendly guide from your blogger, who has had part of a knee, part of a thyroid, and four wisdom teeth removed.

Is This Child Abuse or Sexual Assault? - I think it's both. Find out why.

Salt n Pepa, the “Virgin vs. Whore” Show - Old stereotypes live on in this show.

On the NIH’s New Vulvodynia Awareness Campaign - Awareness is good, but finding out what caused it and how to treat it is probably better.

Boob Baby - A dream I had involving babies, bras and boobs.

Artificially Breaking Waters Shouldn’t Be Routine, Review Says - Another argument for allowing normal birth.

Updated Information On Treatment of Nashville Rape Victims - I did some digging, and turned up new information on Nashville women's choices after sexual assault.

Product Review: The Wear Ease Dawn Camisole - On a piece of clothing designed for women after mastectomy and other breast surgeries.

News Round-Up, 11/3/07 - Assorted items of interest on birth, c-section, sex ed, cervical cancer, abortion, adoption, pap tests, contraception, and a philosophical question on charity.

Visit Women's Health News at its new home - http://womenshealthnews.wordpress.com

Weekly Women's Health News Update, 9/28/07

2007-09-28T18:44:00.000-06:00

Just a reminder that new posts are at the new site, and comments here are infrequently moderated. The new stuff:

Shameless Self-Promotion - OBOS blog post picked up in a midwifery newsletter

Do You Have Your Period? - One high school's inappropriate questioning of teen girls

Pregnant? Maybe You Should Get Plastic Surgery For That Unsightly Belly Fat - The story of a woman allegedly fired by a plastic surgery clinic for being pregnant

When Abusive Partners Try to Force Pregnancy - Nearly 1/4 of girls in abusive relationships reported that their partner tried to force or deceive them into becoming pregnant

More on Tattoos and Epidurals

News Round-Up, 9/24/07 - Assorted goodies

Does a Tattoo Mean You Can’t Get an Epidural? - Or does it mean people think you're a "tramp" who should be punished?

LOLcat Blogger News - Everybody loves a fuzzy kitty picture, LOLcat-style

Documentary Review: Sex Ed and the State - Find out how abstinence-only sex ed had nothing to do with teens' health

Understanding Medical Research

More Products You Probably Don’t Need, the Menstrual Edition - Fear-mongering and money-taking

Sexy Librarian Rage & Banned Books Week - Because nothing is hotter than a miffed librarian

Headline of the Day - Hint: your gallbladder is kind of far from your vagina

Pushing a Genetic Test Most Women Don’t Need (or, Be afraid! Pay money!)

Facebook Deletes Breastfeeding Photos for “Obscenity” - I love hypocrisy with my social networking. Or not.

I’m All Official and Whatnot (at Our Bodies, Ourselves)

Moving Through the World as a Woman - Musings on safety

Finding Trustworthy Health Information Online

Images Prove How Offensive Breastfeeding in Public Really Is

Suicide on the Rise in Young Girls

Applebee’s Nurse Out Coverage

Sex Store Etiquette - Read this if you want to buy a toy without being a jerk

Help A Journalism Student - What Women’s Issues Would You Like Covered? - Head on over and leave suggestions in the comments

Link Love

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Weekly Women's Health News Update, 9/6/07

2007-09-06T19:22:00.000-06:00

Oh my, I have been busy lately. Periodic roundups are here, but new posts are up almost daily at the new place. Also, please be aware that I'm not keeping up with comments over here - come on over and join the discussion at the new digs.

Miscarriage Not a Crime After All - West Virginia police finally get a clue. See "Miscarriage or Crime?" for background.

Review: S.E.X., the All-You-Need-to-Know Progressive Sexuality Guide - I review a book. You will like the book.

Another Look at Vaginal Cosmetic Surgery

44th Carnival of Feminists - The state fair is gearing up down the road from my place, but that has nothing to do with *these* carnivals.

Breastfeeding Promotion Act of 2007 - Strong-arm your Senator. You know you wanna.

National Applebee’s Nurse-Out on September 8th - Eatin' breastmilk in the neighborhood

Guide to Donating Breastmilk - Links to good info

An Announcement - Our Bodies, Ourselves Blogging - I get a big girl blogging gig with some fantastic ladies

Vaginal “Rejuvenation” Not Safe or Necessary - Considering that there's approx. no studies and no evidence, you shouldn't have needed ACOG to tell you this.

Political Pressure Touches Breastfeeding Promotion Campaign - You know, because promoting breastfeeding and accurate information about breastfeeding isn't "friendly" enough to the formula industry. Bad administration! No soup for you!

Eatin’ Stupid in the Neighborhood - Applebee's bullies a breastfeeding mama, despite state law protecting her rights

Miscarriage or Crime? - Apparently every private tragedy must be investigated, or you never know what those rowdy women will get up to

News Round-Up, 8/28/07 - A little bit of this, a little bit of that, a little bit of sex toy quiz

Breastfeeding Baskets for New Moms - An excellent gift idea for the new mama in your life

A Saturday Poll - Why not help plan my future?

Dr. Anna Pao Speaks About Post-Katrina Hospital Experience - My heart breaks every time I read about this

RepHresh? ReNo. - Some things can go in your vagina. Other things should not.

Happy Birthday OTC Emergency Contraception - Join the Pill Patrol - Preparedness is next to librarian-ness. Get your OTC EC.

Forced HIV Testing - I'll take Things That May Not Be Ethical for $2000, Alex.

How to Avoid a C-Section - Don't get pregnant. Ha.

Women’s Health Interview Series - #1, REBIRTH blogger - I ask, the REBIRTH blogger answers

Your Boycott-Related Homework - Support Planned Parenthood - You know you want to (support PP and find out how one anti-choice group tries to make up new copyright law)

Take a Close Look at Those Papers You Sign at the Doctor’s Office - Because they may restrict your online activity

When Sex Ed Isn’t Comprehensive - People do say there's no such thing as a stupid question...

A Bit of Housekeeping - A roundup of all of my guest posts at the Our Bodies, Ourselves blog

Afghan Midwifery on Our Bodies, Our Blog - More with the OBOS blogging

More Stories at Our Bodies, Ourselves - Can you tell I'm excited about this yet?

Expanding Midwifery Care to the Underserved - Nashville, TN midwifery practice expands care to low resource populations

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Weekly Women's Health News Update, 8/19/07

2007-08-19T13:24:00.001-06:00

I'm still doing the weekly updates here because lots of folks end up here via search or old feeds. the little librarian in me of course wants to point them to the new place for more information.

How Operation Rescue and National Right to Life Spin Abortion Research - In response to a new study on the safety of medical abortion

Breast cancer vaccine? - Experimental vaccine seems safe, so further research will be done on whether it works

BlogHer Poll to Set Global Health Agenda - Head on over and vote for the most important issue in women's health

Woman Dropped by Doc at 8 Months Pregnant Over VBAC

Some People Are Just Crazy - Man poisons pregnant woman in an attempt to make her miscarry

When to Fire Your Doctor - Handy tips

Racial Bias in Treatment of Heart Disease - The findings of a new study might surprise you

Mother to be Ordered by Court to Stop Breastfeeding? - When custody battles get in the way of making sense

Guest-Blogging for Our Bodies, Ourselves - I am, and it's a blast

Gorgeous Isn’t Good Enough - Sexist modifications of celebrity photos - let's give the guy more muscle, and take it away from the woman!

News Round-Up, 8/15/07 - It's a goody bag

Abstinence Only Sex Ed No Good For HIV Prevention? - We'll talk about the research

Do You Trust Google With Your Health Information? - I'm not willing to say "yes" just yet

Inducing Labor for Convenience, not Safety - It's probably not necessary as often as they tell you it is

Link Love - Thanks to folks who send visitors my way

The Seven Flavors of Menstrual Suppression - Links to a good review of your options

Wearing Your Bra on the Inside - Who thought implanting a silicon "bra" and anchoring it to your ribs would be a good idea?

Sexual Partners - Who’s Exaggerating? - Somebody sure seems to be

Results from the National Breastfeeding Awareness Campaign - Find out how folks feel about breastfeeding, whether ads had any impact

Ohio Group Pushing for Broader Maternity Leave

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Weekly Women's Health News Update, 8/11/07

2007-08-11T08:28:00.000-06:00

It's been a few extra days between updates, so go check out this unusually long batch of fresh posts over at the new place.

RAINN Benefit Concert Tour - Check out this August series of events

They’re Not Infantilizing You, They Just Don’t Think You Capable of Being Informed - What's new in the abortion argument

How Physicians Are Responding to the “Partial Birth” Abortion Ban - Some clinics are forcing women to have a little-studied shot with their abortion to cover their butts legally

Instead Softcup as Fertility Aid? - One website would have you believe so, even though it hasn't been studied or approved for this purpose

I Help Aunt B Pee Standing Up - Like a proud mama

Plastic Surgery Ad Nauseum - Two new studies on cosmetic surgery you might have seen in the news

Wellcome Medical Image Collection - Check out this cool collection of historical medical images, now free for non-commercial use under a Creative Commons license

Bad Mammogram Tech! No Cookie!

Publix Offering Free Antibiotics - See what's covered, and search for a Publix pharmacy near you

What is Inflammatory Breast Cancer? - A few bits of info and resources on this sneaky form of breast cancer

Is Your Baby Too Big For Your Pelvis? - Probably not

REBIRTH’s Childbirth Ed Series, Part 3 - Very informative and easy-to-understand series on childbirth

Doulas Highlighted by CNN - Doulas get some mainstream media attention

What Not To Wear *In Your Vagina* - I'm so serious about this

Presented Without Comment - Natural Family Planning vs. “Contraceptive” - An amusing series of videos in the style of the "I'm a Mac, I'm a PC" ads

More Free Formula Controversy - Clarifying things related to the next two posts

The Formula Samples - Why Are You So Angry? - People misunderstand the formula "ban," and get angry

More Women Try Breastfeeding, Far Fewer Continue - New statistics on breastfeeding in the United States

An Interview with BadBadIvy - Ms. Ivy asks questions, I answer

Claim Your Free Women’s Health Calendar - Go get your free stuff

Doulas Behind Bars - The problems of birth in prison, and how doulas are trying to help

Nashville: Childbirth Education & Lactation Center Open House - You've missed the open house, but the center is open for business

Carnival Against Sexual Violence #28 is Up - One of my posts is included, along with lots of other interesting pieces from around the blogosphere

Ohio Bill to Give Final Say on Abortion to Men - Oh, Ohio, and your ridiculous stunts

Happy World Breastfeeding Week

Good News for Breastfeeding in New York Hospitals - The healthcare providers stop being complicit in the pimping of formula to all women

Freebirthing Profiled in Washington Post - Updated - Comments on a piece about unassisted childbirth

News Round-Up, 7/31/07 - Linky goodness

Latina Reproductive Health - A new blog from the National Latina Institute for Reproductive Health

How Much Jail Time Should 850,000 Women a Year Receive? - It seems like a valid question if you're trying to make abortion illegal

Get Thin or Get Charged - Bad employers, no cookie

Visit Women's Health News at its new home - http://womenshealthnews.wordpress.com

Weekly Women's Health News Update, 7/29/07

2007-07-29T15:15:00.000-06:00

Check out the latest batch of posts at the new site:

Your Online Childbirth Ed Series

Family Leave and the Employers who Ignore it

In Consideration of the Book

Signs You Need to Find a New Pregnancy/Birth Care Provider

Not for the Squeamish - Why You Have a Washing Machine

More Women Asked to Breastfeed in Bathrooms

More on the Problem of Rape on the Reservation

“Pushed” Author Online

Successful Cephalic Version via Kitty

http://womenshealthnews.wordpress.com/2007/07/25/a-different-kind-of-poke-and-prod/

Grand Rounds are On, I’m in Room 44

Medical Op-Eds Might Consider Presenting Facts

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Weekly Women's Health News Update, 7/25

2007-07-23T07:28:00.000-06:00

Check out the latest batch of posts at the new site:

Your Nipples Are Just Fine How They Are - Don't ask, just read.

Drop in Teen Sex not so Dramatic After All - The hyping of old (sexual behavior) news for new (abstinence-only) money.

Things I Don’t Want to Think too Hard About - More on the recent food warnings.

The Uterus Coffin - I'll take organ donation and a green burial, thanks.

I Want to Add You to the Blogroll - Drop me a line so I can get it done.

TSA Dumps Breastmilk Ban

Birth for Tech Geeks: Wired Covers Childbirth Simulators

Keeping up with Food Recalls - A resource for the times.

Screwing Katrina Victims, One Trailer at a Time - You know, because if you don't test for it, it doesn't exist. Even if it's formaldehyde?

Getting the Most out of a Doctor Visit

Missed Conceptions - A miscarriage blog review.

Girl Parts Name Generator - Self-explanatory

Condoms Monkey? - Does Japan *always* have cooler packaging?

Fisking the Washington Post - Well-Timed Period takes 'em on.

Democratic Presidential Candidates Pay Lip Service To Women’s Rights

Abstinence-Only Quote of the Day - Giving Up the Stickiness - Because human relationships are a simplistic as office supplies, right? Um, no.

I’ll Pass - A job I won't be applying for.

New Coalition to Combat Human Trafficking in Tennessee

Health Information for Travelers

Three Sexual & Reproductive Health Stories to Ponder - This is one of my favorites from the past week or so. The "Drop in Teen Sex..." post linked above is a follow-up to it.

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Weekly Women's Health News Update, 7/14

2007-07-13T12:24:00.000-06:00

Check out the latest batch of posts at the new site:

Nashville: Free Pap Tests Tomorrow - 7/14/07, get 'em while they're hot.

Summer Reading List - come on over and suggest some books.

It's True - the things people say...

Search Request Response - this is a full-service operation, people.

Diaphragms no help against AIDS? No kidding. - Studies telling us what we already suspected.

Missouri law bans Planned Parenthood from providing sex ed in schools - You know, because they're just trying to drum up abortion business. Sheesh.

When the anti-breastfeeding bully is family - Follow the link to discussion of one obnoxious request.

Stop deceptive advertising for women's services - Proposed legislation to stop "crisis pregnancy centers" from using false advertising, with discussion of how CPCs sometimes lie to women.

Shocking news of the day - administration interferes with science - What, you're no longer shocked by this?

Merck and GlaxoSmithKline competing for HPV vaccine market - A new vaccine is in the works to compete with Gardasil. I should have title this, "One More."

More on women judging women - the Plan B survey - More thoughts on women responding to a survey about emergency contraception.

When med school and sex shops collide - Innovative way to get accurate anatomical models.

Marital difficulties? Take a pill. - I dare a doc to suggest that I should fix any marriage issues by taking a drug so I feel better about it.

Blogging Elsewhere - Check out Nashville's new community blog space.

40th carnival of feminists is up - And I'm riding a pony and waving a baton. With streamers, y'all.

Survey of women who ordered Plan B online - What's good enough for me is good enough for thee. Or not.

Rain this morning, unfavorable cervical conditions this afternoon - New device for inducing labor sans drugs.

Are you boycotting Nestle? - Were you aware of the company's formula-promotion strategies?

Visit Women's Health News at its new home - http://womenshealthnews.wordpress.com

Weekly Women's Health News Update

2007-07-03T08:02:00.001-06:00

Check out the latest batch of posts at the new site:

More Women's Words on C-Section - the author takes on those who minimize her c-section experience by telling her that a healthy baby is the only thing that matters.

It's Not You, It's the Liability - The New Jersey Star Ledger investigates VBAC rates and attitudes in the state, including hospitals that simply refuse to let women attempt a VBAC. Also, get your homework assignment.

Don't Fear the Vulva - Why would a medical professional be so afraid of women's bodies?

The CDC's Gruesome Trading Cards - Everybody loves these infectious disease trading cards. I still think the one of the zebra killed by anthrax is a little gruesome.

News Round-Up, 6/28/07 - Everything under the sun, including how Google goofed with its new health advisory council.

How to do a Pelvic Exam - Find out what they're poking around for, and what "troubleshooting" is required.

Visit Women's Health News at its new home - http://womenshealthnews.wordpress.com

New This Week on Women's Health News

2007-06-21T18:08:00.000-06:00

Standard Intro: Although Women's Health News has moved, I'll add a post here now and again to let you know what has been added to the new site. Click on over and join us at the new place.

Note: All of the old posts are still here (as well as at the new place), so you can still search the archives for previously posted information.

Recent Posts:
-Women’s Health News Now Accredited By Health On The Net Foundation, certifies that the site complies with a set of standards for trustworthy health information on the web.
-Because Nothing Says “I Respect This Patient” Like Letting Your Kid do the C-Section - People, don't let your teenager do the surgery you were supposed to do.
-On Treatment of Nashville Rape Victims, They Just Don’t Get It - How people are missing the point about all of Nashville's rape victims having to go to General.
-HHS Releases Report Criticizing Comprehensive Sex Ed - Because I don't think "dental dam" is really an inaccuracy.
-Rising Infant Death Rates in the South
-Bad Blog Exposure - I don't like the rape porn links.
-Fox & CBS Say Disease Prevention is Good, Pregnancy Prevention is Bad - How Fox and CBS show their hypocrisy.
-C-Section Rates, or, Vagina is not a Bad Word - Why c-section rates are rising, and how a discussion board treats the word "vagina."
-“Give Back a Smile” Program Restores Dental Health of Violence Victims - How domestic violence victims can get help replacing teeth lost to abuse.
-Diabulimia - New “Eating” Disorder Among Diabetics? - Teens and adults doing dangerous self-experiments with their insulin for the purpose of losing weight.
-New Adventures in Blood Donation - Your little blogger shows you her boo-boo.
-Welcome to Caitlain’s Corner, Sex Ed Resource - Another resource for getting your sex smarts on.
-STD Wizard - Take a quiz. Learn what you might be at risk for.
-Why the HPV Vaccine is so Expensive - It's not just about the drug company's costs.
-Leukemia & Lymphoma Society Provides Financial Assistance to Cancer Patients - Blood cancer patients can get co-pay assistance, or you can donate to help them.
-Women’s Health News in Top 100 Healthcare Blogs - It's a dynamic list. Sometimes I'm #92, sometimes I'm #126. Such is life.
-25th Carnival of Sexual Violence is up, and it includes your women's health blogger.

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News Stories at Women's Health News on WordPress

2007-06-11T07:00:00.000-06:00

Sex advice from librarians, outrageous treatment of one city's rape victims, and more -
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No More Comments @ Blogger - Comments Welcome @ Wordpress

2007-06-08T07:44:00.001-06:00

Women's Health News has moved to Wordpress - comments are no longer being moderated on this Blogger version on a regular basis. Please join the discussion over at Wordpress.

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New at Women's Health News

2007-05-13T16:38:00.000-06:00

Home improvement safety tips, HPV, oral sex and throat cancer, the Safe and Well registry, obnoxious products from the W hotel, and more. Head on over.

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Women's Health News on WordPress

2007-04-20T08:35:00.000-06:00

For more recent posts and updates on the Supreme Court's ruling on the Partial Birth Abortion Ban Act, the new bird flu vaccine, the right to a home birth in the UK, lawsuits against the FDA regarding emergency contraception, and other news, visit Women's Health News at its new home - http://womenshealthnews.wordpress.com

New Posts are at WordPress

2007-03-29T21:38:00.000-06:00

Want to know about MRIs for breast cancer detection or anti-choice Eric Keroack resigning his position in charge of family planning? Head on over to Women's Health News's new digs at WordPress.

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News Round-Up - 3/27/07

2007-03-27T17:18:00.001-06:00

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Again with the thinking that women having knowledge is dangerous or scary or just plain bad.

Birth control prices going up on college campuses.

South Carolina wants to force women to look at ultrasounds before having an abortion. Thoughts on that at Aunt B's and in this previous post. Also, the underlying assumption that these silly women just haven't *thought* about it is especially offensive.

Ohio Governor to defund abstinence-only sex ed.

The American Medical Women's Association thinks women 30 and over should also be receiving the HPV vaccine, and has released a statement on cervical cancer prevention.

Anti-abortion folks are targeting urban, African-American women with their campaigns.

The CDC has adopted recommendations on HPV vaccination.

The Lactivist issues a World Breastfeeding Week Celebration Challenge, and dissects TSA breastfeeding policy.

Texas wants to pay women $500 to place babies for adoption rather than choosing abortion. Meanwhile, Surrogate Mothers, Inc. provides estimates of the average cost of having a surrogate mother (equivalent to what these TX women would be) ranging from $15,000-$50,000, depending on the method of fertiization. The Center for Surrogate Parenting website Experienced surrogate mothers will receive $23,000 - $30,000 as their compensation." $500 is about 2% of that $23K figure.

The Women's Bioethics Project blog has an interesting piece on "Bioethics Quilt Project: Black Americans and Medicine."

The Washington Post ran an article describing a woman's battle to get a second opinion on a breast imaging find. Kevin, MD points how how her efforts didn't really lead to better care and incurred unnecessary costs. I can see both points - the woman didn't really get the information or explanation she needed, but her efforts didn't ultimately improve her outcome.

(Hat tips to Feministing, the Kaiser Network, the Lactivist, et al)

Stupid Bill Dies in Committee

2007-03-27T17:17:00.000-06:00

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As Sean Braisted is reporting from the hill, and this vote tally page seems to confirm, HB1580 has been voted down by the Health and Human Resources Committee. The bill, covered in this previous post, would have taken authority to require vaccines away from the Commissioner of Health and given it to the General Assembly when the disease is sexually transmitted. Lawmakers made a grab for this authority in reaction to the new HPV vaccine.

Sean says:

The Christian Conservatives oppose this because they want to have cervical cancer as a threat to hang over their daughters heads so that they don't have sex; the state is looking out for the best interest of the girls whose parents are over-confident in their ability to control their daughter's sex life.

I wonder if these same Republicans who are questioning this vaccine, would have put the same grilling towards the polio vaccine? Debra Maggart is comparing the HPV Vaccine to Ritalin...seriously, what is with the Republican aversion to science?

Although much attention has been paid to efforts to make HPV vaccination mandatory, very little has been paid to attempts of this type to circumvent legitimate public health professionals for the sake of the agenda of those who would prefer to deny access to information and healthcare when it comes to adolescents and sex.

Kick Ass Condom Amulet

2007-03-26T19:26:00.000-06:00

The condom amulet to the left was made for me by the blogger at a little red hen, knitting activist and fellow Oberlin alum Naomi Bloom, complete with NYC Condoms for my collection. Visit the Safe Sex section of her blog for more about her condom amulet and condom distribution work - Naomi is especially passionate about HIV/AIDS prevention work in women over 50, and is generally a kick-ass, impressive, and generous woman. Go visit her site.

Naomi - I apologize for the quality of the photo - I had to take it on my cell because the regular digital camera is on the fritz. Thanks so much.
Everybody else - The photo doesn't do it justice, but the amulet is styled in Oberlin colors with a knitted loop to make it wearable around the neck.

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Blogging Elsewhere This Weekend

2007-03-23T18:54:00.000-06:00

I'll be guest-blogging at at NashvilleIsTalking, run by local ABC affiliate WKRN, this weekend. Come check it out.

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Increase in Cosmetic Surgery in the U.S.

2007-03-23T10:12:00.000-06:00

The American Society of Plastic Surgeons released statistics on cosmetic plastic surgery, and reports that:

"Nearly 11 million cosmetic plastic surgery procedures were performed in the United States in 2006, up 7 percent from 2005. Surgical cosmetic procedures increased 2 percent, with more than 1.8 million procedures performed. For the first time, breast augmentation (329,000) is the most popular surgical procedure since the ASPS began collecting statistics in 1992. Minimally invasive cosmetic procedures increased 8 percent, with more than 9 million performed, and hyaluronic acid injectables (778,000) make the top five for first time. Reconstructive plastic surgery decreased 3 percent."

Among the overall trends, "vaginal rejuvenation" increased 30% since 2005, with 1,030 reported. I have mixed feelings about cosmetic surgery. On one hand, you have every right to blow your money that way. On the other hand, I think there's something awry when nearly two million people in one year choose to have elective surgery because they don't think they look perfect enough. I'm also distubed by the Society's piece on what they term "Mommy Makeovers," which apparently include breast augmentation, tummy tuck and breast lift:

"In this day and age, women are giving birth later, returning to their careers sooner, and have busier schedules than ever before. Many are finding cosmetic plastic surgery to be the answer to returning to a pre-pregnancy shape they are comfortable with," said ASPS President Roxanne Guy, MD."

Yeah, women, didn't you know that if you give birth and return to the workplace, you better not look like you popped out a kid? Weren't you just on vacation last week? Damn, you lost some weight. Sheesh.

The Society also reports that women represent 90% of all cosmetic surgery patients, and rates among women are up 55% since 2000. Rates among men are up 8% from 2000, but down 7% from 2005.

Previous related posts:
-Cruel Times for Vaginas
-News Round-Up - 3/11/07 (scroll down to "Feministing takes on vaginal rejuvenation")

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Tennessee Legislators Propose to Take Vaccination Power from Commissioner of Health

2007-03-23T10:09:00.000-06:00

A bill introduced into the Tennessee State Legislature (HB1580/SB1958) and discussed this week would take away the power of the Commissioner of Health to require vaccines for sexually transmitted diseases and give that power to the General Assembly. The existing code (49-6-5001(a)) reads:

The commissioner of health is authorized, subject to the approval of the public health council, to designate diseases against which children must be immunized prior to attendance at any school, nursery school, kindergarten, preschool or child care facility of Tennessee.

The proposed legislation would amend that section to add:

provided, however, an immunization for a disease only transmitted sexually, for which a preventive vaccine has been approved and recommended for girls and women in a specific age group, shall not be required unless specifically authorized by the general assembly.

This move stems from controversy over the HPV vaccine, which some worry will promoting sexual activity among girls.

All of those signing on to the bills are Republicans, with the exceptions of Vaughn, J. DeBerry, and Pinion in the House, and Burks, Jackson, and Tracy in the Senate. The bill has been referred to the committees on Health and Human Resources for consideration on 3/28.

The Commissioner of Health is in charge of the Tennessee Department of Health, an agency staffed with public health and healthcare professionals with training in epidemiology and related issues. The current Commissioner, Susan Cooper, has "an extensive background in vulnerable populations, program planning and evaluation, health policy, healthcare regulation, and evidence-based practice." The current General Assembly has a bare handful of people who have ever worked in any healthcare-related capacity. In a segment on local news channel WTVF last night (look for "Lawmakers disagree on HPV vaccine"), Cooper, who is not currently for mandating the vaccine, stated, "I believe that as science changes, the Commissioner of Health is in the best position to keep up with the most recent science and make appropriate recommendations." In other words, she and her people are trained to keep up with this information, and have the skills to appropriately evaluate and understand the evidence. I don't think it's too big of a stretch to assume that the legislature is not trying to capture these powers in order to have better influence on money spent on vaccines, or to ensure that appropriate health-promoting measures are taken - they're doing it because of the "slut shot" hype.

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Benefit & Donations Needed for Shade Tree Family Clinic (Nashville)

2007-03-21T09:42:00.000-06:00

The Shade Tree Family Clinic is a free walk-in clinic in East Nashville run by (supervised) Vanderbilt medical students "to address the acute and chronic health needs of uninsured and underinsured patients in the East Nashville area."

The clinic, located at 222 Grace Street, open from 12-4 on Saturdays and 6-9PM on Tuesdays, provides the following free services: sick care; blood pressure care; child physical exams; diabetes management; adult physical exams; STD testing; teen care; HIV testing; medications; birth control; lab testing. A community survey was conducted to assess healthcare needs before the clinic opened, which found that "35 percent of community respondents indicated they had no health insurance, 49 percent used the emergency room for primary care, and 14 percent chose not to seek treatment of any kind for a non-emergency health problem."

There are two ways you can currently support the Shade Tree Family Clinic
If you're in the Vanderbilt community:
A Wing-A-Thon is being held on Friday night, with teams of 1st and 2nd-year medical students facing off to see who can eat the most wings, with music provided by VMS’s own Shun Minutiae. Individuals can pledge to donate $X per wing eaten; the goal is to raise $2,000 for the clinic. The event will take place in the Light Hall student lounge at 8:15 PM this Friday, March 23rd. Via personal communication, organizer Jordan Yokley indicated that those pledging a per-wing donation should expect ~350-400 wings to be consumed. Flat donations will also be accepted and appreciated. VUMC folks should contact Jordan to make a pledge or donation (look it up in PeopleFinder).

Make a Donation:
The Shade Tree Family Clinic, incorporated as a 501(c)3 non-profit organization, accepts monetary and medical supply/pharmaceutical donations. A wish list for the clinic will be available soon.

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Reminder: Free Emergency Contraception Today

2007-03-20T10:21:00.000-06:00

Back Up Your Birth Control
Planned Parenthood of Middle & East Tennessee will be providing free emergency contraception on March 20th at the following locations and times:

-Nashville
9:00am-4:00pm
412 Dr. DB Todd Blvd

-Knoxville
9:00am-6:00pm
8078 Kingston Pike, Suite 153

No appointment is necessary.

Blogger's Hospital Won't Allow Birthing Balls

2007-03-20T07:24:00.000-06:00

Katie Allison Granju, Knoxville blogger and author of Attachment Parenting, is scoping out locations for her upcoming birth. Katie has specific concerns due to a genetic condition, but also has certain criteria for how she'd like to labor, and has hit several barriers in finding what she needs, as described in this post. Katie would like to labor in water, but the hospital only has two rooms with tubs. She suggested renting one and bringing it in, but was told by the head of nursing that they only allow women to labor in water "if their water hasn't broken and they aren't dilated." In other words, they don't allow women to labor in water. Why a healthcare professional who presumably knows what labor is would tell a woman that she can labor in water if her water hadn't broken and she isn't dilated is beyond me. Nurse Cranky took things one step further, telling her she can't use a birthing ball because she might fall off, and it's a liability issue. Katie also describes the hospital's "support" for women who don't want epidurals - "support" to them apparently means "we won't push drugs on you," but doesn't seem to include any techniques or strategies for helping laboring women otherwise cope with pain.

I did a medical literature search yesterday to try to find instances of birthing ball injuries or descriptions of liability concerns, but found no such evidence. This doesn't mean it has never happened, but it obviously isn't being discussed much in medical publications. Most of these balls, also used for physical therapy and exercise, are pretty sturdy, and are built with sitting, bending, and stretching on them in mind. They're also low to the ground and flexible, so a fall off of a birthing ball would likely be less dramatic than falling off of a bed, chair, or toilet. One commentary from The Practising Midwife, The Risk-Managed Birth Ball," mentions another U.S. hospital that didn't allow birth balls, because "they haven't been risk-assessed," and makes the point, "Instead of simply risk-managing the things that might help women in labour, surely what we really need to address is the culture of fear and litigation which has somehow enshrouded pregnancy and birth, and the ways in which we can break this down, for the sake of everybody concerned."

Kudos to Katie for pushing the issue and standing up against silliness. The dismissive attitude of the hospital staff tells me we have a way to go before the concerns of laboring women are taken seriously.

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Things I Don't Want to Hear Again (on the HPV Vaccine)

2007-03-18T10:39:00.000-06:00

Okay, people, you really have to stop it with the "HPV vaccines will turn girls into sluts" argument. I'm serious. My brain might just explode. Today's Tennessean (Nashville's newspaper of dubious quality) has an article, "State official doesn't back mandated HPV vaccine." As you may know, mandating the vaccine for school entry (with generous opt-out provisions) is under consideration or has been enacted in several locales. Tennessee's Commissioner of Health, Susan Cooper, reportedly stated, "Do I think every female child should be protected against cervical cancer? If there's a way to do it, yes. Do I think we know enough about the long-term outcomes of this vaccine to say we ought to mandate it today? Maybe not." This is a common concern about the vaccine (see my concerns about Texas's mandatory vaccination proposal). You want to further examine the science and the money and the implications, fine, good idea.

However, Bishop George W. Price Jr., pastor of Bethesda Original Church of God in Nashville trotted out a already tired old line not based in science - "I'm not for it because it does encourage young girls to have sex outside of marriage, and that's now what it's all about."

Let's be absolutely clear:

Most girls are probably not avoiding sex solely because of HPV and/or cervical cancer. A recent CNN article profiled a doctor who indicated that few of her patients are even aware of HPV. I would go out on a limb and say that pregnancy is the number one fear about sex for young girls.
Existing data suggests that 9% of high school students report having been forced to have sexual intercourse, and 20-25% of women in college report being victims of completed or attempted rape. This suggests that there are an awful lot of women who may or may not choose premarital sex, but could nonetheless use some STD protection.
Additional reports suggest that by age 44, 96% of males and 94% of females have had premarital sex. 70+% have had premarital sex by age 20. If these data are correct, 3/4 of people are having sex despite their parents' exhortations and wishes, and could also potentially benefit from this protection.
Spouses cheat, and get divorced. The CDC reported a divorced rate of 3.6 divorces for every 1,000 people in 2005. Additionally, some marriages may include an abstinent-until-marriage woman, but a less abstinent husband.
The vaccine is most effective before sexual activity begins (such as before age 20 for about 3/4 of people). This does not require tremendous understanding - we generally understand that we give vaccines for chicken pox, measles, the flu, etc. before people contract the infection, in order to prevent it.

Essentially, there are a number of factors outside an individual woman's control that may mean, even if she intends to be pure as the driven snow until marriage, she may end up with an HPV infection, and possibly resulting cervical cancer.

One anti-vaccination activist previously stated that, “What they are proposing is vaccinating a bunch of healthy girls that are responsible and that do come from good homes for the benefit of irresponsible people.” However, according to the CDC, “Approximately 20 million people are currently infected with HPV. At least 50 percent of sexually active men and women acquire genital HPV infection at some point in their lives. By age 50, at least 80 percent of women will have acquired genital HPV infection. About 6.2 million Americans get a new genital HPV infection each year.” I suppose 80% of women just come from bad homes and are irresponsible.

Planned Parenthood's Mark Huffman responded to such concerns with, "For those parents who are concerned about what kind of effect this will have on their daughter's behavior, we can assure them that related studies suggest very strongly that vaccinating or providing young people with protection around sexuality does not increase the likelihood that they will engage in sexual behavior." Even the notoriously conservative Family Research Council has gotten with the program and realized that encouraging sex is an unlikely outcome - the organization once stated that it might be seen as a license to have sex, but later released a statement in support of the vaccine. One commenter on the story's discussion thread gets it just right - "Let's be clear on this: I got chlamidia[sic] from my husband. Young girls need to be protected, not so that they can go out and do whatever, but so that they will not be victimized in yet another way."

If you're going to oppose HPV vaccination, you can do it for any number of evidence-based reasons. Let's not use "it'll turn the girls into sluts!" Reefer Madness-style propaganda, given the number of holes in that particular argument. If you'll excuse me, I'm off to stick myself with rusty nails and roll around in a blood spill, because I've been vaccinated against tetanus and hepatitis.

FDA Plans to Fully Fund Office of Women's Health

2007-03-18T09:45:00.001-06:00

The Washington Post is reporting that the FDA's 2007 operating plan includes full funding at $4 million for the agency's Office of Women's Health. Previously, it was suggested that $1.2 million would be withheld, essentially halting operations for the remainder of the year, which was perceived by many as retribution for the Office's evidence-based (rather than politically-based) stance on emergency contraception.

Women & War

2007-03-18T09:27:00.001-06:00

Today's New York Times Magazine has a lengthy piece on women in war, beginning with a profile of Suzanne Smith, a 21-year-old Army specialist who went AWOL rather than be redeployed to Iraq. Swift claimed to suffer from post-traumatic stress disorder, and was pressured to have sex with her commander during her previous deployment. The piece reports that "a 2003 report financed by the Department of Defense revealed that nearly one-third of a nationwide sample of female veterans seeking health care through the V.A. said they experienced rape or attempted rape during their service. Of that group, 37 percent said they were raped multiple times, and 14 percent reported they were gang-raped," and cites findings that women subjected to sexual assault are more likely to develope PTSD.

Although the military has implemented new policies for reporting such abuse, the article reports a "a pervasive sense among them that reporting a sexual crime was seldom worthwhile. Department of Defense statistics seem to bear this out: of the 3,038 investigations of military sexual assault charges completed in 2004 and 2005, only 329 - about one-tenth - of them resulted in a court-martial of the perpetrator. More than half were dismissed for lack of evidence or because an offender could not be identified, and another 617 were resolved through milder administrative punishments, like demotions, transfers and letters of admonishment."

While some may look at stories like these and conclude that women don't belong in war, a more productive approach (given clear personnel needs) might be to take advantage of these individual women's willingness to speak out to tackle the larger problem, attempt to change a sub-culture of violence against women in the military (remember, these men come home to women and society as well), and to ask questions about how we can train killing machines without training dominance machines in general and how we can maintain killing machines if we have to acknowledge that they may be profoundly emotionally affected by their actions and experiences (because women aren't the only ones coming home broken).

More Nursing Hand-Offs May Be Associated Greater Risk of C-Sections

2007-03-17T13:30:00.001-06:00

A study published in the current issue of the journal Birth examined the number of nursing hand-offs (switches in the nurse responsible for a patient's care) for women giving birth to determine whether this was associated with a greater risk of having a c-section.

Who Was Included
Researchers looked at the medical records at a university teaching hospital in Quebec, Canada 9with a c-section rate of 24%). They examined records for women who were admitted to the intrapartum (labor & delivery) unit, were having a 1st birth of a single baby, had a vertex presentation (baby coming out head first), and were at 37 weeks or more gestational age from March 1997-March 1998. Records for 467 women were included in the study that met the inclusion criteria and had complete data.

What Was Done
Medical records included the recording of the nurse (with date and time) responsible for each woman; the researchers examined the number of nurses caring for each woman during labor, the number of times care responsibility switched (patient taken care of by a different nurse), and length of time each nurse was responsible for the laboring woman. Data also included predictors of cesarean birth, such a length of labor, infant birthweight, day of week, maternal age, gestational age, method of delivery, physician attendant during pregnancy and birth, maternal height, type of rupture of membranes, epidural anesthesia, stimulation, and induction. This data was used to control for factors that might also influence c-section rate.

What They Found
After controlling for other factors that may lead to c-section, the researchers found that the number of nurses caring for a laboring woman was associated with number of c-sections. The authors state that "each additional nurse caring for the same laboring woman was associated with a 17% greater risk of cesarean section, with a range of risk 4-32% greater." Other factors ("switches" ≥1 per 2 hours, same nurse responsible for ≥33% of labor) were not statistically associated with a greater risk of c-section.

Comments
The authors note that it might seem strange that only one of the three nursing factors was associated with greater risk of c-section, stating: "Given that the 3 indicators are very closely related, someone might have thought that if one showed an effect, so too would the others. The lack of effect of the "number of switches," however, might be explained by the fact that several switches could have occurred among few nurses (e.g., nurses who are paired) such that a relatively high level of continuity of responsibility remained. Having the "same nurse responsible for ≥33 percent of the labor" likely provided some of the information already included in the "number of nurses," whereas the latter included additional information." They essentially found that while the total number of nurses and greater length of time (>1/3 of time) was not associated with increased c-section risk, the total number of switches is what mattered.

One of the findings that might be somewhat surprising is that the number of nurses per woman ranged from 1-17 (mean, or average, of 5.4), the number of hand-offs or switches per woman ranged from 1-31 (mean 4.5), and the range of length of labor that a single nurse stayed with a woman was 10-1,045 minutes, or from 1/6 of an hour to 17.4 hours (mean 126 minutes, or 2.1 hours). Mean length of labor was 14 hours, with 26% laboring less than 9 hours. Although more individualized data on length of labor and duration of care is not provided, it is clear from the 1-17 range of switches that none of the 467 women were cared for continuously by a single nurse throughout their labor.

Citation
Gagnon AJ, Meier KM, Waghorn K. Continuity of nursing care and its link to cesarean birth rate. Birth. 2007 Mar;34(1):26-31. Free Full Text

Girls' Weightlifting

2007-03-17T12:03:00.000-06:00

From Florida, in today's New York Times: "She was an Atlas of the exurbs, hoisting a 210-pound barbell over her ponytailed head and holding it there, arms just barely aquiver, while the high school gymnasium exploded in cheers. At that moment on a recent Saturday, Jessica Reynolds, 17 and weighing in at 261 pounds, broke the state record for girls’ weightlifting, a high school sport sanctioned only in Florida..." According to the report, no other state has officially adopted weightlifting for girls, as the Florida High School Athletic Association did in 1997.

I think it's fantastic that "it’s pretty much understood that weightlifting is O.K. and you’re not a boy and you’re not gross if you do it,” as one senior weightlifter said, but it's telling that it supposedly took this to gain acceptance: "The presence on many teams of cheerleaders — who become better jumpers and fliers after lifting — has helped remove the stigma from the sport, several girls said. Many wear bows in their hair at competitions, and at a recent meet, one wore pearls with her singlet." Essentially, when the team became more stereotypically "girly," it became more acceptable in general that these strong young women were intruding upon traditionally male territory.

Union Pacific Wins Case to Deny Contraception Coverage

2007-03-16T08:18:00.000-06:00

Yesterday, the 8th Circuit Court of Appeals ruled that Union Pacific's policy excluding contraceptives from its health plan does not discriminate against women. The Court's ruling stated that, "Union Pacific's health plans do not cover any contraception used by women such as birth control, sponges, diaphragms, intrauterine devices or tubal ligations or any contraception used by men such as condoms and vasectomies. Therefore, the coverage provided to women is not less favorable than that provided to men."

Female employees of Union Pacific sued the company for sex discrimination under Title VII amendment, the Pregnancy Discrimination Act, and a district court granted a partial summary judgment in July 2005. Union Pacific appealed the ruling, which the 8th Circuit Court reversed with this decision. The Court decided that the PDA does not apply, because contraceptive use occurs prior to, or to prevent, pregnancy, and so is not related to pregnancy discrimination, and that because contraception is not covered for men or women, it is gender neutral and not sex discrimination.

The dissenting judge (Bye) in the 2-1 ruling disagreed with the gender neutrality of the policy, stating that:

When one looks at the medical effect of Union Pacific’s failure to provide insurance coverage for prescription contraception, the inequality of coverage is clear. This failure only medically affects females, as they bear all of the health consequences of unplanned pregnancies. An insurance policy providing comprehensive coverage for preventative medical care, including coverage for preventative prescription drugs used exclusively by males, but fails to cover prescription contraception used exclusively by females, can hardly be called equal. It just isn't so...even if we were to look at its exclusion of coverage for vasectomies, the policy nonetheless discriminates against females. When a policy excludes coverage for vasectomies, the medical effect of this exclusion is born entirely by women, as the record demonstrates women are the only gender which can become pregnant...Women are uniquely and specifically disadvantaged by Union Pacific’s failure to cover prescription contraception. Because I believe such a policy is violative of Title VII, as amended by the PDA, I respectfully dissent.

The Court's Opinion [PDF]

Connecticut Lawmaker Tells Personal Story of Rape in Support of EC Access

2007-03-16T08:04:00.000-06:00

On Tuesday, Connecticut State Representative Deborah Heinrich told a crowd gathered for a press conference of being raped while in college. Heinrich, in support of a bill that would require all state hospitals to provide emergency contraception, reportedly stated, "Every woman in the state must be assured that when she finds that last ounce of strength, that last bit of trust that will allow her to enter the doors of the hospital, that no matter which hospital she manages to stumble into, that she will be assured of having the highest standards of care. For a rape victim, that must include being offered emergency contraception." Heinrich indicated that only her immediate family had been aware of her rape prior to her announcement, and described the strength it took for her to seek help after her rape, stating that she would not have had the stamina to go elsewhere had a hospital told her to do so for EC.

Colorado Governor Signs Legislation to Require Hospitals to Inform Rape Victims of Emergency Contraception

2007-03-15T18:37:00.000-06:00

Colorado Governor Bill Ritter signed into law today a bill requiring hospitals to inform patients who are victims of sexual assault of the availability of emergency contraception. The bill, passed in the Colorado Senate as SB 07-060 [PDF], states:

"All health care facilities that are licensed pusuant to this Part 1 and provide emergency care to seual assualt survivors shall amend their evidence collection protocols for the treatment of sexual assault survivors to include informing the survivor in a timely manner of the availability of emergency contraception as a means of prophylaxis and educating the survivor on the proper use of emergency contraception and the appropriate follow-up care."

It does allow healthcare providers to refuse to provide information about emergency contraception "on the basis of religious or moral beliefs," and does not require providers to provide emergency contraception if they determine that there is no risk of pregnancy or the victim was already pregnant at the time of the assault. The legislation calls it "critical" that victims have accurate information about the availability and use of emergency contraception, so "encourages" but does not require victim assistance/counseling and rape crisis hotlines to provice information on EC and for pharmacies in the state to distribute EC information. Further, the bill requires pharmacies that do not have the drug in stock to prominently place a sign reading, "Plan B Emergency Contraception Not Available."

The findings (or, the rationale) for the legislation included the following points:

One of every six women in the United States and one of every four women in Colorado will be the victim of a sexual assault

Forty-four percent of the victims of a sexual assault are under eighteen years of age, and eighty percent of the victims of a sexual assault are under thirty years of age

It is estimated that sixty percent of all sexual assaults are not reported

A woman who is the survivor of a sexual assault may face the additional trauma of an unwanted pregnancy or the fear that pregnancy may result

Each year, between twenty-five thousand and thirty-two thousand women in the United States become pregnant as a result of sexual assaults, and approximately twenty-two thousand of these pregnancies could be prevented if these women used emergency contraception

The findings go on to cite recommendations for EC information provision, and the drug's safety and efficacy in preventing unintended pregnancy. This legislation correctly locates EC, given the scientific evidence, as a means of preventing, but not terminating, a pregnancy. Previous Governor Bill Owens vetoed a similar bill in spring of 2004. When Ritter ran for the Governor's seat, he included a platform of reducing unintended pregnancies through better family planning, better access to health care including birth control and emergency contraception, providing responsible sex education, and promoting adoption. Ritter also stated, "Improving education, health care and our economy - which will be the top priorities for my administration - will do more to improve the lives of children and reduce the number of abortions in our country than a divisive focus on punishing the women who find themselves turning to it as a solution."

Women's Health News Also Available on WordPress

2007-03-14T08:23:00.000-06:00

I'm playing around with WordPress to see if I want to move there from Blogger. If you want to take a peak, and let me know if you prefer one over the other, the site is at womenshealthnews.wordpress.com. I haven't committed to the move yet, and you'll have plenty of warning before I do. Please note that the WordPress page is still in progress, so the categories, blogroll, etc. are not yet fully developed.

Ongoing HPV Vaccine Debate

2007-03-14T07:38:00.000-06:00

The HPV vaccine from Merck continues to make the news and inspire debate. The Nation published "Who's Afraid of Gardasil?" online ahead of the March 26 print issue in which it will appear. The piece indicates that as many as 31 state legislatures are considering requiring the vaccine, and estimates that Merck stands to make $4 billion per year on the product. Concerns about the role of Merck's political contributions in influencing legislators and the Women in Government group who have supported the vaccine push are described, as is the problem that Merck's swift push to require the vaccine has generated controversy and opposition where a slower, more measured approach might have had more success.

AlterNet also has two pieces on the vaccine, "HPV Vaccine Out of Reach for College Students" and "HPV Vaccine: Public Health Boon or Big Pharma Bull?"

Meanwhile, Feministing reports that New Mexico is close to requiring the vaccine, and the Texas Attorney General has issued an opinion stating that the Governor's executive order requiring the vaccine for schoolgirls does not carry the weight of law.

Free Emergency Contraception in Nashville & Knoxville, 3/20/07

2007-03-13T08:23:00.000-06:00

Planned Parenthood of Middle & East Tennessee will be providing free emergency contraception on March 20th at the following locations and times:

-Nashville
9:00am-4:00pm
412 Dr. DB Todd Blvd

-Knoxville
9:00am-6:00pm
8078 Kingston Pike, Suite 153

No appointment is necessary. According to the organization's MySpace page, they will also offer free pap tests on May 19th, so mark your calendars and get screened.

News Round-Up - 3/11/07

2007-03-11T08:01:00.000-06:00

D.C. moves closer to requiring HPV vaccine for girls entering 6th grade

Kroger groceries reiterates policy of providing access to emergency contraception. In response to questions, a Kroger spokesperson, "couldn't tell us which of the Nashville area's 60-plus Kroger pharmacies carry Plan B because those numbers are "strictly based on what kind of demand each individual pharmacy has...f they've never had a customer ask for that medicine, they may not have it."

Salon has a lengthy piece on sexual abuse of women soldiers and the military cultural barriers to reporting assault.

Some colleges may expel suicidal students.

The National Heart, Lung, and Blood Institute released an online guide to healthy sleep [download as PDF].

Older mothers more likely to deliver by c-section, and nobody can figure why. "Researchers funded by the National Institutes of Health have found that older mothers with normal, full-term pregnancies — particularly first-time older mothers — were more likely to undergo Caesarean delivery than were younger women with similarly low-risk pregnancies." Older mothers may be more likely to have certain complications, but c-section rates were higher in normal, uncomplicated pregnancies as well.

Belly Tales has a great post up discussion premature rupture of membranes at term, induction of labor, and the problems associated with active management in labor, and the evidence base on this topic, with lots of references. I hope The Student works this up for publication as a review article somewhere.

Feministing takes on "vaginal rejuvenation," which was featured in this recent article in the Washington Post. Although "the American Society of Plastic Surgeons began tracking vaginal rejuvenation in 2005 and recorded 793 procedures that year" and one doctor reports that "he has performed more than 3,000 in the past 12 years and has trained 140 doctors in a dozen states and 20 countries," one past president of Society of Gynecologic Surgeons states that "There is absolutely zero scientific literature that supports . . . the notion that firing a laser of any kind will tighten [vaginal] muscles," and calls the surgery 'a ripoff.'" Another doctor "who has operated on 18 patients, said he does not consider the lack of published studies to be problematic." Ladies, repeat after me, "If it doesn't cause me pain or otherwise have something medically wrong with it, spending $3,000 for unstudied, loosely regulated 'vaginal rejuvenation' is not going to fix what's really wrong with my self-esteem or relationship. If my partner thinks my vulva or vagina is not 'pretty' enough or 'perfect' enough, he can collect his stuff at the curb and look for a new one." Say it with me three more times. Got it?

High school girls suspended for saying "vagina."

If you're in Pennsylvania, you may want to contact your legislators to support a breastfeeding bill The Lactivist describes.

The Lactivist also notes that tv show SuperNanny may be trying to shock you with a baby still being breastfed at 14 months. Nevermind that the World Health Organization recommends breastfeeding up to 2 years and beyond.

The Well-Timed Period wants to know why a reporter would let a faith-based assessment of Plan B side effects in his story not be balanced by actual evidence.

CNN reports on radiation for breast cancer and heart disease risk

More crap for you to spend money on that you probably don't need, again with making you feel insecure for no reason.

International Women's Day Redux

2007-03-09T13:05:00.000-06:00

As a follow-up to my previous post on International Women's Day, here is a selection of past posts related to non-U.S. women's health. Many of them make mention of news stories, films, or situations that are worth a look.

Frontline Program on Sex Slaves - information on the program covering human trafficking (including a link to a complete transcript), as well as links to organizations fighting trafficking and sexual slavery.

The Unfortunate Experiment - information on an unethical experiment in New Zealand that deliberately let cervical cancer go untreated in numerous women, often without their knowledge.

On Giving Birth in Iraq - information from and link to Washington Post story on the barriers women face when giving birth in Iraq
On Giving Birth in Iraq, Part II - follow-up link to Morning Edition with reporter's perspective on his wife's birth experience in Iraq.

One to Watch: Motherland Afghanistan - review of a documentary highlighting the broken state of maternity care in Afghanistan with links to the film's website and related resources.
Reminder: Motherland Afghanistan Airs Tonight - includes information on the Afghan Women Empowerment Act of 2007.

The Women of El Salvador - information from and links to a New York Times Magazine piece on El Salvador's complete ban on abortion.

Global Unsafe Abortion Resources - overview and links to additional resources.

International Women's Day

2007-03-08T17:25:00.000-06:00

Today is International Women's Day and Blog Against Sexism Day, and I've decided to dedicate my commemorative post to online resources dealing with international women's health issues.

World Health Organization:

Statement by Dr Margaret Chan, WHO Director-General, on the occasion of International Women's Day

Sexual Violence

Women and HIV/AIDS

Gender and Other Health Topics

Sexual and Reproductive Health

Female Genital Mutilation

Others:

Amnesty International: Stop Violence Against Women

Black Women's Health Imperative - primarily US, addresses health disparities

Center for Reproductive Rights

Doctors Without Borders

EngenderHealth

Global Alliance for Women's Health

Global Health Council

Guttmacher Institute

Human Rights Watch: Women's Human Rights

International Women's Health Coalition

Latin American and Caribbean Women's Health Network

MADRE: An International Women's Human Rights Organization, and MADRE's report on gender-based violence in Iraq

Our Bodies, Ourselves: Global Women's Health and Global Access to Birth Control

Planned Parenthood - Where we work internationally

Safe Motherhood

Stop Rape Now

UNICEF: Child protection from violence, exploitation and abuse

United Nations Development Fund for Women

WomenWatch: United Nations Inter-Agency Network on Women and Gender Equality

Women's Global Health Imperative

World Alliance for Breastfeeding Action

The Youth Coalition

Bombing Our Own Territory, and Making Women Sick?

2007-03-08T08:43:00.000-06:00

Women's eNews has a piece today, "Vieques Women Claim Navy's Toxins Destroy Health," regarding the U.S. Navy's decades of bombing practice on Vieques, Puerto Rico and women's claims that this has caused health problems such as cancers. According to Dr. Cruz M. Nazario, an epidemiologist at the University of Puerto Rico quoted in the story, "Before the Navy stepped up target practice, Viequens had one third the average risk of cancer. That risk is now 30 percent higher than average. There is no industry or other source of contamination here to release carcinogens into the environment, so many scientists believe the cause must be mercury, aluminum, arsenic and other pollutants left by the military."

Debate continues over the role of the bombings in the islanders' health problems. The story states that in recent years the U.S. government's "Agency for Toxic Substances and Disease Registry to conduct a series of studies of the island's air, soil, water and fish. All of this research, done in the early 2000s, concluded toxin levels were safe." Vieques has been designated a Superfund site deserving priority cleanup.

I haven't had a chance to do much background reading into this situation, but will post an update after I do.

33rd Carnival of Feminists is Up

2007-03-08T08:31:00.000-06:00

The 33rd Carnival of Feminists is up at "The Greatest Blog You'll (Probably) Never Read." Last week's post on "Pelvic Exams and Informed Consent" is included, as are links to other bloggers' takes on feminism on Facebook, solo traveling, Barack vs. Hillary, women athletes, advertising, the HPV vaccine controversy, and more.

Best of the Web Today

2007-03-06T18:48:00.000-06:00

The Wall Street's Journal's "Best of the Web Today" describes what it called "an amusing little dust-up from the Volunteer State," referring to my dispute with Bob Krumm regarding the response I received from State Senator Henry on the "death certificates for abortion" bill. It also refers to Aunt B's response, which smartly made the point that Krumm's comments overlook or misunderstand my concerns to focus on his perception that I didn't "jump through the hoops correctly" - and I do think B got that exactly right. My original post on Henry's letter is quoted, as is my response to Krumm.

"Best Of" author Taranto's most amusing comments? Referring to me as a "blogress" and stating, "We'd actually go beyond this and say Rachel clearly is literate." My parents will be thrilled.

My Boobs Look Funny

2007-03-05T08:41:00.000-06:00

I jumped out of the shower at the gym this morning to find that I had either forgotten my regular bra or managed to lose it somewhere on the street/elevator. Thus, I'm stuck wearing the not-exactly-freshly-washed sports bra all day. I hereby declare today the Day of the Uniboob, and establish a 5-foot olfactory security perimeter around my person.

Senator Henry Dismisses Complaints About Campfield's Death Certificates Bill

2007-03-03T17:59:00.000-06:00

Last month, I used NARAL's action form to contact my state Senator, Douglas Henry (a Nashville Democrat), regarding Stacey Campfield's proposed legislation to issue death certificates in abortion [SB1094 by Bunch in the Senate, HB0982 by Campfield in the House]. The letter pointed out that Tennessee already collects abortion statistics, and that serious privacy concerns are involved. I have already discussed my concerns about the bill, and Campfield's immature and unresponsive actions with regards to criticism of this legislation. Today, I received the following letter from Senator Henry (a member of the Senate's Health and Human Resources committee), which similarly addresses none of the concrete concerns raised regarding this bill:

March 1, 2007
Dear Constituent:

Thank you for your recent correspondence regarding Senate Bill 1094. It has always seemed to me that one's viewpoint on unborn children depends on whether one views the matter from the standpoint of the child on one hand, or from the standpoint of the unwilling prospective mother on the other hand. There are certainly strong arguments in favor of the unwilling prospective mother, but I decided long ago that I would come down in favor of the child. Appreciating your having written,

I remain,

Very truly yours,
Douglas Henry

Let's be absolutely clear. In addition to the question of whether Campfield understands the implications of his own proposal and/or is being honest or mature about it, Campfield's bill does nothing to reduce unwanted pregnancy. It does nothing to provide access to or information about contraception or related health services such as prenatal care. It does nothing to provide the kinds of support women need to successfully carry a pregnancy to term and raise a subsequent child. What it does is create an additional means of bullying, shaming, and potentially endangering women who, for whatever reason, find it necessary to seek out a legal abortion. Receiving a pithy talking points memo from Henry as a response, one that does nothing to address the legitimate concerns about this bill, is an insulting demonstration of how unwilling certain Tennessee legislators are to appropriately respond to constituents and engage in meaningful discussion of proposed legislation that could profoundly affect women's (and constituents') lives.

Note: I don't have a scanner at home, but if anyone would like to see proof of Henry's statements, I will be happy to access one and provide it.

Update: Bob Krumm, who was defeated by Henry in a recent election, responds to my post here. What Krumm fails to recognize is that it doesn't bother me if Henry sent the same form letter to everyone writing to him on the bill. What bothers me is that his letter did not substantially respond to any of the legitimate concerns raised regarding this piece of legislation. More of my response here and here. Also, Aunt B and her commenters get it exactly right.

Technorati Tags: abortion; legislation; reproductive rights; tennessee

What's Missing From Model Pelvic Exams

2007-03-03T11:12:00.000-06:00

As mentioned in a previous post, some medical teaching institutions have switched from having medical students perform pelvic exams on (often unaware, non-consenting) live women with technological devices, such as this pelvic ExamSIM from Medical Education Technologies, Inc. An author comment (1) following the article reporting disturbing attitudes toward consent (2) rightly points out that these models omit important information about performing pelvic exams, namely the patient's experience of pain or discomfort, and the interaction with the patient as a whole. It takes but a glance at the image to the left to realize that existing models are disembodied and standardized. How many of you would look at your own genital region and think that it is similar to the model shown? What can a medical student learn about pain and natural variations in human anatomy from a model so removed from real women's anatomy and experiences? While anatomical models may be a better option than assaulting unconscious women, I've yet to see a woman's body that looked anything like the image shown.

The authors state, "Students are not learning how to palpate for pain—an extremely important indicator of pathology—and the surgical focus on anatomy does not emphasize the importance of examining each woman with gentleness, with sensitivity to her psychologic state, and with respect for her intellectual presence. When these repeated preoperative educational examinations are performed without the patient's informed consent, the cost to both patient and student is even greater. A tremendous number of women describe these examinations as a form of violation; that fact alone should warrant change. Additionally, our survey research has shown that medical students place less value on the importance of informed consent after participating in the third-year obstetrics-gynecology clerkship than they placed on it before the clerkship. The bottom line is this: teaching institutions should make sure that students do not examine patients, whether alert or anesthetized, until someone first receives the patient's informed permission."

Another published comment (3) in response to the article more pointedly states, "hospital administrators who allow medical students in their facilities to perform pelvic examinations on unconsenting anesthetized women ought to consult with their legal counsel concerning the definition of rape in their jurisdiction."

Citations:
1) Ubel PA, Silver-Isenstadt A. Author reply. Am J Obstet Gynecol. 2003 Dec; 189(6):1808-1809. [Full-text]
(2) Ubel PA, Jepson C, Silver-Isenstadt A. Don't ask, don't tell: a change in medical student attitudes after obstetrics/gynecology clerkships toward seeking consent for pelvic examinations on an anesthetized patient. Am J Obstet Gynecol. 2003 Feb;188(2):575-9. [Full-text]
(3) Coxe MF. A change in medical student attitudes of obstetrics-gynecology clerkships toward seeking consent for pelvic examinations on an anesthetized patient. Am J Obstet Gynecol. 2003 Dec;189(6):1808 [Full-text PDF]

Where did the tags go?

2007-03-03T11:10:00.000-06:00

Now that I've been forced to switch to the new Blogger, which includes a "labels" feature for posts, I'm pondering whether I want to continue adding Technorati and MeSH tags to each post. If you have a preference, please let me know in the comments.

Pelvic Exams and Informed Consent

2007-03-03T10:18:00.000-06:00

The New England Journal of Medicine has a perspective piece by Adam Wolfberg in the current issue (1), "The Patient as Ally — Learning the Pelvic Examination," which addresses the issue of teaching pelvic examinations to medical students. It provides some telling information about the history of how this exam was taught, stating, "in contrast to ambulatory care, the gynecologic operating room has historically provided medical students with an opportunity to learn this exam: they could perform it in anesthetized patients immediately before surgery." This practice became extraordinarily controversial when it became more widely known that pelvic exams were often performed on anesthesized surgical patients without their knowledge or consent, as a teaching tool rather than for medical care. According to the piece, "Academic gynecologists were accused of using patients as unwitting "training dummies" — a reaction exacerbated by the report's revelation that students who had completed an Ob/Gyn clerkship were less likely than other students to believe it is important to obtain the patient's consent for such an exam."

The study cited (2) found that only 51% of those who had completed an OB/GYN clerkship thought consent prior to pelvic exam was "very" or "somewhat" important - 24% were "neutral," 15% found consent to be "somewhat unimportant," and 9% thought consent was "very unimportant." Those who had not done an OB/GYN clerkship were only somewhat better on the issue of consent, with just 70% stating it was "very" or "somewhat" important - still far short of the 100% consent women might reasonably expect. Interestingly, the survey was conducted in 1995, but this paper reporting the results wasn't submitted until 2002 or published until 2003. Women familiar with the practice of performing pelvic exams without consent may assume it happened "a long time ago," but these findings suggest otherwise.

Wolfberg provides disturbing insight into how complaints about this practice are perceived by physicians. Regarding the distinction made by those opposed to the practice who insist that the patient's consent is absolutely necessary for procedures done solely as a teaching tool, the author states, "This stance rankles physicians who downplay this distinction — particularly those who are uncomfortable asking their patients to give written permission for a medical student to perform an operating-room examination. Patients, they argue, are already nervous about surgery, especially when they must sign the surgical consent form describing everything that can go wrong; the last thing they want at that point is to be asked to allow a medical student to examine them." This paternalistic attitude is extremely troubling, a sign that some physicians think women shouldn't have to worry their pretty little heads about what might be done to them without their knowledge while they're knocked out in a hospital. Rather than coming to the conclusion that the exam should then not be performed without explicit consent from women, individuals and institutions have in the past jumped to the conclusion that they simply shouldn't ask or tell when violating women's vaginas.

In response to the controversy, Wolfberg explains, many medical schools have clarified their policies, banned this activity, and switched to teaching the exam with a paid live volunteer or with technological device (such as the Pelvic ExamSIM, a ~$19,000 device), which may not reflect the full range of women's anatomy and experience of the pelvic exam. Others have decided that a fully informed consent approach might actually work - contrary to physicians' fears that women would refuse to be examined for teaching purposes, one OB/GYN residency director found (3) that "more than 80% of patients agreed to let a student examine them in the office if they were asked in advance and didn't feel that they were being pressured."

Citations:
1) Wolfberg AJ. The patient as ally--learning the pelvic examination. N Engl J Med. 2007 Mar 1;356(9):889-90. [Extract - 1st 100 words]
2) Ubel PA, Jepson C, Silver-Isenstadt A. Don't ask, don't tell: a change in medical student attitudes after obstetrics/gynecology clerkships toward seeking consent for pelvic examinations on an anesthetized patient. Am J Obstet Gynecol. 2003 Feb;188(2):575-9. [Full-text]
3) Berry RE Jr, O'dell K, Meyer BA, Purwono U. Obtaining patient permission for student participation in obstetric-gynecologic outpatient visits: a randomized controlled trial. Am J Obstet Gynecol. 2003 Sep;189(3):634-8. [Full-text]

Women's History Month at the National Library of Medicine

2007-03-02T20:07:00.000-06:00

March is Women's History Month, and the National Library of Medicine in Bethesda, MD is celebrating with this lecture:

"Leona Baumgartner and the New York Department of Public Health: Déja Vu All Over Again."
Julia Frank, MD, George Washington University,
Tuesday, March 13, 2007, 2:00 - 3:15 p.m.
Lister Hill Auditorium, Building 38A

A graduate of Yale's School of Medicine, Baumgartner was the first woman commissioner of New York City's Department of Health, from 1954-1962.

Information for visitors to NLM (at the National Institutes of Health) is online here.

The National Library of Medicine also hosts the online "Changing the Face of Medicine" exhibit, which explores "the many ways that women have influenced and enhanced the practice of medicine." A searchable directory of female physicians is provided, with profiles for each addressing the women's inspirations, biographical details, Q&A with the living physicians, and photos. A profile of Baumgartner is included in the exhibit.

Friday News Round-Up - 3/2/07

2007-03-02T13:30:00.000-06:00

I ususally do these on Saturday, but had the content all set up and ready to push through, so here you go:

New England Journal of Medicine (free full-text) - Cesarean Delivery and the Risk-Benefit Calculus - this perspective piece states, "As practicing obstetricians, we find that the risk that women are now willing to assume in exchange for a measure of potential benefit, especially for the neonate, has changed: for many, the level of risk of an adverse outcome that was tolerated in the past to avoid cesarean delivery is no longer acceptable..." without asking whether this is linked to the number of unnecessary c-sections physicians have advocated for and insisted are necessary over the past decades. More on this later.

The Mommy Blawg has a roundup of midwifery-related legislation (found via Belly Tales)

UN Dispatch on community-based interventions to reduce violence against women

Could the REAL ID Act endanger victims of domestic violence? Melissa Ngo thinks it could.

Statehealthfacts.org has added information on women's health, including "new state-by-state and national data for 2006 on state mandates for cancer screening, inpatient mastectomy stay, post-mastectomy breast reconstruction, fertility treatment and osteoporosis screening. In addition, information on mandates for direct access to ob-gyns and for ob-gyns as primary physicians has been updated."

From the Kaiser Network, Increasing Number of Hospitals Banning Gift Bags Containing Samples of Infant Formula. Ban the Bags works to increase these bans, as providing samples of formula is thought to discourage breastfeeding. (found via Katie Allison Granju)

March 8 is "World Kidney Day"

Does bad PR for Merck help or hurt sales of Gardasil? (found via Kevin MD)

CNN - Rising STD rate sparks online dating sites

National Cancer Institute Hosts Meeting on Preoperative Therapy in Invasive Breast Cancer

NYTimes - New Options (and Risks) in Home Care for Elderly

NYTimes - Updating an Old Way to Leave the Baby on the Doorstep

Virginia to Make HPV Vaccination Mandatory

2007-03-02T11:54:00.000-06:00

The Washington Post is reporting that Virginia Governor Timothy Kaine will sign legislation requiring the state's 6th-grade girls to receive the HPV vaccine. The bill passed the VA House 80-17, and unanimously passed in the VA Senate on the 3rd reading. The legislation updates existing vaccination requirements, adding to the list of required vaccinations the language, "12. Three doses of properly spaced human papillomavirus (HPV) vaccine for females. The first dose shall be administered before the child enters the sixth grade."

Parents may opt out under the provision, "3. After having reviewed materials describing the link between the human papillomavirus and cervical cancer approved for such use by the Board, a parent or guardian may elect, on an appropriate form prescribed by the Board, for his child not to receive the human papillomavirus vaccine," which requires them to be informed about the issue but allows them to refuse for any reason.

According to the Washington Times, "In Virginia, Merck [maker of the only currently available HPV vaccine] spent more than $70,000 in lobbying fees since 2005. The company also has donated to numerous political campaigns. Delegate Phillip A. Hamilton, Newport News Republican, who sponsored the HPV bill, has received $10,000 in Merck contributions since 1997, according to the Virginia Public Access Project. Mr. Hamilton said Merck played no role in his decision to sponsor the bill. He said nobody from the company approached him about the idea of proposing the vaccine." Merck's 2005 corporate political contributions document indicates that Hamilton received $1,500 from the company in 2005; VPAP also reports another $1,500 to Hamilton in 2006. This table on the VPAP website details Merck's contributions to Hamilton since 1997. No contributions to Kaine are listed, and a search of multiple data sources did not turn up any direct contributions from Merck to the Governor.

Full-text of the legislation as passed
See previous post regarding concerns about mandatory HPV vaccination legislation in Texas.

Submit to the Breastfeeding Carnival

2007-03-02T09:27:00.000-06:00

No, it's not a travelling lactation show. The Lactivist is solicting submissions for the next Breastfeeding Carnival (a kind of blog post roundup) that relate to breastfeeding advice. If you have recent blog posts on this topic, see the solicitation and contact the coordinators via email.

PS- Dear Blogger (and Google): if you want me to complete the visual verification line in order to post to my own blog, and/or to have my blog reviewed by a human so it can be classified as "not spam" and have the VV turned off, you might want to make the VV actually work so that users can see the verification image in either location. Right now, many Blogger users are stuck in a frustrating loop of not being able to use their own blogs or get the problem fixed in a timely manner.

FDA Response to Budget Cuts for Office of Women's Health

2007-02-28T10:00:00.000-06:00

I received the following response from an FDA representative regarding questions about possible budget freezes within the FDA's Office of Women's Health (message from FDA spokeswoman Julie Zawisza, published with permission):

Rachel,

Thanks for your message. I think there may have been some misunderstanding of how FDA proceeds during the 2OO7 Continuing Resolution process by which FDA develops a spending plan that is approved by Congress. We do not have final budget numbers yet for any of our operating components so it is premature to discuss what the final budget may look like.

Recent press reports discussed preliminary results of an internal numbers exercise, leading to inaccurate and premature reporting. We are still finalizing the 2007 spending plan and intend to apply the same approach to the Office of Women's Health as to other components of the Office of the Commissioner, specifically that the 2007 plan is intended to allow our operating components to spend at least at their 2006 level. This will continue to support our strong commitment to the Office of Women's Health and its role.

I have not yet identified the 2006 spending level figures.

The Washington Post reported in its piece, Women's Health Office Funds Cut, that "The administration had requested -- and Congress had budgeted -- $4 million for the office in fiscal 2007, just as they have for several years running. Last week, however, word came down that the FDA intends to withhold $1.2 million of that, apparently for use elsewhere in the agency. Because the remaining $2.8 million has already been spent or allocated for salaries and started projects, the office must effectively halt further operations for the rest of the year, according to a high-level agency official with knowledge of the budget plan, who spoke on the condition of anonymity because the official is not authorized to speak publicly." The story also mentions concerns that any budget cuts might be retribution for the OWH's support of science-based decision-making on over-the-counter status for Plan B emergency contraception.

The Kaiser Network has an update

HPV Vaccine Discussion on the NewsHour

2007-02-27T19:36:00.001-06:00

The NewsHour on PBS aired a segment tonight, "New Study Stirs Debate over Mandatory Cervical Cancer Vaccination." The NewsHour health correspondent, Susan Dentzer addresses a new study of HPV infection rates, the HPV vaccine, and debate over making the vaccine mandatory. A transcript is available, as are audio versions via RealAudio and mp3 download.

The study mentioned above, released today in the Journal of the American Medical Association, reports that 1/3 of American women are infected with HPV by the age of 24, according to this article in the Washington Post. JAMA is providing the full-text of the article, "Prevalence of HPV Infection Among Females in the United States," for free on its website. According to the report, prevalence of HPV infection among women ages 14-19 was 24.5%. Interestingly, the two most frequently detected types of HPV were not those the Gardasil vaccine protects against, but were considered low-risk forms of the virus. There were no statistically significant differences in rates of each type of HPV found except for the greater frequency of those two low-risk forms. According to the study, "Overall, HPV types 6, 11, 16, or 18 were detected in 3.4% of the study participants, corresponding with 3.1 million females with prevalent infection with HPV types included in the quadrivalent HPV vaccine. Few participants (0.10%) had both HPV types 16 and 18 and none had all 4 HPV vaccine types. At least 1 of these 4 HPV types was detected in 6.2% (95% CI, 3.8%-10.3%) of females aged 14 to 19 years."

More Emergency Contraception Research

2007-02-25T17:25:00.000-06:00

The current issue of the journal Contraception has two articles on emergency contraception availability and awareness, and the journal Women's Health Issues has an article on California women's knowledge of emergency contraception.

1) Schwarz EB, Reeves MF, Gerbert B, Gonzales R. Knowledge of and perceived access to emergency contraception at two urgent care clinics in California. Contraception. 2007 Mar;75(3):209-13.

For this study, the researchers recruited adult (18-45) English-speaking women from two urgent care clinics in San Francisco from Mar-Jul 2005. They excluded women who were currently pregnant, had had a hysterectomy or tubal ligation, had an IUD in place or a partner who had had a vasectomy, were over 45, or who planned to relocate or did not have a telephone. Women completed a computerized survey while they waited for their appointments. The 10-question survey asked about their knowledge of emergency contraception (EC), which was made available without a prescription in California in 2002. 446 women completed surveys that were analyzed. Younger women (<30) and women who had had a prior abortion were more likely to know that EC is currently available in California. Overall, women scored poorly, averaging only 4 correct answers out of 10.

Only 39% knew that emergency contraception is effective in the 3-5 days after intercourse.

Only 27% knew that EC is very or extremely safe, and only 39% knew it is very or extremely effective at preventing pregnancy.

50% knew that EC poses no risk to future fertility, but only 19% knew it does not cause birth defects or miscarriage.

84% knew that EC offers no protection from sexually transmitted infections.

Only 19% reported a personal or religious objection ot abortion, and only 7% reported a personal or religious objection to EC.

Despite the low levels of knowledge of EC found by this survey, the authors note that their design may have actually overestimated knowledge of EC, as it excluded women who did not speak English, 47% of participants had college degrees, and women with less knowledge of EV may have elected not to complete the survey more frequently than those with some knowledge.

****************************

2) Shacter HE, Gee RE, Long JA. Variation in availability of emergency contraception in pharmacies. Contraception. 2007 Mar;75(3):214-7.

The researchers conducted telelphone surveys of EC availability in Boston, MA, Philadelphia, PA, and Atlanta, GA. At the time of the study, state policy required MA pharmacists to fill all valid prescriptions, GA law allws pharmacists to legally refuse to fill the prescriptions, and PA had no policy regarding pharmacist refusals. A prescription was required for emergency contraception in all three states at the time the calls were made. 1085 pharmacies were included in the analysis: 268 in Boston; 427 in Philadelphia; 390 in Atlanta.

23% of pharmacies could not dispense EC within 24 hours, including 4% in Boston, 23% in Philadelphia, and 35% in Atlanta. 18% of these reporting being willing to but unable to dispense within 24 hours due to not carrying the drug.

Atlanta had the highest rate of refusal to dispense, at 9% (34) of pharmacies.

Large chains (20 or more stores in the city) were least likely to be unable to dispense EC within 24 hours (27%), followed by small chains (4 or fewer stores in the city, 32%), and medium chains (5-20 stores in the city, 46%).

No refusals occurred in Boston, where pharmacists are required to fill valid prescriptions.

****************************

3) Foster DG, Ralph LJ, Arons A, Brindis CD, Harper CC. Trends in knowledge of emergency contraception among women in California, 1999–2004. Womens Health Issues. 2007 Jan-Feb;17(1):22-8.

The authors took 6 years of data from the California Women's Health Survey, an annual telephone survey of ~4,000 rnadomly selected adult women in California. Two questions about emergency contraception were added to the survey in 1999 and were asked of women who had ever had sexual intercourse but had not had a hysterectomy.

In 1999, 48% of women knew there was something they could do in the 3 days after unprotected intercourse to prevent pregnancy; by 2004, 65% of women knew this.

Women who answered "yes" to the first question (about whether something could be done to prevent pregnancy in the 3 days after intercourse) were asked what could be done. 3% in 1999 and 4% in 2004 explicitly named emergency contraception in response. 66% in 1999 and 65% in 2004 referred to the "morning after pill" (indicating that they were aware of EC) or some other correct response such as having an IUD inserted or taking a modified dose of birth control pills.

Incorrect responses included RU-486, abortion, douche, injection, and herbal remedies.

Younger women (<25) and college-educated women were more likely to know about EC in both 1999 and 2004.

Racial/ethnic disparities were found, with Hispanic and South/Southeast Asian women having the lease knowledge of EC, and significant differences in EC knowledge between native and foreign-born Hispanic women.

Foreign-born Hispanic women, women with incomes below the poverty level, and women who did not complete high school had the lowest levels of EC knowledge in 2004.

Sunday News Roundup - 2/25/07

2007-02-25T09:42:00.000-06:00

CE Petro at Thoughts of an Average Woman comments on rape as an instrument of war.

Life expectancy by sex and race at 65 for 1999-2004 in the United States.

Stillbirths decline, racial disparities persist

Do's and Don'ts for using walk-in clinic care

No new warnings planned for cervical cancer vaccine

Binge eating most common eating disorder

40% of women in India haven't heard of AIDS?

Jaxn live-blogged the birth

Online Gallery of AIDS Posters

2007-02-24T12:25:00.000-06:00

The UCLA Lousie M. Darling Biomedical Library History and Special Collections Division has launched its AIDS Posters collection online, which consists of images of and information about posters that were issued by a variety of institutions in numerous countries (including the United States) to educate people about HIV/AIDS. Users may search this digital library by keyword, perform an advanced search for keyword, title, description, creator, country, and/or subject, or browse by country, subject, creator, or title. Users may also register with the site in order to create a virtual collection of saved poster images for later reference. Each image is accompanied by a record with details on the above-listed search fields, as well as the current location of the poster, dimensions, date, subjects, notes, and inscription. Copyright status is also provided to inform how a poster image may be used. The only addition I'd like to see is an option to search/browse by year and decade, which might be useful for examining how this type of material has changed over time.

(found via Our Bodies, Our Blog)

Tennessee Pregnant Women Support Act

2007-02-24T12:20:00.000-06:00

Warning: lengthy post follows.

A bill has been introduced in Tennessee entitled the "Pregnant Women Support Act" [SB2161, HB2146] The bill is essentially a state version of the Pregnant Women Support Act introduced in the federal legislature last year and currently winding its way through committees and such. The national bill was introduced by another Tennessean, Representative Lincoln Davis. The national bill began as an effort to reduce abortion, and the state bill will likely be touted in the same terms.

As Sean Brainsted points out, it's difficult for advocates of reproductive rights to find much in this bill to be strictly against, and it's certainly a more reasonable approach to abortion than Stacey Campfield's monstrosity. However, criticism of the bill is likely to address what it does not include. As has been pointed out with regards to the national bill (posts 1 and 2), this bill does nothing to actually reduce unwanted pregnancy in the first place. Some of the language provides for informing women about how to prevent future pregnancies, which is great, but a bill attempting to reduce abortions might at least pay lip service to well-woman care (when reproductive health education can occur), comprehensive sex education, and access to contraceptives.

The bill in full:
AN ACT to amend Tennessee Code Annotated, Title 49; Title 56; Title 63; Title 68 and Title 71, and to enact the “Tennessee Pregnant Women Support Act”.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF TENNESSEE:
SECTION 1. Tennessee Code Annotated, Title 68, is amended by inserting Sections 2 through 6 below as a new chapter thereto to be designated as Chapter 59.

SECTION 2. This act shall be known and may be cited as, the “Tennessee Pregnant Women Support Act”.

SECTION 3. The department of health is authorized to and shall apply for any available federal grant providing for the collection of data regarding the number of abortions performed in this state, the characteristics of those seeking abortions, the reasons why women choose abortion, or any other information applicable to supporting pregnant women in this state who may be seeking an abortion.

While the number of abortions performed in the state is already collected by the Department of Health, this portion encourages the Department to seek funds to research why women have abortions. It seems reasonable to collect this type of data in order to plan any future prevention programs. This section specifically corresponds to the section of the national bill that would have the Institute of Medicine conduct a study on why women have abortions, to release a report by 1/2010.

SECTION 4. The department of health shall develop a comprehensive informational pamphlet for distribution upon request to Tennessee licensed physicians. Every licensed physician in this state shall provide such pamphlet to any woman to whom the physician provides an abortion or provides information concerning a possible abortion. The pamphlet shall contain: a list of public and private health care services available to women during pregnancy and after the birth of a child, whether the women wish to keep their children or place them for adoption; public and private adoption resources available in the state, including but not limited to the surrender of an infant without criminal liability pursuant to § 68-11-255; and public and private services available, pursuant to Title X of the federal Public Health Service Act, to assist women in preventing future pregnancies. The pamphlet shall contain the name, address and telephone number of public and private organizations, health care facilities, or other persons providing these services; provided, that the commissioner of health may promulgate such rules in the commissioner’s discretion as are necessary for any public or private organization, health care facility, or other person to qualify for inclusion in the pamphlet. The department shall make the pamphlet available to physicians by no later than January 1, 2008.

This is a slightly problematic section. I am supportive of women having all possible information on all of their possible options in times of crisis, such as an unplanned pregnancy. The section provides for informational pamphlets on non-abortion-related services to women who ask their healthcare providers about abortion. It might be more appropriate if the pamphlets contained information on all related services and options, including abortion. It might be argued that the pamphlet simply provides an alternative to the information the physician is providing, but physicians frequently provide patients with pamphlets on conditions they have just discussed in the office. If all information were presented, the pamphlet would simply be an information resource for the woman as she weighs her options. As-is, it is specifically positioned to counter the option of abortion, and becomes a persuasive tool rather than a strictly informational one.

Additionally, the Department would provide pamphlets on request, rather than automatically distributing them to the licensed physicians and nurses who are registered with the State. However, the section also requires provision of a pamphlet to any woman asking about a possible abortion. Therefore, if time a woman visited her family physician and received an unexpected pregnancy result, that physician would technically need to have the pamphlets on hand in order to legally have a conversation with the patient about abortion. I hope that logistical concerns such as these will not, in real practice, get between a woman and her physician talking about her health.

SECTION 5. The department of health shall develop a toll-free telephone hotline for pregnant women or other interested parties to obtain information about: public and private health care services available to women during pregnancy and after the birth of a child, whether the women wish to keep their children or place them for adoption; public and private adoption
resources available in the state, including but not limited to the surrender of an infant without criminal liability pursuant to § 68-11-255; and public and private services available, pursuant to Title X of the federal Public Health Service Act, to assist women in preventing future pregnancies. The department shall operate the toll-free telephone hotline no fewer than eight (8) hours per day for no fewer than five (5) days per week, during normal business hours, and shall publicize the hotline through the use of media which may include radio, television, newspaper, billboard or other advertisements. The commissioner of health may promulgate such rules, in the commissioner’s discretion, as are necessary for any public or private organization, health care facility, or other person to qualify for inclusion in the information distributed pursuant to the hotline. The department shall make the hotline available by no later than January 1, 2008.

I'm a librarian, I'm all for the dissemination of information, so a hotline suits me just fine. Numerous voluntary health organizations run hotlines to provide information for consumers on their health information needs. I'd like to see a website with directory accompany the hotline - even if it couldn't be accessed by all w omen, it would be accessible to healthcare providers, librarians, and others who may serve in a role that exposes them to health and community service information requests.

SECTION 6.
(a) There is hereby created in the general fund an account to be known as the "Tennessee pregnant women support fund", hereinafter known as "the fund", as a special nonreverting fund. Funds appropriated from the Tennessee pregnant women support fund shall be administered by the department of health to support women and families who are facing unplanned pregnancy.
(b) The department is authorized to solicit gifts, donations, bequests and grants on behalf of the fund from any source and to deposit all moneys received in the fund. The commissioner shall submit to the governor an annual report of all gifts, donations, grants and bequests accepted; the names of the donors; and the respective amounts contributed by each donor.
(c) All moneys received from any source pursuant to subsection (b) shall be credited to the fund. Interest earned on moneys in the fund shall remain in the fund and be credited to it. Any moneys remaining in the fund, including interest thereon, at the end of each fiscal year shall not revert to the general fund but shall remain in the fund. Moneys in the fund shall be used solely for the purposes of carrying out the activities enumerated below:

The question I still have after reading this section is how much money will be allocated to the program from the State budget, and where that money will come from. I don't see anything in this proposal that says, "The State will provide X dollars to establish the fund and support the activities required by this legislation." It does allow the Department of Health to solicit grants and donations to support the programs, but doesn't seem to provide for how to administer the law if there is not enough grant/gift money to carry out the directives.

(1) Purchasing or upgrading ultrasound equipment for the benefit of any public health program or private health provider in this state;

The emphasis on ultrasound equipment is interesting. Healthcare providers who see pregnant women (and women of reproductive age in general) need equipment other than ultrasound machines on a daily basis. Ultrasound equipment is expensive, and if this section benefits legitimate, unbiased clinics who provide services to women, that is a good thing. However, ultrasound machines are also a point of controversy in the reproductive rights movement, as so-called "crisis pregnancy centers" like to add ultrasound services, believing that they can help coerce women into rejecting abortion as an option. See my previous post on "Option Ultrasound," just such an initiative by anti-choice Focus on the Family. Not every woman will want to have an abortion, but to try to convince women to "choose life" based on emotional manipulation is unseemly. The warm-and-fuzzy a woman gets from viewing an ultrasound is in no way going to make the emotional, physical, and financial resources needed for childbearing magically appear. This provision corresponds to a section in the national bill that would allow grants to be made for the purchase of ultrasound equipment.

(2) Creating a separate program within the department to address domestic violence, dating violence, sexual assault and stalking screening against pregnant women and new mothers;

This is important and worthwhile if well-executed, because the statistics on women abused during pregnancy are staggering. Part 2 corresponds to the national bill section providing for states to "obtain funding for a separate program for domsetic violence, dating violence, sexual assault, and stalking screening and treatments for pregnant women and new mothers. This would include training health professionals to identify and respond to patients experiencing abuse, and ensuring that services are provided in a "linguistically and culturally relevant manner." $4,000,000 would be authorized for appropriation for each of the fiscal years 2007-2011."" Note that the national bill does something the State bill does not, which is to specifically address the training of providers, a monetary value, and linguistic and cultural appropriateness.

(3) Conducting the campaign outlined in this chapter to increase public awareness of public and private resources available to pregnant women in this state;

Again, regarding Part 3, information is a good thing. This is directly taken from the national bill.

(4) Providing support services for students of institutions of higher education in this state who are pregnant;

(5) Providing funds to allow early childhood education programs to work with pregnant or parenting teens to complete high school and provide job training education; or

Part 4 also corresponds with measures in the national bill, which included disbursement of grants (not to exceed $25K) to public higher education institutions to assist pregnant students who intent to carry their pregnancies to term through on-campus facilities. More specific information is needed in the state bill to address what type of support will be offered and how it will be funded. Part 5 also replicates the national bill. Supporting women's pursuit of primary and higher education is a good goal, as it wasn't so long ago that pregnant women were automatically expelled from schools.

(6) Providing education on the health needs of infants to teenage or first time mothers through free home visits by registered nurses.

Part 6 is a laudable objective, and there are already agencies in Tennessee providing this kind of service, who I hope would benefit from funding under this section. This provision appears in the national bill, although the national bill also provided for breastfeeding education through WIC.

(d) The department shall establish an application process and related procedures for community health centers, migrant health centers, homeless health centers, public-housing centers, or any other public or private entity seeking grants from the fund. A grant may be made only if an application for the grant is submitted to the department in such manner as specified by the department pursuant to rule.

This is just administrative, so just needs to be done well. The process needs to be done in a way that is not so burdensome to the already stretched resources of public agencies and healthcare providers that it becomes a barrier to funding and implementing services.

SECTION 7. Tennessee Code Annotated, Title 56, Chapter 7, Part 23, is amended by adding the following language as a new, appropriately designated section:
(a) Notwithstanding any other provision of law to the contrary, any individual, franchise, blanket, or group health insurance policy, medical service plan contract, hospital service corporation contract, hospital and medical service corporation contract,
fraternal benefit society, health maintenance organization, preferred provider organization, or managed care organization which provides hospital, surgical, or medical expense insurance shall not deny coverage under any such policy, contract, or plan for obstetrical services to a pregnant woman insured on the basis that the pregnancy was a pre-existing condition if such plan otherwise provides coverage for obstetrical services for insureds who become pregnant after enrollment in such policy, contract or plan.
(b) The provisions of this section are applicable to all health benefit policies, programs, or contracts which are offered by commercial insurance companies, nonprofit insurance companies, health maintenance organizations, preferred provider organizations, and managed care organizations, and which are entered into, delivered, issued for delivery, amended, or renewed after January 1, 2008.
(c) Reimbursement for obstetrical services for insureds who are pregnant at the time of their enrollment shall be determined according to the same formula by which charges are developed for obstetrical services for other insureds. Such coverage shall have durational limits, dollar limits, deductibles, copayments, and coinsurance factors that are no less favorable than for other types of obstetrical services generally.
(d) Nothing in this section shall be construed to prohibit any insurer from providing medical benefits greater than or more favorable to the insured than the benefits established pursuant to this section.
(e) The provisions of this section shall not apply to short term travel policies, short term nonrenewable policies of not more than six (6) months’ duration, accident only policies, limited or specific disease policies, contracts designed for issuance to
persons eligible for coverage under Title XVIII of the Social Security Act, known as Medicare, or any other similar coverage under state or governmental plans, including the TennCare and Medicaid programs.

I'm not seeing a corresponding portion in the national legislation, but I seem to recall another federal bill that addressed this topic (I'm unsure of the status). It would essentially prevent insurors from denying care to pregnant women, which is a good thing.

SECTION 8. Tennessee Code Annotated, Title 68, Chapter 5, Part 5, is amended by inserting the following as a new, appropriately designated section thereto: Any person who offers or provides to a pregnant woman a testing or screening service to detect genetic disorders in that woman’s fetus shall inform the woman in a medically and statistically accurate manner of the likelihood that a positive result of such test or screen might be a false positive. For a person who is a licensed physician or osteopathic physician in this state, a violation of this section may be considered a violation of the practice act governing that person pursuant to title 63, chapter 6 or title 63, chapter 9, respectively. In addition, a violation of this section may be considered a violation of the licensure requirements governing any facility licensed by the department pursuant to this title where the testing or screening service was provided.

This is similar to but more limited than the national bill, which would also provide for peer-support programs, a phone hotline and website for patients, a registry of families willing to adopt newborns with genetic disorders, a clearinghouse of information on these conditions, and education programs for healthcare providers. Information on the false positive rates of these tests, as is information on false negatives, which should seemingly also be included.

SECTION 9. Tennessee Code Annotated, Section 68-11-255, is amended by deleting subsection (a)(1) thereof and by substituting instead the following: (1) “Facility” means any hospital as defined by § 68-11-201, birthing center as defined by § 68-11-201, community health clinic, outpatient “walk-in” clinic, local department of health clinic, local office of the department of human services, or local fire department or police station.

SECTION 10. The commissioner of health is authorized to promulgate rules and regulations to effectuate the purposes of this act. All such rules and regulations shall be promulgated in accordance with the provisions of Tennessee Code Annotated, Title 4, Chapter 5.

SECTION 11. This act shall take effect July 1, 2007, the public welfare requiring it.

As stated in my previous post on the national legislation, I do think this bill does some very worthwhile things, and at least partially addresses the old argument that if you want to reduce abortions, you have to make it easier for women to have children and support them after birth. On the other hand, the folks involved with tthe national bill have proposed it as a means to reduce abortion, and I don't see a single thing in it about comprehensive sex education (big surprise) or contraceptives. There is nothing in here that addresses preventing pregnancy in the first place, except when a woman has already experienced an unplanned pregnancy. Also, I think it's good if more women are referred to appropriate community agencies, but I don't see a specific increase in funding for existing providers. If they suddenly become swamped with women, will they be able to afford it, and will women receive good service? I also don't see much that truly makes it easier for women to afford to have a baby, because there isn't a lot of substantial funding increase for prenatal care, the actual birth, or all the expenses that come with children (especially after the first year covered by the home visits, which are educational rather than medical). Finally, this legislation could be read as an attempt to push women into carrying a pregnancy to term and giving up the child for adoption, while it does not in any way address the psychological consequences or provide post-surrender counseling for these women. It will be interesting to see how this plays out.

NARAL Urges Action on Campfield Bill

2007-02-24T10:48:00.000-06:00

Stacey Campfield's proposed legislation to issue death certificates for abortion has come to the attention of NARAL Pro-Choice America, which has an online form set up for Tennessans to send a letter to their Representative and State Senator. The text of the letter is as follows, although you can personalize it as desired:
As your constituent, I'm writing to ask you to oppose HB 982, which would require a death certificate be filed for every abortion in Tennessee.

Women who live in Tennessee already face an uphill battle when it comes to their reproductive rights. Anti-choice legislators in recent years have passed biased counseling and mandatory delay requirements, mandatory parental consent rules, targeted regulations against abortion providers, and an unconstitutional ban on abortion as early as 12 weeks in pregnancy.

This bill is not only unnecessary, it is an assault on women's dignity and privacy. Tennessee's Office of Vital Records already keeps track of the number of abortions in the state, but these records keep the women's identities private.

If passed, death certificates would include personal and identifying information - including full name and mailing address - that would become public record.

Women in Tennessee deserve their constitutionally protected right to privacy when they make their personal reproductive decisions. Please help defeat this dangerous bill by voting "no" on HB 982.

Visit the action center and send your letter.

Campfield, who previously released a set of irrelevant questions in an attempt to deflect criticism of the bill, but claims he doesn't have time to respond to all of the questions he's being asked, has time to leave at least 10 comments like this on another right-wing Tennessee blog. He's harrassing a local reporter to get the facts (if they exist) related to a different, non-legislative story:

Well WKRN it sounds like you have been called out. It is put up or shut up time. Terry has said she will release to MSM (I would say you qualify) But I would think the exchange would be a story on the TV news possibly with credit given where it is due. It has been said a good reporter will dig for the story. I don’t think for this story much digging will be needed. Will you still present the facts on the news if it hurts your agenda or will you cop out?

Will you step up or will we get more snarky comments? I would say it is news worthy if it is true. Are you scared she might be right and have the facts? Why not make the deal and see. In poker if you think the other person is bluffing you put you money on the table and call. People turn over the cards and one person is right. I don’t see the money…..

Make up your mind. Stick with one dodge. You will look less foolish

Given that Campfield is either lying about what his bill would do or simply doesn't understand the implications, and has repeatedly ignored attempts to present factual arguments and ask legitimate questions about the bill, his comments would be laughably ironic if they didn't demonstrate that Campfield is only interested in the free flow of information when it suits his agenda.

In the Hopper

2007-02-23T10:43:00.000-06:00

There are a few posts in the works, but it has been a crazy week and I want to take time to do the topics justice. Coming this weekend:

-Two new studies on emergency contraception availability and knowledge
-The Tennessee Pregnant Women Support Act
-The APA and sexualization of girls (maybe)
-Any truth to a breast cancer myth?
-Rhythm method as effective as the pill? - a new study
-Women + fish + babies + mercury
-Your Saturday news roundup

If I'm In a Carnival, Do I Get a Costume?

2007-02-21T19:34:00.000-06:00

The 32nd Carnival of Feminists is up at Bumblebee Sweet Potato, and the post about Rep. Stacey Campfield's proposed legislation to issue death certificates for abortion got a nod. Check it out for links to discussion of the Edwards blogger flap, policy issues, and other topics.

Merck to Stop Lobbying for Mandatory HPV Vaccines

2007-02-21T10:42:00.000-06:00

In today's New York Times, "Merck to Halt Lobbying for Vaccine for Girls." The company has been criticized for its efforts to push state legislation that would make the HPV vaccine mandatory for schoolgirls. According to the piece, "The company said it made the decision after realizing that its lobbying campaign had fueled objections across the country that could undermine adoption of the vaccine." The company declined to provide information on how much money it has already spent lobbying for mandatory HPV vaccination.

Read more

Adventures in Blood Donation

2007-02-21T09:45:00.000-06:00

This post is not for the squeamish. *evil grin* I'm sure my buddy Ceeelcee will love it.

I went for a blood donation this morning. I do this as often as possible/I remember, and this week the workplace is competing with another Big University in Tennessee to collect the most blood. I had an appointment, I quickly scanned the information sheet, signed in, and waited my turn for processing. I was taken back in less than 2 minutes, and checked in by a nice woman who actually told me my BP, pulse rate, temperature, and iron level as she measured them. So far, so good, and a big improvement over previous experiences.

Next it was time to wait in the glorified lawn chair to start the donation. I waited, and waited a little more, but took the time to read the latest issue of MLA News. There was a little wiggling involved with getting the giant needle properly placed, but this is not terribly uncommon. Then we just tick down the 4-5 minutes it takes to fill the bag, and wait for the attendant to come over to collect the tubes of blood for testing and disconnect everything. No fuss, no muss.

When the Red Cross worker attempted to set up for collecting the tubes of blood, we had an, um, equipment failure. The tip snapped and blood spurted everywhere, like a low-budget horror flick. "Blood fountain" would not be an inappropriate description. I, of course, could not look away. Neither could the lady in the next chair, who I think was a little disturbed. My first reaction was to giggle (sick, I know), and my first thought was, "I wish I had my camera so I could blog this." Ultimately, blood had to be cleaned from my arm, the floor, the attendant, and the arm tray, and the attendant had to change into a clean lab coat. Multiple sets of gloves were gone through. Meanwhile, I had to lift and move my arm so the pools of my blood could be cleaned up, causing stress on the needle (still connected to the tubing and bag), which wiggled around.

So, what of collecting the tubes of blood? Did you know there are 5-6 of these? I had never noticed, because they're usually below the chair and out of site. A supervisor came over to consult, and determined that the only way to collect them would be a "second VP." At first I heard "second BP," which made no sense. No, second VP, for venipuncture. I had to be stuck in the other arm in order to collect the tubes.

I want to say that the Red Cross folks were nothing but professional, and this was more equipment failure than human error. I'll still donate in the future, I just wanted to share my morning of gore with you nice people. I hope we kick Other Big University's behind.

Photo by Yogi and used under a Creative Commons Attribution-Sharealike license.

New Guidelines for Women's Heart Health

2007-02-20T10:49:00.000-06:00

The American Heart Association has released an updated 2007 version of its Evidence-Based Guidelines for Cardiovascular Disease in Women Prevention emphasizing a more lifetime-oriented approach to heart disease prevention. According to an AHA press release, major highlights are:

[Note: "CVD" refers to cardiovascular, or heart, disease]
Recommended lifestyle changes to help manage blood pressure include weight control, increased physical activity, alcohol moderation, sodium restriction, and an emphasis on eating fresh fruits, vegetables and low-fat dairy products.
Besides advising women to quit smoking, the 2007 guidelines recommend counseling, nicotine replacement or other forms of smoking cessation therapy.
Physical activity recommendations for women who need to lose weight or sustain weight loss have been added – minimum of 60–-90 minutes of moderate-intensity activity (e.g., brisk walking) on most, and preferably all, days of the week.
The guidelines now encourage all women to reduce saturated fats intake to less than 7 percent of calories if possible.
Specific guidance on omega-3 fatty acid intake and supplementation recommends eating oily fish at least twice a week, and consider taking a capsule supplement of 850–1000 mg of EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) in women with heart disease, two to four grams for women with high triglycerides.
Hormone replacement therapy and selective estrogen receptor modulators (SERMs) are not recommended to prevent heart disease in women.
Antioxidant supplements (such as vitamin E, C and beta-carotene) should not be used for primary or secondary prevention of CVD.
Folic acid should not be used to prevent CVD – a change from the 2004 guidelines that did recommend it be considered for use in certain high-risk women.
Routine low dose aspirin therapy may be considered in women age 65 or older regardless of CVD risk status, if benefits are likely to outweigh other risks. (Previous guidelines did not recommend aspirin in lower risk or healthy women.)

The upper dosage of aspirin for high-risk women increases to 325 mg per day rather than 162 mg. This brings the women’s guidelines up to date with other recently published guidelines.

The complete guideline will be published in the journal Circulation.

PG-13 Players Needs Actors

2007-02-20T10:33:00.000-06:00

Planned Parenthood of Middle & East Tennessee is looking for teen actors to join its Teen Theatre Troupe and Peer Education Group, the PG-13 Players, a peer education theatre troupe that develops and performs skits on various teen issues such as teen pregnancy, depression, dating violence, etc. Participants must be entering 9th-12th grades in the 2007/08 school year. Auditions are by appointment only on the evenings of March 13th, 14th, and 20th. Contact Kayce Matthews at 345-0952 ext. 218.

From the PPMET website:
The PG-13 Players program combines peer education with theatre to help young people deal with teen issues. Cast members, about 15 per year, are high school teens from throughout the Nashville area.

Each summer, the PG-13 Players receive intensive training in both dramatic skills and teen-related issues. They hear from community experts on more than 15 topics, including HIV/STDs, refusal skills, communication, dating violence, eating disorders, and healthy relationships. The peer educators use this information to develop skits which bring teen issues to life.

The goal of the PG-13 Players is not to give out easy answers, but to enable teens to struggle with the realities of teen life, rehearsing the skills they need to cope with difficult situations.

The Players perform throughout the school year at schools, religious organizations, and youth-serving agencies. During the performance, the situations presented are left unresolved, leaving characters facing tough decisions. After each skit, the actors remain in character for discussion with the audience. Audience members talk to the characters as they struggle with their dilemmas. These conversations with the characters enable young audience members to rehearse decision-making and communication skills, thereby taking the education to a deeper, more personalized level.

The PG-13 Players is supported through private contributions, and grants from:

* The National Council of Jewish Women, Nashville Section
* United Way of Metropolitan Nashville
* Tennessee Department of Health

Each PG-13 Players performance lasts from 45 to 90 minutes according to your group's needs.

Performances are available in the Nashville area only.

Get Up, Stand Up

2007-02-19T09:35:00.000-06:00

This post is simply to give thanks to the blogger at Sitting Still for standing up for a vulnerable pregnant woman during a genetic counseling session. A snippet:

"She's crying. He's yelling at her to stop crying. She's saying she doesn't want testing, doesn't want to know for sure. He's saying that she *will* have the test because he doesn't want a retarded baby."

Visit Nicole's blog to find out how she mustered up her courage and intervened on behalf of the woman.

Saturday News Roundup - 2/17/07

2007-02-17T11:54:00.000-06:00

Welcome new readers who came over from Feministing and AlterNet.

Representative Stacey Campfield, in response to discussion of his bill proposing death certificates for abortion at Nashville is Talking, had this to say: ";-)" The wait for a mature, truthful response to questions about the bill continues.

Women's Health News was among the blogs featured in Friday's on-air blog roundup on Nashville's ABC news affiliate, WKRN. [Video on YouTube]

Lindsey at theology&geometry has a post on how she became a feminist, and it's related to hearing the tale of a surviving "comfort woman."

Who wants to take up a collection to help out our sisters in Alabama, where a ban on selling sex toys has been upheld? I'm thinking an "adopt an Alabamian" program would do it - they never said mailing a sex toy as a gift was illegal! Surely there's a web 2.0 application that could be developed for a sex toy version of "Need a penny? Take a penny. - Have a penny? Leave a penny."
(Tidbit: Alabama's state insect is the monarch butterfly. Too bad the state animal isn't a rabbit.)

The CDC has released a report on state-specific data on people living with heart disease, and finds that "Residents of Alabama, Arizona, Florida, Kentucky, Louisiana, Missouri, Oklahoma, Tennessee, Texas, and West Virginia had the highest prevalence of these heart diseases."

Doctors in China are pushing for more c-sections, resulting in a c-section rate over 60% at some hospitals. The fees the physicians receive for c-sections are 3-4 times higher than those for vaginal birth, so pushing this abdominal surgery brings in more money for the docs.

From the New York Times, "Furor on Rush to Require Cervical Cancer Vaccine." According to the piece, "at least 20 states are considering mandatory inoculation of young girls against the sexually transmitted virus that causes cervical cancer."

"Scientists Determine How HIV Infects Vagina"

Feministing on Camel's new cigarettes targeted to women. This is not the long way we wanted to come, baby.

Obama targeted for history of pro-reproductive rights votes.

The Guttmacher Institute releases "Laws Affecting Reproductive Health and Rights: Trends in the States 2006," with a state-by-state roundup of laws affecting reproductive rights enacted in 2006 [PDF].

Via Our Bodies, Our Blog, an article in Glamour magazine on father-daughter purity balls.

NARAL Pro-Choice America is running a campaign asking Wal-Mart to fill Plan B prescriptions, mentioning a recent refusal in Springfield. Allegedly, Tashina Byrd visited a Wal-mart pharmacy for Plan B after a condom broke, and the pharmacist shook his head and laughed. Tashina and her boyfriend were told that the pharmacy had the drug in stock, but that nobody would give it to them. Note to pharmacists - if you're going to refuse legal medications to women, you could at least not be mocking a-holes about it.

Catholic leaders oppose New York's condom distribution plan.

Japan's Minister of Health says of women, ""Because the number of birth-giving machines and devices is fixed, all we can ask for is for them to do their best per head." [hat tip to David]

Washington, DC - Coming Together with Free Condoms

2007-02-16T11:17:00.000-06:00

Washington, D.C. is getting in on city-branded condom distribution, much like the New York City program mentioned previously. According to the Washington Post, the District plans to give away 250,000 free condoms today, with "Coming Together to Stop HIV in DC" branding; officials say the double entendre of the slogan was unintentional. Similar to the NYC program, the condoms are expected to be placed in government buildings such as health departments, as well as bars, convenience stores, barber shops, and other locations. Organizations can request condoms for distribution through this online form.

The Department of Health has a page on their site describing the initiative to give away 1 million free condoms, with information on how to use male condoms, female condoms, female condoms for anal sex, and dental dams. The site is not quite as useful as its NYC equivalent, as it doesn't yet have information on all of the sites where condoms will be or promotional materials; perhaps it will be updated when the program is further along.

PS - Who wants to send me some? I really want a collection of city-branded condoms.

More on Death Certificates for Abortion

2007-02-16T09:00:00.000-06:00

Representative Stacey Campfield is obviously getting a lot of questions on his proposed legislation to issue death certificates for abortion. Rather than answering the questions posted to his blog on the issue, the Rep says, in what I think is a stunningly childish commentary, "You all look to be doing quite well with out me so I think I will let you all continue on without much input on my bill from me for now. A few questions I would love your input on though," and proposes his own list of questions, essentially ignoring the commentary of his contituents and other concerned Tennesseans. In a later post, he says, "I have responded to other legislators who are getting asked questions as well as Tennessee Right to Life." Again, no response for the people who are pointing out how the bill does absolutely nothing the Rep says it would do.

Now, to respond to the Rep's questions, which are truly nothing but his attempt at distraction:

1. If it is not a life, then why do you care if it gets a death certificate or not?
It has been clearly pointed out on numerous blogs that creating public records containing the names of women receiving a controversial legal medical procedure is a serious privacy issue for the women having abortions. Additionally, asking your constituents, "Why do you care?" is not the level of adult discourse we expect from politicians. You proposed the certificates, Rep, so the burden is on you to convince us what this legislation does (because what you say it does is already being done, or it does not in fact do) and why it matters.

2. Is this bill about paper work more controversial then the fact that abortions don't have to be performed by licensed doctors in Tennessee?
State law requires that "The administrator of such facility shall be: (a) A licensed physician, licensed practical nurse, registered nurse, or have a college degree from a four-year accredited institution and experience in a health-related field; and (b) Of good moral character." You're correct that some abortion providers in the hands-on setting may not be "licensed doctors;" however, you make no argument for why this is necessary, nor do you include provisions to change this in your legislation. Yet another red herring.

3.If you think I am wasting my time on this, Do you also think all of congress is wasting its time on a NON BINDING RESOLUTION that will have no effect on the direction of the war from a political point of view.
Completely irrelevant to criticisms of your proposed legislation. This is simply an attempt at distraction, and you should be ashamed of yourself.

4. If you do, have you told your congress person? Will you hold it against them for doing any thing but condemning it as a waste of time?
See above; in addition, nothing about being opposed to your bill prohibits an individual from having an opinion or contacting their legislators about Iraq. If you want to make a "if you're not doing everything, you should do nothing" argument, perhaps you should consider why you don't have provisions to reduce unwanted pregnancies in your bill.

5. If you work for the state and spend a large chunk of your day surfing the web and complaining about how bad a piece of legislation is, Do you think I should trust you to be non biased when doing an assessment of said legislation? Do you think this is an ethical lapse? Do you think I should trust you when you say you are over worked but seem to have plenty of time to surf the web and author long posts and comments on blogs during time you are getting paid to work? Do you think you would get away with it on a real job?
This is obviously directed at the blogger, an employee of the Department of Health, who commented on the fiscal waste associated with stunt legislation. Again, one person's response to the bill has nothing at all to do with whether the bill is a good one, whether it does what you say it will do, or whether you are either completely misinfored or flat-out lying about your own bill. Especially if you're not really doing your job, as you're only responding to other legislators and an anti-choice group. Distraction.

6.Is a death certificate worse then the fact that partial birth abortion is legal in Tennessee? If you had a choice to end one or the other, what would you put your effort behind stopping? Have you?
This is another mistruth; "partial birth abortion" is a Class C Felony in the state of Tennessee. See Tennessee Code : Title 39 Criminal Offenses : Chapter 15 Offenses Against the Family : Part 2 —Abortion : 39-15-209. Partial birth abortions. —
"(b) No person shall knowingly perform a partial-birth abortion.
(c) Subsection (b) shall not apply to a partial-birth abortion that is necessary to save the life of the mother whose life is endangered by a physical disorder, illness or injury."
Again, you're setting up a false choice between two issues - it's not necessary to choose to "end one or the other," so your premise is false. We'll leave along the fact that "partial birth abortion" is not a medical term, but is a "fighting word" created by anti-choice activists.

7. If you know in your heart you did "the right thing" and had an abortion why would you care if people found out? Shouldn't you be proud of it?
Legal medical care is private, and is protected by privacy laws, which you are trying to make an end run around. How the woman feels about obtaining legal medical care is none of your business. Do you think that all medical records should be open to the public? Will you release yours? However, should the names of women obtaining abortions become part of the public record, those women could be subjected to how *other* people feel about their obtaining legal medical care. Surely you remember the "abortion doctor hit list" that was posted on the Internet - some of us who are concerned about life are concerned about the ramifcations for the lives of women and their families if they become targets of zealots in this manner.

8. If you found out that taco bell has more regulation on it then an abortion clinic would that make you feel safe in your "choice"? What if you found out abortion clinics have no regulation whatsoever, no cleanliness, licensing or any thing? If you found out your legislator voted to keep it that way would you vote for them again? Did you vote Democrat this last year?
This depends on whether Taco Bell needs more regulation than an abortion clinic. Are you arguing that it does or does not? Do you have any evidence one way or the other? Whether a person voted for a Democrat last year is irrelevant to your proposed bill. It's not correct that abortion clinics have "no regulation whatsoever." Examine TN Code:

Title 68 Health, Safety and Environmental Protection : Health : Chapter 11 Health Facilities and Resources : Part 2 —Regulation of Health and Related Facilities : 68-11-201. Definitions. —

Title 39 Criminal Offenses : Chapter 15 Offenses Against the Family : Part 2 —Abortion
These are just a couple of the major sections that compose abortion regulation in Tennessee. To turn your own technique around on you, what are you doing to correct this, if it's a problem? And what does that have to do with criticism of your bill?

Honestly, these questions don't truly deserve a response, but to point out the childishness, dodging and deception Campfield is engaging in. Don't expect the Rep to actually address the serious questions associated with this bill. Thanks to Nashville is Talking for pointing out Campfield's new post, and Brittney for noting the hypocrisy of Campfield claiming to not have time to respond to valid criticism, but having had the time to set up the above list of irrelevant, distracting nonsense.

NYC Condoms - Get Some

2007-02-15T09:40:00.000-06:00

As mentioned in a previous post, New York City gave out 150,000 free condoms in the subways for Valentine's Day. The free condom extravaganza doesn't end there - the city has established the NYC Condom website, which provides info on the numerous locations in the city where free city-branded condoms can be obtained, including bars, hair salons, health departments, and even a dry cleaner. Organizations can order online to receive condoms for distribution. The New York Times has an article on the initiative, and you can also read the Health Department's press release. I'd love to see more cities take such a proactive approach to condom distribution.

Warning: This site mucks up the operation of Firefox for me, so I have to close the window to get back to other tabs. Your mileage may vary.

PS - Who wants to send me some? :)

Breastfeeding Welcome

2007-02-14T17:55:00.000-06:00

Mothering Magazine had a contest to design a symbol that would serve as "an international symbol for breastfeeding is to increase public awareness of breastfeeding, to provide an alternative to the use of a baby bottle image to designate baby friendly areas in public, and to mark breastfeeding friendly facilities." The symbol (shown at left) has been donated to the public domain, and can be posted anywhere to indicate a breastfeeding-friendly environment.

Meanwhile, New York City is spending $2 million+ in city hospitals to encourage breastfeeding.

Thanks to Belly Tales for pointing out both stories.

Technorati Tags: breastfeeding
MeSH Tags: Breast Feeding

Tennessee Representative Proposes Death Certificates for Abortion

2007-02-14T14:28:00.000-06:00

Tennessee State Representative Stacey Campfield has proposed legislation that would require "A death certificate for each induced termination of pregnancy which occurs in this state shall be filed with the office of vital records within ten (10) days after the procedure by the person in charge of the institution in which the induced termination of pregnancy was performed."

In his blog post on the proposed legislation, Campfield states his purpose as "This bill will give information to the state that is not available now on how many abortions are given each year as well as information on race, age, weight. It will also give consistency to when and what is a life based on factors that are already used and consistent. When we make the definition of life a little more consistent we can begin to treat it with the respect it deserves and not base it on whims of fancy." In truth, information on how many abortions are performed is already required to be reported to the State. In an interview, the Rep said, "All these people who say they are pro-life — at least we would see how many lives are being ended out there by abortions." The bill also does nothing to define "what is a life," and does not require death certificates for all miscarriages - State law does issue some certificates for miscarriage, depending on weight/age (500 grams or 22 weeks), but not for all, and not in the first trimester, when most abortions occur (the CDC estimates that 1.4% of abortions occur after 21 weeks). So at the same stage we would be issuing death certificates for most abortions, the State would not issue one for a miscarriage, because it wasn't far enough along. How's that for clearing up "what is life?" Thus far, we have a bill that does nothing that the Rep says it would do.

The pressing question, as mentioned by several folks in the roundup below, is privacy, as the effect would be that the State would essentially be creating a set of records identifying women who had abortions. Vital Records are publically available documents, and death certificates include parental information. It is not currently clear whether and how the State would handle requests for this information, or whether HIPAA laws would apply. HIPAA does not usually cover death certificates, but providing the certificates with parental details in this case would essentially be providing a living woman's medical record/history details to the requestor (rather than cause of death for a deceased person). I'm concerned that, if made available, these records could be used to intimidate/harass/target women who have had abortions. If so, that could put women and entire families in jeopardy.

It's not entirely surprising that this bill would do nothing in terms of using the information to target preventive services, provide reproductive healthcare to vulnerable populations, or otherwise take actual measures to reduce abortion. What it would do is create a climate of fear and privacy invasion for women and an additional reporting burden for providers (who currently have to report on abortions, but in a confidential manner and not within 10 days - nobody really needs that information within 10 days.)

So, Campfield, are you simply misinformed about the existing data collection requirements, or is this really an attempt to make an end run around state laws/medical privacy?

See Update, 2/16/07

A Roundup of Tennessee Bloggers:

The Rep Himself - Is it a Life?

Tiny Cat Pants - Stacey Campfield Wants in Your Medical Records; I Appeal to You Anti-Abortion Folks; Stace, Shall I Send My Used Tampons to You or to the Medical Examiner?

Tennessee Guerilla Women - TN Lawmaker Wants State to Call a Fetus a Person

Thoughts of an Average Woman - Death Certificates for Fetuses Would Identify Women

No Silence Here - More GOP Big Government

Cup of Joe Powell - Campfield Targets Women?

Volunteer Voters - More Talk of Certificates for Clumpy - "This bill accomplishes only one goal: getting Stacey Campfield's name in the paper. That's all this does. Campfield, by introducing this bill has done nothing for the unborn or the cause of Life. He is an embarrassment and impediment to it." - AC, we finally agree on something!

Salem's Lots - Here’s one for all you folks who want to cut out waste in government - Interesting fiscal perspective from a Dept. of Health Employee

In the News:

Knoxville News-Sentinel - Abortions: Lawmaker touts death certificates

Safer Sex Wednesday

2007-02-14T10:55:00.000-06:00

From the New York Times:

Free Condoms on the Subway? And Who Says New Yorkers Aren’t Friendly?

Greatest Generation Learns About Great Safe Sex - "By the time Ms. Binford got around to describing a safe sexual act involving Saran Wrap, a woman shouted, 'Enough, already!' and the room erupted in laughter."

Happy National Condom Week

2007-02-14T08:53:00.000-06:00

Did you know that Valentine's Day kicks off National Condom Week? Neither did I, and I have Tyler at RHReality Check to thank for pointing it out.

Press release and condom info from the American Social Health Association

Silly slogans - "If you think she's spunky, cover your monkey"

Guttmacher Institute press release

National Condom Week of Action from FeministCampus (part of the Feminist Majority Foundation), with everything you need to know about condoms and an e-card (scroll down until you see a shamrock)

The Condom - info from Planned Parenthood

Talking to your partner about condoms

Birth Control - Condom - KidsHealth

Condoms: Effective birth control and protection from sexually transmitted diseases - MayoClinic.com

How Effective Are Latex Condoms in Preventing HIV? - CDC

While you're reading about condoms, don't forget that the Great American Condom Campaign needs your support.

Maternity Scrubs

2007-02-14T08:47:00.001-06:00

Someone arrived at this blog from a search for "scrubs for pregnant women." Admittedly, I never thought of this as a need, because scrubs are so stretchy in the first place. However, I did some searching and turned up a few companies offering maternity scrubs. Please note that I have no experience or ties with these companies and can't vouch for the quality or fit, and that this list is not exhaustive.

ScrubMed - maternity tunic and maternity pants

Accent Uniforms - maternity tops and pants

GOTOSCRUBS - maternity pants by Landau, print maternity tunics by Karesan

Scrubies - maternity pants and tunics

Sassy Scrubs - tops, pants, and jackets

AllHeart - maternity scrubs from various companies

Responding to the Clinicians and Conscience Study

2007-02-13T18:22:00.000-06:00

The New York Times has published an editorial in response to the study summarized here last week that found some physicians would withhold treatment, referrals, and information from patients when they had personal objections to certain legal procedures. In part, the editorial states:

"Although the close-mouthed doctors claim a right to follow their consciences, they are grievously failing their patients and seem to have forgotten the age-old admonition to “do no harm"...The researchers put the burden on patients to question their doctors upfront to learn where they stand before a crisis develops. But that lets doctors off the hook. Physicians have a right to shun practices they judge immoral, but they have no right to withhold important information from their patients. Any doctors who cannot talk to patients about legally permitted care because it conflicts with their values should give up the practice of medicine."

Reminder: Motherland Afghanistan Airs Tonight

2007-02-13T13:47:00.000-06:00

Motherland Afghanistan, on the state of women's healthcare in Afghanistan and one man's attempt to help in the crisis, airs tonight on your PBS station.

Update: After watching the film, you may wish to take a moment to contact your Senators/Representative to ask them to support the Afghan Women Empowerment Act of 2007, which would include the authorization of $30,000,000 (each fiscal year 2008-2010) "for grants to Afghan women-led nonprofit organizations to support activities including the construction, establishment, and operation of schools for married girls and girls' orphanages, vocational training and human rights education for women and girls, health care clinics for women and children, programs to strengthen Afghan women-led organizations and women's leadership, and to provide monthly financial assistance to widows, orphans, and women head of households." The legislation also includes monetary support for the Afghan Ministry of Women's Affairs and the Afghan Independent Human Rights Commission.

The Feminist Majority Foundation has a letter of support all set up for you, which will automatically identify your Congressional representatives.

The Great American Condom Campaign Needs Your Help

2007-02-13T09:25:00.000-06:00

The Great American Condom Campaign needs your help to continue to the important work of ensuring that all people have access to condoms and appropriate disease prevention and contraceptive information. To learn more, visit the links at the bottom of this post. Your donation will help support this work, including providing 100 condoms a month to registered SafeSites for distribution to the community. From an email, republished with permission:

Just wanted to check in and ask that you give a few bucks to The Great American Condom Campaign. We are in a very challenging financial situation. As you might know, our flagship project, "Safesites" - a national grass-roots condom distribution program - has expanded FAR faster than any of us had predicted: Reaching ten times more people per month than we thought we could hit in a year. This is a GREAT problem to have, to be sure, but the added cost of creating a logistical system to support the 90,000 people we are hitting every month has been hard on us. Especially considering we are a volunteer organization. None of us are paid. No salaries. No benefits. Nothing. In fact, the whole Campaign has been self-financed for the past year and a half. The only problem is that we've run out of things to sell, houses to mortgage, and loans to get to pay for this very important next phase.

It is hard to ask for money, but I can not think of a more worthwhile cause to ask for your support on. I'm not asking you for $10,000 (but if you gave it, I would be hard-pressed to say no ;) but I am asking you to consider giving as much as you can. Twenty bucks from you, in the context of two thousand other people giving $20, makes a huge difference.

Every little bit counts, Rachel. Get your friends to donate, your office, your neighbors -- your contribution will make a difference, I guarantee that. Please donate right now, just visit our homepage and click on the blonde in the lower left corner. It takes less than a minute.

Please also feel free to contact me directly whenever you like at stephen@condomcampaign.org or 202.341.0656.

Be Great,
Stephen

Stephen B. Sobhani, MPP
The Great American Condom Campaign
www.condomcampaign.org

Great American Condom Campaign
PO Box 3769
Washington, DC 20027

Related Info:
Why a Condom Campaign?
SafeSites Sign Up
How To Use A Condom
STIs 101 - info on a range of sexually transmitted infections

One to Watch: Motherland Afghanistan

2007-02-11T16:43:00.000-06:00

In Motherland Afghanistan, filmaker Sedika Mojadidi follows her OB/GYN father to Afghanistan to witness his work in a Kabul maternity ward (once the Rabia Balkhi maternity women's hospital, renamed the Laura Bush Maternity Ward). Dr. Mojadidi was asked by the U.S. Government to help rehabilitate post-Taliban Rabi Balkhi in 2003, and the film documents the doctor's frustration and lack of support (including the U.S. Department of Health and Human Service's failure to supply the promise basic medical supplies and equipment), and the resulting difficulties in providing medical care for Afghanistan's women. As the piece reports, Afghanistan has the second highest maternal mortality rate in the world, with a 2000 survey finding 1,600 maternal deaths for every 100,000 live births. In the same year, only 10% of Afghanistan's clinics were equipped to perform c-sections, and 2/3rds could not provide basic reproductive health services. According to World Health Organization statistics from 2000, only Sierra Leone experiences more maternal deaths (2,000 per 100,000 live births). By comparison, the United States experienced only 16 deaths per 100,000 live births. While some estimates disagree on the exact numbers, the rate of maternal mortality in Afghanistan is nonetheless extremely high.

Motherland Afghanistan makes real the problems of a broken healthcare system that cannot provide enough trained doctors, infrastructure, or knowledge to properly care of the nation's pregnant women. Alongside images of the Afghanistan landscape and insight into the culture and social climate, the documentary presents startling images of broken, overflowing sinks, filthy toilets, patients bringing their own medical supplies, and other scenes from a hospital on the edge of ruin. It also presents up-close encounters with the women affected by this lack of care. Yet when Dr. Mojadidi complains to the HHS that they have not fulfilled their promises to send money and supplies, he receives in return only a letter congratulating him on his good works. The doctor eventually leaves the country in frustration.

Two years later, in 2005, the filmmaker once again follows her father to Afghanistan, this time to an NGO-sponsored medical facility. While conditions are better there, the doctors, patients, and families still face extraordinary hurdles in providing even the most basic care. One baby is born prematurely at 7 months; in the U.S. the baby might survive, but in this facility with no incubators, where the baby is fed milk via a spoon, the chances of a good outcome are strikingly lower. The film also highlights the problem of fistula, an injury that can occur when emergency care is not available to laboring women, resulting in a hole between the bladder and vagina or rectum and vagina. One woman has seemingly suffered from this problem, with urine leaking from her bladder into her vagina and down her legs, for 8 months before receiving care.

The features shown on Independent Lens are typically informative and moving, and this documentary is no exception. Motherland Afghanistan is an eye-opening and worthwhile look at the state of reproductive health care in Afghanistan. Visit the website and see these selected resources to further explore this topic.

Motherland Afghanistan can be seen this week on Tuesday, February 13th as the Independent Lens broadcast on your local public television station. [search for showtimes]

Thanks to itvs for provision of a screener copy of the film.

Pennsylvania Pushing to Oust Direct-Entry Midwives

2007-02-09T11:20:00.000-06:00

From the Philadelphia Inquirer, "A Push to Stop Midwives."

According to the piece, "In Pennsylvania, only midwives who have nursing degrees can be licensed. The state argues that the practice of lay midwifery - usually defined as midwives trained through apprenticeship - is illegal, and many doctors say it is dangerous. However, the Pennsylvania statute does not explicitly prohibit the practice of lay midwifery." One midwife (Diane Goslin) without a nursing degree, who has practiced for more than 25 years and delivered more than 5,000 babies, came to the State's attention after an Amish baby she delivered died a day after work. The coroner reported that the death was "likely from pneumonia caused by bacteria transferred in utero." The State Board of Medicine is now accusing Goslin of practicing medicine and nurse-midwifery without a license, with each charge carrying a maximum fine of $10,000. If the court orders that Goslin must stop catching babies and she refuses, she could be subject to criminal charges.

Some are concerned about the Amish population in Pennsylvania, which oftens depends on "lay" midwives for birth. From the article - "Home-birth advocates say safe home births would be nearly impossible without lay midwives, who attended nearly half the 3,481 out-of-hospital births in Pennsylvania in 2004, the last year for which the state has statistics."

Direct-Entry Midwifery State-by-State Legal Status-Last Updated 4-17-2006

Clinicians, Conscience, and Information

2007-02-08T18:49:00.000-06:00

The paper, Religion, Conscience, and Controversial Clinical Practices, published in the current issue of the New England Journal of Medicine, examines U.S. physicians' attitudes about disclosing information to patients concerning "legal but morally controversial medical procedures." Essentially, the doctors were surveyed about whether they would withhold information, treatment, or referrals from patients if they personally objected to the procedure in question. A summary:

Who Was Included: Practicing U.S. physicians who were 65 years old or younger chosen randomly from a database of all U.S. docs. A modest incentive ($20) was offerred for participation in the survey.

What Was Done: A 12-page questionnaire [PDF] was mailed to physicians for them to complete and return. Participants were informed that the survey was intended to assess physicians' perspectives on religion and spirituality in medicine, and were asked questions about their own religiosity and opinions on refusing treatment and withholding information based on their beliefs.

What Was Asked:
Physicians were asked a number of questions to assess their own religiousity, how often religious discussions occur with patients, and how, their level of objection to controversial procedures (abortion, birth control for adolescents without parental consent, and physician-assisted suicide/"terminal sedation"), the physician's obligation to the patient when the procedure is legal but the physician objects on religious or moral grounds, and general patient, workplace, and individual demographics.

Findings: 1114 surveys were returned to the researchers. Among the results:

83% have no objection to "terminal sedation," 48% do not object to abortion, and 58% do not object to prescription of birth control to adolescents without parental consent.

37% reported low,27% reported moderate, and 36% reported high religiosity, while 46% reported attending religious services twice a month or more.
When the doctor objects to a legal medical procedure requested by a patient:

63% thought it would be ethical to explain in detail to the patient why he or she objects to the procedure.

Only 86% thought they had an obligation to present all possible options to the patient (including about the procedure objected to); 6% were undecided, and 8% believed they had no such obligation.

Only 71% believed they were obligated to refer the patient to another doctor who does not object to the procedure, while 11% were undecided, and 18% believed they were not obligated to refer the patient to another provider.

"Catholics and Protestants were more likely to report that physicians may describe their religious or moral objections and less likely to report that physicians are obligated to refer patients to someone who does not object to the requested procedure." (Jewish, None, and Other were the remaining categories)

"Physicians who objected to the three controversial medical practices were less likely to report that doctors must present all options and refer patients to other providers. The associations for religious characteristics and objections to controversial clinical practices persisted after controlling for age, sex, ethnic group, region, and specialty."

"Physicians who objected to abortion for failed contraception and prescription of birth control for adolescents without parental consent were more likely than those who did not oppose these practices to report that doctors may describe their objections to patients." The researchers did not find a connnection between objection to terminal sedation and believing it was appropriate to discuss these objections with patients.

Male physicians were more likely than their female colleagues to both believe it is appropriate to present personal religious/moral objections to patients and to be willing to withhold information/referral from the patient.

Notes:
The survey was conducted in 2003 - I think the debate over pharmacist refusals to women has heated up since the time of the survey, but I don't know how/if that would affect a suvery conducted now. Doctors were not asked how often they actually had refused information or referral to a patient or told patients about their religious/moral objections. Rather, they were asked if they believed those refusals are appropriate. The authors also point out that because they surveyed physicians from a number of medical specialties, many of the responding physicians may not be in the position to provide or be asked to provide the "legal but morally controversial" procedures, thus making their opinions about what is appropriate perhaps not representative of what happens in real practice. For example, a set of OB/GYNs asked about birth control and abortion might respond differently overall than a set of cardiologists asked the same thing, but the issue would almost never come up in the cardiologists' medical practice, whereas the OB/GYN's opinions may affect real patients.

Don't you really want to believe that 100% of the time, if you ask your physician about something, you'll be provided with all of the relevant information about your options, and referred somewhere else if your physician believes he or she cannot care for you?

Citation: Curlin FA, Lawrence FE, Chin MH, Lantos JD. Religion, conscience, and controversial clinical practices. N Engl J Med. 2007 Feb 8;356(6):593-600. Free full-text.

The Hoohaa Monologues

2007-02-08T12:12:00.000-06:00

Some Atlantic Beach, FL woman was offended by seeing the word "Vagina" on the marquis of a theater running a production of "The Vagina Monologues," and having to explain to her niece what "vagina" means. You know, the play that is supposed to help take away the stigma about talking about the vagina? The theater changed the marquis to read "The Hoohaa Monologues." More/images from BoingBoing and WJXT.

In Support of Amanda & Melissa

2007-02-07T13:26:00.000-06:00

It's stand up for bloggers day in the wake of the Edwards campaign blogging "scandal." My contribution.

Dear John Edwards,

If you did your homework before hiring your bloggers, and approved of their work, you should stand by them. If you are cowed into firing them because the Catholic League says you should, you don't have what it takes to be President.

If didn't do your homework before hiring your bloggers, and had not even the slightest notion that they might be criticized at the speed of electrons all across the tubes, you also don't have what it takes to be President.

As you "weigh their fate," consider what it suggests about what your own should be. I'm looking forward to seeing just what kind of stuff you're made of.

Yours,
Rachel

[Background info here]

Update: Two (almost) official thumbs down to Edwards, who has allegedly fired the bloggers.
Update 2: Amanda and Melissa are not fired. Or they're unfired. Or something.

National Black HIV/AIDS Awareness Day

2007-02-07T11:16:00.000-06:00

Today is National Black HIV/AIDS Awareness Day. According to the CDC, "The primary goal of NBHAAD is to motivate African Americans to get tested and know their HIV status; get educated about HIV/AIDS; get involved in their local community; and get treated if they are currently living with HIV or are newly diagnosed."

Resources:

HIV/AIDS and African Americans - CDC

Fact Sheet: HIV/AIDS among African Americans - CDC

What African Americans Can Do - CDC, prevention information

National HIV Testing Resources - searchable database of testing sites in the U.S.

National Black HIV/AIDS Awareness Day - campaign site, includes information on "Blacks and HIV/AIDS" and getting tested, registration and supplies for local events, and the NBHAAD blog.

African American HIV/AIDS Program - American Red Cross. According to the website, "The African American HIV Education and Prevention Instructor Course" addresses public health concerns for African American communities in the area of HIV prevention. It is designed by African Americans for African Americans. The course trains instructors to deliver culturally sensitive and culturally specific HIV education and prevention. Instructors learn how to facilitate community sessions using a series of activities including role plays, brainstorming, practice and demonstrations. The sessions help participants build critical skills towards preventing the spread of HIV. These skills include decision-making, problem solving, negotiation and refusal."

The Balm in Gilead - " For 18 years, The Balm In Gilead has mobilized The Black Church Week of Prayer for the Healing of AIDS, which engages Black churches to become centers for education, compassion and care in the fight against HIV/AIDS."

BlackAIDS.org

Events Recognize National Black HIV/AIDS Awareness Day - Kaiser Network, with list of events, statements, and opinion/editorial pieces on the day

National Black HIV/AIDS Awareness and Information Day: February 7 - Office of Minority Health

National Black Leadership Commission on AIDS

National Minority AIDS Council

Racial/Ethnic Disparities in Diagnoses of HIV/AIDS --- 33 States, 2001--2004 - CDC, Morbidity and Mortality Weekly Report

Mobilizing against the HIV/AIDS crisis among African Americans

Living with HIV/AIDS - CDC, tips for patients

AIDSInfo - lots of patient-friendly information, a glossary of terms, etc. Also has special page set up on National Black HIV/AIDS Awareness Day 2007

HIV: Coping with the Diagnosis - familydoctor.org

YOUR RIGHTS AS A PERSON WITH HIV INFECTION OR AIDS - U.S. Department of Health and Human Services, Office for Civil Rights

HPV Vaccine Concerns

2007-02-07T08:29:00.000-06:00

First of all, I'd like to welcome new readers who have come here for information on the Texas HPV vaccine law. I hope you'll stick around. A few of you have made comments which have caused me to want to clarify my stance on the vaccine, as you have made very good points which I did not yet cover adequately. I have five main points of concern regarding the Merck vaccine and making it mandatory (even with opt out provisions):

1) Long-term effects data is not available
The vaccine in question has only been studied for a few years. This weekend I'll compile a list of citations for studies on the vaccine, and summarize some of the adverse effect data. However, none of this data will reflect whether girls will have problems with the vaccine further down the road.

2) Consumers do not have a choice
Another HPV vaccine made by another pharmaceutical company is currently being tested. If you're going to make the vaccine mandatory, why not wait until a second option is available and let patients make the choice?

3) HPV may not be an urgent or public health concern
Most other vaccines are for more readily transmittable infections, things you can catch through close contact or the air. HPV is not so readily transmissable. The "State" may not have as legitimate an interest in requiring this vaccine as it does in vaccines such as the MMR, so perhaps it should stay out of it.

4) Women do not have a choice.
The bodily autonomy argument is a difficult one. On one hand, the vaccine would be most effective if girls got it before they were sexually active, which for most people is going to mean while they are still minors and their parents are making medical decisions on their behalf. On the other hand, I'm not convinced that young girls should be forcefully subjected to something (by either parents or the State) for which long-term effects are not known.

5) The public is not receiving full disclosure of the interests of the legislators proposing these vaccine laws.
Several people have suggested that the Texas governor has financial ties to Merck. This should be something every parent is informed of. I did a search yesterday, and found the Merck political action committee had donated $5,000 to an organization supporting Perry's election. I don't want anyone's health messed around with for the sake of money.

There are aspects of the vaccine I support. I think it's a great idea when consumers have all available information. My own mother had cervical cancer, and her complaints were ignored by doctors until it was at a point where a hysterectomy was required. Growing up in the shadow of "I hope mom's cancer doesn't come back" tends to make you supportive of things that would prevent such cancers. Granted, cervical cancer is not the biggest killer of American women, but we don't have a vaccine for heart disease or breast cancer yet. I do think this vaccine is an encouraging development for researchers who may want to look for other viral causes of cancer (and some researchers are currently looking at viral causes of breast cancer in mice). I think it's a positive development, but that we may be jumping the gun when we start to require it. On the other hand, my understanding is that when the vaccines become mandatory, funds have to be allocated to provide the vaccine to people who could otherwise not afford this very expensive regimen, thus making protection available to more women. However, I think perhaps legislation could be passed to require funding without requiring vaccination for school entry.

It's a complicated issue, and I thank those of you who were civil and thoughtful in your comments and emails.

Stay Tuned for Technical Difficulties

2007-02-07T08:26:00.000-06:00

Blogger just forced me to upgrade. It appears to have gone well, but I'm not yet convinced. If you posted a comment last night that is still awaiting moderation, it will appear shortly.

Support "Birth" on Public Radio

2007-02-06T19:17:00.000-06:00

Via an email, republished with permission:

Dear BOLD Supporters,

I want you to know about an exciting, empowering radio documentary called "Birth." Thin Air Media have produced an hour-long radio documentary on the practices and perceptions of birth in America that will be airing on public radio in March for Women's History month. Below is a summary of the documentary's objectives:

Starting with early perceptions, we move through the process of birth beginning before labor, continuing during labor, and following the actual event. With a multiplicity of voices woven with sound we examine the process of birth from an emotional, physical and philosophical perspective.

I have recently listened to "Birth" and find it a hopeful piece for women who want to tap into the power of giving birth. It also weaves facts about giving birth that will certainly help spark a national discussion on birth.

If you'd like to listen to this documentary on your local NPR station you need to BE BOLD and call the station so they know you're interested. And email all your friends and family encouraging them to call too! Public radio stations respond to listener requests. Many times excellent radio documentaries do not air on public radio stations because the station hasn't heard from any of their listeners requesting this topic.

To find out the contact details for your local station go to: www.npr.org/stations

To learn more about the radio documentary "Birth" and to listen to an excerpt from the documentary go to: http://www.thinairmedia.org/birth.html

Thank you for Being BOLD. I hope everyone has a chance to listen to this excellent documentary.

Warmly,

Karen Brody
playwright, Birth
Artistic/Executive Director
Birth On Labor Day (BOLD)
www.birthonlaborday.com

Backlash Against Texas HPV Vaccine Law Continues

2007-02-06T10:46:00.000-06:00

In response to the Executive Order requiring HPV vaccination for Texas schoolgirls, legislation has been proposed in the state that would prohibit HPV vaccination status from being used as a condition for public school enrollment. Other legislators are expressing concern that the issue wasn't properly reviewed and asking the Governor to rescind the order, as evidenced in this Dallas News piece - " State Sen. Jane Nelson (R), chairwoman of the Senate's health and human services committee, said lawmakers should have been allowed to hear from doctors, scientists and patients before the state implemented such a sweeping mandate. 'This is not an emergency,' said Ms. Nelson, R-Grapevine. 'It needs to be discussed and debated.'"

TX Governor Rick Perry has released the following statement in response to critics:
“Never before have we had an opportunity to prevent cancer with a simple vaccine. While I understand the concerns expressed by some, I stand firmly on the side of protecting life. The HPV vaccine does not promote sex, it protects women’s health. In the past, young women who have abstained from sex until marriage have contracted HPV from their husbands and faced the difficult task of defeating cervical cancer. This vaccine prevents that from happening.

“Providing the HPV vaccine doesn’t promote sexual promiscuity anymore than providing the Hepatitis B vaccine promotes drug use. If the medical community developed a vaccine for lung cancer, would the same critics oppose it claiming it would encourage smoking?

“Finally, parents need to know that they have the final decision about whether or not their daughter is vaccinated. I am a strong believer in protecting parental rights, which is why this executive order allows them to opt out.”

Pro-vaccination editorial in the Austin Statesman

Supportive editorial from the New York Times

Previous Related Posts: (see links for additional HPV information resources)

American Cancer Society Issues New HPV Vaccine Guidelines

FDA Approves First Vaccine Against HPV, Leading Cause of Cervical Cancer

Status of HPV Vaccine and Cervical Cancer Prevention

One Vaccine, 100 Voices - HPV Vaccines and Screening in the Prevention of Cervical Cancer

CDC Recommends HPV Vaccination, Backlash Continues

FDA Committee Recommends Approval of HPV Vaccine

The Annual Poke and Prod

2007-02-05T09:27:00.000-06:00

I have to go for the annual poke and prod and swab today. I'd liveblog it, but it's hard to type on your back. :P

A Mix of Troublesome and Overblown

2007-02-04T10:39:00.000-06:00

The Tennessean is reporting today that "Tennesseans lead nation in prescriptions," stating that, "Tennesseans use more prescription drugs than any other state in the nation — an average of 17.3 prescriptions for every man, woman and child, according to a new study by BlueCross BlueShield of Tennessee. The state's prescription drug spending topped $7 billion in 2005, according to the insurer's latest report. The national average is 11.3 prescriptions per person." If Tennesseans are receiving too many, unnecessary prescriptions, that's a problem.

However, the article states, "That figure includes everything from people who take dozens of pills per day to people who take a single prescription but refill it every month and are recorded as taking 12 prescriptions that year." That's the part that makes no sense. If what the Tennessean reports is true, every woman in the state who refills birth control every month would be counted as taking 12 prescriptions, when they are only taking one drug on a regular basis. It is also unclear whether this includes only prescriptions that an individual goes to a pharmacy to fill, or whether it would include every drug administered during a hospitalization, and how many of the prescriptions are chronic, or everyday pills, as opposed, for example, to antibiotics for a short-term illness. The Tennessean piece lists several "chronic" drugs for chronic conditions among the list, so I wonder if those are contributing to overcounting the number of drugs people are truly taking.

Tennessee certainly has problems in healthcare management. "Tennessee ranks 47th nationwide in the health of its residents. It has some of the nation's highest rates of drug-resistant infections and accidental drug overdoses...'We are over-prescribing. That much is clear," said Dr. William Schaffner, an epidemiologist and chairman of preventive medicine at the Vanderbilt University School of Medicine. 'It's not that the doctors in all the other 49 states are getting it wrong and we're on the right track. ... It's a matter that has puzzled us for some time.'" Maybe the doctors and hospitals and health administrators are getting more detailed data that answers some of these questions about counting. If not, then I suspect we'll continue to be puzzled, because the Tennessean's report doesn't include enough information on the findings and methodology to make any valid observations about the state of prescription-writing in the State. Not having a clear representation of the true picture is bound to hinder progress in making the necessary corrections.

Technorati Tags: prescription drugs; Tennessee
MeSH Tags: Prescriptions, Drug; Tennessee

On the Texas HPV Vaccine Law

2007-02-04T10:28:00.000-06:00

Texas has passed legislation to require all girls ages 11-12 to receive the HPV vaccine before entering 6th grade. Some have responded to this by claiming that the government is taking control away from parents, and that this is simply a money-making venture for Merck, producer of the Gardasil vaccine, the only currently approved HPV vaccine. Merck certainly has a financial interest in having as many girls as possible vaccinated, and this New York Times article suggests the company is actively lobbying state legislatures to require vaccination. However, the executive order signed by the TX Governor makes no specific mention of Merck; it refers only to "HPV vaccine." When other companies get their vaccines (which are already in development) approved, Texas parents and doctors would be able to choose among them. Likewise, parents may opt out of the program on behalf of their children, by this provision: "The Department of State Health Services will, in order to protect the right of parents to be the final authority on their children's health care, modify the current process in order to allow parents to submit a request for a conscientious objection affidavit form via the Internet while maintaining privacy safeguards under current law." I can understand the concerns about the vaccine from a long-term effects standpoint (it's a new vaccine) - that, to me, would be the primary concern, along with keeping an eye on the company's lobbying efforts. However, "taking control away from parents" hysteria is a bit overblown, as parents clearly have a provision for opting out and not vaccinating their children, which is not restricted to religious reasons. The parents may simply have to be informed of risks and benefits before making the decision, and I don't think that's such a bad thing.

See Update, 2/6/07
More Updates, 2/7/07

Complete text of the Executive Order:
Executive Order RP65 - February 2, 2007
Relating to the immunization of young women from the cancer-causing Human Papillomavirus.
BY THE
GOVERNOR OF THE STATE OF TEXAS
Executive Department
Austin, Texas
February 2, 2007

WHEREAS, immunization from vaccine-preventable diseases such as Human Papillomavirus (HPV) protects individuals who receive the vaccine; and

WHEREAS, HPV is the most common sexually transmitted infection-causing cancer in females in the United States; and

WHEREAS, the United States Food and Drug Administration estimates there are 9,710 new cases of cervical cancer, many of which are caused by HPV, and 3,700 deaths from cervical cancer each year in the United States; and

WHEREAS, the Texas Cancer Registry estimates there were 1,169 new cases and 391 deaths from cervical cancer in Texas in 2006; and

WHEREAS, research has shown that the HPV vaccine is highly effective in preventing the infections that are the cause of many of the cervical cancers; and

WHEREAS, HPV vaccine is only effective if administered before infection occurs; and

WHEREAS, the newly approved HPV vaccine is a great advance in the protection of women's health; and

WHEREAS, the Advisory Committee on Immunization Practices and Centers for Disease Control and Prevention recommend the HPV vaccine for females who are nine years through 26 years of age;

NOW THEREFORE, I, RICK PERRY, Governor of Texas, by virtue of the power and authority vested in me by the Constitution and laws of the State of Texas as the Chief Executive Officer, do hereby order the following:

Vaccine. The Department of State Health Services shall make the HPV vaccine available through the Texas Vaccines for Children program for eligible young females up to age 18, and the Health and Human Services Commission shall make the vaccine available to Medicaid-eligible young females from age 19 to 21.

Rules. The Health and Human Services Executive Commissioner shall adopt rules that mandate the age appropriate vaccination of all female children for HPV prior to admission to the sixth grade.

Availability. The Department of State Health Services and the Health and Human Services Commission will move expeditiously to make the vaccine available as soon as possible.

Public Information. The Department of State Health Services will implement a public awareness campaign to educate the public of the importance of vaccination, the availability of the vaccine, and the subsequent requirements under the rules that will be adopted.

Parents' Rights. The Department of State Health Services will, in order to protect the right of parents to be the final authority on their children's health care, modify the current process in order to allow parents to submit a request for a conscientious objection affidavit form via the Internet while maintaining privacy safeguards under current law.

This executive order supersedes all previous orders on this matter that are in conflict or inconsistent with its terms and this order shall remain in effect and in full force until modified, amended, rescinded, or superseded by me or by a succeeding governor.

Given under my hand this the 2nd day of February, 2007.

RICK PERRY(Signature)
Governor

Attested by:
ROGER WILLIAMS(Signature)
Secretary of State

See Update, 2/6/07

Technorati Tags: cervical cancer; HPV vaccine; Texas
MeSH Tags: Adolescent; Papillomavirus Vaccines; Texas; Uterine Cervical Neoplasms;

Miscarriage of Justice

2007-02-03T13:32:00.000-06:00

These stories have been covered elsewhere, but they bear repeating, to as many people who will listen.

Woman Raped, Taken to Jail, Denied Emergency Contraception
In Tampa, FL, a woman was raped, called 911, and was taken to the hopsital for an examination. According to this story, "When they [police] started checking the victim's background, they discovered she had an arrest warrant out for her." The story does not indicate whether it is standard practice to check the crime victim's record. The woman was apparently not aware of the warrant (from when she was a juvenile), and her attorney says it was a paperwork error. The just raped woman was taken to jail in handcuffs and denied bond. Although the hospital had prescribed emergency contraception, the jail's medical supervisor would not allow her to take it, "because she said it was against her, the supervisor's, religion." Thus, the woman's rights were violated at least twice (3 times, if she was wrongfully jailed). The jail is disputing the story, claiming essentially a procedural error, although I'm hesitant to accept that what amounts to the jail not following its own procedures and so hindering lawful medical care constitues a "good" excuse. The police department, on the other hand, has taken corrective action by apologizing to the woman for the arrest and instituting a policy to allow more discretion in postponing arrests of crime victims who are wanted on traffice, misdemeanor, or felony property crime charges.

Pregnant Woman Arrested, Denied Medical Attention, Miscarries
A Kansas City, Missouri woman who was 3-4 months pregnant was arrested for traffic violations (including a fake temporary license tag) and outstanding city warrants. She told officers that she was pregnant and bleeding, having a miscarriage, and needed to go to the hospital. Police ignored her requents, took her to jail, and according to a lawsuit she has filed, "jailers allegedly ignored Salva’s pleas for assistance until she passed “a large bloody mass” and was finally released to go to Truman Medical Center, where her baby was born five months prematurely. He died." A video from the police cruiser has now been released of the woman's arrest. She repeatedly tells officers (one of whom is a woman) she is pregnant and bleeding, and has taken the car to go to the hospital, while police continue to question her about the car. From a news story on the video:

"Sofia Salva told officers nine times during the first five minutes of the stop that she was bleeding or wanted to go to a hospital. After the ninth request, a female officer asked: “How is that my problem?”

Salva requested help at least 12 more times during the 30-minute encounter nearly a year ago.

"You can go to the hospital when we're done with you."

Salva again told Spencer to “look down” to see the blood. “It’s called a menstrual cycle,” Spencer [one of the officers] said.

“If I die here, will you take care of me?” Salva said. “If I die here?” “Fair enough,” Schnell [another officer] said.

“I don’t doubt that you’re possibly bleeding, but you got a lot more problems with us,” Schnell said.

When the arrest van arrived to take Salva to jail at 11:11 p.m., she again said to Schnell: “I’m bleeding.” “When we take you to the station, we’ll be able to report all that.”

Disturbing video of KC officers’ treatment of pregnant woman
Appalling incident can't be excused
Police incident prompts review
Officers suspended in case of woman who miscarried - This incident happened on 2/5/06, and the officers have just now been suspended, only after the video was released?

The embedded video below includes subtitles so you can understand some of what the woman is saying, and is set to a rather appropriate NWA song. For an unenhanced version and partial transcript, see the "disturbing video" link above.

PS - I want to clarify that I think the NWA song choice was appropriate for this incident. I've met some great police officers. I've also been involved in a car wreck wherein the other driver was drunk, drinking while driving, and the officers knew the driver so let him leave the scene to sober up. The police officers you see in the video? Decidedly in the "not good" category.

Technorati Tags: emergency contraception; jail; Kansas City; police; rape; Tampa
MeSH Tags: Abortion, Spontaneous; Contraception, Postcoital; Human Rights Abuses; Police; Reproductive Rights;

It's Vagina Monologue Time

2007-02-03T12:36:00.000-06:00

Yes, yes, they're not really always talking about vaginas. I know. Still, it's a show worth seeing, and your ticket price typically benefits a local organization. In Nashville, the Sarratt Cinema at Vanderbilt will have performances. From the website of the Margaret Cuninggim Women's Center:

THE 2007 COLLEGE CAMPAIGN PRODUCTION OF THE VAGINA MONOLOGUES
Eve Ensler’s Award-winning play presented by Project Safe. All proceeds benefit a local organization working to stop violence against women.
Date: February 11th, 13th and 14th; 7:00 p.m.
Location: Sarratt Cinema, Vanderbilt University
Tickets: Tickets can be purchased for $12 at the Sarratt Cinema box office (Vandy card, cash or check accepted) or by will call at 322-1333. For more information, please contact kacy.silverstein@vanderbilt.edu.
[Note: I contacted the Center for specifics, and proceeds are going to the Nashville chapter of Amnesty International.]

Vanderbilt will also host V-DAY: UNTIL THE VIOLENCE STOPS - Documentary film highlighting the rise of V-DAY and The Vagina Monologues around the world. Date: February 6th; 6 p.m. Location: Furman Hall 114, Vanderbilt University
For more information or directions to the event, please contact kacy.silverstein@vanderbilt.edu.

You can search for V-DAY events near you using this online database from the main V-DAY website.

Technorati Tags: V-DAY; vagina monologues; violence
MeSH Tags: Battered Women; Vagina; Violence

Tennessee Earns a D+ for Reproductive Rights

2007-02-02T11:40:00.000-06:00

NARAL Pro-Choice America has released its "Who Decides: The Status of Women's Reproductive Rights in the United States" information for 2007, and given Tennessee a grade of D+ for protecting women's reproductive autonomy. A run-down of the state's laws that affect this grade are provided on the site.

Profiles for other states are available here. A complete list of state grades is available as a PDF.
States earning an F are Alabama, Arkansas, Idaho, Indiana, Kentucky, Louisiana, Michigan, Mississippi, Missouri, Nebraska, North Dakota, Ohio, Pennsylvania, South Carolina, South Dakota, Texas, Utah, Virginia, and Wisconsin. Pro-woman politicians may want to rethink that whole "flyover states" thing.

States earning a grade of A- through A+ are: Alaska; California; Connecticut; Hawaii; Maine; Maryland; Montana; Nevada; New Jersey; New York; Oregon; Vermont; Washington.