Daily Women's Health Policy Report

Daily Women's Health Policy Report by the National Partnership for Women & Families
Updated: 25 min 18 sec ago

Concerns Raised About Blood Tests That Can Determine Sex, Genetic Disorders Early in Pregnancy

1 hour 3 min ago

A blood test available in drugstores and online that can accurately predict a fetus' sex is among the first of an "expected raft" of related tests that also can detect genetic disorders, such as Down syndrome, early in pregnancy, science reporter Pam Belluck writes in the New York Times' Sunday Review Desk.

Concerns Raised About Blood Tests That Can Determine Sex, Genetic Disorders Early in Pregnancy

August 22, 2011 — A blood test available in drugstores and online that can accurately predict a fetus' sex is among the first of an "expected raft" of related tests that also can detect genetic disorders, such as Down syndrome, early in pregnancy, science reporter Pam Belluck writes in the New York Times' Sunday Review Desk.

The unregulated tests allow pregnant women to determine the fetus’ sex several weeks earlier than an ultrasound can and are less invasive and less risky than amniocentesis, according to the Times (Belluck, New York Times, 8/21). A recent study published in the Journal of the American Medical Association found that the blood test, which analyzes fetal DNA in a pregnant woman's blood, can determine fetal sex with 95% accuracy at seven weeks of pregnancy and with 99% accuracy at 20 weeks if used correctly (Women's Health Policy Report, 8/10).

The possibility that the test will lead to sex-selective abortion "discomfits many and is also providing fuel for antiabortion politics," Belluck reports.

"I think over the long run this has the potential of changing attitudes toward pregnancy and to family," Audrey Chapman, a bioethicist at the University of Connecticut Health Center, said. "Women may be less invested in their pregnancies earlier than they are later, and the question has been raised whether women will look at their pregnancies increasingly as being conditional: 'I will keep this pregnancy only if,'" she added. James Egan, a professor of obstetrics and gynecology at the University of Connecticut Health Center, explained that many women could consider relatively private medication abortions early in pregnancy based on the results of such genetic tests.

Antiabortion-rights groups oppose the tests in general and have been pushing sex selection abortion bans in state legislatures. According to John Robertson, a professor of law and bioethics at the University of Texas, the laws may not survive court challenges. However, abortion rights groups that oppose bans on sex selective abortion could nevertheless be reluctant to challenge them in court (New York Times, 8/21).

N.C. District Judge Grants Preliminary Injunction on Budget Provision Blocking Planned Parenthood Funding

1 hour 9 min ago

U.S. District Judge James Beaty on Friday temporarily blocked a budget provision preventing the North Carolina Department of Health and Human Services from distributing state and federal family planning grants to Planned Parenthood of Central North Carolina, the Raleigh News & Observer reports.

N.C. District Judge Grants Preliminary Injunction on Budget Provision Blocking Planned Parenthood Funding

August 22, 2011 — U.S. District Judge James Beaty on Friday temporarily blocked a budget provision preventing the North Carolina Department of Health and Human Services from distributing state and federal family planning grants to Planned Parenthood of Central North Carolina, the Raleigh News & Observer reports (Jarvis, Raleigh News & Observer, 8/20). The grants fund family planning, teen pregnancy prevention programs and other preventive health services. The money cannot be used for abortion services.

PPCNC on July 7 filed a lawsuit alleging that the provision targets the group for supporting abortion rights and providing abortion care and, thus, is a violation of the First Amendment. The group also said the state violated the due process and equal protection clauses of the Constitution, as well as the bill of attainder clause, which prohibits lawmakers from singling out individuals or groups for punishment without trials (Women's Health Policy Report, 8/11).

In his 35-page ruling, Beaty agreed with PPCNC that the provision "was adopted specifically to penalize Planned Parenthood" for the organization's support of abortion rights, even though the funds do not pay for abortion services. He dismissed the state's argument that the budget is consistent with the General Assembly's policy of "favoring childbirth over abortion" and said the state "has not presented any evidence or even contention to establish how" the ban "is rationally related to a legislative policy of funding childbirth services over abortion services" (Breen, AP/Yahoo News, 8/19).

The judge also asked the state's health secretary to immediately reinstate Planned Parenthood's funding, stating that the court expects the department "to follow all applicable state and federal laws and regulations." If the health department continues to withhold funds from the organization, "further proceedings would be appropriate," Beaty said, adding that Planned Parenthood had an operational contract already in place for this year prior to the legislative session.

Beaty pointed to a similar lawsuit in Kansas where the judge ruled that an "attempt to punish the plaintiff for its support of abortion rights" is a violation of the First and 14th Amendment.

Planned Parenthood CEO Janet Colm said the organization is "deeply grateful that the court has stopped the state from enforcing the ban prohibiting Planned Parenthood from providing much-needed preventative health care to thousands" of North Carolina residents (Raleigh News & Observer, 8/20).

Paige Johnson -- vice president of public affairs for PPCNC --said Beaty's ruling is a "tremendous win" for women. According to Johnson, the lawsuit's next steps depends on whether the state appeals the injunction. If the state doesn’t appeal, Beaty could have a final ruling soon (AP/Yahoo News, 8/19).

N.H. Health Officials Defer To Federal Government on Family Planning Services Funds

1 hour 33 min ago

Earlier this month, New Hampshire Health Commissioner Nick Toumpas informed HHS officials that state health officials do not plan to restore family planning services previously offered by Planned Parenthood of Northern New England, the Concord Monitor reports.

N.H. Health Officials Defer To Federal Government on Family Planning Services Funds

August 22, 2011 — Earlier this month, New Hampshire Health Commissioner Nick Toumpas informed HHS officials that state health officials do not plan to restore family planning services previously offered by Planned Parenthood of Northern New England, the Concord Monitor reports. Toumpas, in an interview with the Monitor last week, said federal health officials would be able to assume control over the funding to provide the services at PPNNE's six centers in the state (Langley, Concord Monitor, 8/18).

Earlier this summer, the all-Republican Executive Council voted 3-2 against a new contract that would have awarded PPNNE $1.8 million in state and federal funds for two years. Following the decision, the six PPNNE centers stopped dispensing contraceptives because the organization operated under a limited retail pharmacy license that was contingent on having a state contract. PPNNE President and CEO Steve Trombley said the organization would have to reduce other services as well if the contract was not renewed (Women's Health Policy Report, 7/12).

Toumpas told the Monitor he does not have any information about what form a federal plan would take, or when it would be implemented. "Now the ball is in the court of the federal government," he added. Toumpas said he plans to review the 10 other family planning contracts that the Executive Council approved at the same time that it rejected the Planned Parenthood contract(Concord Monitor, 8/18).

Cervical Cancer Screenings Conducted Too Frequently Despite Guidelines, Study Says

1 hour 35 min ago

Many physicians recommend women receive the human papillomavirus and Pap test for cervical cancer screening on an annual basis, despite guidelines that call for screenings every three years, according to a Centers for Disease Control and Prevention study in the American Journal of Obstetrics & Gynecology, MedPage Today reports.

Cervical Cancer Screenings Conducted Too Frequently Despite Guidelines, Study Says

August 22, 2011 — Many physicians recommend women receive the human papillomavirus and Pap test for cervical cancer screening on an annual basis, despite guidelines that call for screenings every three years, according to a Centers for Disease Control and Prevention study in the American Journal of Obstetrics & Gynecology, MedPage Today reports.

For the study, researchers examined 2006 data from the National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey, which garnered responses from 376 private-practice physicians and 216 physicians at hospital outpatient centers.

The report found that about 51% of physicians ordered co-testing and only 14% recommended re-screening every three years for women with normal results.

According to MedPage Today, the American Cancer Society in 2002 and the American College of Obstetricians and Gynecologists in 2003 recommended co-testing for women age 30 and older. When the results are normal on both tests, women can wait three years before their next screening, the guidelines say.

The researchers wrote that the findings "suggest a need for continued surveillance and data collection on adherence to cervical screening guidelines, and perhaps an open dialogue on provider, patient, and systems preferences for prevention and management of cervical cancer and abnormalities" (Fiore, MedPage Today, 8/18).

CDC Advises Pregnant Women To Receive Flu Shot

1 hour 37 min ago

Officials with the Centers for Disease Control and Prevention are urging pregnant women to be vaccinated for the upcoming flu season, Wall Street Journal's Health Blog" reports.

CDC Advises Pregnant Women To Receive Flu Shot

August 22, 2011 — Officials with the Centers for Disease Control and Prevention are urging pregnant women to be vaccinated for the upcoming flu season, Wall Street Journal's "Health Blog" reports.

According to CDC, 49% of pregnant women received flu shots during the 2010-2011 season, the same as during the prior flu season. The agency said pregnant women are at particular risk of flu complications.

Findings also show that being offered the shot increased the likelihood that a pregnant woman would get vaccinated by 71%, while only 14% of pregnant women sought the vaccine when not offered the shot.

CDC also urged health care workers to be vaccinated, noting that 63.5% of such workers received the shot during the 2010-2011 flu season, compared with 62% in the previous season.

The agency said it expects that about 166 million vaccines will be produced this year, up from 157 million last year (Martin, "Health Blog," Wall Street Journal, 8/18).

Sanford Health Mounts $100M Effort To Cure Breast Cancer With New Facility

1 hour 39 min ago

As part of a $100 million effort to find a cure for breast cancer, Sanford Health will build a new cancer center on the company's main hospital campus in Sioux Falls, S.D., and expand a cancer institute in Fargo, N.D., the Sioux Falls Argus Leader reports.

Sanford Health Mounts $100M Effort To Cure Breast Cancer With New Facility

August 22, 2011 — As part of a $100 million effort to find a cure for breast cancer, Sanford Health will build a new cancer center on the company's main hospital campus in Sioux Falls, S.D., and expand a cancer institute in Fargo, N.D., the Sioux Falls Argus Leader reports (Walker, Sioux Falls Argus Leader, 8/18).

The initiative is funded by retired banker and philanthropist T. Denny Sanford of Sioux Falls (AP/Connecticut Post, 8/18). The new facility will be named the Edith Sanford Breast Cancer Center after his mother, who died of the disease.

The center will include a repository of thousands of women's blood samples. The samples will make up a database for researchers to study women's risk of developing the disease and determine treatment. Sanford intends the blood bank to include samples from women of all ages and medical histories.

According to Sanford CEO Kelby Krabbenhoft, the first phase of construction will begin next year and cost about $18 million. The center likely will open in 2014, Krabbenhoft said (Sioux Falls Argus Leader, 8/18).

Eugene Hoyme, a geneticist and president of research for Sanford, said of the initiative, "Our vision is to eradicate breast cancer through personalized medicine," adding, "With a comprehensive genetic picture, we will know more specifically what treatments will work with each woman, how to prevent disease on an individual basis and ultimately find a cure" (AP/Connecticut Post, 8/18).

Blogs Comment on Kan. Lawsuit, Gov. Perry's Stance on Women's Health, Affordable Care Act

Fri, 08/19/2011 - 14:49

The following summarizes selected women's health-related blog entries.

Blogs Comment on Kan. Lawsuit, Gov. Perry's Stance on Women's Health, Affordable Care Act

August 19, 2011 — The following summarizes selected women's health-related blog entries.

~ "Drawing a Line in the Sand: Stopping Politicians From Taking Away Insurance Coverage for Abortion Care," Brigitte Amiri, American Civil Liberties Union's "Blog of Rights": A lawsuit filed in federal court this week by the American Civil Liberties Union of Kansas and Western Missouri is "the first to take a step toward putting an end to [a] growing trend" of states passing laws to prohibit some or all health plans from covering abortion care, according to Amiri of ACLU's Reproductive Freedom Project. Kansas' "extreme" law bans abortion coverage "for the vast majority of abortions, including those necessary to protect a woman's health and for pregnancies resulting from rape/incest," Amiri writes. She adds, "As a result of the law, thousands of women in Kansas will lose their existing abortion coverage and will now have to pay out-of-pocket for this medical procedure." Amiri continues, "It's time to draw a line in the sand, and stop states from taking away insurance coverage for medical care that one in three women in the U.S. need," adding, "We hope the court will stop the law and protect the ability of women in Kansas to make the best decision for themselves and their families" (Amiri, "Blog of Rights," ACLU, 8/16).

~ "Perry: I'm Against It," Robert Walker, Huffington Post blogs: It's "no surprise" that Gov. Rick Perry (R) has "publicly reversed his longstanding support for requiring girls to be vaccinated against the human papillomavirus (HPV), a commonly sexually transmitted disease that is the principal cause of cervical cancer," Walker -- executive vice president of the Population Institute -- writes. Walker notes that as governor, Perry has been "an ardent champion of restricting a woman's right to choose an abortion and a stalwart opponent of comprehensive sex education," though his recent support of mandatory HPV vaccinations "got him into trouble with the religious right." Besides his turnaround on the HPV vaccinations, Perry also "suddenly backed away from declaring that abortion was a matter of 'state's rights,' by publicly supporting a constitutional amendment banning abortion." Walker concludes, "With that maneuver, it's now perfectly clear where Gov. Perry stands when it comes to government supporting the reproductive health and rights of women. He's against it" (Walker, Huffington Post blogs, 8/16).

~ "The Right to Choose to Become Pregnant: One Woman's Story," Thomas, NARAL Pro-Choice America's "Blog for Choice": Protecting a woman's right to choose to become pregnant "isn't as easy as it might seem," especially in the case of one working mother in Washington state, Thomas writes. The woman's insurer, Regence BlueShield, covered the implantation of an intrauterine device, "But when she wanted her IUD removed so that she could get pregnant again, Regence refused to cover the procedure." He continues, "According to the insurance company, removing the IUD wasn't 'medically necessary.' But it most certainly was necessary for conceiving a second child." After the woman filed a complaint with the state insurance commissioner, Regence was required to reimburse the woman and "nearly one thousand other women whose similar claims had been illegally denied," Thomas notes. He writes that this was possible because of laws in "Washington and 27 other states [where] covering birth control is required." He writes, "Beginning next year, all newly-issued insurance plans throughout the country will cover the full range of FDA-approved contraception without an additional copay." He concludes, "This means that women from Alaska to Alabama will have the same right that women in Washington now have. They'll be able to choose the birth-control method that's right for them -- and choose to plan a pregnancy when they want to" (Thomas, "Blog for Choice," NARAL, 8/17).

~ "Affordable Care Act Helps Women," Sen. Harry Reid, Huffington Post blogs: "The Affordable Care Act is helping women -- young and old -- avoid the onset of illness and improve their quality of life," Senate Majority Leader Harry Reid (D-Nev.) writes. He continues, "Starting in 2012, new health insurance plans will not only put money back in the pockets of women, but they will cover a wider net of preventive care services, such as Human Papilloma Virus DNA testing, HIV screening and counseling, FDA-approved contraception, breastfeeding support, and domestic violence screening and counseling." Reid cites a 2009 Commonwealth Fund study that found more than half of women delayed or avoided preventive care because of cost concerns. He writes, "Even moderate copays for preventive services such as mammograms or pap smears have deterred women from visiting a doctor." Reid concludes, "In a country as great as ours, no one should be forced to struggle without medical coverage because of an illness that could have been detected and treated" (Reid, Huffington Post blogs, 8/16).

~ "The Pill Still Doesn't Make You Fat," Robin Marty, RH Reality Check: "Despite how much many of us would like to believe otherwise, it is once again proven that it's our lifestyle (exercise, diet, slowing metabolism as we age) causing weight gain, not our birth control," Marty writes. She quotes a Slate article in which physician David Grimes of the University of North Carolina calls the notion that birth control pills make you fat "an elaborate mythology, one 'fueled by rumor, gossip and poor-quality research.'" In addition, Slate reports that "there's never been convincing evidence that the pill in any of its forms provokes weigh gain." Marty concludes that pregnancy is the "[o]ne thing that has been proven repeatedly to make you gain weight," although it "usually goes away sometime after" (Marty, RH Reality Check, 8/17).

Susan B. Anthony List Appeals Health Care Suit Ruling

Fri, 08/19/2011 - 14:14

Susan B. Anthony List on Thursday filed an appeal of a federal judge's ruling that the group incorrectly claimed in advertisements that the federal health reform law (PL 111-148) includes taxpayer funding for abortion, The Hill's "Healthwatch" reports.

Susan B. Anthony List Appeals Health Care Suit Ruling

August 19, 2011 — Susan B. Anthony List on Thursday filed an appeal of a federal judge's ruling that the group incorrectly claimed in advertisements that the federal health reform law (PL 111-148) includes taxpayer funding for abortion, The Hill's "Healthwatch" reports. The appeal was filed in the 6th U.S. Circuit Court of Appeals (Baker, "Healthwatch," The Hill, 8/18).

During former Rep. Steven Driehaus' (D-Ohio) campaign for the 2010 election, which he ultimately lost to Rep. Steve Chabot (R), SBA List sponsored ads claiming that Driehaus' vote to support the health reform law amounted to support for taxpayer-funded abortion (Women's Health Policy Report, 8/2). Driehaus sued SBA List for defamation, and the group sought to dismiss his lawsuit, saying that Ohio's election laws limit free speech in violation of the U.S. Constitution ("Healthwatch," The Hill, 8/18).

Driehaus asked the Ohio Election Commission to intervene on the grounds that the billboards violated Ohio election law by making "false claims." The commission sided with Driehaus, ruling that there was "probable cause" that SBA List violated Ohio law by making false statements in an election campaign.

U.S. District Judge Timothy Black in early August agreed, saying, "The express language of (the health reform law) does not provide for taxpayer-funded abortion." He added, "That is a fact, and it is clear on its face." Black's decision allowed Driehaus' lawsuit against SBA List to move forward (Women's Health Policy Report, 8/2).

In response to Black's decision, SBA List President Marjorie Dannenfelser said, "The idea that a judge would take it upon himself to police speech, specifically statements on a position taken by the majority of the U.S. House of Representatives, The Congressional Research Service, the Catholic Church, and the entire pro-life movement, shakes our Constitutional foundation," ("Healthwatch," The Hill, 8/18).

Judge Rejects Kansas' Request To Block Injunction In Planned Parenthood Funding Case

Fri, 08/19/2011 - 14:11

U.S. District Judge J. Thomas Marten on Wednesday rejected a request from the state of Kansas to block a temporary injunction that halts enforcement of a state law blocking federal family planning funding for Planned Parenthood, AP/WIBW reports

Judge Rejects Kansas' Request To Block Injunction In Planned Parenthood Funding Case

August 19, 2011 — U.S. District Judge J. Thomas Marten on Wednesday rejected a request from the state of Kansas to block a temporary injunction that halts enforcement of a state law blocking federal family planning funding for Planned Parenthood, AP/WIBW reports (Hanna, AP/WIBW, 8/18).

Marten on Aug. 1 granted a request from Planned Parenthood of Kansas and Mid-Missouri to temporarily block enforcement of a recently enacted state law that would require Kansas to allocate federal family planning funding to public health departments and hospitals, leaving no money for Planned Parenthood and similar groups.

The ruling orders the state to resume allocation of federal Title X family planning grants to Planned Parenthood clinics as it has for the last 25 years and as promised in the grant application Kansas submitted when requesting a five-year family planning grant (Women's Health Policy Report, 8/10).

Lawyers at the Kansas Attorney General's office have asked that Marten dismiss Gov. Sam Brownback (R) as the defendant, arguing that he is "clothed with absolute legislative immunity" and cannot be sued for actions "taken in the sphere of legitimate legislative activity." The state's lawyers also have requested that Marten dismiss the case all together.

Marten's judicial assistant said the judge would not comment on the pending case.

Meanwhile, Planned Parenthood President and CEO Peter Brownlie said the organization may ask the federal court to force the state to immediately release federal funds for the group's non-abortion services, the AP/Wichita Eagle reports. Brownlie said the organization thinks the state is not complying with the judge's order, noting that none of its clinics has received any state money since Marten's Aug. 1 ruling. "The state's refusal to comply with the court's order is rather remarkable," Brownlie said, adding that the organization is trying to decide next steps (Hanna, AP/Wichita Eagle, 8/18).

Planned Parenthood of Arizona Ends Abortion Services in Three Cities

Fri, 08/19/2011 - 14:03

Planned Parenthood of Arizona on Thursday announced that it is ending abortion services in three cities to comply with recently enacted state laws, the AP/Washington Post reports.

Planned Parenthood of Arizona Ends Abortion Services in Three Cities

August 19, 2011 — Planned Parenthood of Arizona on Thursday announced that it is ending abortion services in three cities to comply with recently enacted state laws, the AP/Washington Post reports. Starting Friday, women will no longer be able to seek abortion services -- including medication abortion -- at Planned Parenthood clinics in Prescott Valley, Flagstaff and Yuma, though they still can visit clinics in the Tuscan and Phoenix area for surgical and medication abortion care (AP/Washington Post, 8/18).

The move comes after the Arizona Court of Appeals allowed parts of a 2009 law restricting abortion access to take effect. A lower court judge had issued a preliminary injunction against provisions that banned anyone except physicians from performing surgical abortions; required a physician to meet in person with the patient at least 24 hours before the procedure; required notarized parental consent for minor; and allowed pharmacists and other medical professionals to refuse to provide abortion or contraceptive services.

The appeals court ruled that requiring a licensed physician to perform abortions does not impose an undue burden on women's constitutional right to abortion. The fact that a law may place some burden on women is not enough for it to be struck down, the court said. Judge Peter Swann, who wrote the unanimous opinion, said it is not legally relevant that nurse practitioners are specifically trained to provide abortion procedures, are available in rural areas without doctors and have a comparable safety record to doctors. In addition, the judges disagreed that a telephone consultation prior to obtaining abortion care is sufficient "informed consent."

The preliminary injunction will remain in place to allow Planned Parenthood of Arizona to decide whether to appeal and for the Arizona Supreme Court to decide whether to review the case (Women's Health Policy Report, 8/12).

PPAZ President Bryan Howard said the state has "really done women a disservice in all parts of the state by imposing rules that have no medical significance and just creating barriers." He added that the organization likely will appeal the ruling to the Arizona Supreme Court.

Dave Cole, solicitor general for the state attorney general's office, said the state would defer decisions about the law to the judge (AP/Washington Post, 8/18).

ACLU, Arizona Coalition Against Domestic Violence File Suit Against Tax Credit Prohibition

In related Arizona news, the American Civil Liberties Union of Arizona and the Arizona Coalition Against Domestic Violence on Thursday filed a lawsuit in an Arizona federal court against a state law that prohibits the use of state income tax credits for charitable donations to PPAZ or other groups that offer or refer for abortion services, the AP/Washington Examiner reports. The organizations have asked the court to declare the law unconstitutional and to prevent it from taking effect in December (AP/Washington Examiner, 8/18).

Under the law, donors to charitable organizations can only get a tax credit for their donation if the charity has provided a statement to the Department of Revenue that they do not provide, fund, promote or provide referrals for abortions, and do not fund any entity that does. The law also forbids the use of any state or federal funds, as well as tuition and fees, to train medical professionals to provide abortion services (Women's Health Policy Report, 4/13).

Claims of Birth Control Causing Weight Gain Not Supported by Research

Fri, 08/19/2011 - 13:36

Concern about weight gain is one of the most common reasons that women stop taking oral contraceptives, according to a study published in the journal Contraception, Slate reports.

Claims of Birth Control Causing Weight Gain Not Supported by Research

August 19, 2011 — Concern about weight gain is one of the most common reasons that women stop taking oral contraceptives, according to a study published in the journal Contraception, Slate reports. Many women who discontinue birth control pills switch to a less effective method or stop using contraception altogether, which can result in unintended pregnancies.

David Grimes, a physician at the University of North Carolina who is the paper's lead author, calls the notion that birth control pills cause weight gain a myth "fueled by rumor, gossip and poor-quality research." There has never been significant evidence that any type of oral contraception currently on the market can provoke weight gain, according to Slate. A recent paper found scant evidence that progestin-only pills could make women gain weight, while a 2008 study found no connection between weight gain and pills with progestin and estrogen. Moreover, a few studies have found that the pill can lead to weight loss.

Nearly all studies identify what researchers call "nonspecific" symptoms -- vague issues like headaches and moodiness -- according to Slate. However, it is difficult to pinpoint how much a particular contraceptive affects weight without conducting a randomly controlled trial that compares women using drugs to women taking a placebo. Only three such studies have been conducted involving birth control pills, and each found no significant differences between women who took the pills and women who received a placebo (Aschwanden, Slate, 8/17).

Cervical-Length Screening During Pregnancy Could Signal Premature Delivery Risk

Fri, 08/19/2011 - 13:33

A growing body of evidence suggests that measuring women's cervical length during pregnancy could identify women who are likely to deliver prematurely and thus should receive treatment with the hormone progesterone, the Philadelphia Inquirer reports.

Cervical-Length Screening During Pregnancy Could Signal Premature Delivery Risk

August 19, 2011 — A growing body of evidence suggests that measuring women's cervical length during pregnancy could identify women who are likely to deliver prematurely and thus should receive treatment with the hormone progesterone, the Philadelphia Inquirer reports.

According to a recent study in the journal Ultrasound in Obstetrics & Gynecology, pregnant women with shortened cervixes who used a daily progesterone gel were 50% less likely to deliver before 28 weeks than women with the condition who did not use the gel. Further, the study found fewer preterm births at nearly all gestational ages, fewer newborns weighing less than 3.3 pounds and fewer cases of respiratory distress in infants born to women treated with progesterone.

Researchers involved in the study are calling on obstetrical groups to update their pregnancy guidelines to include cervical-length screening, which involves a five-minute vaginal ultrasound about halfway through pregnancy. The cervix is about 1.5 inches long in most women, according to the Inquirer. Research by Vincenzo Berghella, director of maternal-fetal medicine at Thomas Jefferson University, and colleagues found that a cervical length of 0.4 inches to 0.8 inches at 19 weeks to 24 weeks of pregnancy was optimal for progesterone therapy. The treatment was not effective in women with cervixes of shorter lengths.

Although cervical shortening is relatively rare -- studies show it affects about 2% of pregnancies -- doctors are eager to identify controllable factors that contribute to preterm birth. The preterm birth rate has been rising for 30 years, and many known risk factors -- including obesity, advanced age, carrying multiples and infertility treatment -- are difficult or impossible to treat.

Cervical-length screening also would be cost-effective. An analysis by Yale University researchers found that if physicians adopted screening and progesterone therapy, 10,000 fewer infants would be born before 34 weeks in the U.S. each year. The potential savings would be $19 million in hospital-care costs per 100,000 women screened, or about $760 million annually.

Berghella contributed to draft guidelines that would make cervical-length screening and progesterone therapy a standard part of obstetric care. The American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine are working on a final version, he said (McCullough, Philadelphia Inquirer, 8/18).

Breastfeeding Lowers Risk That Black Women Develop a Type of Breast Cancer, Study Finds

Thu, 08/18/2011 - 16:51

Childbearing can increase the risk of estrogen or progesterone receptor-negative breast cancer, which is more common in black women than women of other races, but breastfeeding appears to reduce that risk among blacks, according to a study published in the journal Cancer Epidemiology, Biomarkers & Prevention, Los Angeles Times' "Booster Shots" reports.

Breastfeeding Lowers Risk That Black Women Develop a Type of Breast Cancer, Study Finds

August 18, 2011 — Childbearing can increase the risk of estrogen or progesterone receptor-negative breast cancer, which is more common in black women than women of other races, but breastfeeding appears to reduce that risk among blacks, according to a study published in the journal Cancer Epidemiology, Biomarkers & Prevention, Los Angeles Times' "Booster Shots" reports.

Researchers followed about 47,000 black women from 1996 to 2009. Every two years, participants completed a questionnaire to assess a wide range of factors that can affect a woman's risk for breast cancer, including weight, age, pregnancies and birth control use.

The findings indicated that black women who gave birth to more children were more likely to develop estrogen or progesterone receptor-negative cancer than those who had not given birth or who only had one child. Women who breastfed two or more infants had a considerably lower risk of developing the cancer (Healy, "Booster Shots," Los Angeles Times, 8/16).

Advocates Claim Victories in Campaign To Bolster Ill. Sex Trafficking Laws

Thu, 08/18/2011 - 16:50

Illinois Gov. Pat Quinn (D) earlier this month signed legislation (SB 1037) that allows individuals recruited or coerced into sexual exploitation to clear their records of prostitution convictions, the New York Times reports.

Advocates Claim Victories in Campaign To Bolster Ill. Sex Trafficking Laws

August 15, 2011 — Illinois Gov. Pat Quinn (D) earlier this month signed legislation (SB 1037) that allows individuals recruited or coerced into sexual exploitation to clear their records of prostitution convictions, the New York Times reports. The legislation is the latest step in a statewide campaign by law enforcement and local advocacy groups to aid sexual trafficking survivors and impose harsher penalties on pimps, customers and others involved in the trade.

In functioning as one of the nation's main transportation centers, Chicago also has become a "hub of the nation's sex trade," the Times reports. Several studies show that 16,000 to 25,000 women and girls in Chicago are involved in sex trafficking annually, according to the Times.

Lynn Johnson, policy director at the Chicago Alliance Against Sexual Exploitation, said the new law is "an important part of a larger fabric of responses that we are advocating for." Other efforts by the state include the Illinois Predator Accountability Act (SB 0421) of 2006, which created the nation's strongest legislation for helping sex trafficking survivors, according to the Times. The law allows victims to file civil suits for punitive damages against suspected traffickers, people who solicit sex, strip club proprietors and Web site publishers, even if no criminal charges were filed. Successful plaintiffs will receive compensation, and advocates hope the financial penalties will have a chilling effect on the industry.

However, no lawsuits have been filed since the law's creation. Advocates said that survivors face psychological and emotional distress in bringing such suits. They also noted that the law only applies to crimes that occurred after 2006. Daria Mueller, a senior policy analyst at the Chicago Coalition for the Homeless and an author of the law, said the greatest challenge would be "finding those individuals who are ready to do this."

Meanwhile, a new partnership formed in July between the Cook County state's attorney's office, the information services company LexisNexis and the Legal Aid Bureau of Metropolitan Family Services aims to identify and assist victims to bring their cases to trial by January 2012. The lawsuits could serve as a model for other states considering similar legislation (Knight, New York Times, 8/13).

Socioeconomic Status Linked to HIV in Heterosexuals, Study Finds

Thu, 08/18/2011 - 16:48

Heterosexuals with a low socioeconomic status are at a higher risk for HIV infection, according to a study in the Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report, MedPage Today reports.

Socioeconomic Status Linked to HIV in Heterosexuals, Study Finds

August 15, 2011 — Heterosexuals with a low socioeconomic status are at a higher risk for HIV infection, according to a study in the Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report, MedPage Today reports.

The findings are based on the National HIV Behavioral Surveillance System, which surveyed 14,837 people in 2006 and 2007 who lived in 24 urban areas with high HIV/AIDS rates. Participants answered a questionnaire and had an HIV test (Smith, MedPage Today, 8/11). For the new study, researchers excluded data on men who have sex with men and people who reported injecting drugs (Sapatkin, Philadelphia Inquirer, 8/12).

Among individuals included in the study, 2% tested positive for HIV, with rates similar among men and women. The rate found in the study is 10 to 20 times higher than the rate among all U.S. heterosexuals who do not inject drugs, possibly because the participants were from areas with high HIV/AIDS prevalence, researchers said. The study did not find any difference in HIV rates across racial or ethnic groups, a finding that also is at odds with national trends. Nationwide, blacks are eight times more likely than whites to have HIV, while Hispanics are three times more likely than whites to have HIV, according to CDC.

The study found that poverty, lack of education and unemployment were associated with higher rates of HIV. About 2.8% of participants with less than a high school education were HIV-positive, compared with 1.2% of those with more than a high school education. About 2.6% of participants who were unemployed had HIV, compared with 1% of those who were employed. Those with annual incomes of less than $9,999 had an HIV rate of 2.3%, compared with a 1% among those with household incomes between $10,000 and $49,000.

The socioeconomic and racial/ethnic data show that "poverty-related factors might account for some of the racial/ethnic disparities in HIV prevalence observed nationally," according to CDC. The study also found that people with a previous sexually transmitted infection had higher rates of HIV. About 4% of people in the survey with a previous STI diagnosis were HIV-positive, compared with 1.7% who never had an STI (MedPage Today, 8/11).

The report emphasized that HIV was more closely associated with poverty than behavior, including smoking crack cocaine or exchanging sex for money. These behaviors "are probably symptoms of the socioeconomic conditions in these areas rather than independent risk factors," lead author Paul Denning said (Philadelphia Inquirer, 8/12).

New York Times Magazine Examines Ethics Involved in Reducing Twin Pregnancies After Fertility Treatments

Thu, 08/18/2011 - 16:47

A procedure developed in the mid-1980s to reduce the number of fetuses in women who became pregnant with high-order multiples after fertility treatments has "quietly" become an option for women carrying twins, the New York Times Magazine reports.

New York Times Magazine Examines Ethics Involved in Reducing Twin Pregnancies After Fertility Treatments

August 12, 2011 — A procedure developed in the mid-1980s to reduce the number of fetuses in women who became pregnant with high-order multiples after fertility treatments has "quietly" become an option for women carrying twins, the New York Times Magazine reports. The procedure began as a way to protect the health of the woman and remaining fetus by lowering the risks of the pregnancy, but it has shifted "from a medical decision to an ethical dilemma."

The procedure usually is performed around the 12th week of pregnancy and involves a fatal injection of potassium chloride into the fetus' chest. The dead fetus shrivels over time and remains in the womb until delivery. Some physicians consider reducing "unnerving," because the procedure is conducted in conjunction with an ultrasound and can be "visually explicit," according to the Times. However, some physicians who oppose abortion support reduction, claiming that it is better to save some fetuses than risk them all, the Times reports.

No agency tracks how many pregnancy reductions occur in the U.S., but some hospitals say that though the demand remains fairly low, it is beginning to rise. At Mount Sinai Medical Center in New York, 15% of reductions in 1997 were to create a singleton pregnancy, but last year, 61 of the center's 101 reductions resulted in a singleton. Thirty-eight of those pregnancies began as twins.

Beyond medical reasons, factors that drive the decision to reduce a pregnancy include concerns about quality of life for the future infant, as well as emotional, financial or social concerns for parents. The Times compares the decision to reduce to a singleton to the decision to abort a wanted pregnancy after prenatal tests reveal fetal abnormalities. The pregnancies became unwanted when they began to involve complications for the parent and child. In both cases, the "underlying premise" is that women feel "this is not what I want for my life."

Josephine Johnston, a bioethicist at the Hastings Center who focuses on assisted reproduction, said, "In an odd way, having more choices actually places a much greater burden on women, because we become the creators of our circumstance, whereas before we were the recipients of them. I'm not saying we should have less choices; I'm saying choices are not always as liberating and empowering as we hope they will be.

Shifting Guidelines

In 1988, Mark Evans, an ob-gyn who was among the first to reduce a pregnancy, drafted guidelines with an NIH ethicist on pregnancy reductions. They said it was unethical to reduce below twins. Two years later, demand for twin reductions increased and Evans wrote that reducing to singletons "crosses the line between doing a procedure for a medical indication versus one for a social indication." He told his colleagues to resist becoming "technicians to our patients' desires."

During the early 1990s, physicians agreed that reducing quadruplets or quintuplets was beneficial to the health of the woman and remaining fetus or fetuses, although there was some disagreement about whether to reduce to triplets or twins and whether to reduce triplet pregnancies at all. "Going below twins, though, was usually out of the question," the Times reports. In 2004, Evans reversed his guidelines publically, endorsing twin-to-singleton reductions for pregnant women in their 40s and 50s. He noted that more women were having children in their 40s and 50s and that there were acceptable social reasons for not wanting more than one child, such as if they already had children from a previous marriage.

Evans also cited evolving knowledge on the risks of the reduction procedure -- which are now less likely to prompt a miscarriage -- and twin pregnancies -- which are now known to be riskier than previously thought. Evans wrote that "parents who choose to reduce twins to a singleton may have a higher likelihood of taking home a baby than pregnancies remaining with twins," adding, "Ethics evolve with technology" (Padawer, New York Times Magazine, 8/10).

High Levels of Toxic Chemicals Present in Calif. Pregnant Women, Study Finds

Thu, 08/18/2011 - 16:46

Pregnant women in California had the highest levels of flame-retardant chemicals that have ever been recorded in pregnant women, according to a study published in the journal Environmental Science & Technology, the Bay Citizen reports.

High Levels of Toxic Chemicals Present in Calif. Pregnant Women, Study Finds

August 12, 2011 — Pregnant women in California had the highest levels of flame-retardant chemicals that have ever been recorded in pregnant women, according to a study published in the journal Environmental Science & Technology, the Bay Citizen reports. The pilot study involved 25 low-income women from Northern and Central California who were in their second trimester of pregnancy.

The chemicals -- known as polybrominated diphenyl ethers, or PBDEs -- are associated with lower IQs and attention deficit disorders in children (Mieszkowski, Bay Citizen, 8/10). According to FDA, the chemicals can be toxic to the liver, thyroid and nerve development (Hennessy-Fiske, "Greenspace," Los Angeles Times, 8/10).

Many PBDEs have been banned in California since 2004, but before then, they were commonly used in flame retardants to treat polyurethane foam found in furniture and baby products. Because PBDEs were not chemically bound to the foam, the particles could scatter and be inhaled through dust (Bay Citizen, 8/10).

The findings support other research that low-income individuals might have higher exposure to PBDEs. Researchers noted that low-income individuals are more likely to have older or poorly made furniture (Colliver, San Francisco Chronicle, 8/10).

Study co-author Ami Zota of the University of California-San Francisco Program on Reproductive Health and the Environment said exposure to the chemicals "can have long-lasting effects on the way that the fetal brain develops" (Bay Citizen, 8/10).

The American Chemistry Council said the study was "limited" because it looked at only one class of flame retardants that largely are no longer in production. Researchers said they are increasing the number of participants in the pilot study to at least 100 to get a stronger sampling (San Francisco Chronicle, 8/10).

GOP's Silence on HHS Regulations a Lesson for Planned Parenthood, Opinion Piece Says

Thu, 08/18/2011 - 16:42

There are several factors that caused Republicans "to clam up when handed an opportunity to bash Democrats for mandating birth control coverage," Amy Sullivan writes in Time's "Swampland."

GOP's Silence on HHS Regulations a Lesson for Planned Parenthood, Opinion Piece Says

August 16, 2011 — There are several factors that caused Republicans "to clam up when handed an opportunity to bash Democrats for mandating birth control coverage," Amy Sullivan writes in Time's "Swampland." The mandate, which HHS announced earlier this month, is part of a provision of the federal health reform law (PL 111-148) that requires health plans to cover certain preventive health care services without copayments and other patient fees. Catholic groups quickly decried the regulations, even though the rules included an exemption allowing certain religious groups to not offer the coverage, Sullivan notes. "And yet what was the response from congressional Republicans? Silence," she says.

One reason for the GOP's response is that "birth control itself is extremely popular," with CDC data showing that 99% of women who are sexually active have used contraception, according to Sullivan. Moreover, an NPR/Thomson Reuters poll found that 77% of U.S. residents believe private insurers should cover all or some of the cost of oral contraceptives and 74% believe the cost should be covered for women with publicly supported health plans.

"Another factor that could be driving Republicans to keep quiet about the new mandate is the fact that the religious exemption may turn out to be broader than expected," Sullivan writes. She notes that "HHS took the unusual step of calling for public comment on other religious exemptions, suggesting that it is willing to consider broader definitions," such as one that would include Catholic hospitals, which are not covered in the proposed exemption.

Differences From Family Planning Battle

Republican reaction to the HHS regulations stands "in stark contrast to the battle over birth control funding that nearly scuttled budget negotiations in April," Sullivan continues. The NPR/Thomson Reuters poll found that 75% of U.S. residents support federal funding for family planning clinics. Sullivan asks, "If there is virtually no difference in public support for the new birth control coverage mandate and support for federal funding of clinics that provide birth control, why has the former provoked little outcry while the latter almost resulted in a government shutdown? And why is there a roiling movement at the state level to defund family planning clinics, with five states so far this year eliminating funding for Planned Parenthood's contraception services?"

She continues, "The answer is that Republicans have been able to conflate birth control with abortion when they focus on Planned Parenthood, which has the distinction of being the nation's single largest abortion provider, even though abortions represent just a small percentage of Planned Parenthood's services."

Sullivan writes, "There's a lesson here for Planned Parenthood advocates. In an effort to alter their public image as simply as abortion provider, Planned Parenthood has emphasized the other medical services they provide ... and argued that they are the main health provider for many of their clients." However, she writes, "the attempt to come off as just another health clinic is just a little too slippery," as well as "unnecessary." She concludes, "The organization's message can and should be much simpler: birth control, birth control, birth control. That's the debate Republicans don't want to have" (Sullivan, "Swampland," Time, 8/12).

Blogs Comment on Michele Bachmann, Sex Education, IUDs

Thu, 08/18/2011 - 16:41

Blogs provide an interesting perspective on reproductive health and rights. Read a few of our picks this week from NARAL, RH Reality Check, Huffington Post, Salon and Our Bodies Ourselves.

Blogs Comment on Michele Bachmann, Sex Education, IUDs

August 16, 2011 — The following summarizes selected women's health-related blog entries.

~ "Was Asking Bachmann About 'Submission' a Sexist Question?" Jodi Jacobson, RH Reality Check: While some political observers have suggested that it was sexist for a reporter to ask Republican presidential candidate Rep. Michele Bachmann (Minn.) whether she "submits to her husband," RH Reality Check editor-in-chief Jacobson disagrees, adding that she does not believe that "historically, the roles played by a spouse have been irrelevant among male politicians." Jacobson notes that the "question arose out of Bachmann's own declaration that she has been guided to make decisions about and throughout her career by her God as commanded by her husband." Jacobson continues, "I don't care if we are talking about a woman or a man: I want to know what [the candidates'] beliefs are and what their politics mean for this country, me, my family." She concludes, "It is totally fair game to force her hand on this and other issues of ideology, and in fact, I hope that hard questions about these issues are put to all of the candidates who make religious belief a central aspect of their campaigns" (Jacobson, RH Reality Check, 8/12).

~ "Sex Education Tips," Kerry Cohen, Huffington Post blogs: Cohen, an author, "applaud[s]" New York City's new requirement to teach sex education in public schools, calling the policy "the right thing based on all the statistics (and plain old common sense)." She writes a number of suggestions for the teachers of the program and what materials should be covered. "For one, we can encourage girls to learn to trust their bodies and what their bodies tell them," she suggests. She also suggests discussing "outercourse," which "allows a teenager to explore and test intimacy, which is essential for building the self-confidence girls need to be both powerful and self-protected in the world of relationships." Educators also should discuss masturbation, sexual desire and emotions and acknowledge that they can be healthy parts of the sexual experience, Cohen writes (Cohen, Huffington Post blogs, 8/15).

~ "The Lowdown on No-Cost Birth Control," Thomas, NARAL Pro-Choice America's "Blog for Choice": Thomas writes, "We're all super excited that, starting next year, newly issued insurance plans will cover the full range of FDA-approved contraception without a copay," mostly because 98% of "American women use birth control at some point in their lives, and the new no-cost birth control regulation is a big win for women's health." Thomas answers many questions about the new policy, explaining, "'No-cost birth control' means that women can get their prescriptions for birth control without a copay. Under the health care law, the cost of contraception will be included as part of your premium -- meaning no more out-of-pocket payments." He continues that the regulation will improve access to contraception in many ways, including by "[a]llowing women to plan and space their pregnancies," which "contributes to healthy childbearing" and leads to fewer unintended pregnancies and abortion. "A woman who can plan when to have a family is able to participate in society more fully," he writes, adding, "No-cost birth control is especially important for women who cannot afford prescription contraception or a deductible" (Thomas, "Blog for Choice," NARAL, 8/15).

~ "Revisiting the IUD for Contraception -- Pros and Cons for Women," Rachel Walden, Our Bodies Our Blog: "Newer, safer IUDs are now on the market, and the contraceptive method is apparently being used more and more, reportedly rising from 2.4% in 2002 to 5.6% by 2008," Walden writes. A recent WBUR "Common Health" blog post "suggests that one reason for the rise may be the convenience of the IUD as a long-acting birth control method that has less chance of user error (compared to birth control pills that you might forget to take, for example)," she writes. Walden quotes an interview with OBOS' Judy Norsigian and includes a link to a fact sheet about the IUD that highlights the pros and cons (Walden, Our Bodies Our Blog, 8/12).

~ "The Sex Ed Hall of Shame," Tracy Clark-Flory, Salon: In reaction to news that New York City has begun requiring sex education in public schools, Clark-Flory notes that "there are still 24 states that haven't mandated sex education, including New York state." According to Clark-Flory, the "worst of them ... not only fail to mandate sex ed but require that when it is taught, abstinence and the 'importance of sex only within marriage' are stressed" and "make sure to defend 'traditional' values, but they don't protect scientific ones." These eight states include Alabama, Arkansas, Florida, Indiana, Louisiana, Missouri, Texas and Virginia, Clark-Flory writes. However, the "good news is that there are 20 states, along with the District of Columbia, that currently mandate sex education" -- a "very basic achievement," considering the number of "requirements and restrictions that are made on curricula across the country." She concludes, "And we wonder why the U.S. has the highest teen birth rate in the developed world" (Clark-Flory, Salon, 8/13).

Reps. Bachmann, Paul Play Up Social Conservatism in Iowa

Thu, 08/18/2011 - 16:40

GOP presidential candidate Rep. Michele Bachmann (Minn.) on Saturday won the Iowa straw poll after emphasizing her Christian faith and social conservative values on issues like abortion rights and same-sex marriage, the AP/Washington Post reports.

Reps. Bachmann, Paul Play Up Social Conservatism in Iowa

August 15, 2011 — GOP presidential candidate Rep. Michele Bachmann (Minn.) on Saturday won the Iowa straw poll after emphasizing her Christian faith and social conservative values on issues like abortion rights and same-sex marriage, the AP/Washington Post reports.

"In Iowa, we are social conservatives and we will never be ashamed of being social conservatives," Bachmann said. According to the AP/Post, Bachmann has hoped that a strong finish in Iowa will give her momentum in battling Texas Gov. Rick Perry for the support of tea party and evangelical voters. Perry, who was not listed on the straw poll ballot, announced his candidacy on Saturday (AP/Washington Post, 8/14).

Bachmann said her campaign will focus on her opposition to abortion rights and same-sex marriage. She also touted her Iowa roots and said her Christianity will be the cornerstone of her campaign (AP/Washington Post, 8/13).

Meanwhile, Texas Rep. Ron Paul, who came in a close second in the straw poll, also highlighted his opposition to abortion (AP/Washington Post, 8/14).

The libertarian-leaning candidate, who is an obstetrician, has long opposed abortion rights but is mainly known for his calls for smaller government, Politico reports. On Saturday, Paul said that while his campaign is "identified with the cause of liberty, ... [t]here is something that precedes liberty, and that is life." He added, "The prime reason that government exists in a free society is to protect liberty, but also to protect life. And I mean all life."

He described himself as "very strong right to life" and claimed that in the 1950s, when he was training as a physician, that "everyone was pro-life and abortions weren't to be done." He also said, "We cannot play God and make those decisions. All life is precious," adding, "You have to understand where that liberty and that life comes from. It does not come from the government. It comes from our creators" (Burns, Politico, 8/13).

Bachmann received about 29% of the 17,000 votes in the straw poll, and Paul earned 28% of the votes (Zeleny, New York Times, 8/13). Although the poll is the first indication of what Iowans think of the Republican presidential candidates, it is "hardly predictive" of who will win the party nomination, according to the AP/Post (AP/Washington Post, 8/14).

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