As many of our readers will already know, the National Institutes of Health held a consensus development conference last week on vaginal birth after cesarean in the U.S., featuring panelists who spoke about VBAC trends, medical evidence, risks and benefits to women and babies, non-medical factors influencing VBAC availability (such as fear of legal liability), and related topics.

Materials from the conference are available at http://consensus.nih.gov/2010/vbac.htm, including the draft panel statement, archived webcasts from each day of the conference, the previously completed evidence report on VBAC, and call-in access to the archive of a telebriefing that followed the event wrap-up (a transcript will be available soon).

One important topic included perceptions of the risk of trial of labor; a speaker who reviewed factors associated with uterine rupture and other adverse outcomes stated that “there is a major misperception that trial of labor is extremely risky,” calling the risks to women comparable to other common medical procedures. Amy Romano provides additional commentary on uterine rupture risk at Science & Sensibility, noting that “we heard a rather consistent message that uterine rupture itself is not the issue.”

There was an excellent audience question following the presentation about whether, if successful VBAC carries the lowest morbidity, it is ethical for providers to refuse to allow a trial a labor. One panelist’s response was, “I think that’s the point of the conference.” Audience discussion sections for day one start at about 1:41, 3:01, 4:03, 5:55, and 7:19 [hour:minute].

Day one also featured another presenter, Dr. George Macones, who challenged ACOG’s “immediately available” physician and anesthesiologist standard for offering VBAC. This requirement has effectively led to the restriction of VBAC around the U.S.; Dr. Macones called it “overkill,” and argued that “the risk of rupture is comparable to other bad things that happen in labor that lead to an emergency cesarean section.”

As examples, he noted that prenatal diagnosis for Down Syndrome via chorionic villus sampling is routinely offered to all pregnant women and carries a 1% pregnancy loss rate, and external cephalic version requires immediate c-section about 1-3% of the time, making the risks from VBAC not that different from other things that are done “all the time” in obstetrics.

Day three generated perhaps the most heated discussion, in which a panelist stated that it is not a settled matter that women have a right to refuse a cesarean, reminding us of the need to continue to advocate for choices and rights for childbearing women. The relevant audience question comes up at 1:47:20 and comes from Shannon Mitchell of BirthAction. She raises the concern that there is nothing in the draft document that says that women have the right of refusal of a cesarean, an issue of concern given reports of court-ordered cesareans. The moderator refers the question to a medical ethicist, who responds:

That’s a very large topic in obstetric ethics there’s not a settled answer to it. There’s actually — contrary to what you heard yesterday — some serious disagreement in the obstetric ethics literature, but in any case I think it’s beyond the charge of this panel to take that question up.

Courtroom Mama provides further discussion of this issue at The Unnecesarean, including additional commentary from the telebriefing.

Despite this comment on women’s right to refuse a repeat cesarean, I hope that the conference will lead providers and institutions with codified or de facto VBAC bans to reconsider their policies and attitudes. I’m encouraged by this statement from the conclusions of the draft panel statement:

We are concerned about the barriers that women face in accessing clinicians and facilities that are able and willing to offer TOL [trial of labor]. Given the level of evidence for the requirement for “immediately available” surgical and anesthesia personnel in current guidelines, we recommend that the American College of Obstetricians and Gynecologists and the American Society of Anesthesiologists reassess this requirement relative to other obstetrical complications of comparable risk, risk stratification, and in light of limited physician and nursing resources. Healthcare organizations, physicians, and other clinicians should consider making public their TOL policy and VBAC rates, as well as their plans for responding to obstetric emergencies. We recommend that hospitals, maternity care providers, healthcare and professional liability insurers, consumers, and policymakers collaborate on the development of integrated services that could mitigate or even eliminate current barriers to TOL.

On How a Bill Becomes a Law: The bill that will likely become the reconciliation bill on healthcare has been posted (PDF). Ezra Klein explains what it means.

Democratic leaders say a bill will pass this week.  House Minority Leader John A. Boehner (R-Ohio) pledges obstruction, saying Republicans will do “everything we can to make it difficult for them, if not impossible, to pass the bill.”

Jen Nedeau covers the multiple threats to women’s health and reproductive rights that must be addressed, including the House anti-abortion language. You know it as the Stupak/Pitts admendment. But Richard Doerflinger, the U.S. Conference of Catholic Bishops’ point man on abortion, should have had his name in there, too. Meanwhile, Jessica Arons tries to see the world through the lens of Rep. Bart Stupak (D-Mich.).

In an editorial in Monday’s paper, The New York Times urges anti-abortion Democrats to accept the Senate’s restrictive provisions, the lesser of two evils.

Too Many Tests, Too Much Treatment: “A spate of recent reports suggests that many Americans are being overtreated. Maybe even President Barack Obama, champion of an overhaul and cost-cutting of the health care system,” reports Lindsey Tanner of the Associated Press.

“More care is not necessarily better care,” wrote cardiologist Dr. Rita Redberg, editor of Archives of Internal Medicine, commenting on Obama’srecent physical, which included prostate cancer screening and a virtual colonoscopy. The PSA isn’t recommended at any age and a colonoscopyisn’t recommended under age 50.

Over-testing may be due to a combination of what is known as “defensive medicine” — doctors ordering tests and procedures because they’re trying  protect themselves against lawsuits (or because they’ll be compensated by a fee-for-service system) — and patients insisting on tests and treatments that they’ve heard about or know is commonly prescribed. But the thinking around more care = better care may be shifting.

“This week alone,” writes Tanner, “a New England Journal of Medicine study suggested that too many patients are getting angiograms – invasive imaging tests for heart disease — who don’t really need them; and specialists convened by the National Institutes of Health said doctors are too often demanding repeat cesarean deliveries for pregnant women after a first C-section.”

Stopping the Campus Rape Crisis: Jaclyn Friedman, executive editor of Women, Action and the Media and co-editor of “Yes Means Yes,” wrote a must-read op-ed in the Washington Post on ending the silence around sexual assault on college campuses.

First, colleges can eliminate the “miscommunication” excuse that many rapists use by creating an on-campus standard that requires any party to a sexual interaction to make sure their partner is actively enthusiastic about what’s happening — not just not objecting. They can create judicial boards equipped to seriously investigate rape accusations, instead of throwing their hands up at the first sign that the accused’s testimony contradicts the accuser’s. They can defend the safety of the entire campus by permanently expelling those found guilty of sexual assault. And they can be transparent about every step of the process.

Plus: The Center for Public Integrity recently released “Sexual Assault on Campus: A Frustrating Search for Justice,” an in-depth report filled with useful data, articles and resources.

Recognition for Midwives: Granny midwife Margaret Charles Smith was inducted into the Alabama Women’s Hall of Fame at Judson College this month. Smith attended nearly 3,000 births between 1949, when she received her midwife permit, and 1981, when she attended her last birth. Her life story is told in a book Smith co-wrote with Linda Janet Holmes, “Listen to Me Good: The Life Story of an Alabama Midwife.”

Plus: Rachel previously noted that the National Library of Medicine is featuring an exhibition on African American midwives. ”Nothing To Work With But Cleanliness: African American ‘Grannies,’ Midwives & Health Reform” tells the story of “granny” midwives and the state and local training programs that educated them and succeeding generations of midwives. View a wonderful set of photos from the exhibition on Flickr.

Utah’s Controversial Law Charges Women and Girls With Murder for Miscarriages: Writing at AlterNet, Rose Aguilar breaks down the problems with Utah’s new law that makes it a criminal offense for having miscarriages caused by “intentional or knowing” acts.

“What happens to women who are in abusive relationships?” asks Planned Parenthood’s Melissa Bird. “What happens if a woman threatens to leave the abuser, falls down the stairs and loses the baby? What if the abuser beats the woman and causes a miscarriage? Could he turn her in? Who would the prosecutor believe? What happens if a drug addict who’s trying to get clean loses her baby? Will she be brought up on murder charges?”

Some critics point out the legislators erred in not considering the lack of access that young people have to comprehensive sex education, and the overall lack of contraception and health services, especially in remote parts of the state.

The Girls Who Kicked in Rock’s Door: Not exactly health related (unless you’re like me and consider loud music essential for well-being), but I am completely intrigued by the “The Runaways,” the new film about the 1970s all-girl rock band, starring Dakota Fanning and Kristen Stewart. Sia Michel writes about the story behind the film and its director, Floria Sigismondi.

Amanda Lenhart, senior research specialist at Pew Research Center’s Internet & American Life Project, has posted her presentation on social media and young adults that was delivered this week at the National STD Prevention Conference in Atlanta. The slideshow covers the latest data on electronic and digital communciation, including cell phone usage and sexting.

Presenting with Lenhart was Kicesie Drew, who provides sex ed information via YouTube; Sally Swanson from the Adolescent Pregnancy Prevention Campaign of North Carolina, a group that usess texting to answer questions about sexual health; and Cornelis Rietmeijer, director of the Sexually Transmitted Disease Control Program/Denver Public Health.

More health professionals are turning to innovative techniques and technologies to reach young and at-risk populations. I recently took part in a symposium, sponsored by Chicago Department of Public Health and the National LGBT Tobacco Control Network, on how public health workers can use social media to reach the LGBT community. We looked at some of the promises and obstacles that new communciation tools present. One of the most important lessons: Know how your audience uses technology, and go where they go.

I was honored to be on a panel with Lovette Ajayi, a superstar at Community Media Workshop and co-founder of the Red Pump Project, which raises awareness about the impact of HIV/AIDS on women and girls. And that brings me to the second point of this post: March 10 was National Women and Girls HIV/AIDS Awareness Day.

The Red Pump Project presents statistics about HIV/AIDS  and women — and the great disparities. Though black and Latina women represent 24 percent of all U.S. women combined, they account for 82 percent of the estimated total of AIDS diagnoses for women in 2005.  Consider that HIV is the:

* Leading cause of death for black women (including African American women) aged 25–34 years.
* 3rd leading cause of death for black women aged 35–44 years.
* 4th leading cause of death for black women aged 45–54 years.
* 4th leading cause of death for Latina women aged 35–44 years.
* The only diseases causing more deaths of women are cancer and heart disease.
* The rate of AIDS diagnosis for black women was approximately 23 times the rate for white women and 4 times the rate for Latina women.

These numbers illustrate the need for massive improvements in education, prevention and treatment — all topics the National STD Prevention Conference aims to address. High-priority issues are identified for each biennial conference, and this year’s top three issues couldn’t be more  relevant or directly worded.

The last point is a great reminder of how change is both incredibly simple and complex: “It is essential to find ways to move beyond our longstanding societal reticence to openly discuss sexual health issues and to normalize conversations around STD prevention.”

Plus: In related news, Washington, D.C. will make 500,000 female condoms available — for free. The condoms will be available in beauty salons, convenience stores and high schools in parts of the city with high HIV rates, reports the Washington Post. The project is funded through a $500,000 grant from the MAC AIDS Fund, a subsidiary of MAC Cosmetics.

Heather Corinna, founder and editor of Scarleteen and author of S.E.X.: The All-You-Need-to-Know-Progressive Sexuality Guide to Get You Through High School and College, is doing a large study on multigenerational experiences with and attitudes about casual sex. The data will ideally be used for publication, but answers are completely anonymous and will only be used anonymously.

In contrast to a lot of the hype and stereotypes about “hooking up,” Corinna is looking for what’s real, both in sexual attitudes and experiences among a diverse array of ages, genders and sexual identities, races and sexual ideologies/constructions. The only requirements for participating in this study are being over the age of 16, and having had some kind of sexual partnership before, even if none has been casual. The study takes around twenty minutes.

Corinna would like the study to show as diverse an array of people as possible, especially since so often media representations or cultural conversations about casual sex are usually only about heterosexual white women or about gay men. She particularly wants to be sure LGBT people, people of color, those over 45 and social conservatives are adequately represented, so please share this link with your networks after you take the survey yourself, especially if your networks include people in any or all of those groups.

To take the survey, visit http://www.surveymonkey.com/s/S97WR6H.

Beginning today and continuing through March 10, the National Institutes of Health is hosting a “consensus development conference” on the topic of vaginal birth after cesarean section.

A free live webcast (with captioning) of the conference is being made available for those who can’t attend the Bethesda, MD event. (You may need to download an appropriate media player to watch it.)

Various experts are discussing the medical evidence on VBAC (audience discussion has been lively already!), including the following key questions:

• What are the rates and patterns of utilization of trial of labor after prior cesarean, vaginal birth after cesarean, and repeat cesarean delivery in the United States?
• Among women who attempt a trial of labor after prior cesarean, what is the vaginal delivery rate and the factors that influence it?
• What are the short- and long-term benefits and harms to the mother of attempting trial of labor after prior cesarean versus elective repeat cesarean delivery, and what factors influence benefits and harms?
• What are the short- and long-term benefits and harms to the baby of maternal attempt at trial of labor after prior cesarean versus elective repeat cesarean delivery, and what factors influence benefits and harms?
• What are the nonmedical factors that influence the patterns and utilization of trial of labor after prior cesarean?
• What are the critical gaps in the evidence for decision-making, and what are the priority investigations needed to address these gaps?

They are also expected to discuss a systematic literature review on the topic prepared under contract with the Agency for Healthcare Research and Quality (AHRQ) which will be completed and released this year and will address these same key questions. The previous AHRQ review on the topic was completed in 2003, and identified significant gaps in the literature and the problems those gaps pose for informed decision-making. A full agenda with listed presenters and sponsors is available online.

Following the conference, a panel will prepare a consensus statement addressing the key questions; you can sign up to be notified when the draft and final statements are available online and/or to receive a mailed copy of the final statement.

The Feminist Breeder is planning to have coverage of the conference on her blog and radio show, and the International Cesarean Awareness Network is planning a blog carnival on the topic of why VBAC is a viable option [hat tip to Jill at The Unnecesarean]. The hashtag #nihvbac is being used for discussion on Twitter.

The full conference will be archived at the NIH website, so if you can’t watch this week, you can view the proceedings later.

Our own Judy Norsigian will be a guest on Internet talk radio show “Saturday Mornings with Joy Keys” this Saturday, March 6 from 11:00-11:30 a.m. EST.

Visit www.blogtalkradio.com/joykeys to listen to the show online, and call (646) 929-0368 to ask questions. You can also go to the site now to sign up to receive a reminder via email or text message.

According to reports, the Mississippi bill that would make non-nurse midwives illegal in the state is dead after “a barrage of calls and e-mails on lawmakers, urging them to kill the bill” from advocates for midwifery and home birth.

We mentioned the bill in a post last week, after it passed the House and was referred to the state Senate’s Public Health and Welfare committee. Committee chair Hob Bryan has now indicated that he will not bring the bill up for a vote, saying that “This is something there’s a good bit of concern about. Several people in the committee said they had gotten calls to oppose it.”

The Big Push for Midwives, mentioned in the story, led the campaign to mobilize against this bill and issued action alerts last week encouraging midwifery supporters  to contact their State Senators regarding the bill. Campaign manager Katherine Prown explained that their opposition was not opposition to regulation of midwifery, but to the limitation of midwifery practice solely to CNMs (who typically do not provide home birth support).

“At least 26 states have laws authorizing CPMs and there’s an effort under way to get more states to license them so the practice of out-of-hospital midwifery is regulated nationwide,” Prown said. Without those laws “you end up with this buyer beware kind of climate and anyone can claim to be a midwife,” said Prown.

The Big Push campaign works to expand access to Certified Professional Midwives and out-of-hospital maternity care, including work to regulate and license CPMs in all 50 states.

A bill has passed in the Mississippi House that could effectively make  midwives who are not also trained as nurses illegal in the state. The bill states that “the practice of midwifery shall only be conducted by Certified Nurse Midwives; to provide that any person who is not a Certified Nurse Midwife who engages in the practice of midwifery shall be subject to criminal penalties and injunctive relief.”

The bill would make it illegal for Certified Professional Midwives — midwives who who are specially trained to deliver babies in out-of-hospital settings– to practice.

Right now, the Midwives Alliance of North America (MANA) categorizes the current situation in Mississippi for non-nurse midwives as “Legal by Judicial Interpretation or Statutory Inference” – in other words, interpreted to be legal but not explicitly provided for in the current law.

The organization provides some documentation from the previous MS Attorney General who concluded in 1991 that, “By its express terms, the practice of medicine as defined in Miss. Code Ann. Section 73-25-33 specifically excludes the practice of midwifery. Thus, it is the opinion of this office that those persons otherwise not licensed as nurses may engage in the practice of midwifery without licensure as a physician and for compensation.”

The current bill, which would add language to explicitly make non-CNM midwives illegal, passed the state House on February 9th and has been referred to Public Health and Welfare committee in the state Senate, whose members bill opponents are contacting. That committee consists of: Hob Bryan, Chairman; Alan Nunnelee, Vice-Chairman; Terry C. Burton; Eugene S. Clarke;Bob M. Dearing; Joey Fillingane; Hillman Terome Frazier; Billy Hewes; W. Briggs Hopson III; John Horhn; Cindy Hyde-Smith; Gary Jackson; Kenneth Wayne Jones; Tom King; Chris McDaniel; Nolan Mettetal; Willie Simmons; Bennie L. Turner; Lee Yancey. Contact information for each Senator is linked from this Senate roster.

MANA is encouraging supporters of Certified Professional Midwives who live in Mississippi to contact their state Senators. Tell them that you do NOT support making Certified Professional Midwives illegal, and ask them to vote NO on HB 695.

In other birth-related legislative news, the American Association of Birth Centers is asking supporters to contact their Senators and Representatives to support the Medicaid Birth Center Reimbursement Act (H.R. 2358 / S. 1423). For further information, see our previous post and information provided by AABC.

We have reached The Summit.

Thursday’s bipartisan meeting at the White House (which you can follow live) promises to kick-start what may be the final descent toward healthcare reform. An overview:

Does healthcare reform have a chance? Is bipartisanship a real possibility? David Leonhardt of The New York Times provides some provisional answers.

Igor Volsky over at the Wonk Room brings us up to speed by providing a nice, clear comparison of the House bill, the Senate bill and President Obama’s new proposal.

As far as questions women should be asking about their stake and status in the debate, Lisa Codispoti and Brigette Courtot at the National Women’s Law Center remind us of the “8 Questions” they have been asking all along — and how Obama’s proposal addresses (or fails to address) the issues.

Writing at Raising Women’s Voices, Amy Allina identifies ways in which Obama’s proposal builds on the Senate bill but also notes that it  “does not include the changes that Raising Women’s Voices has been urging Congress to make to the restrictive abortion provisions in [the Senate] bill” — namely by eliminating the requirement that policyholders make two separate monthly payments if they want a policy that includes abortion coverage.

It’s also worth taking a look at The National Partnership for Women and Families’ “The Top Ten Best Kept Secrets About Health Insurance Reform and Why Congress Should Pass It Without Delay” [pdf].

Finally, this is politics, and political agendas and expediency can often trump what’s right. Brian Beutler and Christina Bellantoni at Talking Points Memo dissect each party’s strategies, and Ezra Klein at the Washington Post provides a viewer’s guide.

All of this may come down to an arcane Senate procedure known as reconciliation. David M. Herszenhorn at The New York Times offers a primer.

When you feel yourself getting tired of all the red tape, get a pep talk from Ellen Schaffer and Joe Brenner at EQUAL/Center for Policy Analysis, whose PowerPoint — “The Truth About Health Reform: It’s Up to Us” — helps to put priorities in order.

The American College of Nurse-Midwives has posted a new position statement on nitrous oxide for labor analgesia [PDF], stating:

“It is the position of the American College of Nurse‐Midwives that women should have access to a variety of measures to assist them in coping with the challenges of labor.”

The ACNM notes that a blend of inhaled nitrous oxide and oxygen is used for pain relief in labor in many other countries, but it not typically available in the United States, where epidural anesthesia and systemic opioids are more common.

Potential benefits of nitrous oxide are outlined in the document, including the ability for a woman to self-administer via face mask, the ability to quickly administer or discontinue the gas, and the lack of known adverse effects on the woman, fetus, or progress of labor.

Concerns about potential adverse effects, especially from occupational exposure to the gas for health workers, are also detailed and addressed in the document.

ACNM concludes:

While nitrous oxide is not without side effects and will not be agreeable to or effective for every laboring woman, it is an inexpensive, simple, reasonably safe and effective analgesic. It is important that midwives know about nitrous oxide analgesia and be able to offer it to women during labor.

See our previous related posts and companion content on the topic for more information and discussion, as well as this archived chat with the author of “Birth Day: A Pediatrician Explores the Science, the History, and the Wonder of Childbirth.”

Publicado por Christine / del orginial en inglés Sept 15, 2009:

OBOS is committed to expanding our audience and in this spirit we’ve asked former board member Moises Russo to translate into Spanish several of our blog entries. We hope to translate more entries in the coming year.

En OBOS estamos comprometidos a expandir nuestra audiencia de lector@s  y en este espíritu le hemos solicitado a Moisés Russo, ex-miembro de la Junta de OBOS, que traduzca al español varios de los blogs que tenemos en la página electrónica. Esperamos continuar con dichas traducciones durante este año.

Una segunda vacuna diseñada para proteger contra el cáncer cervicouterino estará disponible pronto en Estados Unidos.

La semana pasada, un panel de la de Food and Drug Administración (FDA) dio su aprobación a la vacuna Cervarix de GlaxoSmithKline PLC*, esencialmente recomendando que la FDA apruebe la vacuna para el uso en mujeres de 10 a 25 años de edad. La recomendación no es obligatoria; la FDA puede rechazar la decisión, pero ésta generalmente acepta la opinión de paneles externos de expertos.

La vacuna protege contra dos tipos de virus papiloma humano (VPH), asociados al 70% de los cánceres cervicouterinos.

Escribiendo en el Wall Street Journal, Jennifer Corbett Dooren resumió las preocupaciones con respecto a la seguridad que la FDA levantó acerca de Cervarix, incluyendo “una mayor tasa de abortos entre las mujeres que recibieron Cervarix”. La FDA refirió además “no se puede excluir un ‘pequeño efecto’ sobre los embarazos”. (La vacuna no está aprobada para su uso en mujeres embarazadas).

GlaxoSmithKline intentó por primera vez conseguir la aprobación el año 2007, pero la FDA solicitó más información luego de que algunos reportes sugirieron una tasa más alta de abortos en mujeres embarazadas. Dooren escribe:

La agencia dijo que se requeriría de un estudio de seguridad post- marketing para monitorizar los resultados de embarazos en mujeres que pudiesen recibir Cervarix, junto con otras potenciales preocupaciones sobre su seguridad incluyendo el desarrollo de enfermedades autoinmunes como Artritis Reumatoide y Esclerosis Múltiple. En su revisión del año 2007 de Cervarix, la FDA indicó que tenía preocupaciones sobre un “desequilibrio” en posibles desordenes autoinmunes visto en algunos estudios clínicos. Sin embargo, la agencia ha dicho que revisiones adicionales de los datos realizadas por sus propios equipos y por un reumatólogo externo concluyeron que las diferencias no eran estadísticamente significativas.

Oficiales de Glaxo dijeron que estaban planeando un estudio de post-marketing que enrolaría a 100.000 mujeres en los EEUU, el cual incluiría un registro de embarazos. La compañía también se encuentra realizando otro estudio de post-marketing de grandes proporciones en Finlandia.

Gardasil, la popular vacuna contra el VPH fabricada por Merck y & CO. Fue aprobada por la FDA el 2006. Uno de los principales investigadores para la vacuna recientemente ha comenzado a denunciar preocupaciones con respecto a sus riesgos, beneficios y agresivas estrategias de marketing – principalmente que la protección puede no durar más allá de los 5 años, por lo que las niñas que sean vacunadas a una edad temprana pudiesen en el futuro aún encontrarse en riesgo.

El mes pasado, Rachel apuntó a una editorial del Journal de la Asociación Médica Americana sobre los riesgos y beneficios de la vacunación contra el VPH y analizó un comentario en la misma edición de JAMA (sólo resumen) sobre el marketing de Gardasil. Describiendo los hallazgos de los autores, Rachel escribió: “ La táctica de la compañía fue fomentar que todas las mujeres dentro de un cierto grupo de edad se vacunaran como una medida para evitar el cáncer, en vez de trabajar con oficiales de la salud pública para enfocarse en aquellas niñas que tienen un riesgo más elevado”.

Los Centros para el Control y Prevención de las Enfermedades (CDC por sus siglas en inglés) recomienda la vacuna para niñas de 11 y 12 años, y niñas y mujeres entre las edades de 13 y 26 años que aún no hayan sido vacunadas. Esa recomendación sin embargo se convierte en un mandato para las mujeres inmigrantes entre 11 y 26 años que buscan la ciudadanía Estadounidense. Gardasil fue agregada a la lista de vacunas requeridas el año 2008.

Simona Davis, una niña de 17 años en Florida que nació en el Reino Unido está buscando la ciudadanía Estadounidense pero se rehúsa a vacunarse. El noticiario ABC News tiene un reportaje completo sobre su rechazo a la vacuna. Davis, que es una cristiana devota que dice no tener intención de iniciar relaciones sexuales en el futuro cercano (menciona su promesa de virginidad como una prueba), está buscando una exención por razones morales y religiosas. Los Servicios de Ciudadanía e Inmigración de los EEUU han rechazado su solicitud.

“La decisión de incluir el VPH como una vacuna requerida fue hecha por el CDC”, ha dicho la vocera de los Servicios de Ciudadanía e Inmigración de los EEUU Chris Rhatigan a ABC News. “Nosotros seguimos la ley….La objeción a una exención debiese ser a todas las vacunas, no solamente a Gardasil”.

Un vocero del CDC ha dicho que se espera que el CDC publique nuevos criterios dentro de aproximadamente un mes para determinar que vacunas debiesen ser recomendadas a inmigrantes a los EEUU.

If you’re in New York this evening, you may want to head over to the Housing Works Bookstore Café (126 Crosby St.) at 7 p.m. for a free panel discussion on “marketing embarrassing products to women.”

While that might not sound like the most appealing way to spend a Monday night, consider these three reasons to attend

Panelist #1: Sarah Haskins created, wrote and performed in the “Target Women” series on Current TV, where she spoofed advertiser’s and marketer’s ridiculous ways of selling women products, entertainment and ideas. She now writes screenplays. Funny ones.

Panelist #2: Susan Kim is a playwright, TV writer and author. She co-wrote “Flow: the Cultural Story of Menstruation” with Elissa Stein, and she has two graphic novels, “City of Spies” and “Brain Camp” (co-written with Laurence Klavan) due out from First Second Books this year. Her plays include the stage adaptation of Amy Tan’s “The Joy Luck Club” and numerous one-acts.

Panelist #3: Allison Silverman launched “The Colbert Report” as co-head writer and later helmed the show as executive producer. She was awarded a Peabody, an Emmy for Outstanding Writing, a Writers Guild Award and three Producers Guild Awards. Her previous writing credits include “Late Night with Conan O’Brien” and “The Daily Show with Jon Stewart,” for which she won a Peabody and an Emmy. Silverman was recently a recipient of New York Women In Film and Television’s Muse Award.

The moderator is Hanna Rosin, co-editor of Slate’s DoubleX and contributing editor at The Atlantic Monthly.

Bonus: 100 percent of the profits at this cultural center go to Housing Works, Inc., which provides housing, healthcare, job training and advocacy for New Yorkers living with HIV/AIDS. Now go with the flow.

A new study published in the American Heart Association’s journal Circulation looks at what American women know about the risks for cardiovascular disease and the barriers to disease prevention.

The researchers surveyed women ages 25 and older about their demographics, their knowledge about heart disease (including their awareness of heart disease as the leading cause of death for women), perceived risk factors and prevention strategies, their sources of information about heart disease, preventive actions taken in the last year and barriers to prevention. Findings were also compared to surveys on these topics conducted in 1997, 2000, 2003, and 2006 to see how the responses have changed.

Among the results, 54% of respondents correctly identified heart disease/heart attack as the leading cause of death among women. However,  a disparity exists in this knowledge. Although awareness that heart disease/heart attack is the leading cause of death has doubled in white and Hispanic women and tripled among African American women since 1997, African American, Hispanic, and Asian women are still significantly less likely to be aware of this fact than white women.

Knowledge of heart attack warning signs had not increased significantly from the 1997 findings, with 56% of women correctly listing chest pain and neck, shoulder, and arm pain, 29% correctly identifying shortness of breath, and 17%, 15%, and 7% recognizing chest tightness, nausea, and fatigue, respectively. The authors also found that only 53% of women said they would call 911 if they were having heart attack symptoms; it’s usually recommended that people experiencing heart attack symptoms call 911 right away, even if they’re uncertain of whether they are really experiencing a heart attack.

The authors also noted that many women cited beliefs about effective methods of preventing heart disease that are not currently supported by the evidence, such as use of multivitamins (69%), antioxidants (70%), and special vitamins (58%, such as vitamin A, C, or E). 19% of women still reported a belief that hormone therapy was a useful preventive method, although this has declined from the 47% who held this belief in 1997 prior to the 2002 early halt to the Women’s Health Initiative trial and the accompanying warning that postmenopausal hormone therapy could actually increase cardiovascular risk.

Women reported numerous barriers to living a heart healthy lifestyle, including family obligations/caregiving (reported by 51% of respondents), confusion in the media about what they should be doing (42%), a belief that some higher power determines their health (37%), a lack of confidence in their ability to successfully change their behavior (33%), and a lack of money or health insurance (32%), among others less frequently reported. Lack of clear communication from health care providers (19%) and language barriers (8%) were also cited as concerns.

First, Dr. Mark Sloan, author of Birth Day: A Pediatrician Explores the Science, the History, and the Wonder of Childbirth, is chatting with readers online through February 21st via the LibraryThing website.

If you don’t have a LibraryThing account (they’re free), you’ll need to sign up first if you want to post questions or comments (you can browse the discussion without signing up). After logging in, scroll down the right side to “Author Chats” and select the chat with Mark Sloan. You’ll be able to post questions and comments, which Sloan is responding to – the author indicates that “all questions, comments, birth stories, new parent experiences, and hard-earned pearls of grandparental wisdom are welcome.”

I haven’t had a chance to read “Birth Day” yet – any readers have comments/reviews to share?

Second, the Baltimore chapter of the International Cesarean Awareness Network (ICAN) is seeking submissions for an art exhibit titled “Cesarean Voices,” which will be “the first of its kind in the country and will be an exploration of the issues surrounding cesarean birth.” Deadline for submissions is April 7, 2010, and artists should contact tiffanyaverill at hotmail dot com if they are interested in submitting artwork or have any questions. From the call for submissions:

We are accepting submissions for artwork to be shown in an ongoing installation to include original paintings, drawings, computer generated art, belly casts, poetry, and tapestries. Artwork must translate to the public the experience of having a cesarean either through your own or someone else’s eyes. In addition to cesarean art, the exhibit will feature an area called the “Birth Empowerment Zone” with artwork illustrating Ten Steps of the Mother-Friendly Childbirth Initiative (http://www.motherfriendly.org/mfci.php#step1) and Lamaze’s Six Care Practices that support having a natural and healthy birth. The six guidelines can be found at http://tinyurl.com/lumqx4

The complete call for entries is available for download [.doc file].

We wanted to share this important notice from SisterSong regarding a Georgia House bill created ostensibly to protect women of color from being targeted by abortion providers. Note the Trust Black Women press conference on Tuesday on the steps of Georgia’s Capitol, mentioned at the end of this bulletin.

For more information about the current anti-abortion billboard campaign in Georgia, visit SPARK Reproductive Justice Now.

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SisterSong Women of Color Reproductive Justice Collective OPPOSES House Bill 1155 — The Sex and Race Selection Bill. This bill seeks to ban the solicitation and targeting of women of color by abortion providers throughout the state.

This misleading issue of abortions for sex- and race-selection in Georgia means that we have to use facts and science to stand up for women of color without undermining our support for abortion rights or without enforcing racial stereotypes about women of color. Intent on driving a wedge between reproductive justice and racial justice organizations, and pro-choice advocates, the bill reflects the false assumption that abortion providers throughout the state “solicit” women of color.

If implemented, this bill will adversely impact abortion providers by requiring them to prove that they are not targeting women of a certain race or ethnicity. This burden could result in delayed medical services, particularly for women of color. Additionally, this legislation would alter the racketeering laws of the Georgia Code to include abortion providers. This is unacceptable as abortion is legal in the State of Georgia, and the alleged abuses of this medical procedure are unfounded. Such a bill would have a terrible effect on women’s ability to access reproductive health care services throughout the state.

This bill comes on the heels of a controversial billboard campaign that targets Black women in Georgia. The blatantly sexist and racist billboards declare Black children as an endangered species and prey on the conscience of Black women. The mere association between the born and unborn with endangered animals provides a disempowering and dehumanizing message to the Black community, which is completely unacceptable.

The statewide 80-billboard campaign is sponsored by The Endangered Species Project, a collaborative effort between The Radiance Foundation and Georgia’s Operation Outrage. We recognize that the lived experiences of women of color, and Black women specifically, drive how and when women choose abortion, not abortion providers who defend women’s rights. In order to protect the lives of women and families, abortion must remain safe, legal, affordable, and accessible. Any attack on women’s rights is in violation of all of our human rights.

SisterSong will detail the damaging effects of HB 1155 and how the public can advocate for the reproductive justice, reproductive rights, and reproductive health of women of color. Sponsored by SPARK Reproductive Justice NOW, during their Legislate THIS! Action Day, the Trust Black Women Press Conference will take place on Tuesday, February 16, 2010 at 12:00 pm on the steps of Georgia’s Capitol.