The Big Push for Midwives: Great post by Amy G. about the campaign for the regulation and licensure of certified professional midwives. Amy mentions a number of blog posts on the issue, including ours.

Metabolic Syndrome Is Tied to Diet Soda: “This is interesting,” said Lyn M. Steffen, an associate professor of epidemiology at the University of Minnesota and a co-author of the paper, which was posted online in the journal Circulation on Jan. 22. “Why is it happening? Is it some kind of chemical in the diet soda, or something about the behavior of diet soda drinkers?”

I don’t know, but it makes me see red ….

Feeling Bad?: Those susceptible to Seasonal Affective Disorder, take note: Chicago had 11 — count ‘em — 11 minutes of sunshine during the first eight days of February. Chicago Tribune health columnist Julie Deardorff writes that she is going to try a sauna that that “uses infrared energy to warm the body and release toxins.” Readers, if you have suggestions for coping with a long gray winter, please leave them in the comments.

Why I am an Abortion Doctor: “I can take an anxious woman, who is in the biggest trouble she has ever experiences in her life, and by performing a five-minute operation, in comfort and dignity, I can give her back her life.” — Canadian abortion doctor Garson Romalis, who has survived being shot and stabbed because of his work.

NYT Op-Ed on Same-Sex Marriage Ruling: “In a decision at once common-sensical and profound, a New York State appeals court ruled Friday that same-sex marriages validly performed in other jurisdictions are entitled to recognition in New York. It was common sense because it simply accorded same-sex marriages the same legal status as other marriages. It was profound because of the way it could transform the lives of gay people.” Continue reading …

A Health Law With Holes: “This idea of an individual mandate absent comprehensive reform – how to say this politely? – is nuts. It makes a social failure the problem of the individual,” writes Robert Kuttner in an op-ed published in the Boston Globe about health care in Massachusetts.

Health Cuts Trigger Crisis in Chicago: In a front-page story on Friday, the Chicago Tribune reported on what doctors are calling “an emerging health crisis” in the city, with “hundreds of women with abnormal Pap smears, unusual bleeding, pelvic masses and other worrisome symptoms are waiting for weeks or months to see gynecologists in the Cook County health system.”

“The longer women wait for care, gynecological experts warn, the more likely it is that untreated medical problems could worsen, exposing the women to severe pain, cancers that are harder to treat or even life-threatening emergencies.”

Breastfeeding and HIV-Infected Mothers: “An antiretroviral drug already in widespread use in the developing world to prevent the transmission of HIV from infected mothers to their newborns during childbirth has also been found to substantially cut the risk of subsequent HIV transmission during breast-feeding,” according to this release from the John Hopkins Center for Clinical Global Health Education. Approximately 150,000 infants are infected through breastfeeding each year.

The findings were made public during the 15th Conference on Retroviruses and and Opportunistic Infections held in Boston this past week.

Another study presented at the conference found that the risk of HIV transmission decreased by 90 percent within couples in which one person is HIV-positive and the other is HIV-negative — if the HIV-positive person took antiretrovirals, which drive down the level of HIV in the blood.

“Getting an early diagnosis, and getting treatment to drive down viral load, is going to be good for prevention,” said Dr. Rebecca Bunnell, a researcher for the CDC in Kampala, Uganda, told the San Francisco Chronicle.

SF Chronicle writer Sabin Russel described the study as “one of the few rays of hope” to come out of the conference, “a meeting that has been dominated by discussions of setbacks, such as the failure of a major AIDS vaccine trial that was abruptly ended in September.”

And The New York Times reports on yet another study that was discussed, one that showed that male circumcision did not result in a lower risk of transmission for female partners. “Although the findings did not reach statistical significance, they still underscore the need for more effective education among men who undergo circumcision and their female partners, the authors of the study said,” reports the Times.

Earlier this week, President Bush released his $3.1 trillion 2009 budget request, which includes freezes and decreases for the budgets of many health programs, alongside massive defense spending. The budget documents are difficult to sift through, but a few health-related proposals are worth noting.

Among the cuts and lack of increases:

• No increase in funding for the National Institutes of Health, which funds a vast amount of medical research
  
• A $412 million (~4.5%) decrease in program funding for Centers for Disease Control and Prevention.
  
• An $995 million (~14%) reduction in program funds for the Health Resources and Services Administration, including flat funding for Title X family planning and decreases in funding for healthcare workforce development.
  
• A $198 million (~6%) decrease for the Substance Abuse and Mental Health Services Administration.
  
• Flat funding for child welfare and child abuse prevention under the Administration for Children and Families
  
• Nearly 30% reduction in international family planning and reproductive health funding

The kicker? The budget includes $191 million for abstinence-only education through the Administration for Children and Families, a $28 million increase (~17%).

Additional coverage of and reactions to the 2009 proposed budget:

• Kaiser Daily HIV/AIDS Report
  
• Daily Women’s Health Policy Report: Medicaid family planning cuts and abstinence and AIDS relief
  
• Planned Parenthood
  
• AIDS Action

Note: If you find additional relevant changes in the 2009 budget proposal, please let us know in the comments.

One-third of all sex education teachers in Illinois are not providing comprehensive instruction, according to a new study.

The survey by researchers from the University of Chicago Medical Center appears in the February 2008 issue of the journal Obstetrics and Gynecology (here’s the abstract). Among the findings: 30 percent of the state’s sex-education teachers had never received sex-education training. The national average is 18 percent.

“For this study, we set the bar for comprehensiveness fairly low relative to what most medical and public health organizations recommend,” said senior author Stacy Tessler Lindau, assistant professor of obstetrics and gynecology and medicine at the University of Chicago, “and one out of three programs failed to clear it.”

“Our children learn many of the skills they need to be healthy citizens and to take responsibility for their own health in school,” she said. “That should include information about sexual aspects of health. Physicians who care for adolescents need to know what students are, or are not learning, in school in order to fill gaps caused by deficits in program content, quality and teacher training.”

The survey of 335 sex education teachers in 201 public middle and high schools was was funded by the Illinois Campaign for Responsible Sex Education, a project of the Illinois Caucus for Adolescent Health and Planned Parenthood Chicago Area. The survey found that seven percent of the schools did not off any sex education. Here are some of the curriculum details from those that do:

The most frequently taught topics, covered by 96 percent of teachers, were HIV/AIDS and other sexually transmitted diseases. Almost 90 percent of teachers covered abstinence. Among those who taught abstinence, 57 percent emphasized that it was the “best alternative,” 39 percent said it was the “only alternative,” and four percent described it as “one alternative.”

Practical skills — such as contraception, condom use, decision-making and communicating with a partner — and morally debated topics, such as abortion or sexual orientation, were among the least frequently taught. Teachers who had not received sex-education training were less likely to spend time on practical or morally debated topics.

Of the 17 topics, emergency contraception was mentioned least, taught by only 30 percent of teachers. Only 32 percent of teachers brought up homosexuality or sexual orientation, 34 percent taught how to use condoms, 37 percent taught how to use other forms of birth control, 39 percent discussed abortion and 47 percent taught students where to access contraception and sexual-health services.

The most common reason for omitting a topic was “not part of the curriculum.” Those who omitted condom use, however, most often cited “school or district policy.”

Looking for political coverage with a health focus today? RH Reality Check is live-blogging Super Tuesday, promising “fun, irreverent, and relevant takes on the breaking news.”

The team of of live bloggers includes reproductive health advocates, journalists and commentators. Check it all out here:
http://www.rhrealitycheck.org/blog/tag/super-tuesday

And while you’re there, read an interview with Judy Norsigian, executive director of Our Bodies Ourselves. Norsigian was the keynote speaker at the 2008 annual Choice Dinner in Iowa City, which benefits the Emma Goldman Clinic, and she talked with Lynda Waddington after the event.

Here’s more about the benefit from Blog for Iowa and event coverage from Essential Estrogen.

The American College of Obstetricians and Gynecologists has issued an opinion statement on surrogate motherhood [PDF] through its Committee on Ethics. The piece addresses types of surrogacy, public policy, major arguments for and against surrogacy arrangements, and responsibilities of physicians when attending to such arrangements.

Among the guidances:

• “Because of the risks inherent in surrogacy arrangements, such arrangements should be considered only in the case of infertility or serious health-related needs, not for convenience alone.”
• “A physician may justifiably decline to participate in initiating surrogacy arrangements for personal, ethical, or medical reasons.”
• “The pregnant woman should be the sole source of consent regarding clinical intervention and management of the pregnancy, labor, and delivery.”
• “The obstetrician must make recommendations that are in the best interests of the pregnant woman and her fetus, regardless of prior agreements between her and the intended parents.”
• “The intended parents may have access to the patient’s medical information only with the pregnant woman’s explicit consent.”

The entire report is an informative read, summing up a host of surrogacy-related ethical concerns. I found it particularly interesting as it touches on physician refusal, the rights of the surrogate to make her own medical decisions, privacy, convenience vs. medical necessity, and many other topics that arise in discussions of other reproductive rights.

The Pill’s Long-Running Health Saga: “Last week, British researchers published decisively good news about birth control pills: They lower the risk of ovarian cancer — substantially,” writes Amanda Schaffer at Slate. “The new analysis pooled large amounts of data. It was elegantly done. And it’s worth celebrating, partly because health claims about the pill are often much harder to parse.”

New Insights Into Genital Pain: “For decades, women suffering from vulvodynia have been told that nothing seems to be wrong with them — nothing, that is, that the examining physician can discern — or that the condition may be real but that nothing can be done,” writes Jane Brody in The New York Times. According to recent study, vulvodynia (chronic discomfort of the vulva) affects as many as one woman in six, or 13 million American women. Attitudes are now changing, and the article looks at some very real potential causes and treatments.

Rape in the U.S. Military: “[I]n many cases, the military seems more intent on intimidating and harassing the victims than investigating and prosecuting the charges,” writes Lucinda Marshall in this L.A. Times opinion piece.

Consider the statistics cited: 2,947 reports of sexual assaults in the military in 2006, an increase of 24 percent over 2005. According to a March 2007 Pentagon report, more than half of the investigations dating back to 2004 resulted in no action. And when action was taken, only one-third of the cases resulted in courts-martial.

Plus: Also see Marshall’s diligent coverage of gender-based violence, both domestically and globally.

Rape Charges Dropped Over “Fraud”: “Prosecutors say they cannot press rape charges against a pharmacist who allegedly posed as a gynecologist and examined two women because of a half-century old state law that says an assault can’t be considered rape if consent is obtained through fraud or deceit,” reports the AP via the Boston Globe. Denise Lavoie writes:

Justices of the Supreme Judicial Court urged lawmakers to close that loophole in the law in a 2007 case in which they found a man could not be prosecuted for rape for duping his brother’s girlfriend into having sex. The court said state law currently defines rape as sexual intercourse compelled by force and against the will of the victim. Fraud cannot be allowed to replace the force required under the law, the court found.

Iraqi Women Face Greater Danger, Fewer Rights: “Most everyone in Iraq has suffered because of violence, but the lives of women have been, perhaps, affected the most,” reports NPR. “Women’s rights groups report that in the past six months, more than 100 women have been killed in the city of Basra for wearing make-up or what is deemed Western clothing. Those who dare to defend them have also been attacked and, in some cases, killed.”

The Sex of Your Surgeon May Matter: Tara Parker-Pope covers a study by researchers at Columbia University that found the likelihood of whether a woman receives radiation treatment after breast cancer surgery may be influenced by the gender of her surgeon. The study appears in The Journal of the National Cancer Institute (abstract available here). Parker-Pope writes:

About one in four women were not treated with radiation after surgery. Older women, black women, unmarried women and those living outside urban areas were less likely to receive radiation. But after controlling for those factors as well as characteristics of each woman’s cancer, the Columbia researchers spotted other trends.

Women who received radiation were more likely to have a female surgeon. Women who were treated by more experienced surgeons were also more likely to receive radiation treatment, as were women treated by doctors trained in the United States.

Chile Battles Access to Morning-After Pill: “Since assuming office in March 2006, President Bachelet and Health Minister Maria Soledad Barria have instructed public health authorities to work aggressively to ensure the pill’s availability not just at public clinics — where it is distributed for free to women 14 and over — but at all major pharmacies, enabling its availability to women from all social strata,” writes Matt Malinowski at Women’s eNews. But the plan is running into resistance.

The One To Take the Lead: “Although stories about reproductive health and politicization of science have made headlines recently, stories of how these problems are solved are less often told,” begins this essay at RH Reality Check by Susan Wood, who resigned her FDA position in 2005 as the FDA repeatedly delayed approval of over-the-counter emergency contraception. Wood credits Sen. Hillary Clinton for stepping up to the FDA.

“Stigma: The Silent Killer”: BET Networks will air a half-hour news special on Thursday, Feb. 7 at 8 p.m. ET/PT that examines the role that stigmas have played in the spread of HIV/AIDS among people of color in both the United States and the Caribbean. The special coincides with Black HIV/AIDS Awareness Day and is part of a public education partnership with the Kaiser Family Foundation, the BET Rap-It-Up Campaign.