Although this January marks the 40th anniversary of the landmark Supreme Court decision legalizing abortion, we know that there is still much work to be done to ensure reproductive justice for all women.

The Guttmacher Institute reports that 2012 saw the second highest number of abortion restrictions enacted in a single year; the Center for Reproductive Justice addresses each state in this report.

Among the provisions ultimately defeated were “fetal personhood” bills in Mississippi and Oklahoma. But the notion that fetuses should be protected from the women carrying them has resulted in the restriction and punishment of women across America.

Lynn Paltrow, executive director of National Advocates for Pregnant Women, and Jeanne Flavin, a professor of sociology at Fordham University and chair of NAPW’s board, have put together an extremely interesting and important study: “Arrests of and Forced Interventions on Pregnant Women in the United States, 1973–2005: Implications for Women’s Legal Status and Public Health.”

Paltrow and Flavin (who is also the author of the 2008 book “Our Bodies, Our Crimes: The Policing of Women’s Reproduction in America“) tried to identify and examine U.S. cases from 1973, the year of Roe v. Wade, through 2005, in which a medical or government authority tried or succeeded in stripping a woman’s autonomy because of pregnancy. The study appears in the Journal of Health Politics, Policy and Law.

These cases could have involved threat of or actual arrest, incarceration, or increased prison/jail time; detention in a hospital, treatment program, or mental institution; or forced medical intervention. Descriptive detail of several cases is provided, along with summary statistics on the findings.

Looking at legal, medical and other sources, Paltrow and Flavin analyzed 413 cases, which they speculate are “a substantial undercount,” because cases were difficult to identify and some sources referred to additional cases.

The data reveals substantial racial, income and geographic disparities. While almost every state had multiple cases, the regions with the most were the south (56 percent) and midwest (22 percent). These cases disproportionately targeted black women (52 percent of cases overall, and 72 percent of cases in the south), and 71 percent involved low-income women (enough so that they qualified for indigent defense).

Most women who faced criminal charges were charged with felonies; a greater percentage of black women (85 percent) were charged with felonies than white women (71 percent).

The authors explore how these disparities are interlinked with disparities in drug laws, disproportionate application of criminal laws, and outdated stereotypes about cocaine use (such as the “crack baby” myth).

The vast majority of the cases — 84 percent — involved allegations of illegal drug use. In the remaining cases, “women were deprived of their liberty based on claims that they had not obtained prenatal care, had mental illness, or had gestational diabetes, or because they had suffered a pregnancy loss.”

Although concern for the health of the fetus/infant is typically offered as a reason for increased scrutiny or detainment of pregnant women, in 64 percent of the cases there was no reported health issue cited in the allegation.

Chillingly, most cases were reported by people in so-called “helping professions”: health care providers (41 percent), social workers (12 percent), and hospital, child protective services, or police personnel (17 percent). Health care providers reported black women at a higher rate (48 percent) than white women (27 percent).

As the authors point out:

Due in part, no doubt, to the strong public health opposition to such measures, no state legislature has ever passed a law making it a crime for a woman to go to term in spite of a drug problem, nor has any state passed a law that would make women liable for the outcome of their pregnancies. Similarly, no state legislature has amended its criminal laws to make its child abuse laws applicable to pregnant women in relationship to the eggs, embryos, or fetuses that women carry, nurture, and sustain. No state has rewritten its drug delivery or distribution laws to apply to the transfer of drugs through the umbilical cord. To date no state has adopted a personhood measure, and no law exists at the state or federal level that generally exempts pregnant women from the full protection afforded by federal and state constitutions.

In other words, nothing about existing law should make women subject to such persecution. They also note that public health groups have observed that targeting pregnant women may lead to women avoiding medical care or having unwanted abortions to avoid increased and punitive scrutiny.

Paltrow and Flavin also highlight these cases in the context of proposed personhood laws, which would give fetuses individual rights and potentially could lead to increased prosecutions of women. They authors note that they have identified “more than two hundred cases initiated against pregnant women since 2005 that also overwhelmingly rest on the claim of separate rights for fertilized eggs, embryos, and fetuses.”

Opponents to personhood laws have cautioned that such measures could lead to forced medical interventions on pregnant women along with possible punishment for miscarriages and stillbirths. While personhood proponents often dismiss these warnings as scare tactics, the research shows there is good reason to be concerned.

Paltrow and Flavin conclude with a call for change:

In light of these continued efforts and our findings, we challenge health care providers, law enforcement and child welfare officials, social workers, judges, and policy makers to examine the role they play in the arrests and detentions of and forced interventions on pregnant women. We call on these same people to develop and support only those policies that are grounded in empirical evidence, that in practice will actually advance the health, rights, and dignity of pregnant women and their children, and that will not perpetuate or exacerbate America’s long and continuing history of institutionalized racism.

Finally, our study provides compelling reasons for people who value pregnant women, whether they support or oppose abortion, to work together against personhood and related measures so women can be assured that on becoming pregnant they will retain their civil and human rights.

The whole article is well worth a read if you can get a copy. The abstract is freely available online.

In light of Congress’s recent failure to reauthorize the Violence Against Women Act, it’s heartening to hear about the ongoing efforts of White Ribbon, a movement of men and boys working to end violence against women and girls.

Here in Boston, the Men’s Initiative Project of Jane Doe Inc., a coalition of community-based sexual assault and domestic violence groups, is gearing up for the sixth annual Massachusetts White Ribbon Day. The event will take place at the State House in Boston on March 7.

The event, which is open to all, aims to change societal attitudes and beliefs that perpetuate and make excuses for violence against women, promote safety and respect in all relationships and situations, and promote the safety, liberty and dignity of survivors.

Men can sign up online to be an Ambassador for the campaign and to participate in other ways.

OBOS Board member and MA White Ribbon Day co-chair Jarrett Barrios spoke about the campaign recently in an interview with New England Cable News’s BroadSide program. Jarrett talks about the negative media imagery about women that young boys receive, and the need for parents and others to take responsibility for actively countering those messages and work to address rather than excuse them.

Jarrett calls for people to wear the white ribbon, to talk to their sons about treating women with respect, and to not “let go” of or overlook the language that is used against women that is part of a culture of violence.

The 112th Congress ended without reauthorizing the Violence Against Women Act (VAWA), threatening the funding of programs and services that prevent and respond to domestic violence, rape, stalking, and other forms of violence against women. It’s the first time Congress has failed to reauthorize VAWA since it was signed into law in 1994.

The failure is due to objections by House Republicans over new provisions adding protections for LGBTQ individuals, Native American women on tribal lands, and undocumented immigrants — protections that are considered “controversial,” according to Florida Republican Rep. Sandy Adams.

Those provisions are included in the Senate version, which passed with bipartisan support in April. The House passed its own version, stripping those provisions and making other changes that the administration has refused to approve.

The National Task Force to End Sexual and Domestic Violence Against Women addresses objections to the LGBTQ and Tribal provisions with a smart analysis of myth vs. fact. The organization also provides a good outline of many of the problems with the House version and its possible effects on vulnerable communities, and it asks the 113th Congress to reauthorize VAWA immediately.

Please encourage your senators and representatives to pass an inclusive version of VAWA. You can also contact House Speaker John Boehner’s office (202-225-0600 or 202-225-6205) and House Majority Leader Eric Cantor’s office (202-225-2815 or 202-225-4000).

Here’s further commentary and analysis, on both the bills and the failed reauthorization. Feel free to suggest other commentary or news items in the comments.

• We live in a culture of violence, and it needs to stop. — Adrienne K., Native Appropriations
• Congress Fails to Reauthorize Violence Against Women Act — National Center for Lesbian Rights
• House bill takes VAWA name, leaves Latinas behind – National Latina Institute for Reproductive Health
• Blocking VAWA, The GOP Keeps Up the War on Women — Erika Eichelberger, The Nation
• GOP House’s inaction on VAWA shows bigotry — Ilyse Hogue, CNN
• Racism and Sexism Go Hand in Hand in Opposition to VAWA Reauthorization — Scot, Changelab
• No real answers on ‘death’ of Violence Against Women Act — Jamil Smith, Melissa Harris-Perry show; Jamil also had a great analysis back in December, Why does the Violence Against Women Act remain stalled?
• House GOP lets the Violence Against Women Act expire for first time since 1994 – Zerlina, Feministing
• In Last Salvo on War On Women for 2012 Legislative Session, Congress Refuses to Renew VAWA – Robin Marty, RH Reality Check
• Everything You Need to Know About The GOP’s Opposition To Protecting Native American Women From Abuse — Erik Stegman, ThinkProgress
• Violence Against Women Act Debacle: Why Congress Should Be More Diverse – Tara Culp-Ressler, The Atlantic
• Why the Violence Against Women Act is a LGBT issue – Suzy Khimm, Wonkblog

This January 22 marks the 40th anniversary of Roe v. Wade, the landmark U.S. Supreme Court decision that made abortion legal.

Many local and national pro-choice and reproductive justice organizations will be holding events to mark this anniversary. Here are a couple we know about, including one we’re excited to co-sponsor with many great organizations in our home state. Know of others or want to share your own? Please tell us in the comments!

In Massachussetts, we’re co-sponsoring the Roe v. Wade 40th Anniversary Legislative Breakfast and Lobby Day at the State House on January 14. You can sign up to attend the breakfast, with keynote speaker Paula Johnson, MD, MPH, Executive Director of the Connors Center for Women’s Health and Gender Biology, and/or the lobby events, a chance for you to meet with elected officials after a brief advocacy training. Please sign up online to participate.

In Manhattan on Jan 14, Physicians for Reproductive Choice and Health is hosting “Roe Revealed: Doctors Tell Their Stories on the 40th Anniversary of Legalized Abortion,” with Dr. Willie Parker, Dr. Linda Prine, and a special guest. The event with these abortion providers is $20; additional tickets are required for the reception.

NARAL Pro-Choice America is holding its annual Blog for Choice Day on Jan 22. This year, they’re asking participants to share their own stories of why they’re pro-choice. As usual, you can sign up online to join in.

While there’s plenty of reason to celebrate 40 years of Roe, legislative attacks on reproductive and sexual health and choice continue around the country. In 2011 alone, U.S. lawmakers enacted 92 abortion-restricting provisions in bills designed to curtail women’s rights to health services. According to the Guttmacher Institute, that number shattered the previous single-year record of 34 such provisions enacted in 2005. Such laws make it more difficult, and painful, for women to exercise their legal right to terminate a pregnancy.

What will you do this year to ensure reproductive justice for all? For starters, check out Our Bodies, Our Votes, our resource for fighting back against attacks on women’s health and rights. While you’re there, order a sticker and submit your picture to our awesome Click It, Stick It, Share It tumblr.

Related:
History of Abortion in the U.S. – an “Our Bodies, Ourselves” excerpt
The 40th Anniversary of Roe v. Wade: A Teachable Moment, by Linda K. Kerber

If you’re a filmmaker with an interest in spreading the word about female condoms, check out this contest from PATH, a global health organization:

Why does the world need female condoms? How can female condoms enhance your life? Submit a short film (1:00–5:00 minutes) that tells a story about what Female Condoms Are to you and your community. The deadline to enter is March 1, 2013.

First prize receives $5,000. Winning entries will also be screened at the 2013 Women Deliver conference. Full details and rules are on the contest website.

To learn more about female condoms, see our previous posts and this excerpt from the most recent edition of “Our Bodies, Ourselves.”

The topic of routine screening mammography has become extremely controversial in recent years, especially following publication of a 2009 evidence review and subsequent U.S. Preventive Services Task Force recommendation that mammography be considered on an individual basis for women in their 40s, rather than automatically recommending mammograms for all women in that age group.

A new study published in the New England Journal of Medicine adds to the questioning of routine mammograms, concluding that “whatever the mortality benefit, breast-cancer screening involved a substantial harm of excess detection of additional early-stage cancers that was not matched by a reduction in late-stage cancers.”

The authors looked at data on how many women age 40 or older had screening mammograms and the incidence of early and late stage breast cancers. The assumption is that if widespread mammography is really helping to catch cancers at earlier, presumably more treatable stages, we’ll see fewer of those late stage breast cancers.

What they actually found was a large increase in detection of early cases (122 per 100,000 women), but a much smaller decrease (8 per 100,000 women) in late cases.

If mammograms were simply shifting diagnosis earlier, they should have seen about the same number for the increase in early cases and decrease in later cases. Instead, it resulted in diagnosis of numerous extra early cases that might not have progressed to more serious disease and would be considered over-diagnosis (with the corresponding over-treatment).

The researchers conclude that “the excess detection attributable to mammography in the United States involved more than 1.3 million women in the past 30 years.”

The authors did find that the death rate attributable to breast cancer had decreased over the last three decades, but they suggest that improvements in treatment over the last few decades may be primarily responsible.

As Dr. Diana Petiti, former vice chair of the USPSTF, explained in an email exchange:

Not all breast cancers detected by mammography would have caused a lump. Some breast cancers detected by mammography (we don’t know how many) revert to normal. Some breast cancers detected by mammography (we don’t know how many) don’t grow to the size of a lump. Some breast cancers detected by mammography (we don’t know how many) grow so slowly, they would not cause a lump in the forseeable lifespan of a woman.

Further not all lumps found by a woman (without mammography) would have caused death from breast cancer. Some breast cancers found as lumps (without mammography) are cured by treatment. Some breast cancers found as lumps (without mammography) grow so slowly that they never cause death due to breast cancer (which occurs because the cancer spreads). Some breast cancers found as lumps (with or without mammography) occur so late in life that something else causes death before the breast cancer spreads and causes death.

The newest data suggests that a not-small percentage of the breast cancers detected by mammography (without a lump) would not have killed the woman from breast cancer had it not been found.

While this is a complicated topic, this New York Times op-ed by Dr. H. Gilbert Welch, one of the authors of study published in NEJM, does a reasonable job of explaining it clearly. Welch, a professor of medicine at the Dartmouth Institute for Health Policy and Clinical Practice and an author of “Overdiagnosed: Making People Sick in the Pursuit of Health,” includes this call for change:

What should be done? First and foremost, tell the truth: woman really do have a choice. While no one can dismiss the possibility that screening may help a tiny number of women, there’s no doubt that it leads many, many more to be treated for breast cancer unnecessarily. Women have to decide for themselves about the benefit and harms.

But health care providers can also do better. They can look less hard for tiny cancers and precancers and put more effort into differentiating between consequential and inconsequential cancers. We must redesign screening protocols to reduce overdiagnosis or stop population-wide screening completely.

Dr. David Newman, an emergency room physician in New York City and author of the book “Hippocrates Shadow: Secrets from the House of Medicine,” tackles the controversy head-on in a column titled ”Ignoring the Science on Mammograms“:

For years now, doctors like myself have known that screening mammography doesn’t save lives, or else saves so few that the harms far outweigh the benefits. Neither I nor my colleagues have a crystal ball, and we are not smarter than others who have looked at this issue. We simply read the results of the many mammography trials that have been conducted over the years. But the trial results were unpopular and did not fit with a broadly accepted ideology—early detection—which has, ironically, failed (ovarian, prostate cancer) as often as it has succeeded (cervical cancer, perhaps colon cancer).

More bluntly, the trial results threatened a mammogram economy, a marketplace sustained by invasive therapies to vanquish microscopic clumps of questionable threat, and by an endless parade of procedures and pictures to investigate the falsely positive results that more than half of women endure. And inexplicably, since the publication of these trial results challenging the value of screening mammograms, hundreds of millions of public dollars have been dedicated to ensuring mammogram access, and the test has become a war cry for cancer advocacy. Why? Because experience deludes: radiologists diagnose, surgeons cut, pathologists examine, oncologists treat, and women survive.

Newman also notes that mammography is not the only area of medicine ripe for questioning:

It is normally troubling to see an observational study posing questions asked and answered by higher science. But in this case the research may help society to emerge from a fog that has clouded not just the approach to data on screening mammography, but also the approach to health care in the United States. In a system drowning in costs, and at enormous expense, we have systematically ignored virtually identical data challenging the effectiveness of cardiac stents, robot surgeries, prostate cancer screening, back operations, countless prescription medicines, and more.

To further explore this topic, listen to this WBUR Boston (NPR) segment with Dr. Welch, Judy Norsigian, OBOS founder and executive director, and Dr. Otis Brawley, chief medical officer at the American Cancer Society. Norsigian also wrote a column for WBUR’s Cognoscenti section, “Do Screening Mammograms Do More Harm Than Good?“

Though it won’t be as accessible as condoms, health experts are proposing to make the birth control pill available without a prescription. Photo / Jenny Lee Silver

This month, the American College of Obstetricians and Gynecologists released a statement calling for oral contraceptives to be sold over-the-counter, no longer requiring a doctor’s prescription.

ACOG considered a host of issues, including the safety of birth control pills; whether pharmacists could screen for who shouldn’t get them, or if women could self-screen; adherence to taking the pill; whether women would skip other preventive care if they didn’t visit a health care provider for a prescription; and cost.

Notably, ACOG addresses frequent objections to OTC oral contraceptives by concluding that “several studies have shown that women can self-screen for contraindications,” and “cervical cancer screening or sexually transmitted infection (STI) screening is not required for initiating OC use and should not be used as barriers to access.”

As Kevin Drum points out at Mother Jones, most countries outside of North America and Europe do not require a prescription for these drugs.

ACOG notes, though, that making the pill non-prescription might increase the cost for women who have health insurance — especially since under health care reform, contraception can be purchased without a co-pay. Over-the-counter costs might end up being anything from the $4 deals many pharmacies offer to more than $100. Dr. Kent Sepkowitz also explores this concern at The Daily Beast:

Yes, your life is easier because you will be able to get the pill right this second, without calling my office. No, you don’t need to fill out forms and show insurance cards and wrangle over copay. But guess who is paying for the whole shabang? You. Yes, you.

Another concern is that if the pill were dispensed by pharmacists, we might see the more of same kinds of refusals as have happened with emergency contraception.

However, many patients may experience increased access with an OTC model. The National Latina Institute for Reproductive Health issued this response:

The recommendation that birth control be available over-the-counter supports what we know about Latinas and contraception: over-the-counter access will greatly reduce the systemic barriers, like poverty, immigration status and language, that currently prevent Latinas from regularly accessing birth control and results in higher rates of unintended pregnancy.

Pre-Prescribing Emergency Contraception to Teens
Another professional medical organization, the American Academy of Pediatrics, issued a statement recognizing high teen birth rates in the United States and barriers to access to emergency contraception for adolescents 17  and younger. The AAP strongly admonishes pediatricians who refuse to discuss or provide contraception to teens based on their own beliefs, stating:

Pediatricians have a duty to inform their patients about relevant, legally available treatment options to which they object and have a moral obligation to refer patients to other physicians who will provide and educate about those services. Failure to inform/educate about availability and access to emergency-contraception services violates this duty to their adolescent and young adult patients.

The AAP recommends that physicians provide prescriptions to emergency contraception like Plan B in advance, so teens have it ready if and when the need arises. They also urge physicians to provide accurate information to teens on this topic, and, “At the policy level, pediatricians should advocate for increased nonprescription access to emergency contraception for teenagers regardless of age and for insurance coverage of emergency contraception to reduce cost barriers.”

Nice job, AAP!

HHS Urged to Remove Restrictions on Emergency Contraception
Finally, a petition is circulating urging the U.S. Department of Health and Human Services to remove restrictions on emergency contraception and make it available to women of all ages without a prescription. To learn more, see RH Reality Check’s audio news conference and related links and commentary from Kristin Moore. Our previous posts provide background on why EC is not *already* available OTC to all women:

• Evidence Trampled By Politics: HHS Secretary Sebelius Overrides FDA Decision on OTC Emergency Contraception
• Susan Wood Issues Response to Sebelius’s Overruling of Emergency Contraception Access

Each year, the Centers for Disease Control and Prevention (CDC) releases information on the number of abortions in the United States. Newly published data from 2009 shows that rates of abortion overall have decreased 5 percent since 2008 to the lowest levels since 2000. In general, rates of abortion were highest right after legalization, fell steadily in the 1980s and 1990s, and started to level off in the past decade.

It is not clear why rates have fallen. Possible contributors range from the expanded use of contraceptives and better sex education to the declining number of abortion providers and increases in restrictive abortion laws. Unintended pregnancy rates have not changed in decades – about half of all U.S. pregnancies are unintended — so that is not responsible for any decline.

As we know, many myths persist about who gets abortions and why. The following details shed some light on the topic:

• Women in their 20s have the highest rates of abortion (ages 20–24: 27.4 abortions per 1,000 women / ages 25–29: 20.4 abortions per 1,000 women), and account for 57.1 percent of all abortions.

This doesn’t seem terribly surprising given that women in their 20s are more likely to be fertile. In addition, they are more frequently uninsured. The insurance factor likely decreases their use of the most effective birth control methods –IUDs and implants –as those methods require a visit to a health care provider.

• The majority of women (55.3 percent) having abortions have not had a previous abortion. About 25 percent have had one previous abortion, and about 11 percent have had two previous abortions. Only about 8 percent have had three or more abortions, suggesting that the overwhelming majority of women having abortions do not fit the “using it as birth control” myth.
• Six out of every 10 women having abortions have already had one or more children. Women very frequently say that they chose abortion in order to best be able to care for their existing families.
• Abortions are usually performed early in pregnancy, with 64 percent done at less than eight weeks gestation, and about 92 percent done by or before 13 weeks.

There has been a clear shift to earlier abortions, with an almost 50 percent increase in abortions done at less than six weeks’ gestation. The CDC report is not able to address the reasons why; the increase may be caused by the greater availability of medication abortion (medication abortions are performed only up to 9 weeks) or an increased number of abortion laws that make later abortions more difficult to obtain.

Other points of interest:

• Use of medication abortion continues to increase; 16.5 percent of abortions in 2009 were done medically instead of surgically, a 10 percent increase from 2008.
• Abortion ratios (the number of abortions for every 1,000 women) decreased among non-Hispanic white women but not among women in any other racial/ethnic group.

Poor women, young women, and women of color are less likely to have access to reproductive health care services, more likely to have an unintended pregnancy, and more likely to have an abortion.

The CDC concludes its report with public health recommendations, including support for no-cost birth control. The Affordable Care Act comes close by eliminating co-pays for insured women (though employers who oppose reproductive rights are still fighting this provision), making birth control available without a co-pay for an estimated 47 million women. Here’s what the CDC has to say:

Moreover, although use of the most effective forms of reversible contraception (i.e., intrauterine devices and hormonal implants, which are as effective as sterilization at preventing unintended pregnancy ) has increased, use of these methods in the United States remains among the lowest of any developed country, and no additional progress has been made toward reducing unintended pregnancy. Research has shown that providing no-cost contraception increases use of the most effective methods and can reduce abortion rates. Removing cost as one barrier to the use of the most effective contraceptive methods might therefore be an important way to reduce the number of unintended pregnancies and consequently the number of abortions that are performed in the United States.

See our analysis of a recent study on unintended pregnancies in St. Louis for further discussion of how improved access to free birth control reduces abortions. The study is important for its role in dismantling persistent myths about contraception and abortion.

Plus: Though some members of Congress with less-than-accurate ideas about women’s bodies lost re-election, that doesn’t mean Congress is apt to back smarter policy. Let’s remind all members about the importance of access to contraception and reproductive health services. Join the Educate Congress campaign to send “Our Bodies, Ourselves” to every elected senator and representative. You’ll receive an “I Educated Congress” button (and other perks) showing you did your part!

We’ve been amazed by — and grateful for — the comments left by supporters of the Educate Congress campaign about why the site matters to them and what they want Congress to know about reproductive and sexual health.

During the recent election cycle it became all too apparent that there is a *lot* that some members still need to learn. Speaking from my experience, I want Congress to understand more about the science behind conception. Rep. Paul Ryan was a co-sponsor last year of HR 212, the Sanctity of Human Life Act, which states that “human life shall be deemed to begin with fertilization.”

I’m hoping members of Congress will stop proposing “personhood” legislation that would potentially ban some forms of contraception, such as the birth control pill, and threaten the health of women and their families in numerous ways (see this fact sheet from the Oklahoma Coalition for Reproductive Justice, a group that formed to fight personhood legislation in that state).

What do you think Congress should know about women’s bodies and health?

Tell us what you  think Congress should know when you join our campaign to Educate Congress. It can be something based on your health, the health of a family member or friend, or a community need or policy change.

Then make sure to share your message here on the blog, post it on our Facebook page, or tweet it using the hashtag #EducateCongress.

Our Bodies Ourselves has long believed that women’s stories and experiences inform what we know about women’s health. Who better to educate Congress than all of us?

The story of Savita Halappanavar, who died last month as a result of Ireland’s abortion ban, has sparked much debate over Ireland’s abortion laws and, in a broader sense, the issue of access to reproductive health care.

Savita went to a hospital in Ireland while experiencing severe back pain. The medical staff diagnosed her with miscarriage of a fetus with no chance of survival, but refused to perform an abortion because they detected a fetal heartbeat.

Several days passed before the heartbeat ceased and removal was allowed. But by this point, Savita had developed an infection that led to her death.

This is a tragic example, but one that unfortunately is quite predictable when women are unable to obtain legal abortion care. Abortion has been banned in the Republic of Ireland since 1983 by constitutional amendment, but traces back to an 1861 law. According to the Irish Family Planning Association, more than 4,000 women living in Ireland traveled to England and Wales for abortions in 2011, because the service is not legally available in Ireland.

Earlier this year, The Guardian reported that despite apparent declines in this number, more women may simply be disguising their home country, as “The number of women contacting a charity that helps people in Ireland seek abortions in Britain is set to double for the third year in a row.” (For more on the history of abortion law in Ireland, see this timeline, and “Ireland’s abortion ban: a history of obstruction and denial.”)

Here are some of the articles and analysis stemming from Savita’s death:

• Justice for Savita — Jessica Valenti gets to the bottom line for The Nation: “It’s not just our lives and health that are in danger, but our human dignity.”
• Hospital Death in Ireland Renews Fight Over Abortion – Douglas Dalby at The New York Times writes of a state of Irish politics that will not be entirely unfamiliar to U.S. readers: “Given the divisiveness of the abortion issue in Ireland, which has prompted two bitterly fought referendums, successive governments have avoided passing any legislation.”
• Death in Ireland is a Wake Up Call to Fight Bans on Later Abortion Here at Home – Susan Yanow at RH Reality Check contemplates the U.S. implications and concludes: “We have a sobering lesson to learn from Ireland — when doctor’s medical judgement is compromised by restrictive abortion laws, it is women’s health and women’s lives that suffer.”

Several writers have referred to the “X case” in covering this story. This was a controversial 1992 Irish Supreme Court case in which a 14-year-old girl expressed suicidal thoughts after being raped by a neighbor and becoming pregnant as a result. The girl planned to have an abortion elsewhere, but was prevented from doing so. The court eventually ruled that women have the right to seek abortions in life-threatening situations, including possible suicide.

Despite this 20-year-old ruling, Irish legislators have not passed a law to codify this right, leaving women in dangerously uncertain territory.

A Choice Ireland spokesperson explained:

Today, some twenty years after the X case we find ourselves asking the same question again — if a woman is pregnant, her life in jeopardy, can she even establish whether or not she has a right to a termination here in Ireland? There is still a disturbing lack of clarity around this issue, decades after the tragic events surrounding the X case in 1992.

Ireland’s Deputy Prime Minister Eamon Gilmore has said that the government would act “to bring legal clarity to this issue as quickly as possible.”

See also these additional commentaries on the failure to pass relevant laws after the X case to make abortions clearly legal in life-threatening situations.

Emer O’Toole writes at The Guardian about the struggles of pro-choice activists in Ireland, pointing to the culpability of doctors, legislators, journalists, and others in perpetuating the lack of justice in abortion laws. She issues an apology to Savita’s family that is also a call to action to supporters of abortion rights:

To her family, I want to say: I am ashamed, I am culpable, and I am sorry. For every letter to my local politician I didn’t write, for every protest I didn’t join, for keeping quiet about abortion rights in the company of conservative relations and friends, for becoming complacent, for thinking that Ireland was changing, for not working hard enough to secure that change, for failing to create a society in which your wife, your daughter, your sister was able to access the care that she needed: I am sorry. You must think that we are barbarians.

Related: Study Examines How Inability To Obtain Abortion Care Affects Women’s Lives

Do you live in the Boston area? If so, come on out this Sunday to see Our Bodies Ourselves founder and executive director Judy Norsigian at the Ryna Greenbaum JCC Boston Jewish Book Fair happening in Newton, Mass.

Judy will participate in the “Up Close and Personal” discussion session led by Judith Rosenbaum of Jewish Women’s Archive.

Naomi Wolf, author of the new book “Vagina: A Cultural Exploration” (which Jaclyn Friedman and many others have reviewed) will also participate.

The program kicks off at 2:30 p.m. on Sunday, Nov. 18, at the Leventhal-Sidman Jewish Community Center, 333 Nahanton Street, Newton, MA 02459.

The cost of the event is $5 for members of the Jewish Community Center of Greater Boston, and $8 for non-members.

We hope to see you there!

Bisphosphonates, a category of drugs that includes Fosamax and Boniva, are commonly prescribed to treat and prevent osteoporosis. Unfortunately, concerns have been raised about possible adverse effects of these drugs when used for longer than 3 – 5 years.

There are many unanswered questions about the long-term use of bisphosphonates.  A 2012 New England Journal of Medicine perspective piece notes that it is unclear how long most people should take the drugs, whether certain groups of patients are more likely to benefit from longer term use of the drugs, how long benefits of the drugs last after stopping them, and whether there are reliable measures to help make that decision in individual patients.

One of the concerns regarding long-term use is the potentially higher risk of unusual thigh bone fractures (often called “atypical femur fractures”).

A new study published in the The Journal of Clinical Endocrinology & Metabolism attempts to shed more light on the potentially higher risk of these fractures. The researchers collected the stories of 78 women and 3 men who suffered an atypical femur fracture after taking a bisphosophonate for treatment or prevention of osteoporosis. Medical histories were collected to see how long people had been on the drugs, if they experienced another fracture in the other leg, how long they were in pain before the fractures were actually diagnosed, and other factors.

They found that 77% of the patients were in pain before they were initially diagnosed with a fracture, and they were in that pain for an average of about 9 months (ranging from 1 to 24 months). The authors write, “Sixty-one patients had sought treatment for persistent thigh, leg, or hip pain and had multiple studies and procedures that did not discover the problem.” Almost 40% of the patients ended up with another fracture on the other side. About a third of the patients also had metatarsal (foot) fractures, while 2.5% had a pelvic fracture and 3.7% experienced jaw osteonecrosis. Despite the lack of certainty about long-term safety of these drugs, the patients on average had been taking them for more than 9 years.

The authors note that while patient reports may sometimes be inaccurate or incomplete, they hoped the reports would provide more complete information than that found in bits and pieces across medical charts. Although additional rigorous study is still needed, the authors raise important questions about whether we should also be concerned about foot fractures with these drugs, and whether patients receive timely diagnosis when they do experience bad outcomes.

A systematic review on the risk of fracture was reportedly discussed at a recent American College of Rheumatology meeting – we’ll keep an eye out for those findings being published.

Last night, the War on Women suffered a setback — due largely to women voters who used the ballot to re-elect President Barack Obama and to push back against absurd, insulting and just plain offensive comments about rape and women’s bodies.

As Veronica Arreola posted on Facebook:

Two of the biggest losers last night were the gentlemen who claimed that women have magic wombs that stop pregnancy from occurring during legitimate rape and if it does happen, it was a gift from God. The magic was in our votes, ladies. We’ve had it all along.

Erin Gloria Ryan’s post at Jezebel is succinctly titled “Team Rape Lost Big Last Night.” Read it for a complete look at races around the country.

Some highlights …

Missouri Rep. Todd Akin failed to unseat incumbent Sen. Claire McCaskill, causing Twitter to explode with a new round of Akin-related humor, like “Claire McCaskill legitimately wins and shuts that whole Akin thing down!”

John Koster was defeated by Suzan DelBene in Washington state — Koster famously referred to “the rape thing” and confused one woman’s choice with controlling all women’s choices: “I know a woman who was raped and kept the child, gave it up for adoption and doesn’t regret it.”

And in Illinois, Rep. Joe Walsh, who doesn’t believe abortion is ever necessary to save the life or health of a mother, lost to challenger Tammy Duckworth, an Iraq War veteran who lost both legs in combat.

For more analysis, Bryce Covert at The Nation examines the impact of politicians’ misogyny on the election outcomes, and concludes: “Score one for women’s rights, zero for attempts to control their bodies.”

***

Our Bodies, Our Votes …

“Our Bodies, Ourselves” turned up in a number of tweets last night. Anne Elizabeth Moore, who led The Ladydrawers on the road trip to deliver “Our Bodies, Ourselves” to the offices of Akin and McCaskill, posted this upon news of Akin’s defeat:

hey @RepToddAkin, now maybe you’ll finally have time to get crackin at all those books @oboshealth and @TheLadydrawers dropped off!

We heartily second that recommendation.

Following the defeat of Indiana Senate candidate Richard Mourdock — who recently said, “I think even when life begins in that horrible situation of rape, that it is something that God intended to happen” — Jason Lefkowitz tweeted: ”And in Indiana, Mourdock has officially been buried under a massive pile of hardback copies of ‘Our Bodies, Ourselves.’”

Jason Cherkis also took note of the upsets, tweeting: ”GOP furiously buying ‘Our Bodies, Ourselves’ on Amazon.”

No need; with the public’s help, we’ll deliver the book to each and every member of Congress (41 days left to make this happen!).

***

Big gains for women and marriage equality …

We now have a record number of women in Senate, with 20 women Senators elected.

Rep. Tammy Baldwin became the first openly gay senator, and the first woman senator from Wisconsin. Rep. Mazie Hirono became the first woman senator from Hawaii as well as the first Japan-born immigrant to be elected to the Senate and the first Buddhist.

Another big success last night was the passage of ballot measures in Maine and Maryland approving same-sex marriage, the first time it has been made legal through a popular vote. An amendment to ban same-sex marriage was defeated in Minnesota.

We’re still waiting to hear for sure about Washington state, but early returns are promising. Same-sex marriage is now legal in eight states as well as in Washington, D.C.

More good news: Iowa Supreme Court Justice David Wiggins is staying on the bench – he had been targeted for removal because of his role in the legalization of gay marriage in that state.

***

Mixed results on abortion-related measures …

Abortion-related measures were considered in two states. In Florida, voters defeated Amendment 6, which would have prevented state employees from using their healthcare coverage for most abortions, and would have affected privacy rights in a way that could have led to further restrictions.

In Montana, voters approved a parental notification measure requiring girls under age 16 to notify a parent or seek judicial bypass prior to terminating a pregnancy.

 ***

Lessons learned and work to be done …

Akiba Solomon at Colorlines shares “Five Race and Gender Justice Lessons Learned from This Marathon Election Cycle,” including this important point: “The Republican-led war on abortion, Title X-funded reproductive health care and contraceptive access was—and still is—a war on poor women of color and their families.”

And if anyone needs a reminder of the work we still have before us, On the Issues magazine has appropriately titled its fall issue “The Day After.”

From the editor’s note: “On wide-ranging issues — the economy to the environment, reproductive freedom to voting freedom, sexuality to media representation — our writers, artists and thinkers in The Day After remind us to extend our vision beyond the ballot box to where we need to place our energies, build our muscles and put our feet on the ground every day of the year.”

In other words, it’s time to get busy — again.

by Rachel Walden & Christine Cupaiuolo

This Halloween, ask yourself: Which is scarier — Furry creatures that scamper in the night? Or a Congress ignorant of how reproduction and women’s bodies work?

Unsure? Take a quick quiz to find out which frightens you more!

1. (A) Possessed Vampire Kitty

OR

(B) Legislators claiming that pregnancy from “legitimate rape” is really rare because women’s bodies can just “shut that whole thing down,” and suggesting that pregnancies resulting from rape are “something that God intended to happen.”

2. (A) Golden-Eyed Vampire Kitty

OR

(B) A member of Congress believing that thanks to ”modern technology and science, you can’t find one instance” of abortion being necessary to protect the health or save the life of the mother.

3. (A) Fork-Tongued Vampire Kitty

OR

(B) Forcing women to undergo unnecessary and medically unwarranted procedures,  such as a transvaginal ultrasound, in order to obtain an abortion [HR 3805]. (If you’re in Pennsylvania and you don’t want to view the images, just close your eyes!)

4. (A) Lord Cattula

OR

(B) Holding a Congressional hearing on contraception with no women present?

If you consistently selected “B,” then you’re more scared of misinformed policy and inaccurate statements about how women’s bodies work!

What can you do to change the conversation and protect yourself from misinformation? Join the Educate Congress campaign!

We’re delivering copies of “Our Bodies, Ourselves” to every senator and representative so they have access to accurate, evidence-based information about reproductive health — and you can be part of this important effort.

Because nothing is more scary than legislators drafting policy that harms women — not even Meow Mix …

Credit: Cat photos
1. Possessed Vampire Kitty / Opacity on Flickr
2. Golden-Eyed Vampire Kitty / Digidave on Flickr
3. Fork-Tongued Vampire Kitty / mohd fahmi on Flickr
4. Lord Cattula / sgatto on Flickr

A new documentary, “She’s Beautiful When She’s Angry,” chronicles the history of the women’s movement from 1966 to 1972, including the genesis of Our Bodies Ourselves, the founding of NOW, and other historical milestones.

The filmmakers are running a Kickstarter campaign to raise funds to finish the project, and have a little more than a month to go. Check it out to learn more about the project and consider supporting their efforts.

The creators note that the film doesn’t aim to romanticize the women’s movement and will cover controversies “over race, sexual orientation and leadership that arose.”

Here’s a clip with the founders of Our Bodies Ourselves talking about their perspectives on women’s health and women’s bodies more than 40 years ago. Included is a discussion of their first women’s health course, organized when they were in their 20s, and turning their collective knowledge into a book. (Neat fact: the first version they distributed was run off on a copying machine, making it perhaps the first zine ever.) The clip includes lots of images from the early editions. of “Our Bodies, Ourselves.”