Archive for the ‘Breastfeeding’ Category

September 14, 2010

CDC Releases Breastfeeding Report Card: Initiation is Up, but Continuation is Stagnant

The CDC released a new breastfeeding report card [PDF] yesterday, reporting that 3 out of 4 new mothers in the now U.S. start out breastfeeding, meeting the Healthy People 2010 national objective for breastfeeding initiation for the first time.

However, rates of breastfeeding at other time points remain lower than the HP2010 objectives and have been stagnant for the past three years.  The target rates are 50% at 6 months (currently 43%), 25% at 12 months (now 22.4%), 40% exclusively breastfed through 3 months (now 33.0%), and 17% exclusively breastfed at 6 months (now 13.3%).

Rates vary widely by state – for example, the percent of women who initiated breastfeeding was >80% in several Western states (California, Utah, and Washington, for example), but only 52.5% in Mississippi.

A CDC press release on the report emphasizes the role of hospitals in increasing the rate, with a CDC representative stating that, “High initiation rates tell us that a lot of moms plan to breastfeed, but these rates do not indicate that a birth facility is doing what it needs to support them in their effort.”

The release also notes that <4% of U.S. births occur at facilities designated as Baby-Friendly, a designation indicating that the facility takes steps to encourage breastfeeding initiation. Another CDC rep notes the importance of support in workplaces and communities; see these previous posts for our past discussions related to workplace and economic pressures and breastfeeding.

April 20, 2010

CDC Releases Breastfeeding Data by Location, Race/Ethnicity

A recent issue of the CDC’s Morbidity & Mortality Weekly Report publication included a piece on racial and ethnic differences in breastfeeding, describing rates of breastfeeding initiation and continuation to six and twelve months by survey respondents’ status as Hispanic, non-Hispanic white, or non-Hispanic black.

The report finds that “National estimates for breastfeeding initiation and duration to 6 months and 12 months were 73.4%, 41.7%, and 21.0%, respectively (Table 1). Breastfeeding estimates varied by race/ethnicity, participation in the WIC supplemental nutrition program, and mother’s age and education.”

When examined by race/ethnicity, it was found that non-Hispanic blacks generally had the lowest prevalence of breastfeeding initiation, followed by Hispanics, with non-Hispanic whites having the highest rates. The authors note that “Most states were not meeting the HP2010 targets for breastfeeding duration for any racial/ethnic group.” HP2010 refers to national goals for health status and healthy behaviors; HP2010 had a goal of having 75% of women initiate breastfeeding, with targets of 50% and 25% for six and twelve months.

The report also provides geographic data, with a good chart of breastfeeding data by state and race/ethnicity, and some maps showing geographic differences in breastfeeding rates. For example, you can see that breastfeeding rates are pretty low in the Southeast where I live, but are a fair bit higher in OBOS’s home state of Massachusetts. The report notes wide racial/ethnic gaps here as well, indicating that “in the southeastern United States…13 states had a prevalence of breastfeeding initiation that was ≥20 percentage points different between non-Hispanic blacks and non-Hispanic whites.” In Massachusetts, however, that gap is just 11 percentage points.

The report concludes that: “Breastfeeding should be promoted through comprehensive clinical and social supports starting in pregnancy, and including the birth, delivery, and postpartum periods.”

Of course, no discussion of breastfeeding rates is complete without consideration of all of the workplace, societal and other barriers to breastfeeding for women who choose to do so. The CDC report offers, among other factors, “returning to work sooner (where support for breastfeeding often is insufficient) and lack of social or partner support” as barriers that may prevent women who want to initiate and continue breastfeeding from doing so.

The recent health care reform legislation should help women with at least the workplace barriers. As we mentioned in a previous post, the legislation includes a provision which requires employers with more than 50 employees to provide “reasonable break time for an employee to express breast milk for her nursing child for 1 year after the child’s birth each time such employee has need to express the milk; and a place, other than a bathroom, that is shielded from view and free from intrusion from coworkers and the public, which may be used by an employee to express breast milk.”

It’s unpaid break time, but at least it’s a start.

March 23, 2010

Effects of Health Reform on Maternity Care

Although the just-passed health reform bill has generated considerable debate about abortion (see Christine’s previous post), at least two other reproductive health components of the bill are worth mentioning — provisions related to freestanding birth centers and certified nurse midwives.

We have written previously about the Medicaid Birth Center Reimbursement Act, a bill supported by the American Association of Birth Centers. We’re pleased to report it was included in the health reform bill (section 2301 for those interested in reading the text). As the AABC notes, the reform bill includes provisions for Medicaid payment to freestanding birth centers in states where those centers are licensed.

Now that President Obama has signed the bill, it will go to the Centers for Medicare and Medicaid Services (CMS), which issues Medicaid rules and regulations and pays the federal percentage of Medicaid payments that states might make to birth centers.

The bill also includes a provision to increase Medicare Part B coverage for certified nurse midwife services from 65 percent to 100 percent as of Jan. 1, 2011 (section 3114).

Other relevant provisions include: coverage of tobacco cessation counseling and pharmacotherapy for pregnant women receiving Medicaid (section 4107); establishment of a fund to award grants to states to higher education institutions to enable them to establish, maintain or operate services for pregnant and parenting students (section 10212/3); and amendment of the Fair Labor Standards Act to require reasonable (but unpaid) break time for nursing mothers for one year each time the employee needs to express the milk, in a private place other than a bathroom (section 4207).

Citizens for Midwifery talks more about the effects of the legislation in this release from the MAMA campaign. I, for one, am still attempting to digest all of the bill’s content. Seen any other positive reproductive health items in the bill? Let us know in the comments.

September 7, 2009

Women & Labor: Lillian Moller Gilbreth, Peggy Olson and the Next Generation

Hope you’re all relaxing today, at least for a little bit. Here are a few articles that seem fitting in honor of Labor Day …

- At Women’s eNews, Kate Kelly describes the work of Lillian Moller Gilbreth, also known as the Mother of Modern Management, who was an industrial engineer and a pioneer in creating work environments that met the needs of the disabled. This is the first I’ve heard of Gilbreth, a mother of 12, and continued to read more about her incredible life at Webster and Wikipedia. Gilbreth’s papers are at Smith College.

- From Plain Dealer columnist Connie Schultz: “Last week, in a 5-1 ruling, the highest court here ruled that an Ohio law that bans discrimination against pregnant women does not protect them from punishment for taking unauthorized breaks to use a breast pump after they birth those babies. And you thought we were a trendsetter only in presidential election years.” Read on.


- “Mad Men,” my favorite TV show of the moment, offers a poignant look at the trials of women in the workplace in the early 1960s. The series is set at a growing ad agency on Madison Avenue (that’s copywriter Peggy Olson, played by Elisabeth Moss, above), and it’s full of cringe-worthy moments. Seven of the show’s nine writers are women, which Amy Chozick notes is a rarity in Hollywood television.

Joan Wickersham, who worked as a copywriter in a Boston ad agency in the 1980s, writes in the Boston Globe that “long after the 1960s, the workplace was still stuck in the same cultural blind spot satirized in ‘Mad Men.’” She shares this story of a client presenting prototypes of two computer games — the one targeted to boys involved building a railway empire; the one targeted to girls involved deciding where to put furniture in a house.

I suggested to the client that maybe the girls’ game needed a little more substance. The boys’ game was ambitious, intellectually challenging – couldn’t something similar be devised for the girls? Or maybe they didn’t need their own game. Maybe they’d be just as excited as the boys about building a railway empire. Maybe . . .

One of the men I worked with gave me a look. A look that said: “You’re being a pest, and a troublemaker. Shut up.’’

And I did.

Fast forward another 25 years, and consider Wal-Mart’s gendered back-to-school commercials, as described by Claire Mysko:

Boy version with Mom voiceover: “I can’t go to class with him. I can’t do his history report for him, or show the teachers how curious he is. That’s his job. My job is to give him everything he needs to succeed while staying within a budget…I love my job.” Cut to boy with his new affordable laptop. He’s getting applause from his teacher and the students in the class as he delivers a report.

Girl version with Mom voiceover:“I can’t go to school with her. I can’t introduce her to new friends.” Cut to girl nervously asking “Can I sit here?” to a group of girls sitting together at lunch. “Sure, I like your top!” one of them answers. “Or tell everyone how amazing she is. But I can give her what she needs to feel good about herself without breaking my budget. All she has to do is be herself.” Cut to smiling girls walking arm-in-arm down the hallway.

It appears that much work still needs to be done.

August 12, 2009

10 U.S. Hospitals Added to Baby-Friendly List

During last week’s World Breastfeeding Week, we learned via Women’s eNews that 10 additional U.S. facilities have been added to the list of Baby-Friendly Hospitals so far this year.

To be included on the list, facilities must meet 10 criteria demonstrating a commitment to improve institutional breastfeeding policy, training and practices. The ten steps for successful breastfeeding outlined by UNICEF/WHO for the Baby-Friendly Hospital Initative include helping mothers initiate breastfeeding, appropriately training all staff, avoiding non-breastmilk food unless medically indicated, allowing “rooming in,” and other practices. The steps are also included among the Ten Steps for Mother-Friendly Care outlined for the Mother-Friendly Childbirth Initiative.

The ten new qualifying hospitals (bringing the current number up to 83) are in California, Missouri, and Texas. Visit the BFHI site for a complete list of the qualifying U.S. facilities.

April 13, 2009

HHS Call to Action on Breastfeeding – Submit Your Comments

The U.S. Department of Health & Human Services’ (HHS) Office on Women’s Health, Office of the Surgeon General, and Centers for Disease Control and Prevention have announced a Call to Action on Breastfeeding, and are soliciting comments from individuals and organizations about breastfeeding in the United States.

The website for the initiative explains:

“Breastfeeding is unquestionably healthier for mothers and babies compared to feeding with infant formula. The scientific literature is clear. Numerous reviews of the medical literature have confirmed these benefits. But life in America often creates barriers to breastfeeding and makes it hard for women to breastfeed. It is time for our society to get serious about giving families the support they need to be successful with breastfeeding. For this reason, the U.S. Department of Health & Human Services (HHS) would like to open up a national dialogue on how to make breastfeeding easier in this country.”

The Call to Action on Breastfeeding website also provides some information on the types of comments they are interested in:

“We welcome your suggestions about policies, activities, or other initiatives to protect, promote, and support breastfeeding that need to be considered for inclusion in our national action plan for the next decade. We are especially interested in new ideas that will increase equity in breastfeeding rates among all racial, ethnic, and socioeconomic groups. Ideas should build on programs and policies that are recognized to be effective or evidence-based. In addition, we welcome suggestions to adopt, expand, implement, research, or improve existing strategies.”

There are 12 specific areas for which the agencies are soliciting comments:

  • Maternal and Infant Care Practices: Prenatal, Hospital, and Post-Delivery Care
  • Access to Lactation Care and Support
  • Health Professional Education, Publications, and Conferences
  • Use of Banked Human Milk
  • Worksite Lactation Support, Onsite Child Care, and Milk Expression
  • Paid Maternity Leave
  • Portrayal of Breastfeeding in Traditional Popular Media and New Electronic Media
  • Support for Breastfeeding in Public Settings
  • Peer Support and Education of Family Members and Friends
  • Community Support for Breastfeeding in Complementary Programs (e.g., Early Head Start, Home Visitation, Parental Training)
  • Research and Surveillance
  • Other Areas

The collected comments are intended to be considered by the Office on Women’s Health and other agencies in the development of a “a new national plan of action” on breastfeeding. Comments that have already been submitted can be viewed here, and you can submit your own comments via this online form. Although the website doesn’t seem to provide it, the deadline for your submissions is May 31, 2009.

March 26, 2009

New Study Addresses Hospital Practices and Breastfeeding Rates

A new study published in the American Journal of Public Health looks at hospital practices, women’s intent to breastfeed, and how the former may influence the latter.

I don’t currently have access to the full-text, but here’s what I can gather from the abstract and the press release:  The study authors looked at data from the Listening to Mothers II survey, which asked women to recall their breastfeeding intentions, infant feeding practices at one week, and hospital practices. The researchers found that 70% of these women reported an intention to exclusively breastfeed, but only 50% achieved that goal at one week.

The women also reported hospital practices that conflicted with the Baby-Friendly Hospital Initiative’s ten steps to successful breastfeeding, including supplementation (49%) and pacifier use (45%). The researchers report that women who had their babies in hospitals practicing 6 or 7 of the steps were much more likely to achieve their goal of exclusive breastfeeding than those whose hospitals practiced 1 or none of the steps, suggesting that hospital practices have an influence on whether women succeed at breastfeeding.

Additionally, according to the press release, “about half (49 percent) of first-time mothers who intended to exclusively breastfeed reported that their babies were given water or formula for supplementation, while 74 percent reported being given free formula samples or offers.”

Commenting on the findings, lead author Eugene Declerq asks:

“Why are those hospital practices that have been repeatedly shown to increase breastfeeding among new mothers not more consistently instituted in United States hospitals? A large proportion of mothers stop exclusive breastfeeding within the first week, and that action was strongly related to hospital practices.”

For related coverage of hospital practices and breastfeeding, see our past posts, Task Force Recommends Prenatal and Postnatal Breastfeeding Support and CDC Releases New Report on Hospitals’ Support for Breastfeeding.

February 14, 2009

Double Dose: Chemicals in Toyland; IVF Provides Clues on Nature vs. Nurture; Recession Affects Botox Sales; Happy Valentine’s Day …

Chemicals in Toyland: The Consumer Product Safety Improvement Act (CPSIA) took effect this week, mandating stricter enforcement of lead and phtalates in children’s products and toys.

“While the ban was hailed as a victory for children’s health, it’s no guarantee that the products are safe,” reports NPR’s “Morning Edition.” “That’s because companies currently aren’t required to publicly disclose the chemicals they use in place of phthalates — and little is known about the health effects of one of the most widely used alternatives.”

Pthalates have been shown to affect the development of the male reproductive system in lab animals. They’re also present in some cosmetics, personal care products, pharmaceuticals, food packaging and cleaning and building materials — making them almost impossible to avoid. Check out NPR’s timeline of phthalate regulation and an interactive look at chemicals in the home.

IVF – New Lab for Studies: “In addition to helping thousands of infertile couples have children, ‘test tube’ babies are offering scientists a novel laboratory for resolving one of the most vexing debates in science: nature vs. nurture,” writes Rob Stein in the Washington Post.

In the first study of its kind, British researchers have studied children conceived through in vitro fertilization (IVF) to examine whether children whose mothers smoked during pregnancy were more likely to develop behavioral problems because of the toxic effects of smoking — as has been suspected — or because their mothers passed on a genetic predisposition to antisocial behavior.

The study, which appears to debunk the notion that smoking’s effects on the brain of a developing fetus result in antisocial tendencies, could be the first in a series of attempts to use the approach to disentangle whether genes or various prenatal exposures are responsible for later behavioral problems.

Friends Don’t Let Friends Get “Booty” Injections: And definitely not from a woman who administers shots without a medical license. Two women are now hospitalized in critical condition in Tampa, Fla. “It almost is bootleg cosmetology here,” said sheriff’s office spokesman JD Callaway.

Plus: The economy is having some effect on cosmetic enhancements, reports The New York Times. Natasha Singer writes that doctors and pharmaceutical executives thought antiwrinkle shots like Botox would be resistant to the downturn, but the latest earnings report from Allergan, the maker of Botox, fell almost 9 percent compared with a year earlier. Allergan’s sales of breast implants were down 12 percent.

“You could forecast that with implants, but the bigger question was, ‘How have injectables been holding up?’” said Gary Nachman, an analyst with Leerink Swann, a health care investment bank. “Now, even the injectables have been impacted significantly.”

Maternal & Child Health in the Obama Administration: “[...] President Obama has lauded and pledged to expand presidential initiatives to fight HIV/AIDS, TB and malaria — recognizing the sizeable effect they have had not only in saving hundreds of thousands of lives, but also in improving U.S. foreign policy. Now is the time for President Obama to elevate the issue of global family health to that high level,” argues Maurice Middleberg, vice president for public policy at the Global Health Council.

Council members, including global maternal health, child health and family planning organizations, are developing a framework for a Global Family Health Action Plan.

On Their Own Terms: “[B]etween the clinic demonstrations, the political discussions and the imprecations from the pulpit, too many American women have come to feel that their pelvis is public property. Slowly, quietly, a new abortion method has become part of the landscape, and it’s no accident that those women who have chosen it often cite reclaiming privacy and control as the reason,” writes Anna Quindlen at Newsweek, describing how RU-486 has allowed women to keep abortion private and personal.

Plus: Glamour magazine recently featured a whole section on abortion, acknowledging that one in three women will have at least one abortion by age 45. Eight women share their personal stories.

Salma Hayek Sparks Breastfeeding Discussions: By now you’ve probably heard about Salma Hayek breastfeeding an infant in Sierra Leone. ABC’s “Nightline” filmed Hayek during a trip to Africa to spotlight efforts to eliminate tetanus through vaccinations. The infant’s mother had no milk, so Hayek did what came naturally. Tracy Clark Flory nicely sums up some of the respectful and sophmoric public reactions.

Hayek, who is still breastfeeding her 1-year-old daughter, said, “I actually think my baby would be very proud to share her milk. And when she grows up I’m going to make sure she continues to be a generous, caring person.” Read more reactions and more about Hayek’s journey. The full “Nightline” episode is quite moving.

Happy Valentine’s Day: Some feminist advice from RH Reality Check. Plus, researchers at the University of Iowa report on what college-age men and women are looking for in a mate and how priorities have changed since the 1930s. While it’s nice to see that “chastity” is no longer an important characteristic, I’m surprised “similar political background” is considered unimportant as well.

And here’s the best act of defiance I’ve seen mentioned for Valentine’s Day — members of the Facebook group “A Consortium of Pub-going, Loose and Forward Women” are encouraged to “Join us on Feb. 14, Valentine’s Day, the day on which Indian women’s virginity and honor will self-destruct unless they marry or tie a rakhi. Walk to the nearest pub and buy a drink. Raise a toast to the Sri Ram Sene.” Swati Prasad explains the rebellion against the right-wing Sri Ram Sene.

January 31, 2009

Double Dose: Breast Cancer Memoirs; Keeping Open the Window on Healthcare Reform; Red Sex, Blue Sex; Chemicals May Delay Pregnancy …

What I Learned From Breast Cancer Memoirs: “Breast cancer memoirs have become such staples — reliably displayed during Let’s Wave Pink Ribbons for Breast Cancer month — that it’s hard to remember a time when women didn’t document their journey from onset through the catalog of treatments to restored health, stabilization, or imminent death. But it wasn’t always thus,” writes S.L. Wisenberg in the Chicago Reader.

She continues:

True, British author Fanny Burney wrote to her family about the agonizing mastectomy she underwent — without anesthetic — in 1811. And Katharine Lee Bates (whose poem “America the Beautiful” became the famous hymn) wrote to friends in 1915 about her partner’s breast cancer and death. But neither of these works was published in the author’s lifetime. It was only after World War II that prominent American women went public with their tumors. Marion Flexner, wife of a well-known doctor, wrote “Cancer — I’ve Had It” for Ladies’ Home Journal in May 1947, breaking a taboo by refusing to euphemize her condition — and even inserting a little slapstick with a passage describing “roving boozies”: prosthetic breasts that escaped the confines of a bra and fell to the floor.

It’s a terrific essay, and it makes this reader eager to read Wisenberg’s own story, “The Adventures of Cancer Bitch,” due out in March from University of Iowa Press. In the meantime, visit her blog.

Healthcare Overhaul: “Mindful of how delays sapped the political will to overhaul healthcare during the Clinton administration, health advocates hoped to get a major bill during the new administration’s first 100 days,” reports the Boston Globe. “Now, it looks like it will take longer, and some observers fear that a historic opportunity could be missed.”

Family Planning Nursing Program Saved in Washington: “A campaign by Planned Parenthood to save a program that provides family-planning services in welfare offices has apparently worked, for now,” reports the Yakima Herald. “The Community Service Office (CSO) Family Planning Nurse program, which houses 70 nurses statewide at 58 Department of Social and Health Services offices, will stay open through June. Previously, DSHS planned to shut down the service Jan. 30.”

Split Over Abortion-Reduction Tactics: “The election of a pro-choice administration and a Democratic Congress has divided the pro-life movement, between those who are preparing for the fight of their lives and those who see an opportunity to redefine what it means to be pro-life,” reports Newsweek.

Plus: Red Sex, Blue Sex: Back in November, The New Yorker looked at another type of divide:

During the campaign, the media has largely respected calls to treat Bristol Palin’s pregnancy as a private matter. But the reactions to it have exposed a cultural rift that mirrors America’s dominant political divide. Social liberals in the country’s “blue states” tend to support sex education and are not particularly troubled by the idea that many teen-agers have sex before marriage, but would regard a teen-age daughter’s pregnancy as devastating news. And the social conservatives in “red states” generally advocate abstinence-only education and denounce sex before marriage, but are relatively unruffled if a teen-ager becomes pregnant, as long as she doesn’t choose to have an abortion. A handful of social scientists and family-law scholars have recently begun looking closely at this split.

What About …: The delivery of octuplets in Los Angeles this week raised many questions, including: Can a woman breastfeed eight children?

Lawsuit Takes on Higher Insurance Rates for Women: “California insurers are discriminating against women, charging them more for individual health insurance than men, the city of San Francisco maintained in a lawsuit filed Tuesday against the state regulators who govern them,” reports the L.A. Times.

Gender rating is health insurance is also the focus of two bills have been introduced in the California state Legislature to address the issue. If either of the bills is signed into law, the suit may be dropped.

Study Says Common Chemicals May Affect Fertility: HealthDay News reports on a study that suggests chemicals known as perfluorinated chemicals, which are pervasive in food packaging, pesticides, clothing, upholstery, carpets and personal care products, may delay pregnancy. The study appears in the Jan. 29 edition of Human Reproduction and is available online.

These chemicals are being phased out in the United States because of their toxic effects, and are expected to be completely gone by 2010. However, they remain in the environment and in the body for decades, and have been linked to developmental problems.

“These widespread chemicals apparently lower the fertility in couples trying to get pregnant,” said lead researcher Dr. Jorn Olsen, chairman of the Department of Epidemiology at UCLA’s School of Public Health.

Danish women in the study who had with high levels of perfluorooctanoate (PFOA) and perfluorooctane sulfonate (PFOS) took longer to get pregnant, Olsen said.

January 28, 2009

Breastfeeding and Feminism Symposium: Registration and Call for Abstracts

This just in
4th Breastfeeding & Feminism Symposium: From Birthplace to Workplace
Thursday and Friday, March 26 – 27, 2009

We are now accepting abstracts for poster presentations that describe research, programs or policies that address our theme. From Birthplace To Workplace will build on the following principles addressed at previous symposia:

  • Breastfeeding is public health imperative and an important aspect of reproductive health, as well as a reproductive right and a social and biological process;
  • Women must have the right of self-determination to breastfeed freely and without constraint;
  • It is important to re-orient the paradigm in which breastfeeding is viewed as  a “lifestyle choice” to a paradigm in which it is a “human right” and a “social justice issue” so as to ensure the social, economic and political conditions necessary to promote success; and
  • Women’s decisions to breastfeed should not result in the loss of their economic security or any rights or privileges to which they are otherwise entitled.

The 2009 symposium brings a feminist lens to ensuring the social, economic and political conditions necessary to secure breastfeeding for all women from the birthplace to the workplace. Working together in a transdisciplinary manner, with social scientists, health workers, lactation and feminist advocates, employers,  and policy makers, we will create a policy agenda for action.

Hosted by: The UNC at Greensboro Center For Women’s Health and Wellness and The UNC at Chapel Hill Carolina Breastfeeding Institute.

Please email CWHW AT uncg DOT edu for more information.

January 17, 2009

Double Dose: Mass. Mothers Get Breastfeeding Protection; NABJ Conference on Health Disparities; A Funny Thing Happened on the Way to the Clinic; The Cutting Edge of Opera; Studies on IVF, Fosamax …

Who Decides? A State-by-State Analysis: NARAL Pro-Choice America has released its 18th edition of “Who Decides? The Status of Women’s Reproductive Rights in the United States.” The report summarizes the state of women’s access to reproductive healthcare nationwide, including legislation considered and enacted in 2008. This year’s edition also examines attacks on choice in the states and in the courts and highlights pro-choice legislative and non-legislative victories, including NARAL’s Prevention First initiative.

Trading in “Barefoot and Pregnant” for Economic and Reproductive Justice: “The relevance of barefoot and pregnant remains central to an inclusive and just America,” writes Gloria Feldt. “Economic parity and reproductive justice are still intertwined, not only in the lives of individual women; they are indivisibly connected to our economic recovery as well.”

A Funny Thing Happened on the Way to the Clinic …: That’s the title of an essay in Exhale’s latest issue of its bilingual abortion zine, “Our Truths/Nuestras Verdades” (download the pdf). Yes, it’s the humor issue. As Exhale founder Aspen Baker writes in the intro to the issue:

Abortion is a serious personal issue that is hotly debated in public while real women have abortions in private, often in secret, and with little social support or understanding.

What could possibly be funny about that?

In this issue of Our Truths, we aim to find out. We witness funny women who use humor to get through tough times, truth-tellers who bust ridiculous myths about women who have abortions, and discover laughter that heals the soul. We also question humor that hides what’s real, judges or hurts others.

Check it out.

Massachusetts Adopts Breastfeeding Law: Massachusetts this month became the 48th state to offer legal protection to women who breastfeed their children in public. The Massachusetts Breastfeeding Coalition will provide mothers a “license to breastfeed” card with details of the new law and instructions on how to report violations, according to the Patriot Ledger.

The state Legislature passed the bill, “An Act to Promote Breastfeeding,” in December, and the governor signed it into law Jan. 9. Up to this point, women could have been prosecuted for indecent exposure or lewd conduct.

North Dakota and West Virginia remain the only states without breastfeeding legislation.

The Cutting Edge of Opera: “Skin Deep,” a new production opening in the UK, looks at the work of an unscrupulous fictional plastic surgeon: Dr. Needlemeier. At this BBC video slideshow, composer David Sawyer describes the opera as a story about “fear of death, vanity and the wish for immortality.” The “Skin Deep” website is far from superficial.

NABJ Conference on Health Disparities: The National Association of Black Journalists is hosting a conference on health disparities Jan. 30-31 at Morehouse School of Medicine.

The purpose is to “give journalists insight into health disparities affecting the African American community, resulting in significantly higher mortality rates. Learn how to cover major health and medical stories that make an impact. Topics include obesity, heart disease, stroke, HIV/AIDS, mental health and the aftermath of Hurricane Katrina.”

IVF Doesn’t Restore Fertility in Women Over 40: “A study involving more than 6,000 women who underwent the treatment at a large Boston clinic found that while [in vitro fertilization] could give infertile women younger than 35 about the same chance of having a baby as women typically have at that age, it could not counteract the decline in fertility that occurs among those older than 40,” writes Rob Stein at the Washington Post.

“Even as effective as IVF is, it can’t reverse the effects of aging,” said Alan S. Penzias of Harvard Medical School, who led the study, published in the New England Journal of Medicine. “We cannot reverse the biological clock.” Here’s the study’s abstract.

Kidney Transplants Less Likely to go to Women: A new study indicates that women over 45 are significantly less likely to be placed on a kidney transplant list than their equivalent male counterparts, even though women who receive a transplant stand an equal chance of survival. The study appears online in the Journal of the America Society of Nephrology.

“As woman age, that discrepancy widens to the point where woman over 75 are less than half as likely as men to be placed on a kidney transplant list,” said lead researcher Dorry Segev, M.D., a Johns Hopkins transplant surgeon. “If the women have multiple illnesses, the discrepancy is even worse.”

Fosamax Linked to Two Diseases: “Two recent reports have linked the osteoporosis drug alendronate (Fosamax) with rare but serious side effects,” reports the L.A. Times.

“In a letter to the New England Journal of Medicine published Jan. 1, a Food and Drug Administration official reported that since Fosamax was first marketed in 1995, 23 cases of esophageal cancer in patients taking the drug — including eight deaths — have been reported to the agency. And a USC study published in the January issue of the Journal of the American Dental Assn. reported that nine patients who were taking Fosamax suffered osteonecrosis of the jaw — a bone-killing infection — after having teeth extracted at USC dental clinics.”

January 1, 2009

A New Year Review of Women’s Health Heroes

Among the many luminaries who died in 2008 are women who made significant contributions in the areas of women’s health and hospice care. Please add names and links we might have missed in the comments.

Pamela Morgan | b. 1949
In November, Our Bodies Ourselves lost one its founders, Pamela Morgan. A writer, editor and administrative manager of the organization in its early days, Morgan was “one of these extraordinarily multitalented individuals, and as a dancer, everything she did was with élan and flair,” said Judy Norsigian, executive director of OBOS.

Remembrances by other OBOS co-founders who had the privilege of working closely with Pamela can be read here.

Barbara Seaman | b. 1935
Barbara Seaman, a self-described muckraker, co-founded the National Women’s Health Network in 1975. A tireless advocate, she is credited with helping to create the concept of patients’ rights, particularly “informed consent,” and is well-known for her writings on women’s health. Her first book, “The Doctors’ Case Against the Pill” (1969), led to congressional hearings on the safety of oral contraceptives. “The Greatest Experiment Ever Performed on Women” (2003) was an expose of hormone replacement therapy.

OBOS co-founder Norma Swenson wrote wrote a rememberance of Barbara Seaman focusing on their involvement in the early women’s health movement.

Edwina Froelich | b. 1915
In the 1950s, Edwina Froelich was part of a group of suburban Chicago moms who met at each other’s homes to help new mothers with breastfeeding. The seven women, all Catholic housewives, founded the La Leche League.

“In those days you didn’t mention ‘breast’ in print,” Froehlich once said. “We knew that if we were ever going to get anything in the paper we would have to find a name that wouldn’t actually tell people what our organization was about.”

When we first wrote about her death in June, it sparked a discussion about La Leche and feminism. In an essay about Froelich published in The New York Times Magazine last week, Emily Bazelon addresses the history of the organization and its attitude toward working mothers.

Florence Wald | b. 1917
Here’s a hero we haven’t yet mentioned. In the 1960s, after attending a lecture by a British physician about opening the world’s first hospice, Florence Wald resigned her position as dean of the Yale School of Nursing to focus on developing a hospice care center in the United States.

“In those days, terminally ill patients went through hell, and the family was never involved,” she said. “No one accepted that life cannot go on ad infinitum.”

In 1974, Connecticut Hospice, the nation’s first home-care program for the terminally ill, opened its doors. A 44-patient hospice opened six years later. From The New York Times:

“This hospice became a model for hospice care in the United States and abroad,” the publication Yale Nursing Matters said this week, adding that Mrs. Wald’s role “in reshaping nursing education to focus on patients and their families has changed the perception of care for the dying in this country.”

There are now more than 3,000 hospice programs in the United States, serving about 900,000 patients a year.

In recent years, Mrs. Wald had concentrated on extending the hospice care model to dying prison inmates.

“People on the outside don’t understand this world at all,” Mrs. Wald told The New York Times in 1998. “Most people in prison have had a rough time in life and haven’t had any kind of education in how to take care of their health.”

Rosetta Reitz | b. 1924
Rosetta Reitz is best known for her support of women involved in early jazz and blues — stars who were overlooked in the shadow of male performers. With $10,000 borrowed from friends, Reitz created Rosetta Records, releasing 17 albums of lost music. But as The New York Times notes, music history was just one of Reitz’s accomplishments:

Ms. Reitz was at different times a stockbroker, a bookstore proprietor and the owner of a greeting card business. She was a food columnist for The Village Voice, a professor, a classified-advertising manager and author of a book on mushrooms. She was a founding member of Older Women’s Liberation. She reared three daughters as a single parent.

Ms. Reitz also wrote “Menopause: A Positive Approach” (1977), considered one of the first books to look at menopause from the viewpoint of women and not doctors. She listened to her recordings of women while she wrote the book, many of them celebrating the strength of women rather than treating them as victims.

“I was so alone and needed to be nurtured, and I found I was getting it from them,” she told The Los Angeles Times in 1992.

December 20, 2008

Double Dose: Discussing Health Care Reform; Study: HIV Infects Women Through Healthy Tissue; Facebook Censors Breastfeeding Photos; “Unofficial” Feminists …

What to Discuss When You’re Discussing Health Care: If you’ve signed up to join or lead a health care discussion in your community — as requested by President-elect Barack Obama and Obama’s secretary-designate for Health and Human Services, former Sen. Tom Daschle — you might want to read Judith Graham’s “community discussions” blog series. Graham, a health writer for the Chicago Tribune, poses questions to ask and consequences that should be considered as part of any conversation.

And if you haven’t yet signed up, consider taking part; don’t leave health care reform up to the insurance and drug companies.

Plus: As part of the national discussion, The Big Push for Midwives is hosting a meeting today in Missouri on maternity care in the heartland. From the press release:

The conversation will explore the national maternity care crisis, which sits atop the two crumbling pillars of affordability and birth outcomes. The recent “D” and “F” grades that Kansas and Missouri received respectively from the March of Dimes for pre-term birth rates will be examined. Further, the need for our community, our state, our nation, to immediately shift its ingrained belief “that more medical intervention, regardless of cost, is better — even when the evidence doesn’t support such a claim” will be explored, specifically as it relates to mother and child health.

New Perspective on How HIV Infects Women: A new study by U.S. researchers has found that HIV appears to attack normal, healthy genital tissue in women. Previously researchers thought HIV transmission was more likely through breaks in the skin, such as a vaginal tear or herpes sore.

“Normal skin is vulnerable,” Thomas Hope, of Northwestern University’s Feinberg School of Medicine, told Reuters.

Hope said the study suggests the virus takes aim at places in the skin that had recently shed skin cells, in much the same way that skin on the body flakes off.

The finding casts doubt on the prior theory of the virus requiring a break in the skin or gaining access through a single layer of skin cells that line the cervical canal.

And it might explain why some prevention efforts have failed. Hope said one clinical trial in Africa in which women used a diaphragm to block the cervix had no effect at reducing transmission of the virus. Nor have studies of drugs designed to prevent lesions in genital herpes proven effective.

Breastfeeding Photos Censored; MILC Fights Back: Via Motherlode, we learn that MILC, the Mothers International Lactation Campaign, is asking Facebook members on Dec. 27 to change their profile picture, just for one day, to an image of a nursing mom, to protest the way Facebook has arbitrarily removed photos of women breastfeeding from member albums and profiles. The event description reads:

This could be a picture of you or someone you know nursing a child, it could be a painting or image of a sculpture of a breastfeeding woman, it could also be a photo or image of any nursing mammal … We ask that you include the status line of “Hey Facebook, breastfeeding is not obscene!”

Residency Law Struck Down in CA: “A San Francisco judge struck down a state law Tuesday that requires low-income women to live in California for six months before qualifying for state-funded care during pregnancy and immediately after childbirth,” reports the San Francisco Chronicle

“Time is of the essence in obtaining access to prenatal care, especially in the first trimester,” said Lynn Kersey, executive director of Maternal and Child Health Access, a nonprofit organization that filed a lawsuit against the state in April. “Study after study shows that early access to prenatal care is important for the well-being of the mother and the child. To deny working women health care simply because they are new to the state endangers the health of both the mother and the child.”

The ACLU of Northern California, one of the groups that represented MCH Access, has more.

Journal Articles on Promoting Preconception Health: The November/December issue of the journal Women’s Health Issues includes a free supplement — Policy and Financing Issues for Preconception and Interconception Health — meaning all articles are available online without a subscription. Topics include welfare reform, Medicaid funding and the role of community health centers.

For example, an article (pdf) by experts at the Kaiser Family Foundation reviews Medicaid’s eligibility policy and benefits of relevance to women of reproductive age and discusses challenges facing the program.

V-Day is Coming Soon: Chicago Women’s Health Center is holding an open call for all self-identified women to join the cast of The Vagina Monologues in Chicago. The open call takes place at 1p.m. on Sunday, Jan. 4. No experience needed. Email sexual DOT empowerment AT for more info.

Pharmacy Owners’ Case Against Morning-After Pill Moves Forth: “Two pharmacists who object to filling prescriptions for emergency contraception, commonly known as the morning-after pill, will get their day in court after the Illinois Supreme Court on Thursday overturned an appellate decision dismissing their case,” reports the Chicago Tribune.

The pharmacists are challenging a 2005 executive order issued by now-troubled Gov. Rod Blagojevich requiring all Illinois pharmacists to dispense contraceptives, including the morning-after pill. The executive order later became an administrative regulation.

Pro-choice groups aren’t getting too upset about the 5-2 ruling (view the decision [pdf]).: “The court avoided the merits of the [pharmacists'] claim. All they did was say, procedurally, the case has to go back to the trial court for further consideration,” said Lorie Chaiten, director of the reproductive rights project at the American Civil Liberties Union of Illinois.

Dear Obama: Here’s Why You are Wrong on Warren: Leah McElrath Renna breaks it down:

The Presidential Inauguration is – by definition – a symbolic event. That’s its entire purpose. What it is NOT is a policy roundtable. No one disputes your right to seek a variety of viewpoints about policy concerns.

The point is that – with an entire world of spiritual leaders chomping at the bit to participate in this Inauguration – there is simply no valid reason that you could not have chosen someone to perform the Invocation who actually recognizes lesbian, gay, bisexual and transgender people as whole and perfect children of God exactly how they are.

Plus: Wanna send donuts to Pastor Warren? Other ideas?

Enough with the Unofficial Feminism: I love Kate Winslet, which is why it pains me all the more to see her answer the tired gotcha question, “Are you a feminist?” with the tired mushy response:

“I think I probably am, aren’t I?” Her assistant hurriedly adds, “In a loose, unofficial kind of way,” but Winslet continues to ponder. “I think I probably am. I mean, not in a bra-burning way. But I think I am a feminist, yeah.”

Winslet does think Betty Friedan was “a feisty chick.”

October 22, 2008

Task Force Recommends Prenatal and Postnatal Breastfeeding Support

The U.S. Preventive Services Task Force has updated its statement on breastfeeding promotion following a review of the evidence, and recommends that “health care settings use strategies that work with women and families both before and after delivery to encourage and support breastfeeding.” The previous review, published in 2003, did not address prenatal support and had found insufficient evidence for interventions such as counseling by primary care providers.

The Task Force is part of a government agency and focuses on better informing healthcare providers by reviewing evidence of effectiveness and developing recommendations for clinical services. Its recommendation in this case is Grade B, meaning that “There is high certainty that the net benefit is moderate or there is moderate certainty that the net benefit is moderate to substantial.”

In the recommendation, the reviewers note that there is evidence that breastfeeding may have health benefits for women and children, and that interventions to support breastfeeding have been found to increase the rates of initiation, duration, and exclusivity of breastfeeding, while the harms of such interventions are thought to be minimal.

The commentary on these potential harms specifically addresses the empowerment of women to make informed choices. The reviewers explain (emphasis added):

“No studies identified for the USPSTF reported harms from interventions to promote and support breastfeeding. Nonetheless, there are potential harms, such as making women feel guilty. Breastfeeding interventions, like all other health care interventions designed to encourage healthy behaviors, should aim to empower individuals to make informed choices supported by the best available evidence. As with interventions to achieve a healthy weight or to quit smoking, breastfeeding interventions should be designed and implemented in ways that do not make women feel guilty when they make an informed choice not to breastfeed.”

The reviewers also note that additional research is needed on issues such as exclusive vs. partial breastfeeding, costs and cost benefits of interventions to promote breastfeeding, the effectiveness of compliance with the World Health Organization’s Baby-Friendly Hospital Initiative in the United States, the effects of individual components of breastfeeding support, and “to allow the tailoring of interventions to the needs of individual women and families.”

The agency’s Recommendation Statement is freely available online, and links to supporting documents are provided here.

August 14, 2008

Breastfeeding, Language and Privilege

A post at Well this week about a new breastfeeding study provides several lessons in language and privilege — and it also serves as a reminder of the importance of collective action.

The study, published in the August issue of the Journal of Human Lactation, found that while three-quarters of new mothers try breastfeeding, only 36 percent of babies are breastfed through six months. The recommendation from the American Academy of Pediatrics is to breastfeed exclusively for six months, with continued breastfeeding for one year or more. WHO recommends continuing for two years or more.

Despite those recommendations, the United States famously lags behind other countries in providing much-needed support for nursing mothers. Factors include the absence of breastfeeding training and support after hospital discharge; the high percentage of hospitals handing out free infant formula samples; the lack of paid maternity leave (only 51 percent of new mothers receive any paid maternity leave, and even among companies considered the best for working mothers [PDF], the statistics aren’t good); and the difficulties women encounter upon returning to work, including a lack of time and privacy to express milk in a safe, clean environment.

One of the first commenters on the Well post described her own experience:

I can tell you why breast feeding drops off before 6 months: Women have to work! As I type, I’m hooked up to a beast pump in my nice office with a locking door. It would not be possible for me to breastfeed if I didn’t have these small perks.

As a prosecutor, I’ve had to make some sacrifices to continue to breastfeed my daughter. For example, I can’t take any cases to trial because I can’t be away from my office for an entire day. Luckily, I have a supportive work environment.

I don’t know what one of my secretaries would do if she wanted to breastfeed. They are all stuck in cubicle land. [...]

Which prompted this response a few comments later:

Perhaps the prosecutor – and other women with the privileges and perks she cites – ought to stand up for the secretaries and others who don’t have those perks. Rather than wondering what those in cubicle land would do, she might ask those women what they do, and what the workplace as a whole could do to support them. There must be some space that could be used periodically by any woman needing to pump, and advocating for that would be a nice way for the poster, or anyone else (male or female!) to support working mothers. [...]

The commenter makes a great point, but really it’s the responsibility of all of us to advocate for these changes. Here’s another comment from a mother whose workplace seems to offer the ideal supportive environment that should be available to all women:

After returning to work when he was 3 months, I pumped three times a day in my work place’s “Mom’s rooms” which were a couple of small rooms in different buildings where we could plug in our pumps and store milk if needed in a fridge. Now 10 years later, we have more rooms and also company provided hospital grade pumps so Moms can just bring their own attachments instead of carting around the pump. I know being able to pump at work was a huge factor in me staying in the work force and not quitting to stay home. [...]

This amenity is available to all workers at our location – both manufacturing technicians in our plants and office (we only have cubes) employees. I will say, it took a lot of work to pump, deal with the bottles, skip outside lunches etc but it was worth it to me and my family. Meeting other Moms who were also pumping was another factor in sticking with it, so now I try to give this info to any new Moms in my group. I try to be non-judgemental when I mention this, just letting them know what is out there and thats its possible.

A number of commenters also took issue with the headline of the post: “Most Moms Give Up on Breastfeeding.” I think this response best sums up the critique:

“Giving up” definitely implies failure by the person doing the giving up — and yes, how you express the fact of abbreviated nursing periods DOES matter, a great deal.

Blame for the failure should be shared by many overlapping systems (and, of course, in some cases, the particular families involved). But when the problem is expressed in terms that frame it as a matter of personal, individual responsibility, the solutions to the problem end up focusing on improving individual behavior.

Even though the evidence of the benefits of avoiding artificial feeding continues to accumulate, we fail SYSTEMICALLY to allow all women and children to enjoy these benefits. So yes, some families “give up”. But this article isn’t about a few individual women or families who choose badly, it’s about the many hurdles faced by breastfeeding women in this country.

If you’re looking for a place to get started, Moms Rising has a statement you can sign in support of the Breastfeeding Promotion Act, which was introduced by Rep. Carolyn Maloney (D-N.Y.) in 2007 and now seems stuck. These are the major provisions:

• amends the Civil Rights Act of 1964 to protect breastfeeding women from being fired or discriminated against in the workplace
• provides tax incentives for businesses that establish private, lactation areas in the workplace
• provides for a performance standard for breast pumps
• allows breastfeeding equipment to be tax deductible for families

Rachel has more details about the bill here (along with a smart quibble!). And check out more campaigns sponsored by Moms Rising concerning family leave, health care and fair pay.

Plus: For anyone interested in the history of campaigns to increase breastfeeding rates, I came across this interesting article in the American Journal of Public Health that describes infant feeding practices and public health campaigns in the early 20th and 21st centuries.