The Real Deal, the blog of the National Council for Research on Women (and a new addition to our blogroll!), last week asked leaders of women’s organizations to speculate how life might be different in an Obama era, that is: “more equitable, healthier, more secure — for women and girls.”

The answers were posted on the Real Deal, and excerpts appeared on The Huffington Post.

Among the responses — Women’s eNews founder and editor Rita Henley Jensen calls for the creation of an Office of Maternal Health; Marie Wilson, president and founder of The White House Project, calls for the nation’s first Presidential Commission on Women and Democracy; and Marcia D. Greenberger and Nancy Duff Campbell, co-presidents of the National Women’s Law Center, note that “the nation has no time to spare in providing guaranteed, affordable health care for all, passing essential legislation that provides basic fairness in the workplace, like the Lilly Ledbetter Fair Pay Act, and undoing some of the onerous restrictions on women’s access to reproductive health that were imposed by the Bush Administration.”

The NCRW is hoping readers of blogs like OBOB will add their suggestions to the comments sections at HuffPo. So have at it.

Speaking of the National Women’s Law Center, the organization has been very tuned into health care and is hosting monthly Reform Matters conference calls for women’s advocates who are focused on health reform at the state and federal level.

The next call takes place Thursday, Nov. 13, 2008 at 1 p.m. (EST), and the discussion will focus on what the election means for women and health care reform. Interested? Register for the call here.

These calls provide a collaborative forum to share experiences and questions that have come up in addressing various health reform proposals. So if you miss this one, keep NWLC in mind for future conversations. You might also check out the NWLC’s resources on comprehensive and affordable health care.

Finally, the International Women’s Health Coalition has made available remarks by IWHC President Adrienne Germain on the prioritization of women’s and young people’s health under a new administration. The  16-page agenda for the future can be read online here (PDF).

With less than one week to go until Election Day, we’re taking a look at some of the women’s health issues at stake. Want to add more? Leave links to blog entries or other resources in the comments.

One other note — I can’t believe some folks aren’t voting. If you know anyone who plans on sitting this one out, please urge them to consider the importance of their vote on local and state issues, in addition to what’s obviously a national turning point for women’s reproductive rights and access to health care.

Still wondering about the differences between the health care reform proposals of senators John McCain and Barack Obama? You might want to review this non-partisan report, “Health Care Reform and the 2008 Election - A Guide for Women.”

Through the stories of seven “fictional women,” each with a different set of health problems and insurance coverage, readers can understand what each candidates’ health reform plan means to them. The report was published by the Connors Center for Women’s Health and Gender Biology at Brigham and Women’s Hospital.

And don’t forget Kaiser Family Foundation’s excellent Health08.org, which includes in-depth comparisons of the candidates’ health care plans and positions on issues.

Turning to ballot propositions, USC’s Initiative and Referendum Institute (IRI) offers a good overview (PDF) of the 153 ballot propositions before voters in 36 states, including headline issues of same-sex marriage and abortion (also the subject of discussion on Monday’s “Talk of the Nation”).

Measures to ban gay marriage are on the ballot in California, Arizona and Florida, with most eyes on California, which the IRI refers to as a “critical firewall in the battle over gay marriage.” This document (PDF) analyzes the likelihood of passage in each of the three states, and it features a list of all same-sex marriage propositions. Did you know that 29 of 30 measures banning same-sex marriage — some proposed by initiative, others by state legislatures — have passed?

BallotPedia.org is another comprehensive site. It’s easy to search and it does a nice job of listing initiatives by category, including abortion, marriage and health care. These pages include not only this year’s ballot items, but also initiatives coming up next year — and even those that failed to get on the ballot. Very cool.

Here’s a look at some of the discussions on three specific ballot items:

1. Colorado Amendment 48 Definition of Person: This amendment seeks to define “person” and grant constitutional rights from the “moment of fertilization.” It’s also been tied to “Horton Hears a Who” (”a person’s a person, no matter how small”) — much to the consternation of thinking Dr. Seuss fans everywhere.

Protect Families, Protect Choices has a good fact sheet about the far-reaching consequences of this amendment, including:

• Emergency contraception for rape and incest victims would be banned. By giving legal rights to fertilized eggs, this amendment could ban birth control options like the Pill and IUD’s. (These kinds of birth control can prevent a fertilized egg from implanting in the uterus.)
• Establishing rights from the moment of fertilization would ban some stem cell research being used to find cures for chronic disease and disabilities. In vitro fertilization could be banned since fertilized eggs used in these processes would have full legal rights.
• A woman with cancer could be denied access to life saving medical treatment because it could endanger a fertilized egg.

Former U.S. Rep. Patricia Schroeder recently wrote: “Years ago, when I was asked how I could be both a mother and a Congresswoman, I replied, ‘I have a brain and a uterus and I use both.’ On November 4, I urge Coloradans to use their brains and protect women’s uteruses. Vote no on Amendment 48.”

2. South Dakota Abortion Ban Initiative: Following South Dakota’s failed attempt in 2006 to ban abortion, this kindler, gentler initiative “now makes convoluted exceptions for rape, incest and, when there is a full moon and Mount Rushmore spouts Strawberry Quik, the health or life of the woman.” It’s being pushed by anti-choice activist Leslee Unruh, who has trouble following the facts of life (including her own).

South Dakota Campaign for Healthy Families has an incredible amount of useful information, including statements in opposition to the initiative submitted by the South Dakota State Medical Association and the South Dakota section of the American College of Obstetricians and Gynecologists.

Plus: Katha Pollitt this week spotlights Women Run! South Dakota, the umbrella organization for progressive pro-choice Native American women running for the state legislature.

3. California Proposition 4 (”Sarah’s Law)”: In an editorial, the L.A. Times came down against this parental notification proposal, noting:

The initiative purports to protect California girls from dangers associated with abortions by requiring that their parents be notified. But Proposition 4 attempts to solve something that isn’t much of a problem. There’s no evidence that California’s teenage girls are harmed by abortions with any frequency, whether or not their parents have been notified. [...]

In fact, under the guise of protecting underage girls, this proposal really is just the latest attempt to impose any obstacle in the exercise of reproductive freedom. This represents the third try in recent years to pass such a measure. California should reject it again.

The editorial goes on to note, in no uncertain terms, the ridiculousness of the measures included to protect girls in abusive situations:

Proposition 4’s writers say they crafted a measure that would permit girls in potentially abusive situations to get an abortion without their parents being notified. To do so, they would need to tell another adult relative. But a girl can use this option only if she makes a written accusation alleging that her parents are repeat child abusers, with the complaint to be turned over to authorities. Spoiler language like this makes it hard to believe that Proposition 4 is chiefly about girls’ safety.

Read more editorials against Proposition 4. Planned Parenthood has posted a number of videos about how the proposition would endanger teens, including the one below, “Jane’s Journey,” which shows the complexity of the judicial maze that teens would be forced to navigate if they can’t talk to their parents.

The New Health Insurance Model: In the first of a three-part series, the L.A. Times looks at the changing insurance scenario — where once working Americans could rely on employer-based benefits, now more people are being forced into the individual market, where coverage is costly, bare-bones and precarious.

Part two looks at the business side of managing health savings accounts, and part three covers the battle between doctors and insurers. Meanwhile, health care costs continue to rise.

Plus: Read more about how the individual health insurance market fails women. It’s a great report from the National Women’s Law Center.

No Candy or Condoms: Divine Mercy Care Pharmacy in Chantilly, Va., drew attention this week for becoming at least the seventh pharmacy in the United States to refuse to sell contraceptives of any kind, even if a person has a prescription. The decision, say owners, is guided by Roman Catholic teachings, though the pharmacy is not affiliated with the Catholic church. Still, it did receive a blessing from Arlington Bishop Paul S. Loverde. From the AP:

“This pharmacy is a vibrant example of our Holy Father’s charge to all of us to wear our faith in the public square,” said Loverde, who sprinkled holy water on the shelves stocked with painkillers and acne treatments. “It will allow families to shop in an environment where their faith is not compromised.”

Too bad everyone can’t shop in an environment where their health is not compromised. In Virginia, pharmacists can turn away any prescription — for any reason.

Prop What?: Heather at Scarleteen gives a good overview of several important ballot measures that will be up for vote Nov. 4 in states from Arkansas to South Dakota, “such as parental notification laws for minors who want an abortion, age of consent laws, same-sex marriage, civil rights, stem cell research, education issues, even a proposal to lower the voting age for primaries in one state (whoohoo!) and another to ban abortion outright (grrrr).”

Plus: Look up ballot measures for your state here.

2009 Sheroes: Next year’s Sheroes Womyn Warriors calendar is now available for sale (check out the beautiful cover art by Ekua Holmes!). The calendar honors change agents, rebels, radicals and revolutionaries of different times and places around the globe.

“This is definitely not a ‘great women of history’ celebrity calendar,” reads the back cover. Instead, this is a calendar “of womyn who have challenged their societies and who have advanced the struggle of the oppressed and exploited.”

Proceeds support the Gustavus Myers Center for the Study of Bigotry and Human Rights at Simmons College.

Plus: Send in suggestions for who should be included in the 2010 calendar.

Seen But Not Heard: Jeannine Stein at the L.A. Times writes: “Researchers at Texas Tech University Health Sciences Center in Lubbock interviewed eight overweight women ages 20 to 61 to learn about their experiences with the healthcare system, then published their findings in this month’s Journal of Advanced Nursing. During interviews about their experiences, four themes became apparent: struggling to fit in, feeling not quite human, being dismissed, and refusing to give up.”

Scary Sexy Costumes for Kids: “Halloween costumes are reflecting an increasingly sexualized childhood. They often reflect the stars and starlets and popular culture role models that girls have, starting with Disney princesses or Hannah Montana when girls are young. But even traditional favorites, like witches and pirates are sexier every year. And French maids are quite the thing for tweens and teens,” said Diane E. Levin in a Q&A about Halloween costumes and gender roles.

Levin is co-author with Jean Kilbourne of “So Sexy So Soon: The New Sexualized Childhood and What Parents Can Do to Protect Their Kids.”

Life’s Lessons: On the other side of what’s good for kids, “Free to Be You and Me,” which has never gone out of print since its 1973 debut, was reissued this month with a new, expanded edition, reports USA Today.

Jessica Reaves of the Chicago Tribune, who also made her debut in 1973, writes about the book’s appeal and the lessons that have remained incredibly relevant for more than three decades:

Some critics of “Free to Be” accused Thomas of advancing a radical feminist agenda. They pointed to the book’s co-producer (the Ms. Foundation for Women) and Thomas’ role on “That Girl,” the first television program to shamelessly promote the career girl lifestyle. (I mean, really: Ann Marie strung that poor Don along for four years before she finally agreed to marry him!)

As a feminist born into a family of feminists, I’m biased: I happen to think adopting a feminist agenda is the best thing that could ever happen to this country. (Trust me, it hasn’t happened yet.) But those long-ago critics were right about one thing. The witty, wise lessons of “Free to Be” do underscore feminism’s fundamental tenet: namely, that everyone — male, female, black, white, brown, young, old and in between — should be treated equally and empathetically. Yes, even the jerks.

You only need to glance at the headlines to know we’re not quite ready to cross that particular item off our collective to-do list. Which isn’t to say we haven’t learned a lot in the 35 years since “Free to Be” was published. It’s just that we may need another 35 years for it all to sink in.

Kaiser Family Foundation is sponsoring live webcasts with advisers to presidential candidates John McCain and Barack Obama on the subject of the candidates’ health reform proposals. From Kaiser:

Sen. Obama has proposed a plan that builds on the existing employer-based system, while expanding public programs, putting in place new insurance regulations and providing new coverage options. Sen. McCain’s plan would replace the existing tax preference for employer-based coverage with a refundable tax credit for the purchase of private insurance, and allow people to buy health insurance across state lines. During these live webcasts, details of each candidate’s proposals and the rationale behind them will be discussed and questions from viewers will be answered by the candidates’ advisors.

Larry Levitt, vice president of the Kaiser Family Foundation and editor-in-chief of kaisernetwork.org, will moderate the discussions. The first, scheduled for Wednesday, Oct. 8, 11-11:30 a.m. ET, is with David Cutler, health policy adviser to Obama’s campaign and professor of economics at Harvard University. Watch it here.

The discussion with Jay Khosla, health policy adviser to McCain’s campaign, is scheduled for Wednesday, Oct. 16, 1-1:30 p.m. ET. Watch it here.

Send your questions in advance of or during the live program to ask@kaisernetwork.org.

In preparation, don’t forget about Kaiser’s Health08.org, which features a side-by-side comparison of the candidates’ health care proposals, among other cool tools and election news.

Plus: Kaiser will release an election brief on women’s health in mid-October. The research group “joins a cluster of prominent health-care groups — the Women’s Law Center, the Center for Policy Analysis, the Women’s Universal Health Initiative, the National Women’s Health Network, MergerWatch and the Avery Institute for Social Change — which are still wondering how the candidates’ plans could affect women,” writes Molly M. Ginty in this Women’s eNews story on how health care advocates are pushing the campaigns for answers.

The New York Times recently published a special series to help individuals advocate for their own health. The series included information on reliable health information websites, patients’ use of the Internet for self-education about their symptoms and diagnoses, how to understand a medical research report, what FDA approval really means, and several other topics.

Importantly, the Times pieces represented a largely positive take on patients becoming informed and active in their own healthcare, recommending that people seek second opinions when needed and become informed about what constitutes reliable medical evidence by gaining a basic knowledge of good study design. One physician interviewed, with regards to the tendency to go online for additional information, said:

“We have to acknowledge that patients do this research. It’s important that instead of fighting against it, that we join them and become their coaches in the process.”

The pieces make a stark contrast to the historical (and sometimes current) experiences of many women, who may have experienced hostility and condescension from physicians who took a more paternalistic approach. Taken as a whole, the Times pieces encourage individuals to learn and understand, rather than leaving everything to the doctors.

In touching on the estrogen problem as well as the reliability of research, the pieces also remind us that women have too often been on the receiving end of medical practices and traditions that have not been well-supported by the evidence. From individual practices such as previously routine episiotomies and hormone replacement to broader policies such as those that discourage hospitals from allowing vaginal births after a cesarean, individual women may receive care in environments that don’t support the reliance on evidence, questioning and self-education the Times pieces recommend.

For further details, visit any of the following articles from the Times (or this section page):

• You’re Sick. Now What? Knowledge Is Power.
• Searching for Clarity: A Primer on Medical Studies
• What’s Behind an F.D.A. Stamp?
• You Can Find Dr. Right, With Some Effort
• Applying Science to Alternative Medicine

Of course, OBOS has been recommending that women become informed about and advocate for better healthcare for quite a long time - see our content on Navigating the Health Care System for examples, as well as any of the full OBOS books.

The National Women’s Law Center has released a new report, “Nowhere to Turn: How the Individual Health Insurance Market Fails Women,” and is hosting a webinar on Thursday, Oct. 16, to discuss the findings. Register here.

The majority of women (and men) are covered either by their employers or through Medicare or Medicaid. But as Lisa Codispoti, NWLC senior advisor, and Brigette Courtot, policy analyst, explain on the NWLC blog, women seeking insurance on the open market face numerous obstacles:

The barriers include being rejected for coverage for reasons that are relevant to women, being charged more than men for the exact same coverage, and experiencing great difficulty in finding affordable health coverage that includes comprehensive maternity care.

There are many federal laws that protect women who get their health insurance through their employer. Those federal protections simply don’t apply when you try to buy coverage in the individual insurance market.

Insurers can reject applicants for a variety of reasons -– many very relevant to women.  For example, a woman can be rejected simply because she had a Caesarean section (in 2005, 30% of all births were by C-section). In nine states and the District of Columbia, it is still legal to be rejected for coverage because you are a survivor of domestic violence.

Emphasis mine — that fact is beyond infuriating.

And if you plan on getting pregnant, good luck:

On the availability of maternity coverage (or lack thereof), of the more than 3500 individual market health plans we studied, the overwhelming majority did not include any maternity coverage.  We found supplemental maternity policies — called “riders” — in Kansas and New Hampshire for more than $1100 a month (no — not a typo); that cost, of course, is on top of the premium for the underlying health plan. We also found maternity riders offered in 25 states that capped coverage at a paltry $2000 during the first 2 years of coverage –- over $5,000 less than the average cost of a best-case-scenario uncomplicated delivery.

As the NWLC notes, federal law, specifically HIPAA, prohibits pregnancy as a pre-existing condition, but it doesn’t apply to individual coverage. The lack of anti-discriminatory protections across the board makes quite a statement about our failed health care system.

The caesearean section link leads to this scary New York Times story from June, which opens with a 39-year-old Colorado women in good health who was turned down for health insurance — all because she gave birth by c-section:

Having the operation once increases the odds that it will be performed again, and if she became pregnant and needed another Caesarean, Golden Rule did not want to pay for it. A letter from the company explained that if she had been sterilized after the Caesarean, or if she were over 40 and had given birth two or more years before applying, she might have qualified.

Plus: The new Raising Women’s Voices blog has really been staying on top of health insurance-related stories and is a terrific resource for news and studies. Check it out.

Here’s another health care and politics update …

First up, we’ve mentioned Health08.org before, but it is seriously so good it deserves to be spotlighted again — especially now that it includes a new interactive tool that allows users to compare Sen. John McCain’s and Sen. Barack Obama’s “proposals and positions on a range of health care issues not necessarily addressed in the candidates’ health care reform proposals.”

The comparisons — based on information compiled from the candidates’ websites, speeches and campaign debates — cover 15 issues you’re not hearing much about in this campaign, including biomedical research, racial and ethnic disparities, HIV/AIDS/Global Health and women’s health.

Health08.org, created by the Kaiser Family Foundation, is one of the most comprehensive resources you’ll find. Visitors can also view a side-by-side summary of the candidates’ health care proposals and subscribe to the latest election headlines on health care.

In other news, today’s “Morning Edition” looked at the proposed costs of Obama’s health plan and contrasted it with McCain’s. Lots of criticism to go around.

And here’s a PBS television alert that was passed along to us. It looks like an interesting documentary and discussion –

The “NewsHour with Jim Lehrer” will host a Commonwealth Fund-supported show, “Rx for Change,” following the premiere of “Critical Condition,” a new documentary that tells the stories of people without health insurance who found themselves losing jobs, their health, their homes, their savings, and even their lives. “Critical Condition” will premiere on PBS stations Tuesday, Sept. 30, at 9 p.m.

To inform viewers about the presidential candidates’ plans to broaden health insurance coverage, the “NewsHour” program will feature a discussion moderated by by Susan Dentzer, editor of the journal Health Affairs and former “NewsHour” health correspondent. The discussion features Neera Tanden, domestic policy director for Senator Barack Obama’s campaign, and Douglas Holtz-Eakin, senior policy advisor to Senator John McCain, as well Uwe Reinhardt of Princeton University and Stuart Butler of the Heritage Foundation.

Check your local listings for additional showings of “Critical Condition.” Related Commonwealth Fund reports include: “Losing Ground: How the Loss of Adequate Health Insurance is Burdening Working Families”; and “How Many Are Underinsured? Trends Among U.S. Adults, 2003 and 2007.”

Kevin Sack of The New York Times writes in The Caucus:

Senator John McCain’s top domestic policy adviser, former Congressional Budget Office director Douglas J. Holtz-Eakin, recently said in a conference call with reporters that Mr. McCain’s health care proposal would “put 25 to 30 million individuals out of the ranks of the uninsured, into the ranks of the insured.” In an article released Tuesday, a panel of prominent health economists concludes that Mr. Holtz-Eakin’s projection is off by, well, 25 to 30 million.

Continue reading …

NYT op-ed columnist Robert Herbert has more on the critique of the McCain health plan, which was published today on the website of the journal Health Affairs. The journal also published a critique of Sen. Barack Obama’s plan. (Is it odd that one of the authors is an unpaid adviser to the McCain campaign?)

Meanwhile, the Wall Street Journal gives an overview of the costs of both health care plans provided by the Tax Policy Center.

“Sen. Obama’s plan would be costly, the center concluded: $1.6 trillion over 10 years. Sen. McCain’s would cost nearly as much: $1.3 trillion over the same span. The center doesn’t give either campaign credit for initiatives to reduce the cost of health care,” writes Laura Meckler.

But the Tax Policy Center also predicts, adds Meckler, “that the Obama plan would reduce the number of uninsured by 18 million people in the first year and by 34 million in 10 years,” while the McCain plan would see an initial net increase of 1 million and in future years “perhaps reach five million [newly insured Americans] before dropping again.”

And this WSJ post includes a quick overview of all studies mentioned.

Update: A cornerstone of McCain’s health plan includes moving families into the open health insurance marketplace. But as Jonathan Cohn points out, finding a carrier is no easy task if you’ve had any kind of medical history, including a previous c-section or even an irregular period (hat-tip: Feministing). Also see Cohn’s analysis at The Plank on the studies in Health Affairs .

Marxavi Angel Martínez is a 23-year-old library employee in North Carolina who has been arrested on charges of using a dead person’s Social Security Number. Martínez was brought to the United States legally at three years of age, but her parents overstayed their Visas. Martínez was then raised in the United States, becoming an honor student, cheerleader, library clerk, and now mother.

It’s this last item that appears to have sparked Martínez’s arrest, raising concerns about medical privacy and the potential to scare immigrants away from seeking care. Martínez, you see, received prenatal care at the Alamance County (NC) public health department. According to reports, “Alamance County Health Director Barry Bass said that during a recent State Bureau of Investigation inquiry into his health department, a judge ordered him to release the records of about five patients, one of whom was library worker Marxavi Angel Martínez.” Another source reports that “The sheriff has suggested that the librarian’s arrest was related to her care at the health department.”

Physicians and public health officials have responded to object to the chilling effect this may have on residents - legal citizens or otherwise - and their communities when seeking health care is discouraged because of fears of arrest and deportation. According to the Charlotte News & Observer, “several doctors…said that if patients become afraid to seek care, infectious diseases could spread, infant mortality could rise, and emergency costs could increase.”

Regarding privacy, one doctor interviewed for the piece explained:

“Whether you’re legal or illegal, it’s always been assumed that your medical information is private and can’t be used against you,” said Dr. Christopher Snyder III of Concord, president of the N.C. Academy of Family Physicians. “The doctor-patient relationship is sacred, and I’m not sure that has really been challenged until now. We’re in uncharted territory.”

NPR also has recent coverage of doctors’ concerns. We described another incident with similar potential effects in July, when an immigrant was stopped while driving home from a prenatal care visit in Nashville, TN. Although the officer had discretion as to whether to make an arrest, the very pregnant Juana Villegas was taken in and interrogated on her immigration status, ultimately being shackled to the bed during much of her labor and denied access a breast pump following the birth when she was returned to jail.

Related: Some librarians are also objecting to the arrest of Ms. Martínez. REFORMA, the National Association to Promote Library and Information Services to Latinos and the Spanish Speaking, has written a letter of protest, and addresses the use of another public service - the library:

“The manner in which she was arrested is deplorable; the place where this arrest took place is unthinkable: The Graham Public Library where she worked! The library—a traditionally safe space for the public—was transformed, in this instance, to a dangerous place where anyone can be arrested for their immigrant status.”

FDA Report Says No Risk From BPA: I’ve written before about the dangers associated with bisphenol A, or BPA, a chemical used in hard, clear plastics, such as Nalgene and baby bottles, as well as in the linings of food cans and baby formula.

The chemical, which mimics a human hormone, has been linked to hormonal changes in animal studies. Canada recently banned polycarbonate infant bottles, and the U.S. National Toxicology Program earlier this year acknowledged “some concern” that BPA may affect neural and behavioral development “in fetuses, infants, and children at current human exposures.”

But according to a draft assessment released by the Food and Drug Administration yesterday, BPA does not pose a health hazard when used in food containers. From the Washington Post:

The report stands in contrast to more than 100 studies performed by government scientists and university laboratories that have found health concerns associated with bisphenol A (BPA). Some studies have linked the chemical to prostate and breast cancers, diabetes, behavioral disorders such as hyperactivity and reproductive problems in laboratory animals.

Exposure to the small amounts of BPA that migrate from the containers into the food they hold are not dangerous to infants or adults, the draft said.

Here’s the kicker:

The chemical industry and the agencies that regulate the use of BPA, the FDA and the Environmental Protection Agency, have deemed the chemical safe, largely on the strength of two industry-funded studies that found no problems. The American Chemistry Council welcomed the findings of the new report.

“Clearly, their effort was to minimize people being concerned about this,” Diana Zuckerman, president of the National Research Center for Women and Families, told the Post. “It just seems that whenever there is an opportunity to look at a new, important issue, they just seem to be siding with industry’s point of view.”

Wal-Mart and Toys R Us aren’t waiting around for the government to take action — as of January, both businesses will stop selling any childrens’ products made with BPA.

Marrying, or Divorcing, for Health Insurance: “In a country where insurance is out of reach for many, it is not uncommon for couples to marry, or even to divorce, at least partly so one spouse can obtain or maintain health coverage,” reports The New York Times. “There is no way to know how often it happens, but lawyers and patient advocacy groups say they see cases regularly.”

Here’s more on the Kaiser Family Foundation study mentioned in the story.

Report: “Failing Women, Withholding Protection”: The female condom first made its debut 15 years ago, but a lack of investment and marketing on the part of policymakers has limited the condom’s availability and marginalized its role in protecting women from HIV-infection and other sexually transmitted diseases, according to a new report issued by Oxfam International and the World Population Foundation. The report was presented at the International AIDS Conference in Mexico City. The full text is available here.

“This is a 15-year scandal born of ignorance and inertia. It has been made doubly worse as the HIV epidemic is now affecting women at a higher rate than men, especially in Sub-Saharan Africa. We now know that millions of women might have been spared HIV, unwanted pregnancies, and empowered themselves in the process, if they had access to this simple method,” said Oxfam spokeswoman Farah Karimi.

“The female condom is the only method that women have to protect themselves. It has been embraced in many countries and cultures, it works and it is cost-effective,” added Karimi. “Political leadership and funding are needed now. No more excuses.”

Plus: Here are some facts about the female condom from “Our Bodies, Ourselves,” and our previous coverage on the condom’s redesign and how U.S. global policy affects condom promotion.

APA Report: Abortion Not a Threat to Mental Health: “The best scientific evidence published indicates that among adult women who have an unplanned pregnancy the relative risk of mental health problems is no greater if they have a single elective first-trimester abortion than if they deliver that pregnancy.”

That’s one of the conclusions put forth by the American Psychological Association Task Force on Abortion and Mental Health, which just issued this comprehensive report (PDF), an evaluation of all English-language studies published in peer-reviewed journals post-1989 comparing the mental health of women who had an induced abortion to the mental health of comparison groups of women.

Plus: For a closer look, read Lynn Harris’ good analysis at Broadsheet.

Coming Out as an Abortion Provider: Nell, who also blogs at Abortion Clinic Days, writes at the new Feministing Community site about her experience meeting her partner’s Republican grandparents and explaining what she does. Yes, there’s a happy ending.

Obesity Study Looks Thin: That’s the word from “The Numbers Guy,” aka Carl Bialik, who has a different take on a recently published study that projects 100 percent of American adults could be overweight by 2048.

What’s in a Midwife’s Bag?: Writing at Offsprung, Diane Dawson, a homebirth midwife, opens up her big black bag to reveal what she brings with her to deliver a baby. “I think that most people still think I show up with a smile and rabbit’s foot for luck. And maybe an herb or two in my purse. For the vast majority of pregnancies, this may well be enough, but I like to be a bit more prepared. …”

New State Law Calls for GPS Tracking on Abusers: “Gov. Rod Blagojevich signed a measure to create a new early warning system by allowing satellite tracking of people who violate orders of protection,” reports the Chicago Tribune. “Opponents of domestic violence and prosecutors say the Cindy Bischof Law will add teeth to the orders, which some deride as mere pieces of paper ineffective in protecting people from stalkers or abusers. Bischof was among at least four women in the Chicago area killed this year by men with orders of protection against them.”

Several organizations working on reproductive and other health topics are now sharing their message via online video. I’ve listed several examples below; feel free to suggest others in the comments.

Ipas has a video on abortion in Brazil, and explains that “Abortion in Brazil is highly restricted, allowed only in cases of rape, or to save the life or health of the mother. Women who break the law can be imprisoned for up to three years.” Their website also provides more information on the topic and their work in the nation.

World Breastfeeding Week starts today; a video contest was held on the theme of supporting breastfeeding women, and the winning entries are now available.

Consumer Reports Health has been conducting a “Cover America Tour,” in which they interview people about their struggles with paying for healthcare. The resulting videos from across America can be viewed here.

Finally, in a previous post, I mentioned the recent Wide Angle program, “Birth of a Surgeon,” on Mozambique midwives being trained to offer emergency surgical care to obstetric patients; the full episode is now available for online viewing.

In the April issue of the journal Obstetrics and Gynecology, ob/gyn Julian M. Thomas published an editorial, “Vaginal Hysterectomy: An Apparent Exception to Evidence-Based Decision Making,” and questions why more hysterectomies aren’t performed vaginally rather than abdominally/laparoscopically - most are currently performed abdominally. Thomas asks, “With evidence showing vaginal hysterectomy offers most patients the best combination of results, cost, and morbidity for hysterectomy, shouldn’t that be enough for surgeons and patients to demand it?”

The most interesting pieces of this editorial and the follow-up letters, however, may not be the commentary on the procedure itself. Thomas notes a shortage of training opportunities in vaginal hysterectomy, and offers the following as a possible explanation:

“Why? Industry plays a valuable role in teaching surgical procedures to gynecologists. One set of vaginal hysterectomy instruments may last an entire career. Laparoscopic surgery requires single-use, moderately expensive instrumentation. Which type of training would you provide, if you were selling instruments? Non–industry-supported training opportunities are uncommon: In the latest ACOG advertisement on postgraduate courses, there are no vaginal surgery courses.”

In addition to the lack of training, I also have to wonder about the sensitivity of the (predominantly male) ob/gyns when this discussion of vaginal surgery descends into car talk. In a letter published in the July issue of the journal, ob/gyn Mark Vizer says,

“I asked a general surgeon about this and how he felt about learning to perform a vaginal hysterectomy. He looked at me funny. He was concerned about lack of visualization and exposure and wondered why we even did this. It made as much sense to him as changing spark plugs from under the car.”

Thomas responds in kind, asking:

“Regarding your general surgeon’s comments—again, two questions: How does he change his oil? Would he cut a hole in the hood of the car to get at the spark plugs or use the opening that the maker provided?”

Vizer also notes that Medicare pays more for abdominal hysterectomies and asks, “So you do something harder but get paid 15% less. Does this make sense to you?” Thomas responds that, of 53 emails he received in response to his editorial, “14 of those responders, [who] stated that being able to bill more for a transabdominal approach influenced their hysterectomy route.”

I suppose it’s too much to ask that the discussion focus on real benefits and risks to women, rather than Medicare payments and car analogies. Thomas closes with the following point: “Those who choose between a best practice and an extra $200 per case will have to live with their decision.” Although this perspective at least takes “best practice” into account, it makes no mention of the women having surgery who also have to live with these decisions.

In contrast, a recent Cochrane review on hysterectomy for benign disease concluded, “The surgical approach to hysterectomy should be decided by a woman in discussion with her surgeon in light of the relative benefits and hazards.” Ahhh, nothing there about money or cars.

For related information, check out this fact sheet on hysterectomy from the National Women’s Health Network.

Home-Made - Inside Baltimore’s Home Birth Underground: “Disenchanted with a medical system that treats birth as an emergency instead of an emergence, seeking an alternative to the tubes and wires and monitors of a high-tech birth, some women are stepping outside of the hospital to have their babies. And some say their numbers are growing,” writes Michele Gienow in the Baltimore City Paper.

While the headline makes it all seem very radical, the women interviewed consider themselves pretty mainstream. And Gienow does a terrific job of bringing in various viewpoints and plenty of medical statisitcs:

No studies exist for unattended births like Jimmy Gaffney’s, but there are dozens demonstrating that, in low-risk pregnancies, home births attended by a midwife are as safe for mother and baby as going to the hospital. The largest and most scientifically rigorous home-birth study to date, sponsored by the Canadian government, followed all 5,418 planned home births across the United States and Canada attended by Certified Practical Midwives in 2000. The authors concluded that babies are born as safely at home as they are in the hospital, and with vastly fewer interventions like cesarean section, the use of forceps, or episiotomy; other recent studies, including a 1995 study of 11,788 intentional home births under midwife care published in the Journal of Nurse Midwifery, have reached the same conclusion.

Despite evidence that it is safe, “I think some people shy away from home birth because of the responsibility,” Alana Gaffney says. “If you’re at home, attended or unattended, and something happens to the baby, it’s your fault for not seeking appropriate medical care. But if you go to the hospital and something happens, you’re guilt free. No one is going to say anything to you — it’s just one of those things that happens.”

Beyond “The Curse”: Jessica at Feministing wonders: Where are the cool, progressive ads about women’s health?

The Week’s Best Feel-Good Story: New York Times columnist Nicholas Kristof shares the story of recent Connecticut College graduate Beatrice Biira, who credits her academic journey to a goat named “Luck” that was donated to her family in Uganda through Heifer International.

Beat the Heat: I admit I turn into a slug in hot, humid weather (a slug with a margarita, that is); sticking with outdoor exercise is tough when the temperature soars. In this article on how to beat the heat, Gina Kolata asks — and answers — some important questions:

How long does it take to acclimate to the heat and humidity, and what is the best way to do it? How much does your performance time slow when it is sweltering and humid, and why? Does it help to douse your head with water? Should you go out in the morning, when it is cooler but the relative humidity is higher, or at night, when it tends to be hotter but less humid? The answers, some exercise physiologists say, are not always what you might expect.

On the plus side, not exercising may make you less appealing to mosquitoes, but not if you like margaritas …

Papayas Fill Gaps in Doctors’ Abortion Training: K. Aleisha Fetters writes at Women’s eNews:

With instruments in one hand, hundreds of medical students took papayas in the other. Inserting a speculum into the tapered end of the uterine-shaped pieces of fruit, they injected them with numbing medication and gently scraped away their seed-filled lining.

This, they learned at the 15th annual meeting of Medical Students for Choice, is how easy it is to perform an abortion, a procedure that many of their schools will never teach them.

Check out the rest of the story about the decline of abortion providers in the United States and the work of Medical Students for Choice.

Immigration in the News: The National Coalition for Immigrant Women’s Rights sent out a highly informative summer update with links to immigration stories in the news, as well as coalition and legislative updates. Unfortunately, it appears to be available only via email. Here’s an excerpt from the news round-up:

The Washington Post recently ran a four day series, Careless Detention: Medical Care in Immigrant Prisons. These stories provide an overview of the immigration issue, descriptions of the terrible medical ordeals immigrant detainees face, accounts of neglect for those immigrant detainees with mental illness, and reports of the U.S. government drugging detainees for deportation, to name a few.

A kosher meatpacking plant in Iowa was the site of the largest immigration raid in U.S. history in May, which involved nearly 400 workers, including 18 juveniles. 306 workers now face charges and some have already been deported. On-the-ground advocates, while looking into the raids, have also discovered that many of the female workers at the plant were sexually harassed and exploited. Many women were coerced into giving sexual favors in exchange for a promotion or a shift change, and those who refused were given more difficult tasks or unwanted shifts.

The Tucson Weekly reports that rape has become a routine price to pay for immigrant women crossing the Mexican-American border.  The UN reports that 70 percent of women crossing the border without husbands or families are abused in some way. Women find threats of sexual assault from both the men that they pay to take them across the border and those that control deportation and green cards. On May 3rd, three women were raped, two of them minors, and one woman was gang bang raped by six men.

Uninsured Young Adults: Young adults, age 19-29, have the highest uninsured rate of any age group and account for 29 percent of the uninsured in the United States. The Kaiser Family Foundation has published a paper that examines health coverage for young adults, as well as their health status, access to care, and the financial burdens they encounter when paying for care. It also provides an overview of public and private approaches to expand health coverage for young adults.

On Your Feet: Ever wonder exactly how wearing high heels affects your body? This Washington Post graphic shows the effect on feet, ankles, knees and posture. Included are links to a number of related stories, such as this overview on how wearing the wrong shoes affects foot health, and advice on how to be kind to your feet.

They’re not the newest stories, but I just found out that excruciating pain I get when wearing heels (or even hiking downhill) is Morton’s neuroma, so I was kinda curious to learn more. This week I’m in Vermont, so it’s all comfy summer sandals here! … Happy 4th to everyone!