The Female Health Company is announcing [PDF] today that the FDA has approved the company’s FC2 Female Condom for preventing pregnancy, HIV/AIDS, and other sexually transmitted infections.

The company notes that the approval will “enable the United States Agency for International Development (USAID) to procure FC2 for distribution to global HIV/AIDS programs,” and that changes in the material and manufacturing as compared to their original female condom should make the product more affordable. The device has been available in other countries since 2006, but FDA approval apparently means that it can now be purchased for U.S.-funded prevention programs worldwide.

Although the approval documents are not yet available on the FDA website, they should be available here sometime in the near future for examination.

The FDA’s Obstetrics and Gynecology Devices Panel reviewed and recommended approval of the product last December. For further discussion of this and other female condom prototypes, see our recent guest post from Audacia Ray of the International Women’s Health Coalition.

Stimulus Bill Passes House & Senate: Congress tonight approved the $787 billion economic stimulus bill. The House voted 246-183. The Senate followed hours later, 60-38. As expected, passage rested almost entirely on Democrats, who persuaded only three Senate Republicans to cross party lines — and not one Republican in the House — despite numerous concessions. President Obama is expected to sign the bill on Monday.

The National Women’s Law Center today offered this assessment of the bill while urging support :

We are proud that the final bill contains many of the crucial provisions we fought so hard to include. The bill includes new funds to address the needs of women and families, including funding for child care and Head Start, child support enforcement, health care, education and job training. It strengthens the safety net for low-income families, helps eliminate barriers that disqualify women from claiming unemployment insurance benefits, and provides funding to enforce important worker protections, including civil rights laws. And it provides additional tax benefits for low- and middle-income people; the expansion of the refundable Child Tax Credit alone will help the families of 13 million children.

NWLC has more analysis of the final compromise agreement, including details on measures in the bill that are especially important to women and their families.

Health Care for Women Act: “Sens. Debbie Stabenow and Jan Schakowsky have introduced a resolution that recognizes reproductive health care as fundamental to women’s ability to lead healthy lives and to ensure that women’s health care concerns, including reproductive health needs, are included in the push for national health reform,” writes Emily Douglas at RH Reality Check.

If approved, Congress would commit to passing “within 18 months of adopting the resolution, legislation that guarantees health care for women and all individuals and establishes coverage that enables women to attain good health that they can maintain during their reproductive years and throughout their lives.”

Plus: Columbia University’s Mailman School of Public Health released a report, “Women’s Health and Health Care Reform: The Key Role of Comprehensive Reproductive Health Care” (pdf). Co-authors Wendy Chavkin from Columbia University and Sara Rosenbaum from George Washington University use data and evidence to show that “reproductive health is a key determinant of women’s overall health, and therefore, that the treatments and services that promote reproductive health should be part of any national health plan.”

Keeping Tabs: The Congressional Budget Office on Tuesday announced that unless there are changes to federal policy, the number of Americans without health insurance will grow from about 45 million this year to about 54 million in 2019, reports the Associated Press.

Paging a New Secretary: “The leadership void at the top of the Department of Health and Human Services (HHS) is affecting more than President Obama’s health reform agenda,” writes Jeffrey Young at The Hill. “Though the department is capable of fulfilling its day-to-day responsibilities as guardian of the nation’s public health, pharmaceuticals, foods, medical research and other areas, the continued lack of a secretary and of leaders at key agencies will delay the Obama administration from putting its stamp on the massive bureaucracy.”

Hillary Clinton and the End of the Compromise Era on AIDS: Last week we wrote about the controversial removal of Mark Dybul from the Office of Global AIDS Coordinator. In an article published Thursday at The American Prospect, Michelle Goldberg writes that the removal shows that under Secretary of State Hillary Clinton, the era of compromising with the religious right on global HIV prevention is over.

SCHIP Reauthorized, What Comes Next?: Now that Obama has signed the Children’s Health Insurance Program Reauthorization Act of 2009 into law, Kaiser Network hosted a webcast with a panel of experts who address the next steps in children’s coverage, including such questions as: What is included in the new legislation? What impact will the new legislation have on coverage of uninsured children? What new tools will states have to reach and enroll uninsured children in Medicaid and CHIP? How will new funding affect state efforts to move forward? How will the deepening recession affect these efforts? What does reauthorization mean for broader health reform?

Watch, listen or read the transcript (pdf) of the webcast.

Action Items
* Say No to Abstinence-Only Programs
As President Obama begins work on his fiscal year 2010 budget, urge him to stop funding abstinence-only programs and direct our scarce public health resources to evidence-based programs that actually work.
Contact the White House (National Partnership for Women & Families)

A weekly look at what’s happening in Washington and in the new Obama administration related to women’s health and well-being …

Stimulus Bill Makes Progress in Senate: Senate Democrats Friday night struck a deal with Republicans over the economic stimulus bill, paving the way for a vote early next week. The Senate and House versions will have to be reconciled, but House Democratic leaders aren’t thrilled with the Senate cuts, reports the Washington Post.

The Senate changes bring what had been a $920 billion package down to about $820 billion. Among the largest cuts: $40 billion from a $79 billion fund aimed at helping states preserve school funding as they try to balance their budgets. And negotiators cut in half $15 billion in “incentive grants” for states that meet certain goals for their initial education allotment.

“Education took a big hit here,” said  Sen. Kent Conrad (D-N.D.).

The compromise also would cut $5 billion from a plan to help unemployed workers pay for health-care coverage, reducing the amount the federal government would pay for COBRA premiums to 50 percent from 65 percent. And it would cut $2 billion from a plan to help critical-access hospitals computerize medical records.

Sex and the Stimulus: A proposal to allow states to extend Medicaid funding for family planning was nixed from the stimulus package last week, but conservative Republicans and some clueless members of the media were still using it Friday an example of unnecessary padding in the bill.

Writing in The New York Times Economix blog on Thursday, Nancy Folbre, an economics professor at the University of Massachusetts, Amherst, defended the proposal and explained what the economic benefits would have been.

“Increased spending on family planning (including contraceptives) would generate about as many direct and indirect jobs as any other health expenditures, and probably more than an equivalent tax cut. But the short-term effects are less important than benefits down the road,” writes Folbre.

“Ironically, the proposal that was originally part of the stimulus plan did not actually call for increased spending. It simply stipulated changes that would make it easier for states that wanted to expand their Medicaid-financed family planning services to do so. In other words, it would cut red tape,” Folbre adds. “That’s another economic benefit. But the Obama administration should look beyond the current stimulus debate to develop a long-run plan to increase public support for family planning.” Amen.

Daschle’s Gone, What’s Next?: Democrats don’t know who President Obama is going to pick to be secretary of Health & Human Services, a position that was all but former Sen. Tom Daschle’s before he withdrew from consideration over unpaid taxes.

“There were no other names,” an ally of the administration told the Washington Post. Still, there’s cautious optimism that the urgent need for reform will propel members of Congress:

For every one percentage point that unemployment rises, an additional 1.1 million people lose health insurance, said Karen Davis, president of the Commonwealth Fund, a private health research foundation. That means that health care, always a top concern of American voters, has risen on the agenda, she said.

Drew E. Altman, president and chief executive of the nonprofit Henry J. Kaiser Family Foundation, said that economic fears, Democratic control of both the White House and Congress, and the desire in the corporate world to rein in health costs are powerful forces in favor of reform.

But the recession could also sap the time or political energy to tackle it right now, Altman said. And if action is postponed until 2010, when members of Congress will be focused on their own re-election campaigns, the prospects will dim, he added.

One of the names mentioned this week as a potential contender for the HHS post is Tennessee Gov. Phil Bredesen, but health advocates are already criticizing the suggestion (see the action alert below). From Politico:

Driving the outrage is Bredesen’s 2005 decision to cut about 170,000 adults from Tennessee’s expanded Medicaid program. Bredesen’s past as a managed-care executive and continued ties to the health insurance industry haven’t won him many admirers within the progressive health reform community.

Of all the opposition research circulating Friday, one of the favorite nuggets among critics was the fact that BlueCross BlueShield of Tennessee, a company with major state dealings, donated $150,000 to the renovation of the governor’s mansion.

“A lot of elected officials are in bed with the insurance industry, but Phil Bredesen doesn’t stop there. He let them pay to redecorate his mansion. We can’t think of anyone more wrong for health care reform or more wrong for America,” said Jacki Schechner, spokeswoman for Health Care for America Now.

Speaking of Filling Open Positions …: Secretary of State Hillary Clinton’s decision last month to request the resignation of Mark Dybul, head of the Office of Global AIDS Coordinator, drew praise from some health advocates. Dybul was in charge of the President’s Emergency Plan For AIDS Relief (PEPFAR), which was accused of misspending millions of dollars on ideologically driven abstinence-until-marriage prevention programs.

Criticism of Dybul was far from unanimous, however. The San Francisco Chronicle was among those who argued that Dybul did a lot of good and was treated unfairly by the Obama administration.

It’s still unknown who will replace Dybul, though there is some speculation Clinton has already identified a successor. Meanwhile, a coalition of 68 HIV/AIDS organizations have asked Clinton to form a committee to identify candidates.

“That’s a sharp rebuke given the substantive role of the Clinton Foundation in global AIDS affairs,” writes public health expert Josh Ruxin. “At the same time, it’s a promising turn for the activists themselves. They’re insisting on transparency and a merit-based approach, well aware that the fight against AIDS globally cannot flag and will be with us for decades to come.”

Baby Steps: President Obama on Wednesday signed a bill reauthorizing the State Children’s Health Insurance Program. It extends health coverage to 4 million additional uninsured children, bringing the total to 11 million children. Obama also issued a memo to HHS lifting some controversial enrollment rules imposed by the Bush Administration in August 2007, reports the Wall Street Journal.

Supreme Court Choices: We learned this week that Supreme Court Justice Ruth Bader Ginsburg has been diagnosed with pancreatic cancer. She is planning on returning to the court soon, but her illness sparked discussion of who Obama might consider for the nation’s highest court.

According to the Washington Post, there’s also some speculation that another justice might announce his departure this year. Advisers have already begin drafting a short list of replacements that is said to include Harvard Law School Dean Elena Kagan, who has been nominated to serve as solicitor general; Judge Sonia Sotomayor of the Court of Appeals for the 2nd Circuit; Judge Diane Wood of the 7th Circuit; and Stanford University law professor Kathleen M. Sullivan.

Senate Discovers Women: “The U.S. Senate is taking a welcome step: empowering a subcommittee specifically charged with global women’s issues,” writes Nicholas Kristof. “It’s the first time a subcommittee has had that mandate, and it will be led by Barbara Boxer of California, who will surely use her voice and spotlight to do some good on these issues.”

Action Items
* Ask  President Obama to appoint a secretary of Health and Human Services who actually believes in health and human services
Contact the White House (National Women’s Health Network)

Guest post by Audacia Ray, International Women’s Health Coalition

Demand for newer and better devices that protect against pregnancy and sexually transmitted infections is constant — partly due to the fact that the process of development, testing and approval takes forever, and partly because what’s on the market often leaves something to be desired.

The polyurethane female condom (FC) has been available for 15 years now, and it’s gotten a lot of mixed reviews. It is the only barrier method available that is designed for female initiation, but it’s three times as expensive as a male condom, unwieldy, and can squeak during use (not sexy). Male condoms, of course, have their imperfections; loss of sensation and ill-fit are chief among the complaints.

This past December, the new and improved FC2 was recommended to the FDA for approval (see OBOB post). It should be on the market in the United States within the next year. The FC2 is made of a latex alternative, which is by all accounts a thinner, quieter, lower-cost material than polyurethane.

However, there are also other prototypes out there that are being actively tested and promoted outside of the United States, especially in Africa. In early December Jen Wilen, a program officer for Francophone Africa at the International Women’s Health Coalition (IWHC), ventured to the 15th International Conference on AIDS and STIs in Africa (ICASA) in Dakar, Senegal, where she got to check out two different prototypes for new female condoms.

One of these new condoms is the VA w.o.w. Condom Feminine (pictured left), a latex female condom made by the same company that produces the popular Inspiral male condom, which is extra roomy around the glans of the penis to increase male pleasure.

The most striking feature of the w.o.w. (worn-of-woman) FC is that it has a soft sponge where FC and FC2 has an internal ring. The sponge acts as an anchor to hold the female condom in place. The w.o.w has been available in Southern Africa since 2004 and is also available in the UK.

The second female condom (pictured right) was designed by a Seattle-based company called PATH, which has a contract to move forward with making the device available in China by 2010.

This FC is made of nitrile and has something of a parachute effect — its applicator capsule dissolves once it is inside the vagina and the FC expands to its full size.

This particular version is being tested through Family Health International — the packaging warns that it is “limited by law to investigational use only. This product may fail during use and must not be relied upon for contraception or sexually transmitted disease prevention.”

One of IWHC’s partners, Society for Women Against AIDS in Africa, Cameroun Chapter (SWAAC), has been a major advocate for the female condom. They regularly host sexuality education sessions — some in very public places (see below and here) — that teach women and men about how to use the female condom.

Audacia Ray is program officer for online communications and campaigns at the International Women’s Health Coalition.

EngenderHealth has put together an excellent video providing a straightforward and simple explanation of the global gag rule and its effects on world health.

The organization is encouraging others to sign a petition asking President-Elect Obama to rescind the global gag rule during his first 100 days in office.

Relatedly, the “Open Government” section of the Change.gov website presently includes the “Global Health Council Recommendations to President-elect Barack Obama on US Global Health Policy and Programs,” with documents recommending rescinding the Global Gag Rule via Executive Order and restoring UNFPA funding, among other HIV/AIDS-related recommendations.

The Global Health Council website provides more background on the development of the recommendations to the Obama team, and individuals can leave their thoughts and support in the presently skimpy comment section.

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 gmail.com 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.”

Last week, we wrote about a Food and Drug Administration’s Obstetrics and Gynecology Devices Panel meeting to consider approval of a female condom; the product (currently called the FC2) is similar to the existing Reality condom, but with a change in the material.

That panel met on Thursday and unanimously recommended (14-0) approval.

Research was presented on the device assessing mechanical failures (such as breakage and slippage) as compared to the original female condom which it will replace. The research suggests that the two products were very similar in these respects.

However, the FDA’s summary of the meeting indicates that “No clinical studies have been submitted to show FC2 effectiveness for pregnancy or STI risk reduction.” And the FC2 was approved under the condition that the label for the device “be revised to accurately reflect the extent of the evidence comparing FC1 and FC2.” The panel specifically noted that “clinical outcomes (i.e., pregnancy and sexually transmitted infections) had not been studied on FC2.”

What I don’t quite understand is why research data on effectiveness for pregnancy and STI risk reduction wasn’t presented or required. The manufacturer is claiming that the new version is essentially equivalent to the female condom already on the market, but the material has been changed from a polyurethane to a nitrile – it seems like a change in what the condom is made of might warrant additional study. The full transcript of the meeting is not yet available, so perhaps this question was addressed, but it’s not apparent that any research was presented suggesting whether the nitrile material is as effective as polyurethane in preventing sexually transmitted infections or pregnancy.

As this brief from the Daily Women’s Health Policy Report notes, the new material makes the condoms less costly and the FC2 is already in use in other countries.

Update: The National Women’s Health Network has released their testimony to the advisory panel. In it, they address the FDA’s concerns about the study and recommend approval of the condom, and also ask for further discussion of and research on how spermicide may affect the device.

Tomorrow, the Food and Drug Administration’s Obstetrics and Gynecology Devices Panel (an advisory committee) will consider and vote on a premarket approval application for the FC2 Female Condom for HIV and pregnancy prevention.

This type of application means that the company making the condoms, the Female Health Company, believes the product is “substantially equivalent” to the female condom that is already on the market (sometimes know as the “Reality” condom, which is another FHC product). Whether the two products are equivalent is something the advisory committee will discuss, as this has bearing on whether the maker is required to do studies of clinical outcomes (STI/HIV and pregnancy prevention) in the FC2 condom or not.

According to Reuters, a representative of the company indicated that (regarding further testing and comparison to the first generation female condom): “The design is exactly the same, how you use it is exactly the same … we just don’t believe there is any more information required.” The only thing that seems to make the two products different is a material change from polyurethane to a “synthetic nitrile;” company literature explains that this change should “improve affordability.”

The panel will also discuss the data on “breakage, mis-direction, invagination, and slippage,” and what information should be included on the product label.

Pamela Merritt has further discussion of the product and the process at RH Reality Check, including links to a letter of support for approval that several organizations have put together and individuals and organizations can sign. She explains:

“The FC2 has been approved by the World Health Organization and the United Nations Population Fund for distribution by HIV/AIDS and family planning organizations. FDA approval would enable USAID to purchase larger quantities of female condoms and distribute them to non-governmental agencies providing services to the millions of women living in nations with high HIV/AIDS infection rates.”

If you are in the Gaithersburg, Md., area, the meeting is open to the public (see details).

A study published in the December issue of The Lancet reports on a three-year trial of Carraguard gel for HIV prevention and found that the microbicide, developed by the Population Council and derived from seaweed, is no better than a placebo at reducing HIV infections.

The researchers enrolled more than 6,000 sexually-active, HIV-negative women aged 16 years and older from three South African sites. The women were randomized to receive either the Carraguard gel and condoms or a placebo gel and condoms for use in vaginal intercourse, and were followed until they became pregnant or tested positive for HIV (up to two years). Clinical follow-up sessions each included counseling on HIV risk reduction and family planning for both groups.

There were no significant differences in time to HIV infection between the two groups, indicating that Carraguard did not work any better than a placebo. Carraguard was also about the same as placebo in terms of adverse effects.

A commentary in the same issue notes that this finding “continue[s] the discouraging wake of other coitally related topical products,” such as nonoxynol 9, cellulose sulfate, and the SAVVY gel. Researchers have focused on these insertable products as potential female-controlled methods of HIV prevention. Scientific American has a good, recent summary of the current state of this research. OBOS also provides companion content on microbicides.

PS: In another article in the current issue of The Lancet, I learned that the UK’s National Health Service is working on a “a guidance document designed to ensure that goods purchased for use in the NHS are manufactured ethically,” meaning adherence to basic international labor standards and workers paid a living wage. According to the article, the guidance document would inform the spending of £20 billion a year in NHS contracts, but would need adoption by the NHS Trusts to have the most impact.

The International Women’s Health Coalition is encouraging health activists to tell Michel Sidibé, the soon-to-be executive director of United Nations Programme on HIV/AIDS (UNAIDS), what needs to be done to empower women and girls against HIV/AIDS.

The IWHC action alert includes the sample letter below, or you can write your own letter. Send correspondence to communications@unaids.org.

Read more about women and risk of HIV/AIDS infection and IWHC’s coalition campaign, With Women Worldwide, which produced this compact to end HIV/AIDS.

Dear Mr. Sidibé,

As HIV infection rates among young people and women rise, we look to UNAIDS leadership to recognize gender inequality as a driver of the epidemic. That means making sexual and reproductive rights and health central to a comprehensive response to the HIV/AIDS pandemic.

To be effective, you should prioritize: the hiring of staff, consultants and advisors with expertise in women’s and young people’s health and rights; clear objectives for achieving gender equality; open, transparent interactions with a broad range of civil society constituencies, including women living with HIV/AIDS and women’s organizations; and the implementation of a comprehensive approach to prevention, treatment, and care for women and girls.

I care about women and girls because _______________. With lives at risk throughout the world, I hope you will empower them in the face of the pandemic.

Sincerely,
Your name

“Stop AIDS. Keep the Promise” is the campaign message of the 20th annual World AIDS Day. The theme this year is leadership, same as it was in 2007. But while last year people were encouraged to take the lead, this time the emphasis is on delivering on those promises.

“Building on the 2006 theme of accountability, leadership highlights the discrepancy between the commitments that have been made to halt the spread of AIDS, and actions taken to follow them through. Leadership empowers everyone -– individuals, organisations, governments –- to lead in the response to AIDS,” reads the World AIDS Day website. Information on how you can get involved is available here.

Worldwide, 33 million people are living with HIV infection, most of them in developing countries. Close to 2.7 million people were infected just last year. In the United States, more than one million people are living with HIV.

“For 280,000 HIV-positive women in the United States, new treatments have revolutionized care, making it possible to live on for decades and to bear children without transmitting the disease,” writes Molly M. Ginty at Women’s eNews. “But at the same time, women’s health advocates are marking the 20th annual World AIDS Day with more than a hint of frustration.”

“Key scientific questions aren’t even being asked,” Dazon Dixon Diallo, president of SisterLove, an Atlanta-based HIV-AIDS advocacy organization for women, told Women’s eNews. “The disease’s impact on female fertility and reproduction is barely being addressed.”

Ginty also notes some maddening statistics:

Hispanic women are five times more likely to contract HIV than white women, and African American women are 21 times more likely to do so, according to the Atlanta-based Centers for Disease Control and Prevention.

Among black women, the disease has become so rampant that it is this group’s leading cause of death in the 25-to-34 age bracket.

Health advocates say the rapid-fire spread of HIV-AIDS among women is fueled by the health care system’s failure to address it.

Though women account for 27 percent of HIV infections, they account for just 17 percent of HIV-AIDS research subjects.

In the 1990s, studies showed diaphragms and the spermicide nonoxynol-9 did not protect women against HIV, as previously hoped. Researchers started developing microbicides, topical products that prevent HIV from infecting a woman’s cells and give her more control over prevention than condoms do because she doesn’t have to negotiate their use with a partner.

But under the Bush administration, the Bethesda-based National Institutes of Health devoted only 2 percent of its AIDS budget to microbicide research, and trials of two major microbicides failed.

From other sites:

- “Now is the time for the medical community and policymakers to embrace U.S. guidelines for all Americans aged 13-64 to be tested in routine medical care. Barriers to implementation of HIV testing guidelines, such as state laws that mandate counseling with testing or not paying for routine medical care, must be removed,” writes Dr. Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health, in a commentary posted at CNN.

- “A viable vaccine is still very possible, and with it comes the potential to wipe out HIV/AIDS. But the science behind any new candidate vaccine must be much stronger than it has been in the past before testing begins in humans,” reports HealthDay News.

- Susan Dominus writes about the AIDS memorial in New York that didn’t exist before this week.

- Starbucks will donate 5 cents from every drink purchased today to The Global Fund. Miriam suggests separating consumerism from giving. Just give directly.

- President-elect Barack Obama addressed World AIDS Day by posting online videotaped remarks that he made to the Saddleback Civil Forum on Global Health. Via Washington Post.

“I salute President Bush for his leadership in crafting a plan for AIDS relief in Africa and backing it up with funding dedicated to saving lives and preventing the spread of the disease,” Obama said. “And my administration will continue this critical work to address the crisis around the world.”

- RH Reality Check has a package of stories on HIV/AIDS Policy in the Obama Age.

Gay Marriage Legal in California, Massachusetts and now Connecticut: The Connecticut Supreme Court on Friday struck down the state’s civil union law with a 4-3 ruling that same-sex couples have a constitutional right to marry. From The New York Times:

The ruling, which cannot be appealed and is to take effect on Oct. 28, held that a state law limiting marriage to heterosexual couples, and a civil union law intended to provide all the rights and privileges of marriage to same-sex couples, violated the constitutional guarantees of equal protection under the law.

Striking at the heart of discriminatory traditions in America, the court — in language that often rose above the legal landscape into realms of social justice for a new century — recalled that laws in the not-so-distant past barred interracial marriages, excluded women from occupations and official duties, and relegated blacks to separate but supposedly equal public facilities.

View the full ruling here (PDF). Opponents spoke of steps to enact a constitional ban on same-sex marriage, but on Friday night the plaintiffs in the original court case filed four years ago and their supporters were jubilant.

Garret Stack, 59, introduced his partner, John Anderson, 63, and said: “For 28 years we have been engaged. We can now register at Home Depot and prepare for marriage.”

Group Sues Over Required Ultrasound: The Center for Reproductive Rights has filed a challenge to an Oklahoma law that mandates a woman must have an ultrasound and listen to the doctor describe what her fetus looks like before she have an abortion. And that’s not all:

At the same time, the law prevents a woman from suing her doctor if he or she intentionally withholds other information about the fetus, such as a severe developmental defect. The statute also requires doctors to use a specific regimen for administering the medical abortion pill, despite that regimen being less effective and more costly than the one strongly recommended by the American College of Obstetricians and Gynecologists (ACOG).

The lawsuit, filed Thursday in Oklahoma County District Court, says the requirement intrudes on a woman’s privacy, endangers her health and assaults her dignity.

Set to go into effect on Nov. 1, the law would make Oklahoma the fourth state to require the viewing of ultrasounds before an abortion. The other states are Alabama, Louisiana and Mississippi.

South Dakota Abortion Ban 2.0: Lynn Harris of Broadsheeet offers a full, and funny, assessment:

Remember how South Dakota’s 2006 Margaret Atwood honorary abortion ban was defeated in referendum by a (none-too-cushy) 55-44 margin?

The ban’s primary liability, according to polls, was that it contained virtually no exceptions. But as ringleader Leslee Unruh of Vote Yes for Life said at the time, like Jason popping up out of Crystal Lake, “We started something here in South Dakota.” And now, as you may have heard, abortion opponents there are aiming to get the job done. Which means: The ban is back (PDF), in sheep’s clothing. It 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.

Unruh (who says that over 90 percent of women seeking abortion are using it as “birth control”) calls Abortion Ban 2.0 “more moderate, more reasonable, more of a middle ground.” Yeah … no.

Plus: Visit South Dakota Campaign for Healthy Families for more information.

Birth Control Watch: While some voters think access to birth control is not a political issue, those of us who follow the activities of the Bush administration and legislatures around the country know better. Birth Control Watch has a great section on federal and state proposals that will limit our individual decision making and access — it’s called extreme schemes.

An excellent resource to pass along, it includes information on Colorado Proposition 48, a constitutional amendment that seeks to establish legal personhood from the moment of fertilization (which even self-described “pro-life” Catholic Gov. Bill Ritter opposes), and the proposed HHS regulations that would limit patients’ access to information and services.

The two-minute activist gives a concise run-down of actions you can take, and the press room tracks related stories.

Speaking of the HHS regulations, more than 150 Congressional Democrats stated their opposition in letters to HHS. The Senate letter concludes that the proposed rule is “damaging to the health care needs of women, their families and all Americans and will only serve to cause havoc, not clarity, among employers and employees in the health care field.”

Courts Failing Domestic Violence Victims: “For every man convicted in a Cook County court of beating his wife or girlfriend, five men brought in on similar charges walk away legally unscathed. And despite official promises to help women pursue abuse complaints, that conviction rate is only getting worse,” reports the Chicago Tribune.

The Trib also looks at a specialized unit of the Cook County state’s attorney office with a much higher conviction rate. The unit, Target Abuser Call, employs a more intensive investigatory approach for the most serious cases.

Plus: Programs for batterers are underfunded but should be supported to break the habit of abuse, say domestic violence experts. “No matter how many women you take in, it isn’t going to cure the problem,” said Toby Myers, vice chair of the National Center on Domestic and Sexual Violence.

Plus: A judge in Canada tells a woman not to bother calling police if she goes back to her partner. via Feministing

Nobel Prize Winners: The 2008 Nobel Prize in Physiology or Medicine went to Harald zur Hausen of Germany, who discovered the human papilloma viruses that causes cervical cancer, and Luc Montagnier and Francoise Barre-Sinoussi, French researchers who discovered HIV, the virus that causes AIDS.

Montagnier and Barre-Sinoussi later told President Nicolas Sarkozy that they fear the world financial crisis will affect funding to fight AIDS.

One-Year Distribution Update On Gardasil: “About a quarter of the nation’s teenage girls received the controversial cervical cancer vaccine Gardasil last year in its first full year of distribution, federal authorities said Thursday,” reports the L.A. Times.

The Realities of Addiction: Writing in the Washington Post, Jacqueline M. Duda shares the painful story of her daughter’s drug addiction and death — including the difficulty the family had finding adequate medical treatment for addiction.

“Surely, we thought, college-educated suburbanites like us could locate professional help: drug counselors, doctors, therapists specializing in addiction. Surely detoxification centers would treat desperate addicts and work out a payment plan. Surely we could check her into some kind of residential treatment program with a minimum of delay,” writes Duda. “We were wrong.”

PSA to Raise Awareness Around “That’s So Gay”: “For the first time since the Advertising Council was founded in 1942, the organization — which directs and coordinates public service campaigns on behalf of Madison Avenue and the media industry — is introducing ads meant to tackle a social issue of concern to gays and lesbians,” writes Stuart Elliot in The New York Times.

The campaign, created pro bono by the New York office of Arnold Worldwide, urges an end to using derogatory language, particularly labeling anything deemed negative or unpleasant as “so gay.” That is underlined by the theme of the campaign: “When you say, ‘That’s so gay,’ do you realize what you say? Knock it off.”

There will be television and radio commercials, print and outdoor ads and a special Web site devoted to the campaign (thinkb4youspeak.com). Some spots feature celebrities, the young actress Hilary Duff and the comedian Wanda Sykes, delivering the message.

Check out the Wanda Sykes PSA below:

Slavery Overlooked: “World leaders are parading through New York this week for a United Nations General Assembly reviewing their (lack of) progress in fighting global poverty. That’s urgent and necessary, but what they aren’t talking enough about is one of the grimmest of all manifestations of poverty — sex trafficking,” writes columnist Nicholas Kristof, who had doggedly stayed on this issue (view related columns here).

“This is widely acknowledged to be the 21st-century version of slavery, but governments accept it partly because it seems to defy solution,” Kristof continues. “Prostitution is said to be the oldest profession. It exists in all countries, and if some teenage girls are imprisoned in brothels until they die of AIDS, that is seen as tragic but inevitable.”

Kristof goes on to detail the work of Somaly Mam, a survivor of the Cambodian brothels who now leads the Somaly Mam Foundation.

Plus: “For the U.S. to be a significant part of the solution that elevates the status of women and all that such progress entails, our foreign policy has to start dealing with the realities of women’s lives instead of attempting to legislate morality,” writes Anika Rahman at RH Reality Check.

Sarah Palin and the Rape Kits: We’ve been writing for weeks about how Alaska Gov. Sarah Palin approved cutting funding from the Wasilla police budget when she was mayor, leaving sexual assault victims holding the bill for their own forensic exams. Well, Dorothy Samuels of The New York Times is now also outraged.

“Ms. Palin owes voters an explanation. What was the thinking behind cutting the measly few thousand dollars needed to cover the yearly cost of swabs, specimen containers and medical tests?” asks Samuels. Wouldn’t we all love to know.

Congress Approves Mental Health Parity: Congress approved legislation this week requiring private insurers to provide the same level of benefits for mental illness as they do for physical maladies, reports the Washington Post. But we’re not home yet, as Lindsey Layton explains:

The measure has received strong bipartisan support in the House and Senate and has the backing of business, insurance companies, health advocates, the medical community and the White House. But its passage into law was not ensured last night.

The remaining obstacle appeared to be ironing out differences in how to pay the cost to the federal government — estimated at $3.4 billion over 10 years, in the form of forgone tax revenue. Lawmakers also needed to resolve whether the final bill should be a standalone measure or part of a larger package of legislation.

The House approved the language in a standalone bill, while the Senate wrapped it into a $150 billion package of popular tax cuts, including a one-year patch for the alternative minimum tax, and extensions of expiring tax provisions including tuition credits and state and local sales tax deductions (for states that do not have an income tax), as well as research and development tax credits.

It is unclear whether a joint agreement can be reached in the few days remaining before Congress recesses.

Plus: Read how David Wellstone has been lobbying for the mental health parity bill, which would be his father’s legacy. The Wellstone-Dominici legislation is named after the late Sen. Paul Wellstone (D-Minn.) and retiring Sen. Pete Domenici (R-N.M.).

D.C. to Publicize HIV-AIDS Epidemic: Washington, D.C. has one of the highest rates of people living with AIDS among major U.S. cities and the highest rate of new reports of AIDS. Now the city is stepping up with a large-scale “social marketing” campaign to publicize these facts, according to the Washington Post.

Almost 12,500 people in the District were known to have HIV or AIDS in 2006, the most recent year of statistics available. HIV was spread through heterosexual contact in 37 percent of the cases, compared with 25 percent of the cases attributed to men having sex with men — the most common mode of transmission nationally.

New reports of AIDS in the District were coming in at the rate of 128 per 100,000, in contrast to 14 cases per 100,000 nationally. One in 50 residents is thought to have the disease.

According to the Kaiser Family Foundation, the District has the highest rate of AIDS among African Americans in the country: 277.5 for every 100,000 people. It also has the highest rate of new cases reported among Hispanics: 109.2 for every 100,000 people.

This week the DC Appleseed Center released its fourth “report card” that grades the progress of the D.C. government in the fight against HIV/AIDS.

Why Don’t the Candidates Speak Out on HIV?: “When news hit that another Wall Street financial institution was on the verge of collapse, the response from rivals Sen. John McCain and Sen. Barack Obama was swift.  Both candidates issued statements touting their respective economic plans.  What kind of impact could our presidential candidates make if they responded as quickly to the domestic and global HIV/AIDS crisis?” writes Pamea Merritt at RH Reality Check.

Merritt looks at how presidential nominees Barack Obama and John McCain have (and have not) addressed the global and domestic HIV/AIDS crisis …

Forward Thinking from Louisiana State Rep: “Worried that welfare costs are rising as the number of taxpayers declines, state Rep. John LaBruzzo, R-Metairie, said Tuesday he is studying a plan to pay poor women $1,000 to have their Fallopian tubes tied,” reports The Times-Picayune.

And it gets even better. He wants to give tax-incentives to women with higher incomes to have more children.

LaBruzzo said he worries that people receiving government aid such as food stamps and publicly subsidized housing are reproducing at a faster rate than more affluent, better-educated people who presumably pay more tax revenue to the government. He said he is gathering statistics now.

“What I’m really studying is any and all possibilities that we can reduce the number of people that are going from generational welfare to generational welfare, ” he said.

He said his program would be voluntary. It could involve tubal ligation, encouraging other forms of birth control or, to avoid charges of gender discrimination, vasectomies for men.

It also could include tax incentives for college-educated, higher-income people to have more children, he said.

Plus: Feministing has more.

Drug Makers to Report Fees Paid to Doctors: “Amid a national debate over the influence of industry money on medical research and practice, two pharmaceutical giants say they will begin publicly reporting payments they make to outside doctors,” reports The New York Times. Benedict Carey writes:

John C. Lechleiter, chief executive of Eli Lilly & Company, announced on Wednesday that starting next year it intended to post in an online database all its payments to doctors for speaking and consulting services. The postings will “likely include” the names of the doctors, or will provide some other identifying information about them, along with the reason for the payments, the company said.

In the wake of Lilly’s announcement, Merck & Company said later Wednesday that it would disclose speaking fees it pays to doctors, also beginning in 2009.

Members of Congress have been pushing for a national registry of such payments. In the last year and a half, Senate investigations have found that prominent researchers at several institutions, including Harvard and the University of Cincinnati, failed to report millions of dollars in outside income from drug makers, contrary to the institutions’ reporting requirements.

Wait to See Doctors Grows in Mass.: “The wait to see primary care doctors in Massachusetts has grown to as long as 100 days, while the number of practices accepting new patients has dipped in the past four years, with care the scarcest in some rural areas,” writes Liz Kowalczyk in the Boston Globe.

“Now, as the state’s health insurance mandate threatens to make a chronic doctor shortage worse, the Legislature has approved an unprecedented set of financial incentives for young physicians, and other programs to attract primary care doctors. But healthcare leaders fear the new measures will take several years to ease the shortage.”

Play Addresses Birth Control & Other Taboos: I haven’t listened to today’s “Talk of the Nation” yet, but I will — check out the description of the 17-minute segment:

Famous for his work on the first oral contraceptive in 1951, chemist Carl Djerassi has published a number of novels and plays over the last 20 years. His latest play, Taboos, grapples with the questions of sex divorced from reproduction.

Plus: “All Things Considered” had a good report today (text available) on the proposed HHS rule on “physician conscience.” The report notes that the “Bush administration this week received tens of thousands of comments on a controversial rule that demonstrates that even it its waning days, the administration continues to have a major impact on policy.” Comments are now closed.

Foreign Policy magazine recently published a list of the 10 worst ideas proposed or adopted by presidential candidates Sen. Barack Obama and Sen. John McCain.

There’s no overlap. Most of Obama’s ideas that came under fire have to do with trade agreements and energy solutions. McCain gets zinged for policies ranging from flip-flopping on immigration, to calling for 45 nuclear power plants, to balancing the budget through victory in the war on terror (um, seriously?).

But one of McCain’s not-so-bright ideas stands out, because it addresses both a domestic and global issue that women’s health advocates have been writing about forever, but which doesn’t receive all that much attention from policy wonks: supporting abstinence-only education and the global gag rule.

So kudos to FP editors for identifying McCain’s views on reproductive health as one of his 10 worst ideas:

What he said: Asked on the campaign trail if he thought grants for sex education should include instruction on contraception, McCain turned to an aide for help, saying, “Brian, would you find out what my position is on contraception—I’m sure I’m opposed to government spending on it, I’m sure I support the president’s policies on it.” The reporter asked, “Do you think contraceptives help stop the spread of HIV?” After a long pause, McCain replied, “You’ve stumped me.” —Town hall meeting, Iowa, Mar. 16, 2007

Why it’s a bad idea: A landmark, 10-year study sponsored by Congress found in 2007 that students in sexual-abstinence programs “were just as likely to have sex as those who did not, reported having similar numbers of sexual partners, and first had sex at about the same age,” the Chicago Tribune reported. Abstinence-only education is one of the core principles guiding the so-called global gag rule, an executive order passed by President George W. Bush in 2001 that prohibits giving foreign aid to NGOs that offer any kind of counseling on abortion as family planning. McCain voted against repealing the measure in 2005. Critics of the gag rule point to reports showing a shortage of contraceptives, clinic closings, loss of funds for HIV/AIDS education, and a rise in unsafe abortions since it was instituted.

That information is well-documented by the Global Gag Rule Impact Project (a collaborative research effort led by these groups), which has looked at the impact in nine countries since 2002. Most of the research has been done in Africa, but the analysis also includes Europe, Asia and the Caribbean.

First introduced in 1984, the Global Gag Rule, officially known as the Mexico City Policy, was rescinded by former President Bill Clinton in 1993 and reinstated by President George Bush in 2001 on his first day in office.

If McCain is elected, you can be sure he and running mate Sarah Palin won’t be “reforming” or “changing” that policy when they get to Washington.

McCain’s view on abstinence-only education and his failure to grasp the connection between contraception and HIV is something we need to make more noise about. Here’s another item — in a recent op-ed published in the Milwaukee Journal-Sentinel, Ellen Bravo wrote:

Recently, I conducted an informal poll among friends, all smart, politically aware people who keep up with the news. A dozen of the 15 people I asked had never seen the clip of a befuddled McCain stroking his chin when a reporter asked about his position on a proposal to require insurance companies that cover Viagra to cover contraceptive products, reminding him that he’d voted against it.

“I certainly do not want to discuss that issue,” McCain replied. “I don’t know enough about it to give you an informed answer because I don’t recall the vote.”

Had that clip — or any of numerous examples of McCain’s other extremist positions and slip-ups — been played more than 600 times in four days, as the “Dean scream” was, today’s polls would be very different.

So, folks, in an effort to amplify the message, please consider embedding this video on your own site (even if you’ve done so before), and spread the word that McCain’s views on abstinence-only education and the global gag rule rank as one of Foreign Policy’s 10 worst ideas.

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.”