North Shore Birth Center in Beverly, MA has been in the news recently, as its parent company, Northeast Health System, had planned to close the center and transfer all births to the Beverly Hospital. The center is staffed by nurse-midwives and is intended to offer a more “home-like” and less interventionist approach to birth - it is described in the Boston Globe as “one of only two hospital-affiliated centers statewide that offer natural birth options.”
In their initial statement on the issue, hospital officials explained that, “As with other birth centers around the nation, North Shore Birth Center is experiencing a significant rise in the cost of malpractice insurance premiums.” News of the expected closure sparked pickets, fliers and letters of protest, as well as a Facebook group and blog.
OBOS Executive Director Judy Norsigian issued a letter to the trustees along with Cindy Pearson of the National Women’s Health Network, Ann Sweeney of Massachusetts Friends of Midwives, and Eugene Declercq, Professor of Maternal and Child Health at the Boston University School of Public Health supporting the continued operation of the center. The letter urged the trustees to postpone any decision to close the center in favor of “open[ing] a dialog with community members and women’s health advocates who are deeply concerned about the critical importance of this reproductive choice.”
Yesterday, according to the Boston Globe, supporters of the center rallied outside Beverly Hospital during the anticipated meeting of the Board of Trustees, which responded with a statement indicating that the objections to closure had been noticed and that the Board “is diligently weighing the impact that the closure of the Birth Center would have on the community. The board intends to leave the Birth Center services unchanged while it continues to examine and discuss this important issue.”
Although this may eventually represent a victory for choices in maternal care and birth in one part of Massachusetts, the situation at North Shore reflects an overall climate of reducing choices for women nationwide. As the Globe notes, “The controversy comes amid a larger debate in the medical and legal communities about maternity care and high medical malpractice insurance premiums paid by hospitals and doctors. Concern about malpractice lawsuits has prompted physicians nationwide to become hyper-cautious, and that has driven up the numbers nationwide of more controlled, caesarean section births.”
“President-Elect Obama’s healthcare reform proposals have focused intensely on two key questions: How much would reform cost and how many people would be covered? He also must address the critical issue of why the United States has such poor health outcomes despite all the money we spend,” write Judy Norsigian, OBOS executive director, and Eugene Declercq, a professor of maternal and child health at Boston University School of Public Health, in this Boston Globe editorial.
A report from the Centers for Disease Control and Prevention documents a slight decline in the national infant mortality rate (the number of deaths to babies under 1 year of age) in 2006, but the rate has essentially remained flat since 2000, leaving the United States 29th among industrialized countries.
Advocates of health reform who focus exclusively on access presume that the United States provides effective but expensive healthcare, and that the only real problem is lack of access to this care. The reality is more complex when we examine those mortality figures. The low US ranking is misleading since many of the countries rated ahead (e.g., Singapore, Hong Kong, Norway) have fewer births than an average US state. So, what if we do a fair test - only comparing the United States with other wealthy countries that have at least 100,000 annual births?
There are 16 such countries. Among them, the United States ranks last in infant mortality, third to last in perinatal mortality (deaths in the first seven days and fetal deaths), and last in maternal mortality.
It gets even more interesting — in response to the argument that the problem is not our healthcare system itself, but rather a lack of access and social supports across the board, as well as inappropriate health behaviors, the authors turn the lens on births to white, non-Hispanic, U.S.-born mothers who begin prenatal care in the first trimester. Wondering how high we rank then? Continue reading here.
The Cochrane Collaboration recently released a publication on midwifery-led care for childbirth compared with “other” or “shared care” models. The authors defined midwifery-led care as follows: “the midwife is the woman’s lead professional, but one or more consultations with medical staff are often part of routine practice.”
Other models generally means an ob/gyn as the lead professional (although nurses and midwives may be part of the support team), and shared care might have a varying lead professional depending on where the woman is and whether she is pregnant, in labor, or has already given birth. In other words, the review looks at maternal and neonatal outcomes not by strictly midwife vs. physician, but by who was primarily in charge of the woman’s care over the course of her pregnancy, including labor and the postpartum period.
The authors also note that the included studies were conducted in the public health systems of Australia, Canada, New Zealand and the United Kingdom, so it might be useful to look at the individual studies themselves to assess whether they would be applicable to the U.S. situation and population.
The authors also explain that they selected studies in which women were randomly allocated to midwifery-led vs. other models of care, and that consisted of low- or mixed-risk women. They selected 11 studies, and examined a number of outcomes such as hemorrhage, use of analgesia, induction of labor, c-section, episiotomy, maternal or neonatal death, breastfeeding initiation, and postpartum depression.
The authors concluded that women randomised to midwife-led models of care were less likely to have regional anesthesia/analgesia, instrumental birth, or episiotomy, and were more likely to have spontaneous vaginal birth, to initiate breastfeeding, and to report high perceptions of control during labor. There were no significant differences on a number of other outcomes, such as hemorrhage, neonatal death, labor augmentation or induction, c-section, or duration of hospital stay.
I do have questions about some of the outcomes and limitations of the paper which may require more in-depth analysis of the methods and the original studies. For example, the authors list as a finding that those in midwife-led teams were less likely to experience fetal loss or neonatal death less than 24 weeks; however, they note elsewhere that they included miscarriage and termination of pregnancy in the neonatal outcomes, and it’s not immediately apparent if this might have affected that finding. Readers also might have expected, for example, a lower c-section rate with the midwife-led teams, but it’s not entirely clear how the protocols in place during each individual study affected this decision-making.
Although it is not likely to be a defining paper on midwifery care and choice of birth providers, this Cochrane piece does suggest an interesting consideration - that maternity care often happens via teams of providers working together, and women may want to be better informed about who is primarily in charge of those teams and how that control is negotiated in practice.
Double Dose: Obama’s Pre-Inauguration Boom for Women’s Health; Baby in the Home (and Garden); Changing the Culture of Rape Prevention; Prescription Drugs Deliver Phthalates …
Obama Does More for Women’s Health Pre-Inauguration Than Bush in 8 Years: “President-Elect Obama has not been inaugurated yet and, already, he’s taken some critical steps towards restoring the United States as a leader in global women’s health,” writes Amie Newman at RH Reality Check. Newman goes on to identify global reproductive and sexual health mandates that Obama has prioritized since he won the election way back on, oh, Nov. 4.
Baby, You’re in the Home (and Garden): The New York Times published a cool story on the increasing number of women opting for home births (still a very small percentage of all births) that took a very New-York perspective: How does one give birth in a small apartment — especially if the room is filled with family and the walls between neighbors are thin?
If the story had left it there, it’s placement in the Home & Garden section might have been more justified. But as it reads — complete with condemnation of home births from the American Medical Association — it’s better suited for Health.
Plus: Don’t miss the related slide show of home births. And here’s a great trivia question: Who was the first American president to be born in a hospital? Answer: Jimmy Carter.
Sexual Assault on Campus - Changing the Culture: Terrific story in the Star Tribune about rape prevention programs on college campuses that focus on men. Check out the intro below, and be sure to read the rest:
Tyler Jones was tipping back a couple of beers with friends at a Dinkytown bar when he suddenly had to take a stand.
“Hey, see that girl over there?” Jones recalled an acquaintance asking, nodding toward a woman he wanted to take home. “She’s almost drunk. Not quite drunk enough. … What shot should I buy her?”
There was a time, Jones says, when he might have laughed off the remark. Not anymore.
“You want to buy her something really strong to like, basically knock her out?” Jones, a University of Minnesota senior, recalled saying. “Man, that’s not right. That’s rape. That’s sexual assault.”
The acquaintance looked stunned. “Whatever,” he mumbled, and walked away.
It was one moment at one bar. But it’s also a sign of a big shift in strategy on campuses trying to tackle a culture that some say tolerates sexual assault. Instead of teaching women not to walk alone at night or to carry Mace, some colleges are trying something much harder — changing college men. Jones, fresh from sex assault prevention training, is in the vanguard of the movement.
Women Gain Some Access, but Not Political Power: “Women still lag far behind men in top political and decision-making roles, though their access to education and health care is nearly equal, the World Economic Forum said Wednesday,” reports Reuters. “In its 2008 Global Gender Gap report, the forum, a Swiss research organization, ranked Norway, Finland and Sweden as the countries that have the most equality of the sexes, and Saudi Arabia, Chad and Yemen as having the least.”
Where does the United States rank? A measly 27th — below Germany (11th), Britain (13th), France (15th), Lesotho (16th), Trinidad and Tobago (19th), South Africa (22nd), Argentina (24th) and Cuba (25th). Here’s the full report (PDF).
The EPA’s Stalin Era: Yes, it really has been that bad, reports Rebecca Claren at Salon. To wit: “[T]he story of the hundreds of sick people who live near the former Kelly Air Force Base illuminates an entirely new manner in which the Bush administration has diluted science and put public health at risk. This year, largely in obeisance to the Pentagon, the nation’s biggest polluter, the White House diminished a little-known but critical process at the Environmental Protection Agency for assessing toxic chemicals that impacts thousands of Americans.”
Prescription Drugs May Deliver Phthalates: We’ve written before about the potential dangers of phthalates — chemical compounds commonly found in plastics, perfumes and lotions that are linked to reproductive abnormalities. But this one is news to me: Environmental Health News reports that prescription drugs can deliver high doses of phthalates.
“At least 47 prescription medications — including the colitis drug Asacol, an antacid and an HIV drug — contain phthalates, according to scientists at the Harvard School of Public Health and U.S. Centers for Disease Control and Prevention,” writes Marla Cone.
Victoria’s Toxic Secret: Feminist Peace Network picks up the story concerning allegations that Victoria’s Secret’s bras are causing skin irritations. The suspect irritant? Formaldehyde.
Racial Barriers Between Doctors and Patients: “In politics, the racial barriers might have fallen, I thought, but what about in health care?” asks Pauline Chen, MD, in her latest doctor/patient column in The New York Times. Chen looks not only at the striking health care disparities and racial inequality, but also at the experiences of minority physicians:
Of all the surgical residents I trained with, “Eric” was easily one of the smartest. He possessed a great bedside manner, brilliant clinical skills and plenty of that Obama cool. Eric was African-American, and one night, when we were both on call together, he told me something I have never forgotten.
“You know, Pauline,” he said, “there are a lot of times when I go to a patient’s room for the first time and they ask me, ‘Are you transport? Are you here to wheel me to radiology?’” I can remember Eric shaking his head as he spoke. “They never assume I’m one of the doctors.”
Supreme Court Hears Gun Rights Case: Allison Stevens of Women’s eNews explains a gun-control case heard before the Supreme Court this week that could effect abusers’ access to guns in some states.
If the justices side with the U.S. government’s challenge — which argues the law should not be restricted to just a portion of the states — batterers in every state and territory would be subject to the gun control ban.
If the court rejects the government’s reading of the law and limits the application of the law to those states with specific anti-domestic violence laws, safety advocates are apprehensive that thousands of abusers across the country will be erased from criminal lists, giving them new access to guns, said Peter Hamm, a spokesperson for the Brady Campaign to Prevent Gun Violence, a group in Washington, D.C., that lobbies for gun control.
1. That communities preserve the option of vaginal births after cesarean (so-called “VBACs”).
2. That options for hospital-based midwifery care (utilizing Certified Nurse Midwives and Certified Midwives) be made available in all communities across the country.
3. That Certified Professional Midwives (CPMs) be licensed and regulated in order to make the option of homebirth as safe as possible.
The statement also calls for evidence-based practices in maternity care, and for the American College of Obstetricians and Gynecologists and the American Medical Association “to strike those resolutions that deny childbearing women the autonomy and rights that medical professionals, educators, and women’s health advocates have historically endorsed.”
OBOS Executive Director Judy Norsigian, who was instrumental in coordinating the creation of the statement, explains further:
“During the past 8 months, while I was meeting with maternity care providers and community groups after the publication of ‘Our Bodies, Ourselves: Pregnancy and Birth,’ I was struck by how many people were deeply concerned about current trends in childbearing. At the same time that women’s birthing options were increasingly being restricted and that obstetric practices were moving more and more in the direction of highly medicalized births for ALL women - even those women without pregnancy and labor complications - our national statistics regarding birth outcomes were far from impressive, especially as compared with other industrialized countries.
As a result of many conversations with health care professionals and women’s health educators/advocates, we embarked upon a rather unusual ‘group writing’ project, the result of which is this ‘Choices in Childbirth’ statement. We hope that this effort will reinforce other national initiatives seeking to establish a greater focus on evidence-based practice and a commitment to sustaining women’s desires for safe childbirth alternatives. Liability concerns now appear to be taking precedence in community after community, rather than the well-being of women and their babies. This is a situation that must be addressed before the morbidity and mortality from unnecessary and inappropriate medical interventions become trends too difficult to reverse.”
The statement concludes:
We recognize the central importance of health care reform proposals now under consideration and urge all maternity caregivers to become involved in debates surrounding these proposals. We support efforts to make maternity care safer by reducing the risk of systems errors that can harm patients and lead to litigation. It is time to create a system that allows women all reasonable choices in childbirth and to encourage practices that produce optimal outcomes for both mothers and babies.
Maternity care providers, public health professionals and childbirth advocates who support the statement are invited to become signatories, and can do so by filling out this online form.
Since the publication of “Our Bodies, Ourselves: Pregnancy and Birth,” OBOS has become increasingly involved in the movement to reform childbirth practices. We have become vocal in criticizing the highly medicalized births that have become the norm for most women and advocating for changes, including increased access to midwifery care and birth centers and the reversal of hospital bans on vaginal births after cesarean (VBAC).
Now a new report has been released that highlights the many shortcomings of the U.S. maternity care system. “Evidence-Based Maternity Care,” a report by Childbirth Connection in conjunction with the Milbank Memorial Fund and the Reforming States Group, focuses on the reality that many common maternity care practices are not based on the most reliable evidence of what is safe and effective.
The report addresses a range of maternity cares issues in the United States, including costs, geographic and institutional variation in practices, and current barriers to improving care. It also addresses specific interventions and concludes with a series of policy recommendations.
The report raises the following important points:
Financial and other external forces have a large impact on the maternity care that is provided in the United States. This means that the kinds of care mothers and babies receive are often not based solely on what is best for them.
Becoming informed and being actively involved in making maternity care decisions can dramatically influence the health outcomes and experiences of mothers and babies.
For women without established problems, having skilled, dedicated support for their innate capacities to give birth (“physiologic childbirth”) will generally be the path to effective care with the least harm. Relying routinely on external procedures, drugs and other interventions during labor and birth can expose women and babies to avoidable harm.
Rather than focusing solely on the idea of overused interventions such as labor induction, epidurals, and cesareans, the report also suggests a list of interventions that may be underused. The authors list midwifery care, smoking cessation interventions, ginger for nausea and vomiting, upright positioning during labor, and interventions related to postpartum depression among several other examples. In other words, the report does not simply argue what not to do, but suggests things to do to potentially improve maternity care, and does not limit these to traditional medical services (such as prescription drugs for morning sickness).
Among the barriers to improving maternity care, the authors discuss the current payment system, malpractice concerns, the use of specialty care, reliance on expert opinion in the absence of solid evidence, lack of provider skill for aspects of labor such as coping support and vaginal breech birth, the slowness with which new evidence is adopted by providers, industry pressure (such as distribution of formula samples), and other challenges. The review of each of these issues provides an interesting overview of the U.S. maternity system and the challenges a woman may face when interacting with that system.
Finally, the review provides four policy recommendations, focused on increasing knowledge and use of evidence-based maternity care, supporting research, reforming the reimbursement system, and requiring performance measurement, reporting, and improvement.
The report has the potential to be an important tool for childbirth advocates and allies as we work to improve legislation and other policies that impact maternity care. As Childbirth Connection Director Maureen Corry states, it is the hope of the authors that “clinicians, health systems, payers, policymakers, consumers and the media” each take a role in implementing the recommendations in order “to ensure that all mothers and babies receive safe, effective and satisfying maternity care.”
The Childbirth Connection website has an overview of the report as well as the full 113-page report (PDF). USA Today also has coverage of the report that focuses on the high economic costs of the failure to incorporate evidence-based practices.
Double Dose: Palin Condoms; Dispute Over Vaccines Reframed as Catfight; Chicago’s Toxic Air; Black Midwives Conference Oct. 10-12; Pregnant Women & Medical Research; Questioning the “War on Fat”
And did you know that as of Sept. 26, Planned Parenthood took in more $802,678 in donations from 31,313 people made in Sarah Palin’s name?
Donations poured in after an anonymous email was circulated urging donations in any amount and recommending that the personalized thank-you card from Planned Parenthood be sent to Palin at the McCain-Palin campaign headquarters in Virginia.
L.A. Times columnist Patt Morrison took credit for the fundraising, recalling how she first made a similar suggestion after President Bush took office in January 2001.
Every donation generated a “thank you card.” I envisioned a scene out of “Miracle on 34th Street,” sacks and sacks of thank-you cards from Planned Parenthood, delivered to Bush in the Oval Office.
It worked. Boy, did it. Ultimately, more than a million dollars, I was told, was generated for Planned Parenthood in Bush’s name. George Bush became one of the biggest money-generators in Planned Parenthood’s history. The idea won me an award from Planned Parenthood, and a splash in Ms. Magazine. So I am delighted that my ”Mother of All Ironic Donations” notion has been revived for Palin.
Chicago’s Toxic Air: Proving real journalism still happens at the Tribune, here’s the intro to a special report on toxic air pollution:
People living in Chicago and nearby suburbs face some of the highest risks in the nation for cancer, lung disease and other health problems linked to toxic chemicals pouring from industry smokestacks, according to a Tribune analysis of federal data.
The U.S. Environmental Protection Agency spent millions of dollars to assess the dangers that air pollution poses but has failed to fulfill promises to make the research more accessible to the public. So the Tribune is posting the information on its Web site, where users can easily find nearby polluters and the chemicals going into their air.
Those who look up Cook County will see it ranked worst in the nation for dangerous air pollution, based on 2005 data. The Tribune also found Chicago was among the 10 worst cities in the U.S.
Plus: The Trib also published a searchable database of health-risk information (based on the EPA’s Risk-Screening Environmental Indicators (RSEI) database) and the health effects of long-term exposure to various industry-produced chemicals.
Bioethicists Challenge Reticence to Include Pregnant Women in Medical Research: A paper to be posted online and later in print in the November edition of the International Journal of Feminist Approaches to Bioethics (IJFAB) argues why more pregnant women must be included in medical research.
“As a society we are ethically obliged to confront the complex challenges of pregnant women in research, otherwise we relegate all expectant mothers to second-class medical citizens,” said Ruth Faden, director of the Johns Hopkins Berman Institute of Bioethics, in this press release about the journal article.
“One of the key messages of this paper is that progress will not happen until we shift the burden of justification from inclusion to exclusion and to an explicit commitment to studying the effects of drugs in pregnancy,” Faden added.
Midwives Fight AMA to Provide Black Maternal Care: “Shafia Monroe’s sixth annual International Black Midwives and Healers Conference, taking place in New York’s Harlem neighborhood Oct. 10-12, comes in the middle of a showdown between home-birth midwives and the American Medical Association,” writes Malena Amusa at Women’s eNews.
The AMA wants to bar licensing to certified professional midwives, who specialize in out-of-hospital births (births at home and in birthing centers) and is backing state legislation that restricts licensing to nurse midwives who have additional nursing training and certification required to work in hospitals.
“Certified professional midwives are a critical component to meet the growing maternal health needs in the black community,” said Monroe, noting that every sort of midwife is needed to reduce maternal morality rates among African American women.
Top Psychiatrist Didn’t Report Drug Makers’ Pay: “One of the nation’s most influential psychiatrists earned more than $2.8 million in consulting arrangements with drug makers from 2000 to 2007, failed to report at least $1.2 million of that income to his university and violated federal research rules, according to documents provided to Congressional investigators,” reports Gardiner Harris in The New York Times. “The psychiatrist, Dr. Charles B. Nemeroff of Emory University, is the most prominent figure to date in a series of disclosures that is shaking the world of academic medicine and seems likely to force broad changes in the relationships between doctors and drug makers.”
Cancer Research Briefing: Bloggers recently had a chance to discuss the current state of cancer research and biotechnology with Dr. Gil G. Mor, an associate professor at Yale Medical School and director of Reproductive Immunology and Translational Research in Gynecologic Oncology, and Lori Lober, who was diagnosed with stage IV breast cancer in 2000 and has maintained a diagnosis of “no evidence of disease” for five years.
Treating Vascular Disease in Women: Arterial vascular disease is underdiagnosed and undertreated in older women, according to studies. Earlier this year, medical experts met to discuss the differences between men and women when it comes to the prevention, diagnosis and treatment of vascular diseases such as heart attacks and strokes. Out of that symposium came newly released recommendations for improving research on sex differences.
Losing the Weight Stigma: The Idea Lab section of The New York Times Sunday Magazine questions the “war on fat” and offers examples of how academics and activists are emphasizing health over weight. Robin Marantz Henig writes:
This is a core argument of fat acceptance: that it’s possible to be healthy no matter how fat you are and that weight loss as a goal is futile, unnecessary and counterproductive — and that fatness is nobody’s business but your own.
Many fat-acceptance activists prefer a new approach to dieting that focuses on nutrition, exercise and body image. A new book out this fall, “Health at Every Size,” by Linda Bacon, a nutritionist and physiologist at the University of California at Davis, outlines this approach, which is less about dieting than a lifestyle change that emphasizes “intuitive eating”: listening to hunger signals, eating when you’re hungry, choosing nutritious food over junk. It encourages exercise, but for its emotional and physical benefits, not as a way to lose weight. It advocates tossing out the bathroom scale and loving your body no matter what it weighs.
The philosophy is migrating slowly into mainstream programs, like a spa in Vermont that focuses on “acceptance of ourselves and our wonderful sizes.” But the spas and other programs have trouble with the bottom line of fat acceptance — rejection of weight loss as a goal. Weight Watchers, for instance, uses some of the same slogans, and while it promotes its program as “not a diet,” it still tracks weight loss down to the decimal point.
The American Association of Birth Centers has issued an appeal to supporters to contact Congress concerning a payment crisis that threatens insurance support for birth centers around the country.
After more than 20 years of providing funding, the Centers for Medicare and Medicaid Services (CMS) — the federal agency that runs Medicare/Medicaid — is now refusing to pay the federal percentage of Medicaid payments that states might make to birth centers.
“This is not a Medicaid crisis but a payment crisis for birth centers,” according to the AABC. “Historically all payers follow the lead of Medicaid. If Medicaid stops paying the birth center facility fee so will other insurers.”
The AABC explains the background:
Over the past few years, CMS has begun disallowing federal matching funds for state Medicaid payments for freestanding birth center services. Birth centers have been recognized by CMS (and earlier, by HCFA) as a Medicaid provider type in State Medicaid Plans since 1987.
Recently, however, CMS has disallowed such payment by several state Medicaid Agencies, including Alaska, South Carolina, Texas, and Washington State, claiming that it lacks clear statutory authority and direction to do so. CMS has directed its regional offices to stop federal payments to any state for birth center services.
This action by CMS puts pregnant women at risk of losing access to safe, high quality maternity care.
Visit AABC for more information on how to contact your member of Congress and urge legislation to direct CMS to pay birth center facility fees. It would be great if midwives, women who have used birth centers and anyone who believes in the right to choose her own birth site got involved.
Here are some facts about birth centers:
Birth Centers are part of a vital safety net for Medicaid mothers across the U.S.
Birth centers fill the void left in many areas when hospitals — rural, urban or suburban — close their obstetrical services
Many rural and urban birth centers serve a disproportionately high percentage of Medicaid recipients. Texas provides two examples – at least 95% of patients in an inner city Houston birth center, over 85% for a center in Weslaco, Texas in the Rio Grande Valley
Birth centers have a proven history of reducing low birth weight and preterm birth, the main causes of neonatal death in the U.S.
Birth centers provide innovative approaches to maternity care that reduce disparities for low-income and minority women, lower cesarean section rates, and reduce health care costs
Inspired to act by Washington, D.C.’s infant mortality rate — twice that of the nation as a whole — Lubic and her team work to reduce that rate by providing education and healthcare to women and their families. The birth center provides prenatal care, childbirth education, education on preventing premature delivery, nurse-midwife care (at the Center or in a hospital), postpartum care, and other health services for women and children.
According to the CBS piece, “After 800 babies in eight years, they have never lost a child in childbirth, and has cut the rate of premature births — the biggest risk factor for infant mortality — in half.”
Check out the video from CBS, and don’t miss 81-year-old Lubic’s response to the mention of retirement.
After a brief conversation with Lubic, it’s clear that she keeps quite busy advocating for infant mortality improvements.
Among her many activities, she appeared before Congressman Steve Cohen’s (D-TN) briefing on infant mortality last fall (Cohen represents Memphis, Tenn., which also has a shockingly high infant mortality rate), and will participate in another Congressional briefing this week. She will be part of a panel and blog launch event, “Disruptive Women in Health Care,” on the 25th of this month at the National Press Club.
To find out more about Lubic and the Center’s work, check out this video, as well as the articles listed below.
Double Dose: Feminism Quotes of the Week; Dr. Phil & Home Birth; The Season for Viewing Fat People; Domestic Abuse and Deportation; Cheering for the Safety of Cheerleaders …
Quote of the Week: “The “new feminism” may include uncritical support for women who oppose teen pregnancy programs and for women who force rape victims to pay for their own rape kits. But I just don’t see where support for women who persist in fabricating their own records is a feminist principle.” — Dahlia Lithwick
Quote of the Week, Part 2: “In this strange new pro-woman tableau, feminism — a word that is being used all over the country with regard to Palin’s potential power — means voting for someone who would limit reproductive control, access to healthcare and funding for places like Covenant House Alaska, an organization that helps unwed teen mothers. It means cheering someone who allowed women to be charged for their rape kits while she was mayor of Wasilla, who supports the teaching of creationism alongside evolution, who has inquired locally about the possibility of using her position to ban children’s books from the public library, who does not support the teaching of sex education [...] Stop the election; I want to get off.” — Rebecca Traister
Take On Dr. Phil’s Take on Home Births: We’ve heard from several readers that Dr. Phil is soliciting home-birth horror stories on his website for an upcoming show. Perhaps hearing from some satisfied home birthers will lead to a more balanced program. Also see this related call for pregnant women considering a home birth.
It’s Fall, So Viewers Must be Gawking at Fat People: The New York Times’ Alessandra Stanley recently covered the growing number of weight-loss television programs — “binge viewing for a nation obsessed with weight” — and the cultural implications. A sampling: “Bulging Brides” on WE; “The Biggest Loser” on NBC; and “Honey We’re Killing the Kids,” among others …
Plus: Writing at AfterEllen.com, Reese DoWitt questions the saneness of MTV’s “Model Makers,” a proposed reality TV series in which 15 wannabe-models have to slim down to win the show’s $100,000 grand prize.
And Richard Perez-Pena, also of NYT, notes that “The Biggest Loser” is a big win for Rodale and its biggest magazine, Prevention, which have collaborated with the series for the past three years.
Taking Cheerleading Seriously: “A growing body of evidence indicates cheerleading has become one of the riskiest athletic activities for women, leaving a long trail of sprained wrists, twisted ankles, damaged knees, strained backs — and sometimes much worse,” writes Rob Stein in the Washington Post.
Despite a sharp increase in the number and types of cheerleading squads and the complexity of their routines, cheerleading is not officially considered a sport at most high schools and universities. As a result, it’s not subject to the safety regulations that apply to gymnastics, for example.
“When people think about cheerleading, they think about the girls with the pompoms jumping up and down,” said Frederick O. Mueller, a leading sports injury expert at the University of North Carolina at Chapel Hill. “They don’t think about someone being thrown 25 feet in the air and performing flips with twists and other risky stunts we see today.”
Equally shocking are the cheerleading proponents quoted who seem in denial about the risks. It’s a sport, folks, not an after-school club, and should be regulated like any other official athletic activity.
Facing Deportation and Fleeing Domestic Abuse: Women’s eNews reports on the mass arrest this summer of undocumented workers in Rhode Island that left a number of abused women fearing their deportations will put them back within reach of abusers they fled. A longstanding case pending in San Francisco could set a new precedent, reports Amy Littlefield.
What About the Children?: Writing at Huffington Post, Marian Wright Edelman, president of the Children’s Defense Fund, discusses the effect of immigration raids on children. A report by the National Council of La Raza and the Urban Institute, “Paying the Price: The Impact of Immigration Raids on America’s Children,” notes that there are about five million children in the United States with at least one undocumented parent.
Ensuring the Human Right to Survive Pregnancy in Southeast Asia: A meeting of world leaders later this month to discuss progress on the Millennium Development Goals “presents a decisive opportunity to ensure that the limited progress on maternal mortality is at the center of the dialogue,” writes Ramona Vijeyarasa at RH Reality Check. “2005 maternal mortality ratio estimates released by WHO were as high as 540 maternal deaths per 100,000 lives births for Cambodia, 420 for Indonesia and 230 for the Philippines as compared to 14 for the Republic of Korea or 11 for the United States.”
Study: Delivery Method Affects Brain Response to Newborn’s Cries: “When my own daughter was born by Caesarean section delivery, I was surprised how uninvolved I was in the process. My body was numb, and my view of the surgery was blocked by a sheet. When I finally heard a baby cry, it took a minute for me to realize that the sound belonged to my own baby,” writes Tara Parker-Pope at Well.
“That’s why I was particularly interested to read of new research showing that the method of delivery seems to influence how a mother’s brain responds to the cries of her own baby. The brains of women who have natural childbirth appear to be more responsive to the cries of their own babies, compared to the brains of women who have C-section births.”
When an Apple is Harder to Find than French Fries: “You can’t choose healthy foods if you don’t have access to them. And that’s the dilemma faced by millions of residents in the ‘Food Deserts’ of America,” writes Mari Gallagher, a researcher and author of the 2006 study “Examining the Impact of Food Deserts on Public Health in Chicago,” as well as similar studies in Detroit, rural Michigan, Louisville, Harlem and Richmond.
Food deserts are geographic areas lacking in grocery stores and awash in fast-food restaurants. Read more here.
Double Dose: An Open Letter to Gov. Sarah Palin; Transgender Employees Find More Workplace Support; High Rate of C-Sections in Washington; Latest Breast Cancer Rates; Videos You May Have Missed from the RNC …
Many Americans agree with your position regarding abortion — they do this as a matter of faith, ethics, personal experience and sometimes politics. I am just wondering though, if you have thought about what would happen if you succeeded in getting your position — that fetuses have a right to life — established as the law of the land? Did you know that it not only threatens the lives, health and freedom of women who might want or need someday to end their pregnancies, it would also give the government the power to control the lives of women — like you who — go to term?
The Privilege of White Woman’hood/ Mommy’Hood: “Sarah Palin wants to put herself out there as ‘every woman.’ She wants to be seen as ‘just your average hockey mom,’ and other mommies see themselves and their reality reflected through Palin, except, mamis of color, that is,” writes Maegan “La Mala” Ortiz at Racialicious (and at her site, Mamita Mala).
What Women Want: There’s video up from the This Is What Women Want speakout in Boston (Aug. 21), including Rita Arditti advocating for health care as a universal right; Cynthia Enloe on lifting the global gag rule; and Kety Esquivel on treating immigrants as human beings.
Smoother Transitions: “Across the country, particularly at larger companies, transgender workers are being protected and assisted in ways that were hardly imaginable a few years ago,” writes Lisa Belkin, author of the Life’s Work column in The New York Times.
Currently, 125 of the Fortune 500 companies include “gender identity” in their nondiscrimination policies, compared with “close to zero” in 2002, according to Jillian T. Weiss, an associate professor of law and society at Ramapo College of New Jersey, and an expert on transgender workplace diversity. [...]
“It is a different world,” said Dr. Weiss, who attributes the change, in part, to the slow adoption of laws banning discrimination on the basis of gender identity (20 states and roughly 100 cities have such laws), but mostly to the work of the Human Rights Campaign, the largest gay, lesbian, bisexual and transgender civil rights organization in the nation.
Yes, HRC, which releases the Corporate Equality Index — a measure of how receptive a company is to diversity. Questions concerning gender-identity protection and transgender benefits have been included since 2002.
High Rate of C-Section Births is Health Concern for Women: “One in four Washington mothers now give birth through C-section, according to the Department of Health, and the rate of the surgical procedure has been increasing by 6 percent every year for nearly a decade,” reports the Seattle Post-Intelligencer.
“The U.S. Centers for Disease Control and Prevention says we should have no more than 15 percent of low-risk births delivered by C-section,” said Joe Campo, director of research at the [state agency's Center for Health Statistics]. “It’s important for us to know what’s driving this increase.”
About 13,300 of the 21,800 total C-sections are first-time procedures and about 8,500 are repeat procedures, Campo and his colleagues found. Of the total, state officials believe at least 2,200 are clearly unnecessary. A fairly sophisticated analysis of the C-section rates allowed for a geographic comparison that found an especially pronounced increase in the use of the surgical procedure in the Puget Sound region.
Plus: In a guest column penned in response to the SI story, Sara L. Ainsworth, senior legal and legislative counsel at Northwest Women’s Law Center, wrote that the high rate of caesarean sections “raises alarms for those who care about women’s reproductive health and patients’ rights.”
In addition to the potential health risks of the surgery, women who have C-sections face consequences that even conscientious health care providers may not recognize or discuss with their patients.
In many parts of this state, having one C-section delivery will require another at a subsequent birth, even over the objection of the pregnant woman and her doctor. Several Washington hospitals refuse to allow doctors to provide labor and delivery services to pregnant women who have had a previous C-section unless those women submit to a second C-section delivery.
Breast Cancer Rates: The Kaiser Family Foundation has published a state-by-state breakdown of breast cancer incidence rate per 100,000 women in 2004. Massachusetts has the highest rate (134 per 100,000 women), followed by Oregon, Washington, Rhode Island and Connecticut. Arizona has the lowest rate (102.9), followed by Idaho, Arkansas, Nevada and Indiana.
Plus: Feminist Peace Network reports on Molecular Breast Imaging (MBI), a new procedure that may be useful for women with dense breasts who have a higher risk of breast cancer. The downside? Patients receive 8 to 10 times more radiation from MBI’s than from mammograms.
With Child, With Cancer: The New York Times Magazine profiles women who are undergoing cancer treatments during pregnancy and covers the medical history of treating pregnancy-associated breast cancer.
Health Reporters Not Helping Readers: A study by University of Missouri journalism professors found that “the majority of health journalists have not had specialized training in health reporting and face challenges in communicating new medical science developments.”
Of the journalists surveyed, only 18 percent had specialized training in health reporting and only 6.4 percent reported that a majority of their readers change health behaviors based on the information they provide. The journalists had an average of 18 years of journalism experience and seven years experience as health journalists.
“Health journalists play an important role in helping people effectively manage their health,” [assistant professor Maria] Len-Ríos said. “However, we found that many journalists find it difficult to explain health information to their readers, while maintaining the information’s scientific credibility. They have to resist ‘bogging down’ the story with too much technical science data and ‘dumbing down’ the story with overly simplistic recommendations.”
Journalists reported quoting medical experts, avoiding technical terms, and providing data and statistics as the three most important elements to making health information understandable. However, understanding numbers is a challenge for many people, [assistant professor Amanda] Hinnant said.
Celebrate the Anti-Wedding: Read what happens when death and taxes decide to get married and stage a protest against weddings. And there’s video.
Returning for the Final Time to the Republican National Convention: Jon Stewart drives home the hypocrisy of Republican attitudes toward reproductive rights with guest Newt Gingrich, while Samantha Bee tries to remember what that word is …
- The Reverend Debra W. Haffner, director of the Religious Institute on Sexual Morality, Justice and Healing, makes a good argument on the limits of family privacy when there are important public issues at stake. In a column reprinted at RH Reality Check, Haffner writes that the unplanned pregnancy of Gov. Sarah Palin’s 17-year-old daughter “raises legitimate questions about Gov. Palin’s positions on sexuality education, teenage pregnancy and reproductive choice. Americans have every right, and American media the responsibility, to explore those questions without exploiting the child involved.”
- Funny that Rachel today cited a section of the Republican Platform that claims the party has “a moral obligation to assist, not to penalize, women struggling with the challenges of an unplanned pregnancy.”
The Washington Post notes that Palin used her line item veto to slash funding for programs that serve teenage mothers:
After the legislature passed a spending bill in April, Palin went through the measure reducing and eliminating funds for programs she opposed. Inking her initials on the legislation — “SP” — Palin reduced funding for Covenant House Alaska by more than 20 percent, cutting funds from $5 million to $3.9 million. Covenant House is a mix of programs and shelters for troubled youths, including Passage House, which is a transitional home for teenage mothers.
According to Passage House’s web site, its purpose is to provide “young mothers a place to live with their babies for up to eighteen months while they gain the necessary skills and resources to change their lives” and help teen moms “become productive, successful, independent adults who create and provide a stable environment for themselves and their families.”
I’m sorry, but a politician who opposes abortion even in cases of rape and incest and who opposes comprehensive sex education should be at the forefront of championing support systems that make it easier for young mothers to keep their babies. [...]
Surely a program aimed at assisting the most desperate of young mothers — those whose boyfriends aren’t amenable to a shotgun wedding or who don’t have a strong family support system — would be something a pro-life feminist such as Palin would work to expand not destroy.
- On the subject of working mothers, Ann Friedman suggests changing the conversation from can Gov. Palin balance work and family in the White House to what is she doing to help other working mothers?
The real story here is not how Sarah Palin chooses to balance her own life. It’s about whether she (and McCain) are committed to making these choices easier for all women. And clearly, the answer is no.
- FInally, I think Rebecca Traister does an excellent job of summing up the frustration many have voiced about Palin’s nomination:
In his callous, superficial and ill-judged attempt to woo women voters with the presence of mammary glands on his ticket — hot, young ones to boot — McCain has committed a sickening grievance against both voters and those female politicians whom he purports to respect and support. What a failure by McCain to have this woman — with her pregnancies and progeny and sex life and child-rearing prowess now being inspected instead of her policy and voting history — stand in for, and someday, possibly emblemize the political progress of American women, especially at a moment at which women had, temporarily it seems, risen far enough above our gestational capabilities to be taken seriously in the race for the White House.
Just in time for the hurricane season, the CDC has launched a new website aimed at pregnant women and families with young children to help them prepare for an emergency or disaster.
The site includes tips for what to have on hand during an emergency, what to bring if you’re evacuating, and resources to help with the aftermath — including a number to call if you’re concerned about the effects of disaster-related exposures if you’re pregnant or breastfeeding (that would be the Organization of Teratology Information Specialists at 1-866-626-OTIS or 1-866-626-6847).
Bonus: A short sidebar on preparing for an emergency birth suggests visiting the American College of Nurse-Midwives for more information. Great idea for everyone!
