Nancy Chodorow’s “The Reproduction of Mothering” was an instant feminist classic when it was published in 1978. One of the most visionary conclusions was her call for men to take an equal role in the caretaking of children. If they don’t, she argued, women would grow up with a distorted perspective on their own relationships with men.

More than 30 years later, Chodorow’s call appears as challenging as ever — at least in the United States, where parental leave is still unpaid (putting us behind 177 nations, including Haiti and Afghanistan, that provide all women, and in some cases men, income and time off after the birth of a child) and only 12 weeks long, which discourages even willing men from taking over child-rearing duties.

Four years before the publication of Chodorow’s landmark text, however, Sweden had already become the first country to replace maternal leave with parental leave, and Sweden has continued to break new ground by spurring a revolution in male attitudes toward and male participation in childcare. Katrin Bennhold of The New York Times writes:

85 percent of Swedish fathers take parental leave. Those who don’t face questions from family, friends and colleagues. As other countries still tinker with maternity leave and women’s rights, Sweden may be a glimpse of the future.

In this land of Viking lore, men are at the heart of the gender-equality debate. The ponytailed center-right finance minister calls himself a feminist, ads for cleaning products rarely feature women as homemakers, and preschools vet books for gender stereotypes in animal characters. For nearly four decades, governments of all political hues have legislated to give women equal rights at work — and men equal rights at home.

Swedish mothers still take more time off with children — almost four times as much. And some who thought they wanted their men to help raise baby now find themselves coveting more time at home.

But laws reserving at least two months of the generously paid, 13-month parental leave exclusively for fathers — a quota that could well double after the September election — have set off profound social change.

Bennhold goes on to describe the positive effects of this change, such as a lowering of divorce rates and an increase in shared custody when a divorce does occur. It has undeniably transformed what it means to be a man.

Birgitta Ohlsson, European affairs minister, puts it in the terms of an old feminist maxim: “Now men can have it all — a successful career and being a responsible daddy. It’s a new kind of manly. It’s more wholesome.”

For more on how father’s leave in Sweden came to be so popular, read this side piece on politician Bengt Westerberg, who in the 1990s “championed the introduction of the first dedicated father month — 30 days of paid parental leave that could not be transferred to the mother — to encourage reluctant men like himself to do their bit and overhaul Swedish society in the process.”

Despite the fact that Sweden and other countries are far ahead of the United States when it comes to supporting fair and equitable childcare, it’s important to remember that progressives in the United States have been fighting for some form of paid parental leave for almost 100 years.

Yes, 100 years. As Sharon Lerner reminds us in the Washington Post:

As far back as 1919, when the Model T was switching from a crank to an electric starter, the U.S. government came close to signing on to an International Labor Organization agreement, supported by 33 countries, that said women workers should receive cash benefits in addition to job-protected leave for 12 weeks in the period surrounding childbirth. That same year, Julia Lathrop, the chief of the Labor Department’s children’s bureau, issued a report on international maternity leave policy in which she decried the United States as “one of the few great countries which as yet have no system of State or national assistance in maternity.” She had recently returned from Europe, where Germany and France had paid-leave laws that had been in place for decades.

The entire article is a very enlightening history lesson — revealing the twisted politics that have held back justice and common sense for far too long. For more on that subject, check out Lerner’s new book, “The War on Moms: On Life in a Family-Unfriendly Nation.”

According to this release [PDF] on May 28 from the U.S. Senate Armed Services Committee, the proposed National Defense Authorization Act (NDAA) for 2011 includes provisions both to repeal the “Don’t Ask, Don’t Tell” policy and the prohibition on performing legal abortions in Department of Defense medical facilities.

The ACLU and Planned Parenthood have further commentary.

Our own Judy Norsigian – along with Ellen Shaffer of the Center for Policy Analysis – has a new piece up at Salon.  A practical guide forward for progressives on healthcare looks at the myths that have undermined  enthusiasm for the new health care reform package and encourages people to build upon its successes.

Norsigian and Shaffer also propose next steps for progressives who share the goal of affordable universal health care. Check it out, and let us know what you think in the comments!

In 2007, the CDC formed a working group to coordinate public health-related infertility activities, and identified opportunities for improvement in public health activities to understand and address preventable causes of infertility. The group subsequently published a white paper in 2008 on infertility prevention, detection and management, which included a call for the development of a national plan of action to address infertility issues.

A CDC representative from the Women’s Health and Fertility Branch of the agency’s Division of Reproductive Health has now informed us that the resulting outline for an action plan – “Outline for a National Action Plan for the Prevention, Detection, and Management of Infertility” [PDF] – can now be circulated. Our Bodies Ourselves is one of many organizations engaged in the review of the document, alongside other professional, advocacy, consumer health, and educational organizations and institutions.

As the background section explains, some infertility may be preventable through public health approaches:

Known or potential causes of infertility include genetic abnormalities, environmental, occupational, and infectious agents, certain diseases, delayed childbearing, and behavioral risk factors. We do not know what proportion of the infertility burden can be prevented, but it may be substantial.

The authors provide examples such as effects of sexually transmitted infections, as well as environmental and occupational hazards, and concerns that some risk factors for infertility may disproportionately affect those experiencing “social and racial disparities in health status.”

The plan includes four main goals:

1) To reduce the burden of infertility and impaired fecundity in the United States by promoting behaviors that maintain fertility, by promoting prevention, early detection, and treatment of infections (such as chlamydia) and other medical conditions that lead to infertility, and by removing or reducing environmental and occupational threats to fertility;
2) To improve access to the diagnosis and treatment of infertility and eliminate disparities in infertility care;
3) To improve the efficacy and safety of infertility treatment; and
4) To improve the quality of life of people who live with infertility in the US.

The plan outline document lists numerous strategies for surveillance, prevention research, policy development, evidence-based patient care guidelines, public education, expanded prevention and infertility care services, and other approaches, which should form the basis of a more detailed full action plan.

Download the Plan Outline

The U.S. Food and Drug Administration last year formed a task force to increase the agency’s transparency to the public, with a goal to “develop recommendations for making useful and understandable information about FDA activities and decision making more readily available to the public in a timely manner and in a user-friendly format.” This effort stems from the Obama administration’s goal of increasing the transparency of government agencies in general.

In a newly published perspective piece for the New England Journal of Medicine, representatives of the FDA’s transparency initiative describe the task force’s work to date, including release of a website, FDA Basics, “to answer fundamental questions about how the agency does its work.”

Today, the agency has released a report [PDF] from the task force outlining draft proposals “for expanding the disclosure of information by the agency while maintaining confidentiality for trade secrets and individually identifiable patient information.”

The proposal document is fairly technical and seems to assume a fair bit of background knowledge of FDA procedures and policies, but it includes proposals such as disclosing information about commonly observed violations associated with FDA-regulated products, the status of terminated and withdrawn new drug and device applications, and summary safety and efficacy information related to investigational new drug applications (data that may not have been published in the medical literature) when the agency determines the information is necessary to protect the public health

The agency will be accepting public comment on the proposal, including which draft proposals should be given priority, until July 20, 2010 via regulations.gov (direct link for comments not yet available). The FDA has also set up a transparency-related blog for updates on these efforts.

Added: you can now go here at Regulations.gov to submit comment, due by July 20, 2010.

The President’s Cancer Panel, created in 1971 to monitor the National Cancer Program, provides reports to each sitting President on the nation’s cancer programs and priorities. Previous reports have covered topics such as health disparities, translational research, cancer survivorship, barriers to care, and cancer among Native American populations.

The Panel’s recently released report, “Reducing Environmental Cancer Risk: What We Can Do Now,” [PDF] focuses on potential risks posed by contaminants in the environment from industrial, manufacturing, agricultural, medical, military, natural, and other sources, and provides recommendations for reducing environmental cancer risks. For example, the report discusses the radiation exposure from medical CT scans, mercury emissions from coal-fired power plants, and pesticide exposures.

The Panel’s report calls for further research into environmental causes of and contributors to cancer, stronger regulation and enforcement related to hazardous substances, better disclosure to the public of potential hazards created, inclusion of environmental and public health advocates in developing research and policy agendas and information dissemination, minimization of radiation exposure from medical sources, attention to the unequal burden of exposure, and increased use of safer alternatives.

It also calls for a move away from “current reactionary approaches to environmental contaminants in which human harm must be proven before action is taken to reduce or eliminate exposure” to a more “precautionary, prevention-oriented approach.” (For more information on what such an approach would look like, see The Precautionary Principle on the OBOS website.)

The free report also includes a number of recommendations for individuals to reduce their exposure to potentially harmful chemicals.

A representative of the American Cancer Society has criticized the report, arguing that “the report is unbalanced by its implication that pollution is the major cause of cancer…its conclusion that ‘the true burden of environmentally (i.e. pollution) induced cancer has been grossly underestimated’ does not represent scientific consensus. Rather, it reflects one side of a scientific debate that has continued for almost 30 years.”

The chairman of the panel has reportedly responded, “This is an evenhanded approach, and an evenhanded report. We didn’t make statements that should not be made.” A representative of Utah Physicians for a Healthy Environment, in a commentary for The Salt Lake Tribune, further criticized the ACS’s response, commenting that the ACS’s focus on “lifestyle factors” such as diet and exercise reflects a “blame the victim” philosophy that trivializes environmental risks. He also questions the ACS’s relationship with corporate donors who could possibly be affected by increased regulation and enforcement.

Orac at Respectful Insolence (ScienceBlogs) has detailed commentary on the report, including discussion of the ACS’s reaction – the full post is well worth a read.

We have written previously about the Overlapping Conditions Alliance, a group of nonprofit organizations “seeking to advance the scientific, medical and policy needs of individuals affected by medical conditions that frequently overlap.”

On May 19, the Alliance will launch the Campaign to End Chronic Pain In Women with a goal “to improve the quality of women’s lives by raising awareness of chronic pain conditions that disproportionately impact women, as well as the neglect, dismissal and discrimination faced by women suffering from chronic pain. ”

As a campaign alert explains:

Chronic fatigue syndrome (CFS), endometriosis, fibromyalgia, interstitial cystitis (IC), irritable bowel syndrome (IBS), temporomandibular (TMJ) disorders and vulvodynia are just some of the conditions that have sidelined as many as 50 million lives and cost up to $80 billion each year. These four either solely affect women, or target women at least four times more often than men.

At a congressional briefing on the 19th, the Campaign will release a report on chronic pain in women. The briefing will be hosted by by Representatives Lois Capps (D-CA), Tammy Baldwin (D-WI), Janice Schakowsky (D-IL), and will feature representatives of the four organizations of the Overlapping Conditions Alliance. A website for the campaign will also become available on that date; we’ll update with the link.

Amnesty International, which recently released a report on maternal health in the United States, is asking supporters to contact Kathleen Sebelius, Secretary of Health and Human Services, to ask for the creation of an Office of Maternal Health to “ensure that the country’s maternal health care crisis is addressed in a comprehensive manner.”

In the provided letter, the organization asks for such an Office to work on the following priorities:

• gathering comprehensive data on deaths, complications and performance measures along with an effective nationwide review process;
• ensuring access to timely prenatal care;
• issuing evidence-based protocols for health care providers to prevent, recognize and respond to the leading complications that cause pregnancy-related deaths;
• encouraging home visits in the days following childbirth; and
• vigorous enforcement of federal nondiscrimination laws;
• recommending the necessary regulatory and legislative changes to ensure that all women receive the quality maternal care necessary to reduce maternal deaths in the United States.

Organizations can also sign onto a letter to be delivered to Secretary Sebelius tomorrow by contacting demanddignity@aiusa.org.

In this difficult economy, many states are struggling to balance their budgets, often resulting in controversial decisions and cuts. Last month, New Jersey Governor Chris Christie (R) released a 2011 budget plan for the state which continues to generate considerable discussion. An astute reader brought one line in particular to our attention from the proposed budget: “Funding for grants to support clinical family planning and related services is eliminated.”

A representative of the ACLU of New Jersey writes:

Without state funding next year, the centers would serve 40,000 fewer patients, leaving an already vulnerable population with even less. In the midst of a recession, these services are more critical than ever. The recently passed health care legislation may offer some assistance in the coming years, but it won’t keep the lights on in the only medical centers serving neighborhoods that need them the most.

A piece in the Daily Princetonian urges students to contact Christie about the proposed cuts, arguing that the cuts will lead to poorer health for both men and women, and already vulnerable populations, ultimately costing the state more: “These cuts are not just shortsighted, misogynistic and classist — they’re completely nonsensical. And they will result in devastating consequences for public health.”

What’s going on in your state’s budget related to women’s health? Let us know in the comments.

Wondering what health care reform means for you and your family? You may want to invite Raising Women’s Voices to your community for a special education session. From RWV:

We are bringing groups of experts into the community to meet with women, who often are the key health decision-makers for their families. Our aims are to explain the many ways in which health reform will help families — such as providing coverage for 32 million uninsured Americans — and to note the ways in which the law fell short, such as in covering abortion services and including undocumented immigrants.

Check out the list of available experts and topics to be covered. It seems like a wonderful opportunity to hear directly from women who can discuss individual and community-wide benefits and the nuances of the new law.  To learn more, email info [at] raisingwomensvoices.net

* * * * *

Last week, The New York Times Science section published an informative special issue on health care reform. The lead story, “What You Need to Know in the First Year” has an alternative title online that cuts to the chase: “What’s in it for Me?”

“The basic thrust of this law is that all of these nooks and crannies, all these gaps where private insurance has left you without any option, those are going to be taken away,” said DeAnn Friedholm, campaign director of health reform for Consumers Union, the nonprofit publisher of Consumer Reports. “It’s complicated, but it does establish a very key, important policy that you’re going to have options, regardless of your health situation or your employment situation.”

More specific to women’s health is an article by Denise Grady that looks at how health care reform will reduce costs associated with having double X chromosomes.

Among the major changes: Gender rating, the act of charging women more than men for the same insurance policy, even when maternity care is not included, is no longer allowed, and maternity coverage is now considered “an essential health benefit.”

“It has to be a part of the premium just like heart attacks, prostate cancer or any other condition,” said Marcia D. Greenberger, co-president of the National Women’s Law Center. The story continues:

Despite her enthusiasm for many aspects of the new law, Ms. Greenberger said she was profoundly disappointed in provisions that she thought would limit women’s access to abortion services.

Advocates for women’s health said one of the new law’s benefits would be to ban the denial of health coverage to women who have had a prior Caesarean section or been victims of domestic violence. Some companies providing individual policies have refused coverage in those circumstances, regarding Caesareans or beatings as pre-existing conditions that were likely to be predictors of higher expenses in the future.

In a statement issued Thursday, Senator Mikulski said: “One of my hearings revealed that a woman was denied coverage because she had a baby with a medically mandated C-section. When she tried to get insurance coverage with another company, she was told she had to be sterilized in order to get health insurance. That will never, ever happen again because of what we did here with health care reform.”

The success of health care reform will depend on the ability to control soaring health care costs, many experts have argued. Another story in the package looks at how the law will do little to curb unnecessary care, a subject that is also the focus of a piece published this week in the business section. David Leonhardt offers a concise explanation of a major obstacle: Convincing the public — and the medical community — that more care does not necessarily mean better care.

Managed care became loathed in the 1990s. The recent recommendation to reduce breast cancer screening set off a firestorm. On a personal level, anyone who has made a decision about his or her own care knows the nagging worry that comes from not choosing the most aggressive treatment.

This try-anything-and-everything instinct is ingrained in our culture, and it has some big benefits. But it also has big downsides, including the side effects and risks that come with unnecessary treatment. Consider that a recent study found that 15,000 people were projected to die eventually from the radiation they received from CT scans given in just a single year — and that there was “significant overuse” of such scans.

From an economic perspective, health reform will fail if we can’t sometimes push back against the try-anything instinct. The new agencies will be hounded by accusations of rationing, and Medicare’s long-term budget deficit will grow.

So figuring out how we can say no may be the single toughest and most important task facing the people who will be in charge of carrying out reform. “Being able to say no,” Dr. Alan Garber of Stanford says, “is the heart of the issue.”

Here’s what I wrote last year on guidelines to reduce routine breast cancer screenings.

For more on the economics of health care (and resistance to reform), read Atul Gawande’s piece in The New Yorker, which includes an excellent example of the effectiveness of preventative and comprehensive care — and the conundrum of costs.

Plus: Kaiser Family Foundation has published online a handy health reform implementation timeline that looks at when specific provisions of the legislation are scheduled to take effect. KFF also provides a summary of the new health reform law, breaking out key provisions by topic.

And Health and Human Services Secretary Kathleen Sebelius this week announced the appointment of five new HHS regional directors who will work with the states on implementing the Patient Protection and Affordable Care Act.

Last summer, we shared that OBOS had joined an ACLU lawsuit challenging breast and ovarian cancer gene patents.

Briefly, the ACLU and the Public Patent Foundation (with plaintiffs including OBOS, pathology associations, and individuals) filed a lawsuit against the U.S Patent and Trademark Office, Myriad Genetics and the University of Utah Research Foundation, “charging that patents on two human genes associated with breast and ovarian cancer are unconstitutional and invalid.” The suit focused on the BRCA1 and BRCA2 genes, mutations of which are related to increased risk of breast and/or ovarian cancers, and for which Myriad Genetics controlled the patents (effectively controlling the available testing for important mutations).

As Breast Cancer Action explained, “When one company controls all the testing, less information and resources are available to both patients and researchers.” The New York Times story on the ruling also explains that “Some doctors and researchers contend that this monopoly has long held up not only competing, cheaper tests but has also hindered gene-based research.”

Last Monday, a U.S. judge ruling in the case invalidated the patents, arguing that “the company deserved praise for what is ‘unquestionably a valuable scientific achievement,’ but not a patent because the ‘isolated DNA is not markedly different from native DNA as it exists in nature.’” Essentially, the relevant genes are found in nature and thus aren’t novel enough to qualify for patent protection.

The judge dismissed the claim that the U.S. Patent and Trademark Office’s issuing of the patents was unconstitutional. The complete ruling can be found here [PDF]. The ruling has the potential to make the study of and testing for important genetic variations cheaper and more readily available.

Genomics Law Report has a good overview of the ruling, and several ScienceBlogs authors are also talking about the case, with one calling the ruling “a monumental step towards bringing sanity to biotech patents.”

This Sunday, CBS aired an episode of 60 Minutes that prominently featured the case. As OBOS was a plaintiff to the suit, we also got a chuckle out of the title of this editorial at the NYDailyTimes: Our bodies, ourselves: Judge rightly rules that no one can patent human genes

The ACLU itself also has commentary on the ruling, calling it “a huge victory for women’s health and scientific freedom,” and NPR’s Richard Knox has an interview with an attorney who explains the ruling and its implications.

Putting HCR in Context: The Guttmacher Institute looks at the pros and cons of health care reform as it relates to reproductive health, including sex education, Medicaid expansion and funding for public health programs.

The research institute notes that insurance companies not only would have to “jump through numerous, unprecedented hoops to estimate the cost of abortion coverage and ensure that the abortion payments never mix with other funds,” but “they also are likely to face extensive public scrutiny and protest around their action.”

All told, according to an analysis by George Washington University’s Sara Rosenbaum, “the more logical response” for private insurers marketing plans within the exchanges — and eventually in the broader market as well — “would be not to sell products that cover abortion services.”

Plus: Drawing from its Congressional record, NARAL flags Republicans who have voted against reproductive rights and who also warned HRC would lead to government intrusion on private medical decisions.

Lasting Consequences: Katha Pollitt talks with Carol Joffe, author of “Dispatches from the Abortion Wars: The Costs of Fanaticism to Doctors, Patients, and the Rest of Us,” about the effect of HRC on women’s reproductive rights and health. Joffe discusses the good, the bad and the ugly — which refers to the marginalization of abortion.

President Obama and Democratic Congresswomen repeatedly said, “This is a health care bill, not an abortion bill.” I understand why they said it. They felt this was the only way to get the bill through and perhaps they were right. But abortion is health care! One out of three women has an abortion during her reproductive years. One of the best ways to reduce the stigma around abortion is to normalize the procedure within mainstream health care settings. The mantra “this is a health care bill, not an abortion bill” reinforces exactly the opposite message.

Plus: In a separate piece written earlier this month, Katha Pollitt offers concrete suggestions on how the Democratic Party and the Obama administration can repay supporters of women’s rights for cooperating on HRC, including taking steps to improve maternal care and outcomes, and full funding for Title X and the Violence Against Women Act. I love the ending:

Speaking of violence against women, Dems, would you look in the effing mirror? New York’s Hiram Monserrate and David Paterson? Scott Lee Cohen in Illinois? That these men and others like them could get as far as they did says the culture of the party is tone-deaf when it comes to abuse and its warning signs. The only way to detoxify politics of tolerance for violence is to have lots more women in office. If India can pass a law requiring Parliament to be one-third women, surely the Democratic Party can figure out how to achieve equal numbers of women here. Pro-choice women. Feminist women.

Start by backing the grassroots campaign of former teacher and county commissioner Connie Saltonstall, who has announced her intention to challenge Bart Stupak in the August primary. “He has a right to his personal, religious views,” says Saltonstall, “but to deprive his constituents of needed healthcare reform because of those views is reprehensible.” Now there’s a woman with gumption and a gift for stating things clearly.

In Other News …

Revisions to On-Air Abortion Language: NPR reporters will no longer use the terms pro-choice and pro-life to describe both sides of the abortion rights debate. Instead, according to an internal memo:

On the air, we should use “abortion rights supporter(s)/advocate(s)” and “abortion rights opponent(s)” or derivations thereof (for example: “advocates of abortion rights”). It is acceptable to use the phrase “anti-abortion”, but do not use the term “pro-abortion rights”.

Digital News will continue to use the AP style book for online content, which mirrors the revised NPR policy.

Do not use “pro-life” and “pro-choice” in copy except when used in the name of a group. Of course, when the terms are used in an actuality they should remain.” [An actuality is a clip of tape of someone talking. So if a source uses those terms, NPR will not edit them out.]

Georgia Senate Passes Abortion Bill: The latest assault on women’s reproductive health in Georgia is SB 529, a Senate bill that makes it possible to bring criminal charges against doctors, boyfriends, pimps and even parents if they encourage a woman to have an abortion. The bill’s supporters frame it as a way to protect women — especially women of color — but women’s health advocates say the true motivation is to criminalize abortion.

“This bill was created under the false assumption that abortion doctors solicit women of color, particularly, black women,” said Democratic State Sen. Donzella James. “This bill calls into question all who make a deeply private and personal medical decision. Every woman, regardless of ethnic background, should have the ability to make personal decisions. Not the people in this room. It is between, she, her family and God.”

Heidi Williamson of Sister Song has more. “Publicly, white Republican men claim to care about pregnant black women who are allegedly being targeted by the abortion industry. Privately, those same men scramble to ‘opt Georgia out’ of national healthcare reform and find the perfect wedge issue for the mid-term elections to build the Republican base in African-American communities,” she writes.

We previously discussed an anti-abortion billboard campaign in Georgia targeting black women  that proclaims black children are an endangered species. Women’s eNews reports that the campaign may soon go national. For more on the difference in abortion rates among women, see this Guttmacher Institute policy report, which notes that black and Hispanic women have higher abortion rates than white women because they have higher rates of unintended pregnancy.

What’s Up With Lilith Fair?: After announcing that it would donate a dollar from every ticket sold to a women’s organization in each of the 36 host cities, Lilith Fair is coming under fire for including organizations that don’t support a full range of reproductive services.

Apparently, the only vetting Lilith did was to look online for women-focused organizations with federal tax ID numbers. Jessica Hopper interviewed Nettwerk CEO and Lilith cofounder Terry McBride about the selection process and received a less-than-informed response.

“The seeding at the start was done with a basic digital search in each market of woman’s charities,” he said. “It’s not perfect. Nor could it be, as we simply don’t have the local expertise even within our own city of Vancouver.”

Really? Lilith couldn’t have contacted local women’s health advocates, or put a few interns on the project? Perhaps the festival should include a booth for organizers on research skills.

There’s always a chance for improvement. Facebook fans will vote on the selected organizations, and the top three vote-getters in each city will be forwarded to Lilith founders — Sarah McLachlan, Terry McBride, Dan Fraser and Marty Diamond — who will hand pick the winners. And organizations not currently featured can self-submit for consideration. Read more at the Chicago Reader.

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

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

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

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

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

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

In case you slept through Sunday’s exciting (no really! it was!) health care debate on the House floor, here’s a look at what went down — and, most importantly, what health care reform means for the country and for you.

The Nut Graph
The House approved the Senate bill by a vote of 219-212, with 34 Democrats voting against and zero Republican support. The bill expands insurance coverage to 32 million additional people; approximately 23 million will remain uninsured, about one-third of whom are undocumented immigrants.

Passage was sealed once President Obama placated anti-abortion Democrats by agreeing to issue an executive order reaffirming restrictions against the public funding of abortions.

So it Came Down to Support for Women’s Reproductive Health?
Pretty much. Dana Goldstein of the Daily Beast describes how Obama reneged on his pledge to support reproductive rights.

Raising Women’s Voices, which has done a great job advocating for and reporting on health care reform, has a reaction round-up from pro-choice advocates (and a statement on the final bill). Some organizations, angry with the Senate bill’s language on abortion coverage, expressed disappointment with Obama’s order. Terry O’Neil, president of NOW, issued a highly critical statement, as did Stephanie Poggi, executive director of the National Network of Abortion Funds.

The only thing worse at this point would have been the original House language proposed by Sen. Bart Stupak (D-Mich.) — who agreed to support the Senate version when given the cloak of the executive order.

I Heard Stupak’s a Baby Killer
The Republicans initially lacked the maturity to ‘fess up to who shouted “baby killer” while Stupak, now an enemy of the Republicans, was speaking on the House floor. Rep. Randy Neugebauer (R-Tex.) finally came forward. Neugebauer, notes the Washington Post, is otherwise known for co-sponsoring a bill requiring presidential candidates to produce birth certificates to prove their eligibility for office.

It’s Not Over Till It’s Over
President Obama is expected to sign the bill on Tuesday, then the Senate takes up debate on the bill’s amendments. What does that mean? In short, House members disagreed with a bunch of items in the Senate bill and, during careful negotiation prior to last night’s vote, both sides agreed to modifications. The House approved the reconciliation measure, essentially trusting that the Senate will do the same. Christina Bellantoni explains all at TPM.

The National Partnership for Women & Families would like you to urge the Senate to pass reconciliation and finish the job.

This is What Change Looks Like
Writing at AlterNet, Adele Stan has a great re-cap of this weekend’s protests (red scare and all), and the deal-making and high drama that resulted in the bill’s passage.

“This isn’t radical reform. But it is major reform,” Obama said after the House vote. “This legislation will not fix everything that ails our health care system. But it moves us decisively in the right direction. This is what change looks like.”

The Immediate Effects Of the Health Reform Bill
That’s the title of this Kaiser Health News story, a good place to start for a discussion of  the “early deliverables” — benefits that will kick in this year:

* Dependent children could remain on their parents’ health insurance plans until age 26.

* Senior citizens would get more help paying for drugs in Medicare.

* People with health problems that left them uninsurable could qualify for coverage through a federal program.

* Ban on lifetime limits on medical coverage.

* Tax credits for businesses.

Could You Be More Specific?
I found a terrific analysis from the U.S. House Committee on Energy and Commerce that demonstrates the impact health care reform will have on each and every Congressional district. For example, in my district — Ill.-5 (PDF) — the bill is predicted to, among other things:

* Give tax credits and other assistance to up to 142,000 families and 14,100 small businesses to help them afford coverage.

* Extend coverage to 69,500 uninsured residents.

* Guarantee that 13,500 residents with pre-existing conditions can obtain coverage.

* Protect 1,500 families from bankruptcy due to unaffordable health care costs.

* Allow 67,000 young adults to obtain coverage on their parents’ insurance plans.

* Provide millions of dollars in new funding for 23 community health centers.

(Shout-out to my representative, Mike Quigley, who stayed a strong supporter of women’s health throughout the debate.)

But What Does it Mean for Me?
That depends. The New York Times has a good interactive graphic that breaks it down based on whether you’re currently insured (and how you’re covered) — or if you don’t have health insurance.

Who Else Benefits?
Glad you asked! The short answer: hospitals and drug makers. And eventually doctors. For insurers, it’s a mixed bag, but they won’t have to worry about competition from a government-run public option — it didn’t make the Senate bill. But Senate Majority Leader Harry Reid (D-Nev.) says maybe this year. To be continued …

Remind Me Again How We Got Here.
Thank House Speaker Nancy Pelosi. And let’s hear it for Catholic nuns, who demonstrated greater reading comprehension skills (and more common sense) than Catholic bishops. Show these sisters some love.

If you want the long view, check out this interactive timeline on the history of health reform efforts in the United States.

Last Question: What’s Up With Pelosi’s Giant Gravel?
MSNBC’s First Read notes that Rep. John Dingell (D-Mich.), who used the same gavel when the House voted on Medicare in 1965, gave the gavel to Pelosi to use on this momentous occasion. I think it suited her well.

More questions? Ask them in the comments, or leave links to blogs and news coverage.

Publicado por Rachel / del orginial en inglés: January 21, 2009

OBOS is committed to expanding our audience and in this spirit we’ve asked former board member Moises Russo to translate into Spanish several of our blog entries. We hope to translate more entries in the coming year.

En OBOS estamos comprometidos a expandir nuestra audiencia de lector@s  y en este espíritu le hemos solicitado a Moisés Russo, ex-miembro de la Junta de OBOS, que traduzca al español varios de los blogs que tenemos en la página electrónica. Esperamos continuar con dichas traducciones durante este año.

Un informe dado a conocer este mes por el Instituto Southwest de Investigación sobre las Mujeres y el James E. Rogers Collage de Derecho en la Universidad de Arizona, ha expresado preocupación por el trato a mujeres que se mantienen en centros de detención de inmigración en Arizona.

El informe “Prisioneras Invisibles” (PDF), describe condiciones en tres instalaciones penitenciarias de Arizona. La información fue obtenida a través de entrevistas llevadas a cabo con mujeres actual y anteriormente detenidas en las instalaciones y a abogados y proveedores de servicios sociales “que han trabajado de cerca con mujeres detenidas en el estado”.

Las demoras en recibir servicios médicos, cuidados inadecuados, y la falta de atención a los asuntos de salud mental son algunos de los problemas descritos. Los alegatos incluyen la negación de una bomba mamaria (sacaleche) a una mujer que se encontraba separada de su lactante, el rechazo a proveer vitaminas prenatales, una mujer con cáncer cervicouterino con meses de espera para poder ser atendida por una enfermera y una mujer que había sido víctima de mutilación genital femenina y que estaba teniendo dolor abdominal severo a la cual se le dijo que debía “ejercitarse y cuidar su dieta”, cuando la verdadera causa del dolor era un gran quiste que necesitaba extracción quirúrgica.

Según un artículo del New York Times en el informe, “Katrina S. Kane, quien dirige las operaciones de detención y remoción para la Autoridad de Seguridad  de Inmigración y Aduanas de Arizona, descarto el estudio como declaraciones faltas de evidencias de un número limitado de detenidas y sus abogados”.

Ella también afirmó que las denuncias de que una detenida no había recibido tratamiento para cáncer cervicouterino son falsas. Según el Times, un abogado de inmigraciones que tomó parte en el estudio “contrarrestó que las entrevistas con detenidas y mujeres anteriormente detenidas y sus abogados corroboraron el patrón de maltrato endémico”.