Although this January marks the 40th anniversary of the landmark Supreme Court decision legalizing abortion, we know that there is still much work to be done to ensure reproductive justice for all women.

The Guttmacher Institute reports that 2012 saw the second highest number of abortion restrictions enacted in a single year; the Center for Reproductive Justice addresses each state in this report.

Among the provisions ultimately defeated were “fetal personhood” bills in Mississippi and Oklahoma. But the notion that fetuses should be protected from the women carrying them has resulted in the restriction and punishment of women across America.

Lynn Paltrow, executive director of National Advocates for Pregnant Women, and Jeanne Flavin, a professor of sociology at Fordham University and chair of NAPW’s board, have put together an extremely interesting and important study: “Arrests of and Forced Interventions on Pregnant Women in the United States, 1973–2005: Implications for Women’s Legal Status and Public Health.”

Paltrow and Flavin (who is also the author of the 2008 book “Our Bodies, Our Crimes: The Policing of Women’s Reproduction in America“) tried to identify and examine U.S. cases from 1973, the year of Roe v. Wade, through 2005, in which a medical or government authority tried or succeeded in stripping a woman’s autonomy because of pregnancy. The study appears in the Journal of Health Politics, Policy and Law.

These cases could have involved threat of or actual arrest, incarceration, or increased prison/jail time; detention in a hospital, treatment program, or mental institution; or forced medical intervention. Descriptive detail of several cases is provided, along with summary statistics on the findings.

Looking at legal, medical and other sources, Paltrow and Flavin analyzed 413 cases, which they speculate are “a substantial undercount,” because cases were difficult to identify and some sources referred to additional cases.

The data reveals substantial racial, income and geographic disparities. While almost every state had multiple cases, the regions with the most were the south (56 percent) and midwest (22 percent). These cases disproportionately targeted black women (52 percent of cases overall, and 72 percent of cases in the south), and 71 percent involved low-income women (enough so that they qualified for indigent defense).

Most women who faced criminal charges were charged with felonies; a greater percentage of black women (85 percent) were charged with felonies than white women (71 percent).

The authors explore how these disparities are interlinked with disparities in drug laws, disproportionate application of criminal laws, and outdated stereotypes about cocaine use (such as the “crack baby” myth).

The vast majority of the cases — 84 percent — involved allegations of illegal drug use. In the remaining cases, “women were deprived of their liberty based on claims that they had not obtained prenatal care, had mental illness, or had gestational diabetes, or because they had suffered a pregnancy loss.”

Although concern for the health of the fetus/infant is typically offered as a reason for increased scrutiny or detainment of pregnant women, in 64 percent of the cases there was no reported health issue cited in the allegation.

Chillingly, most cases were reported by people in so-called “helping professions”: health care providers (41 percent), social workers (12 percent), and hospital, child protective services, or police personnel (17 percent). Health care providers reported black women at a higher rate (48 percent) than white women (27 percent).

As the authors point out:

Due in part, no doubt, to the strong public health opposition to such measures, no state legislature has ever passed a law making it a crime for a woman to go to term in spite of a drug problem, nor has any state passed a law that would make women liable for the outcome of their pregnancies. Similarly, no state legislature has amended its criminal laws to make its child abuse laws applicable to pregnant women in relationship to the eggs, embryos, or fetuses that women carry, nurture, and sustain. No state has rewritten its drug delivery or distribution laws to apply to the transfer of drugs through the umbilical cord. To date no state has adopted a personhood measure, and no law exists at the state or federal level that generally exempts pregnant women from the full protection afforded by federal and state constitutions.

In other words, nothing about existing law should make women subject to such persecution. They also note that public health groups have observed that targeting pregnant women may lead to women avoiding medical care or having unwanted abortions to avoid increased and punitive scrutiny.

Paltrow and Flavin also highlight these cases in the context of proposed personhood laws, which would give fetuses individual rights and potentially could lead to increased prosecutions of women. They authors note that they have identified “more than two hundred cases initiated against pregnant women since 2005 that also overwhelmingly rest on the claim of separate rights for fertilized eggs, embryos, and fetuses.”

Opponents to personhood laws have cautioned that such measures could lead to forced medical interventions on pregnant women along with possible punishment for miscarriages and stillbirths. While personhood proponents often dismiss these warnings as scare tactics, the research shows there is good reason to be concerned.

Paltrow and Flavin conclude with a call for change:

In light of these continued efforts and our findings, we challenge health care providers, law enforcement and child welfare officials, social workers, judges, and policy makers to examine the role they play in the arrests and detentions of and forced interventions on pregnant women. We call on these same people to develop and support only those policies that are grounded in empirical evidence, that in practice will actually advance the health, rights, and dignity of pregnant women and their children, and that will not perpetuate or exacerbate America’s long and continuing history of institutionalized racism.

Finally, our study provides compelling reasons for people who value pregnant women, whether they support or oppose abortion, to work together against personhood and related measures so women can be assured that on becoming pregnant they will retain their civil and human rights.

The whole article is well worth a read if you can get a copy. The abstract is freely available online.

Last week, we marked the third annual Latina Week of Action for Reproductive Justice, this year themed “¡Soy Poderosa!” (“I’m Powerful!”) and coordinated in part by the National Latina Institute for Reproductive Health.

As part of the event, the NLIRH held a blog carnival, encouraging writing on the theme of Latina civic power. There are many great posts from carnival participants listed here. A few highlights:

• Bloggers at Raising Women’s Voices and Community Catalyst’s Health Policy Hub talk about the Affordable Care Act and its effects, including preventive coverage for women.
• At NLIRH, though, Morgan Meneses-Sheets points out What the Affordable Care Act Hydes, particularly that the health reform legislation does nothing to make abortion more accessible or affordable. She discusses the Hyde Amendment and its disproportionate affects on poor women, who themselves are disproportionately women of color.
• Also at NLIRH, Kimberly Inez McGuire and Morganne Rosenhaus write about environmental justice, effects on communities of color, and the need to be involved in demanding change in exposure to toxic chemicals at home and at work.
• Ana Laura Rivera talks about working as a sex ed advocate, and the need to hold political leaders accountable for access to accurate sex education and health resources for low-income communities.

There are plenty of other great posts, including several profiles of powerful Latina advocates listed in the carnival – go check them out!

Related: Check out OBOS’s Organizing for Change for more resources on women’s health advocacy topics, and information on OBOS’s Latina Health Initiative.

This week marks the third annual Latina Week of Action for Reproductive Justice, this year themed “¡Soy Poderosa!” (“I’m Powerful!”). The event is coordinated by the National Latina Institute for Reproductive Health, this year with California Latinas for Reproductive Justice and the Colorado Organization for Latina Opportunity and Reproductive Rights.

Check out the video below, and go to the campaign site to learn how to get involved.

In conjunction with the week, there will be a ¡Soy Poderosa! blog carnival. To participate, write about an issue the matters to the Latina community, especially with a focus on what civic power looks:

Join us during the week of August 6-10, 2012, and write about how you are poderosa/powerful. You can write a post on your own blog or tumblr and we’ll include it in our blog carnival round-up, or you can submit a guestpost for possible publication at the NLIRH blog.

How do you influence your community? Do you participate in local government? Do you vote? Do you organize to improve the conditions of your community? Do you encourage your elected officials to take actions that represent you and your issues? Do you talk with your friends and family about the issues you care about? Volunteer with local groups?

We all participate in our own way and that is why we are Poderosas.

There’s also ongoing discussion via NLIRH’s Twitter account and Facebook page.

PBS’s FRONTLINE recently aired “ENDGAME: AIDS in Black America,” which looks at disproportionate rates of HIV infection among Black Americans and related factors, addressing, among other issues, poverty, needle reuse and exchanges, policies that have harmed public health, churches and stigma.

In a related interview for NPR’s Fresh Air, “Endgame” director Renata Simone talks about delays in diagnosing women with AIDS, and how those delays affect women both physically and economically:

So the fact that we were not diagnosing women as having full blown AIDS when in fact their immune systems were crashing meant that they weren’t eligible for housing. Nor were the kids that they were trying to bring up. They weren’t eligible for a whole host of economic as well as treatment benefits that automatically come once an AIDS diagnosis has been reached.

A piece of companion content on the Frontline website talks about why some people with HIV *still* can’t get treatment, primarily because of the cost of drugs, including antiretrovirals and treatments for complications of HIV.

There is a lot of other discussion and content freely available on the FRONTLINE website, along with the full video of the program. The CDC has also recently launched a new “Act Against AIDS” campaign, especially focused on “reducing the risk of infection among the hardest-hit populations – gay and bisexual men, African Americans, Latinos, and other communities at increased risk.” It includes a “Take Charge. Take the Test.” initiative to encourage Black women to be tested.

An important and nuanced editorial on U.S. reproductive politics takes issue with “the cynical manipulation of racial themes” by activists who distort the history of reproductive politics to bolster support for restricting access to abortion and birth control.

Writing in the July issue of the journal “Contraception,” Willie J. Parker, a physician who serves on the board of Physicians for Reproductive Choice and Health, and Carole Joffe, a sociologist and professor at UCSF Bixby Center’s Advancing New Standards in Reproductive Health, briefly describe the “mixed legacy” of the United States around reproduction and race, including the history of sterilization abuses, racist concerns about being out-populated by minorities, and the testing of contraceptives on women in developing nations that existed alongside the movement for reproductive freedom:

Starting in the early 20th century, doctors and nurses, along with lay allies, fought for the legalization of first, birth control, and, later, abortion, seeing the particular damage done to the most vulnerable women in the absence of such services. In the 1960s and 1970s, feminist health activists raised an outcry about the sterilization abuses mentioned above; indeed, among the most prominent of the reproductive rights organizations to emerge from the “second wave” feminism of that era was CARASA, the Committee for Abortion Rights and Against Sterilization Abuse, providing a template for the principle that abortion rights should ideally be considered in a broader context that includes the right to have children. That generation of feminist activists also severely criticized the then-common practice of testing new contraceptive methods on Third World women. Today, there are numerous reproductive rights/reproductive justice groups hard at work in the United States, a number of them specifically concerned with the situation of women of color.

The authors move on to discussing how opponents to abortion access have distorted and manipulated the record of Margaret Sanger, the founder of the organization that eventually became Planned Parenthood, and the current campaigns against Planned Parenthood and abortion that specifically target African-American women (see our previous coverage of responses to a billboard campaign in Atlanta that referred to black children as an “endangered species”).

They argue, in part, that the stigma and secrecy around abortion allows race-focused campaigns seeking to restrict reproductive rights to take hold:

The isolation of abortion, in particular, from the rest of health care has contributed to its stigmatization and has helped the development of conspiracy theories, such as we see in the billboard campaign. We decry the inflammatory, false rhetoric of “black genocide” that has been used in this campaign by anti-abortion extremists, and we are hardly the first to point to the hypocrisy of those who oppose contraception and abortion, yet just as fervently oppose any spending for social services

Parker adds that “as a member of the African American community and as a women’s health provider [...] this attempt to manipulate my community is made possible by our unresolved issues regarding gender roles and sexuality in a modern context.” He continues:

The failure of our community to promote the agency of our mothers, sisters and partners, and to deal forthrightly with sexual matters, leaves us treating abortion and HIV-related issues as “open secrets.” This evasion results in exorbitant rates for both. To truly confront these issues, our community desperately needs medically accurate sexuality education, improved health literacy and a constructive engagement of religious and spiritual leaders, given the central importance of religion in the African-American community. This type of empowerment effort towards shared reproductive health responsibility is the only effective rebuttal to the mischief occurring with race and reproduction in our community. To paraphrase Dr. King, just as individual wealth is always a function of the commonwealth, thus it too holds true that compromising the reproductive health and rights of individual black women results in jeopardizing the collective well-being of black communities.

The editorial also includes this call to trust women with their own reproductive decisions:

I join with those in my community who have articulated a vision of reproductive justice, defined as creating a society that enables all women and families to have the children they want, the resources needed to raise them, and the ability to prevent or end the pregnancies that they do not want. I call on my fellow health care providers, of all races, to trust women to make the good and tough decisions about when and whether to expand their families. A fundamental respect for fairness necessitates it, and a respect for human rights demands it.

Plus: Read an interview with Parker from the New Jersey Star-Ledger: “Why I perform abortions: A Christian obstetrician explains his choice.” Parker also recently appeared on “The Melissa Harris-Perry Show” to discuss the possible closure of the last health clinic providing abortion services in Mississippi.

Breast Cancer Action is offering a free, one-hour webinar examining the racial and socio-economic factors that influence the health of individuals and communities.

Titled “Inequities in Breast Cancer: Race and Place Matter,” the webinar will take place Tuesday, May 15, at 2 p.m. PDT/5 p.m. EST (register here) and again on Wednesday, May 16, at 11 a.m. PDT/2 p.m. EST (register here).

“Inequities in breast cancer risk and outcomes vary among different racial and ethnic communities and are well documented,” writes Sahru Keiser, BCA program associate of education and mobilization. “In our efforts to address and end this disease, health activists, practitioners, and legislators must focus on the social and economic context in which the disease arises.”

Keiser is presenting the webinar with Irene Yen, associate professor of medicine and associate director of the Experiential Learning, Health & Society Pathway at University of California, San Francisco. Among the questions they’ll address:

Why are white women more likely to develop breast cancer, yet African American, Latina and Samoan women are more likely to die from the disease? Why do women of color tend to develop more aggressive breast cancers at earlier ages than white women? Why are we seeing the sharpest rise in breast cancer rates in Japanese women in Los Angeles?

Topics covered will include:

• How where we live, work and play defines our access to good health

• Breast cancer inequities in under-served communities

• How breast cancer research acknowledges race

• Inequities in breast cancer clinical trials

• How you can work for health equity

Learn more at Breast Cancer Action about environmental links to breast cancer and the importance of social justice. And visit BCA’s Think Before You Pink project, which raises awareness about conflicts of interest in pink-ribbon marketing — like KFC’s Buckets for the Cure campaign that promoted fast food restaurants in low-income neighborhoods.

One of the current campaigns takes on Eli Lilly, the only company in the world making and distributing rBGH, an artificial growth hormone found in many dairy products that is linked to increased risk of breast cancer. BCA is working to remove rBGH from the food supply completely. Free Think Before You Pink toolkits featuring resources and information are available here.

While there has been considerable attention in the United States to political moves intended to reduce access to women’s health services, our neighbors to the north are also experiencing conservative-led cuts that affect women’s health. Six Canadian organizations focused on research and communication in women’s health have been told that their funding will be cut off next spring.

The six organizations forming the Women’s Health Contribution Program focus on issues including: the women’s health implications of the federal government’s regulation of toxic chemicals; the hyper-sexualization of girls; the inter-generational legacy of residential schools on Aboriginal women and their families; the need for trauma-informed counselling for women with addictions; a working guide for conducting sex and gender-based analysis in health research; and a critical analysis of funding for the HPV vaccine. The Program’s work has also focused broadly on how to best deliver prevention and health care programs to women and their children.

A press release from the Canadian Women’s Health Network describes dissatisfaction with and potential impacts of the cuts:

Staff and directors managing the centres and networks add their voices to the growing body of Canadians who are shocked and outraged by the short-sightedness of the federal government cuts to programs, services and the federal civil service. These cuts are in direct contradiction to the pledges regarding gender equality that Canada has made both in international commitments and to Canadians. Women are being hit particularly hard with these cuts, and, because the research being eliminated generated proactive, preventative strategies for health promotion, these cuts will cost everyone in the long term. The end of this work will be most strongly felt by the disadvantaged and the disempowered.

A spokesperson for Canada’s Health Minister has said that the organizations should compete for funding for individual projects via the $33 million budgeted for “gender health research” through the Canadian Institutes for Health Research (CIHR). Critics of the cut have suggested that the move is one more sign that the current administration, led by Conservative Party leader and Canadian Prime Minister Stephen Harper, is not interested in receiving the groups’ policy advice on women’s health (the non-CIHR groups being cut had a mandate to advise the federal government on policy).

An opinion writer in the Vancouver Sun calls the cuts “penny wise and pound foolish,” writing that:

Set adrift will be researchers and staff with specific expertise; lost will be the opportunity for better and more-effective care and prevention programs for two of the poorest and most vulnerable groups in Canada – elderly women and children growing up in poverty.

Federal budget cuts are also directly affecting programs targeting the health of Aboriginal women in Canada. The Native Women’s Association of Canada points out tremendous health disparities faced by Aboriginal women, calls on the government to rethink its decision, and directly addresses how the move further hurts a vulnerable population:

…more is needed to help local communities struggling with health disparities, but cutting the head off the national voice for Aboriginal women’s health shows a lack of commitment to address the issues that affect the most marginalized population in this country — a country that is envied by many other nations across the globe for its ‘great’ health care system and quality of life

Native American women are subjected to much higher levels of sexual violence than other women in the United States; the Department of Justice estimates that more than 1 in 3 Native American women will be raped in their lifetime, and they are often denied access to justice.

According to a new report, Native American women are also denied access to emergency contraception through the Indian Health Service (IHS). The report, from the Native American Women’s Health Education Resource Center, includes the personal experiences with sexual assault and the perspectives of women of a diverse number of Tribes. It describes the barriers Native American women face when attempting to access emergency contraception and outlines steps that should be taken in order to provide them with on-demand access to emergency contraception.

According to the organization’s 2009 research:

1) Only 10% of IHS unit pharmacies surveyed have Plan B available over the counter (OTC); 2) 37.5% of pharmacies surveyed offer an alternative form of emergency contraception; and 3) The remaining have no form of EC available at all.

At Change.org, a petition has been created to ask IHS Director Dr. Yvette Roubideaux to issue a directive to all IHS service providers to make emergency contraception available on demand without a prescription or doctor visit to all women 17 or older.

In the report’s introduction, Charon Asetoyer the Center’s director writes:

As the country debates the access to Plan B as an OTC for women 16 years and younger, Native American women 17 years and older have yet to receive access to Plan B as an OTC by their primary health care provider, the Indian Health Service. No one but Native American women are concerned about this denial of service. As Native American women we are the only race of women that is denied this service based on race. To make an exception to a legal form of contraception based on race is not acceptable. To deny a Native American woman access to Plan B as an OTC when every other woman in this country can access it is a denial to a basic health care service, which violates her human rights. It is a direct violation to her sovereign right to make decisions for her own health care, it removes her from the decision making process concerning a potential pregnancy resulting from a rape and puts that responsibility of decision in the hands of a government agency.

Sign the petition to support Native American women’s right to access emergency contraception.

See also:
Why Native American Women Are Battling for Plan B – at Colorlines, an interview with Charon Asetoyer. In it, Asetoyer notes that another possible solution is for the Department of Health and Human Services to mandate that all Indian Health Service providers to make Plan B or its generic form available OTC. Contacting HHS on this issue may be another avenue for action.

NAWHERC’s Plan B National Awareness Campaign, including the PSA below for Native women:

Shafia Monroe of the International Center for Traditional Childbearing was recently interviewed for a nice piece in The Skanner on the topic of Breastfeeding: A Wellness Issue for African American Families. Currently, black women start and continue breastfeeding at at much lower rates than other measured races/ethnicities. According to the CDC, rates are:

In the interview, Monroe talks about health benefits of breastfeeding, notes the lower breastfeeding rates among black women, and encourages black women to breastfeed for a year or longer. She says:

…we only hear people telling black women to get a mammogram—I’ve never heard anyone tell black women that if you breastfeed for one year it can reduce your breast cancer risk. So that’s important…

By breastfeeding, it delays your onset of Type 2 diabetes. This can be major, when you have a high diabetic rate within the black community in Portland, and more black women dying from late-stage breast cancer.

Monroe goes on to note that breastfeeding needs to be made “more acceptable in the normal life of African American families, so they feel there’s no shame that comes from doing it. And that the black community should embrace women who breastfeed and make them feel comfortable in all areas.”

The question of why more black women don’t breastfeed is an important one. The CDC identifies a number of potential factors, including “social and cultural norms, social support, guidance and support from health-care providers, work environment, and the media.” Christine talked about the need for support at work and among friends and family members in a previous post as well. Kimberly Seals Allers at BlackandMarriedWithKids asks, Is Slavery Behind Our Low Breastfeeding Rates?, exploring the ways women in slavery in the U.S. were forced to stop own breastfeeding infants and forced to breastfeed white infants.

A couple of online resources are intended to support black women in breastfeeding. One is Black Breastfeeding 360, which has tips, information, and women’s stories about breastfeeding. Another is the Black Women Do Breastfeed blog and Facebook page, which also feature black women’s stories of breastfeeding, including how they overcame challenges they faced after choosing to breastfeed their children. Finally, the federal Office on Women’s Health has a PDF guide, Your Guide to Breastfeeding for African American Women, which teaches about the importance of breastfeeding, how to do it, and how to handle some common challenges.

Relatedly, Kimberly Seals Allers (of Black Breastfeeding 360) has a great piece on media and other coverage issues around this topic, in Dear White Women: Beyonce is OUR Breastfeeding Moment. Please Step Aside. She writes:

…with all the news reports about Beyonce, and all the breastfeeding “advocates” talking about its impact on the nursing world, not one advocate mentioned the particular significance to black women — which is so striking since many claim to be interested in our breastfeeding plight.

Shame on you…some of you white breastfeeding advocates, one of you, should have pointed that out. If not for us then please for our babies. Black babies are still 2.4 times more likely to die before their first birthday and the CDC says increased breastfeeding among black women could reduce this needless disparity by as much as 50%.

Having Beyonce as our black breastfeeding moment potentially means that more African American women will know that breastfeeding is mainstream and beautiful and actively practiced by the celebrities we admire. The celebrities from our community. It means that more black women, particularly young women, may consider breastfeeding their babies–something our community urgently needs.

We’re looking forward to checking out the new book from the Black Women’s Health Imperative, Health First! The Black Woman’s Wellness Guide, which one reviewer called a great gift “for an African-American woman for Valentine’s Day, a birthday, or for no other reason than ‘because.’”

According to the website:

Health First explores Black women’s most critical health challenges, connecting the dots through honest discussions with experts and the uncensored stories of real women—from adolescence through adulthood. The focus is on prevention and awareness, across generations and circumstances—from candid conversations about reproductive health and HIV/AIDS to frank explorations of Black women’s Top 10 Health Risks, including heart disease, cancer, obesity, and violence.

Authors Eleanor Hinton Hoytt and Hilary Beard are doing a number of events around the country over the next couple of months – check out the schedule online.

Every year in the United States alone, more than 12,000 women are diagnosed and more than 4,000 women die of cervical cancer, a preventable disease that disproportionately affects women of color.

January is Cervical Cancer Awareness Month, and the National Latina Institute for Reproductive Health (NLIRH) is launching “¡Acábalo Ya! Working Together to End Cervical Cancer.” The campaign is aimed at educating Latinas about this disease and how to protect their health; raising the profile of cervical cancer prevention as a national reproductive justice and women’s health priority; and advocating for greater access to the tools and care needed to prevent, detect, and eventually end cervical cancer.

The NLIRH is hosting a blog carnival this week on the topic: What will it take to end cervical cancer? Read more on Why Cervical Cancer is a LGBT Issue by Verónica Bayetti-Flores, NLIRH policy research specialist; Cervical Cancer Awareness Month: Trans Men and Genderqueer/Gender Nonconforming People by the National Center for Transgender Equality; Screen More Women for Cervical Cancer – Not the Same Women More Often! by Kate Ryan, program coordinator, National Women’s Health Network; and Thank YOU Affordable Care Act for Helping Cervixes Stay Healthy by Keely Monroe, program coordinator, National Women’s Health Network.

The following text on disparities in access to Pap tests and HPV vaccines has been adapted from the 2011 edition of “Our Bodies, Ourselves.”

* * * * * * *

Most women who die of cervical cancer never had regular Pap tests, had false-negative results, or did not receive proper follow-up.

In the United States, socioeconomic and racial disparities are evident in statistics for cervical cancer. Vietnamese immigrants are five times more likely to be diagnosed with cervical cancer than white women. African-American and Native-American women are twice as likely to die of the disease as are white women. In one study, Hispanic women had about twice the cervical cancer incidence of non-Hispanic women in border counties near Mexico, and Hispanic women are 1.5 times more likely to die from cervical cancer as compared to non-Hispanic white women.

Disparities are due, at least in part, to women of color having less access to Pap screening and regular health care. It is quite possible that those women with the highest rates of cervical cancer will also have less access not only to Pap screening but also to the HPV vaccine. Until our health care system addresses such disparities in access, girls and women likely to benefit the most from this vaccine may well not be able to choose it.

To ensure more equal access to any adolescent vaccine, adequate infrastructure and resources must be made available. Some recommend implementation of school-based adolescent immunization programs similar to those formerly in place for delivery of hepatitis B vaccines. The United Kingdom and Australia have volunteer, nationally supported school-based campaigns that have resulted in high HPV vaccine coverage for about 70 percent of girls.

Currently, school-based health programs and routine preventive care visits for adolescents are limited in the United States, making it highly difficult to provide good access to HPV vaccines, especially the type of access needed to ensure all three required vaccine doses are administered. Available data suggest HPV vaccine coverage in the United States is low (less than 50 percent), and the proportion of girls receiving all three doses of the HPV vaccine is even lower (less than 25 percent).

Pap Tests Essential for Prevention and Treatment

HPV vaccines do not protect against all types of HPV associated with cervical cancer, and it is currently unclear how long they remain effective or whether booster shots will be needed to maintain protection throughout adulthood. Thus, regular Pap tests among sexually active women remain essential for cervical cancer prevention. Resources should not be diverted away from Pap screening programs to pay for the unusually expensive cervical cancer vaccine. Because Merck marketed Gardasil with a campaign that unnecessarily frightened girls, young women, and parents, many people now have a distorted view of this disease, the vaccine, and the continued importance of Pap screening.

There is no question that HPV vaccines represent an important scientific advance in the field of vaccine research, but exaggerating their potential benefit in places such as North America will not serve us well. In countries where there is little or no access to Pap screening, current HPV vaccines might have much more potential for saving lives if their costs were reduced considerably and if adequate infrastructure to prove them responsibly were securely in place.

The District of Columbia and dozens of states — many of which have been lobbied by vaccine makers to expand vaccination requirements — have introduced legislation to require, fund, or educate the public about the HPV vaccine. However, since 30 percent of infections are now caused by virus types for which the HPV vaccines do not provide protection, universal access to Pap tests remains critically important. Unfortunately, many girls in underserved communities (where HPV infection rates are often high) have less access to both the Pap test and the HPV vaccine.

For example, as of September 2009, when the CDC released its first state-level statistics for Gardasil, only 15.8 percent of girls in the relatively poor state of Mississippi had received the vaccine, compared with 54.7 percent of girls in the relatively wealthy state of Rhode Island. Partly because of greater access to Pap testing, the cervical cancer mortality rate in Rhode Island was already 50 percent lower than in Mississippi — which means the girls in Rhode Island are at much lower risk of contracting HPV to start with.

To reduce disparities for Latinas and other under-served women, we will need to make systemic changes in our health care system to increase access to screening and vaccinations for those who need it most.

by Kat Friedrich

There is a striking lack of mainstream news coverage of the health hazards posed by beauty products, such as hair relaxers and skin lighteners, that are commonly used by black women. African-American women spend more on beauty products than white women do, but far too little research has looked at how women use these products.

So when the New York City-based WE ACT for Environmental Justice set out to survey African, African-American, and Latina women this year to find out how they use beauty products and what they know about them, it was an important step toward increasing awareness of a long-standing women’s health issue.

“We noticed that groups conducting surveys around this have focused on middle-class white women,” Ogonnaya Dotson-Newman, campaign director for WE ACT in Harlem, told The Uptowner. “But there is a whole area of hair products that you wouldn’t know about unless you live in certain urban areas.”

Straight hair has often — and unfairly — been an occupational requirement for black women. TV journalism is one of the most problematic fields (see the Maynard Institute’s historical view of “good hair” on the TV news). Reporter Rochelle Ritchie’s 2010 story (right) about going natural with her hair — and doing so publicly — made headlines and is included in the Body Image chapter in the new “Our Bodies, Ourselves.”

Keonte Coleman, an assistant journalism professor at Bennett College, has more on Ritchie’s backstory and decision to cut her hair on TV, and the standards to which black women in professional media positions are often held.

“Maybe there aren’t any guidelines preventing natural hairstyles, but there is a culture in place that fosters the need for black women to look like their white counterparts,” writes Coleman.

The ingredients of hair relaxers, which many black women use to straighten their curls, are anything but relaxing. Almost all of the samples of currently available hair relaxers tested by Environmental Working Group (EWG) were ranked highly toxic, although limited information was available. Allergic reactions, hormone disruption, immune system toxicity and organ toxicity were four of the main risks.

In contrast, hair straighteners, which are more commonly used by white women, have generally been considered to be relatively safer. EWG’s website shows most of these products are medium-risk with the highest concerns being allergic reactions, immune toxicity and hormone disruption. These risks are similar to those of the hair polishers which are used by women of color.

That was the thinking, at least, until 2010, when concern about formaldehyde in Brazilian keratin hair straighteners made headlines after salon workers in Oregon and internationally complained of breathing problems and eye irritation. Formaldehyde is an industrial chemical that can cause a host of health problems, including an increased risk of cancer.

In response, the FDA this year sent a warning letter to the makers of the hair straightening product Brazilian Blowout, which was found to contain formaldehyde even though it was labeled “formaldehyde free.” (The Campaign for Safe Cosmetics provides a timeline and status update since complaints were first lodged.)

It’s interesting that the formaldehyde in Brazilian Blowout drew criticism from the FDA, while the many ingredients in hair relaxers African-American women use have remained under the radar. These relaxers, as well as costly hair extensions, have been on the market for a long time.

Yumna Mohamed, reporting for The Uptowner, summarized some of the research on black women’s hair products:

While hair dyes, bleaches and relaxers have already been linked to skin problems (including rashes, burns, itching and hair loss), a number of national studies are being conducted to determine whether women of color face higher risks of breast and lung cancer from beauty product exposure.

Dr. Mary Beth Terry, a Columbia University epidemiologist, published a study in May in the Journal of Immigration and Minority Health showing that African-American and African-Caribbean women were more likely to be exposed to hormonally-active chemicals in hair products than white women, and used them more often.

“These products are often used daily and over the course of many years,” Terry says. “A number of these commonly-used products contain endocrine disruptors and placenta, and exposure to these could cause women to be more susceptible to hormone-sensitive diseases such as aggressive breast cancer.”

WE ACT expects to release its survey findings in January. It will use the information to lobby the cosmetics industry and advise women about the dangers in hair products.

Kat Friedrich is an environmental journalist whose work focuses on urban communities. She lives in Boston, uses Twitter, and blogs at Science Is Everyone’s Story.

Voters in Mississippi are heading to the polls today to vote on a ballot initiative that would define a fertilized egg as a person. If it passes, it would have far-reaching implications for women’s health and reproductive rights.

Initiative 26 would define personhood as “every human being from the moment of fertilization, cloning or the functional equivalent thereof.” Colorado voted on a personhood amendment in 2008 and 2010, and both times the amendment failed. But in Mississippi the vote looks much more ominous. According to a survey by Public Policy Polling, 45 percent of voters support the amendment and 44 percent oppose it.

Here’s a closer look at the breakdown:

Men (48-42), whites (54-37), and Republicans (65-28) support the proposal. But women (42-46), African Americans (26-59), Democrats (23-61), and independents (35-51) oppose it. The good news for those opposed to the amendment is that 11% of voters are undecided and their demographics are 58% women, 54% Democratic, and 42% black-those still on the fence disproportionately belong to voter groups that oppose the amendment. That suggests when those folks make up their minds the proposal could be narrowly defeated.

“The groups trying to defeat the proposed Personhood amendment in Mississippi have had momentum on their side over the last few weeks,” said Dean Debnam, President of Public Policy Polling. “There is a very real chance now that the proposal will be defeated.”

Among the myriad ways women and families would be affected: Abortions would be banned, with no exceptions for rape, incest or the life of the mother. Birth control, IVF, stem-cell research, miscarriage … it’s all murky.

The initiative would also restrict the ability of doctors to freely practice medicine and raises questions about various health procedures. As Meghan McCarthy writes in National Journal:

For example, an ectopic pregnancy—when the fertilized egg implants in the fallopian tube—can kill a pregnant woman if the egg is not removed. Whether that procedure would be allowed in Mississippi should the ballot initiative pass is under question.

“You have to offer full array of services. You are held to a standard of ‘appropriate medical care,’ ” if you receive federal funds, Sara Rosenbaum, a law professor and the chairwoman of the Department of Health Policy at George Washington University, said in an interview.

Beyond federal health programs, the personhood initiative could end up affecting everything from tax law, such as whether a pregnant woman can claim her unborn fetus as a dependent, to fertility clinics that have unused fertilized eggs.

Loretta Ross, national director of SisterSong, wrote a fantastic commentary last month explaining why the Mississippi ballot initiative on personhood and Initiative 27 on Voter ID exclusions “may be one of the most important opportunities on the ground for the Pro-Choice and Reproductive Justice Movements to work together.”

SisterSong and the Trust Black Women partnership have been on the ground in Mississippi, building bridges and advocating for united campaign work on both initiatives. “We have to make parallels between race and gender so that people easily understand that we take their human rights seriously,” writes Ross, offering a passionate argument for why these issues are intertwined and why a coordinated effort should have begun sooner.

My fear is that if we win, some folks will fail to acknowledge that the African American voters delivered the victory. If we lose, then some may say it was similar to the California gay marriage ballot that some falsely claim was lost because of the black voters in California. In reality, it is the failure of those who run campaigns based on outdated campaign models to invest sufficient resources in the African American community to swing the pendulum our way among some of the most consistent and committed Democratic voters on human rights issues.

Southern African American activists have been sounding the alarm to invest much-needed dollars at the grassroots level in Mississippi and throughout the South for quite some time, recognizing that the Civil Rights movement is not over, and that the Women’s Rights movement is embryonic in our region. Those fighting against the Voter ID initiative around the country and especially in Mississippi are clearly under-funded and lack the resources to provide their own polling research, campaign offices, phone banks, etc. We have been forced to do “quick-fix” organizing and mobilizing in Mississippi; had the call of African American reproductive justice activists been heeded, we could have been stronger and united as two movements working together to save women’s lives and women’s votes.

If the ballot initiative passes, women’s health organizations are expected to challenge its constitutionality in court. Aside from the legal wrangling, we must, as Ross states, look inward at our own strategies in related battles to come.

The National Latina Institute for Reproductive Health released a new report, Latina Immigrant Women’s Access To Abortion: Insights from Interviews with Latina Grasstops Leaders [PDF], a qualitative report describing comments from community activists in Texas, Minnesota and New York. The report includes comments on topics including immigrant youth, access to information and referrals, and program funding.

NLIRH describes the following findings in their press release:

• Far from the stereotype of Latinas being anti-choice, these Latina community health leaders said that Latina immigrants wanted information and in some cases services related to abortion along with other health issues.
• Some community leaders said that Latina immigrant youth need emotional and practical support in making a decision about an unplanned pregnancy, and some immigrant teens do not have consistent resources for medically accurate, unbiased, culturally relevant pregnancy options counseling.
• Program grant restrictions that prohibit discussing abortion and a lack of resources for pregnancy options counseling make it difficult for Latina grasstops leaders to provide women with the full information and resources they would like to regarding unplanned pregnancy options.

Earlier this week, I had the privilege of attending a talk by Rebecca Skloot, author of recently published book, The Immortal Life of Henrietta Lacks.

Henrietta Lacks was a poor, Black woman whose cervical cancer cells were taken in the course of her treatment for cervical cancer at Johns Hopkins in the 1950s. Her cells were the first “immortal” cells — cells kept alive in culture – and went on to be widely used in medical research.

Henrietta’s cells were used in the development of the polio vaccine, were sent up in early space missions, and are mentioned in tens of thousands of research papers.

Rebecca Skloot’s book chronicles the history of Henrietta Lacks and her cells (dubbed “HeLa” cells), as well as Skloot’s  journey uncovering the story.

Lacks and her family never knew about the vast body of research that was being conducted using the cells, or even that the cells had been taken and used for research at all.  She and her family never benefited financially from the selling of HeLa cells. While Henrietta is long dead, her children and grandchildren still struggle to get medical care, and do not have health insurance.

In the course of her talk, Skloot read snippets of the book and discussed questions of ethics, race and class raised by the story. She talked about whether the family should be compensated, the kind of medical care Henrietta received in John Hopkins’s “colored” ward,  and the past and current use of cells and tissue from people’s biopsies and other procedures for later medical research (which may make money for biotechnology corporations). It was really interesting, and I highly recommend the book to anyone interested in these issues.

Skloot has established the Henrietta Lacks Foundation to fund scholarships and medical care for members of the Lacks family. She also blogs about her work. The text of an interview earlier this year with Skloot on NPR’s Fresh Air is available here.