HIV/AIDS, Gender-Based Violence Interlinked, Zambian National Assembly Speaker Mwanamwambwa Says

Amusaa Mwanamwambwa, speaker of the Zambian National Assembly, recently said that gender-based violence and HIV/AIDS are interlinked and that increased efforts should be made to address the relationship, the Times of Zambia/AllAfrica reports.

Mwanamwambwa was speaking to National Assembly members to commemorate World AIDS Day and the 16 days of advocacy against gender violence (Times of Zambia/AllAfrica, 12/4). The 16 days of advocacy against gender violence were launched Nov. 25 during the International Day for the Elimination of Violence Against Women in Lusaka, Zambia (Kaiser Daily HIV/AIDS Report, 11/28).

Mwanamwambwa said that social and cultural factors leave women unable to protect themselves from risky sexual behaviors and HIV transmission, adding that laws against gender violence should be strengthened and that access to reproductive health should be increased in an effort to eliminate gender-based violence. He added that businesses should implement HIV/AIDS policies and voluntary counseling and testing programs (Times of Zambia/AllAfrica, 12/4).

United Nations Special Envoy for HIV/AIDS in Africa Elizabeth Mataka at the IDEVAW launch called on women to openly discuss and increase awareness of how gender-based violence is contributing to the spread of HIV among women (Kaiser Daily HIV/AIDS Report, 11/28).


Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation© 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

Genetic Testing Equipment Company Qiagen To Acquire HPV Test Maker Digene For $1.6B

Gaithersburg, Md.-based biotechnology company Digene, which produces a human papillomavirus test, on Sunday announced that it will sell itself to Netherlands-based Qiagen, maker of genetic testing equipment, for about $1.6 billion in cash and stock, the Washington Post reports (Rosenwald, Washington Post, 6/4).

FDA in March 2003 approved Digene's DNA Pap test -- which combines the traditional Pap test with a DNA test for 13 strains of HPV -- as a primary screening tool for cervical cancer for women ages 30 and older. Digene's test is 99% accurate at identifying changes in cervical cells, compared with an 80% accuracy rate for the Pap test (Kaiser Daily Women's Health Policy Report, 3/26).

Qiagen currently manufactures more than 100 diagnostic tests that are used to search for DNA and protein cues that aid in diagnosing diseases. Qiagen also co-developed and manufactures Digene's Rapid Capture System, which allows labs to run Digene's HPV, chlamydia and gonorrhea tests on one technology platform, the Baltimore Sun reports (Bishop, Baltimore Sun, 6/4).

According to the Post, Digene has been attempting to expand internationally. Digene CEO Daryl Faulkner said that in terms of international expansion, the deal with Qiagen "gets us there faster than doing it alone" (Washington Post, 6/4). He added that the deal allows Digene to grow both domestically and abroad faster. The combined companies will be called Qiagen, and current Qiagen CEO Peer Schatz will remain CEO. Faulkner will co-chair an integration committee, but his role beyond the committee is unclear, Reuters reports.

Both companies "are on a major mission here to help fight, or maybe even eradicate, a disease that kills a woman every two minutes," Schatz said, adding, "The ability to test and amount of testing still has a huge runway to grow" (Flaherty/James, Reuters, 6/3).

"Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

Washington Post Publishes Several Women's Health-Related Articles

The Washington Post on Tuesday in its health section published several articles related to women's health. Summaries appear below.
"Drinking and Breast Cancer; Studies Show a Link, Though Alcohol Has Benefits, Too": Women who consume alcohol have an increased risk of developing breast cancer, according to a Kaiser Permanente study released last week at the European Cancer Conference in Barcelona, Spain, the Post reports. Several other studies also have found modest but statistically significant increased breast cancer risk among women who consume alcohol. However, small amounts of alcohol can reduce women's risk for heart disease and type 2 diabetes, according to the Post (Squires, Washington Post, 10/2).

"Who Needs a Gynecologist -- and When?": The article examines whether annual gynecological exams and Pap tests should be performed by gynecologists or primary care physicians and at what age girls and women should begin undergoing such exams (Ganguli, Washington Post, 10/2).

"Not Her Mother's Hysterectomy": The article examines supracervical laparoscopic hysterectomy, a minimally invasive procedure that removes the uterus through a one-quarter inch incision near the navel, and traditional abdominal hysterectomy. According to the American College of Obstetricians and Gynecologists, of the 617,000 hysterectomies performed in the U.S. in 2004, 75% were abdominal procedures and 25% were laparoscopic or another minimally invasive procedure (Weiss, Washington Post, 10/2).

"More Info About Hysterectomy": The article lists several Web sites and a book that provide information about hysterectomy (Washington Post, 10/2).

"No One Way To Hold Sway; Women Drive Online Health Traffic, but Use Varies": Women are more likely than men to use the Internet to research specific diseases or medical problems, according to a Pew Internet and American Life Project survey released last year, the Post reports. The survey found that 82% of women who have Internet access conduct health research online, compared with 77% of men (Huget, Washington Post, 10/2).

John George, director of gynecologic endoscopy at Washington Hospital Center, will discuss laparoscopic hysterectomy on Tuesday at 2 p.m. ET in a washingtonpost online chat (Washingtonpost, 10/2). Questions can be submitted online before or during the chat. A transcript will be available online after the chat.

Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation© 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

Bush To Veto Stem Cell Research Enhancement Act, Issue Executive Order Encouraging Methods That Do Not Destroy Embryos, Officials Say

President Bush on Wednesday plans to veto a bill (S 5) that would allow federal funding for research using stem cells derived from human embryos originally created for fertility treatments and willingly donated by patients, Bush administration officials said, the Washington Post reports. The president also plans to issue an executive order that will require HHS in the next three months to develop guidelines for funding research on creating "medically useful" stem cells without destroying embryos, according to officials (Fletcher/Brown, Washington Post, 6/20).

Federal funding for human embryonic stem cell research currently is allowed only for research using embryonic stem cell lines created on or before Aug. 9, 2001, under a policy announced by Bush on that date. The Stem Cell Research Enhancement Act of 2007 passed the House 247-176 and the Senate 63-34. Several House Republicans who voted against the measure cited new research reported earlier this month by three independent teams of scientists. The teams said they have developed experimental approaches using the skin cells of mice to create embryonic stem cells without creating or destroying embryos (Kaiser Daily Women's Health Policy Report, 6/8).

White House spokesperson Tony Fratto said that Bush will outline a program that could allow research that creates additional "pluripotent" stem cells, the AP/Forbes reports (Riechmann, AP/Forbes, 6/20). Pluripotent stem cells can develop into all types of tissues in the body and have the potential to repair and restore tissue (Kaiser Daily Women's Health Policy Report, 5/9/06). Two senior Bush administration officials said the president also plans to reconfigure the embryonic stem cell lines currently eligible for federally funded research as the "human pluripotent stem cell registry." According to the New York Times, Bush administration officials said the White House also has been encouraged by recent stem cell research using amniotic fluid and embryos that had been declared "clinically dead."














The administration officials said the president wants NIH to take advantage of recent research that has the potential to "sidestep the ethical controversies" surrounding embryonic stem cell research, the Times reports. According to the Times, the executive order does not include funding and appears to be "largely symbolic" (Stolberg, New York Times, 6/20).

Reaction
Bush administration officials said the order is less a change in policy than a "kick in the pants" to make it clear that federal funding for stem cell research is available for stem cell research, the Post reports. "This disabuses us of this notion that there is this fundamental conflict between science and ethics," Karl Zinsmeister, Bush's head domestic policy adviser, said about the recent research. Fratto said that Bush "supports and encourages stem cell research -- including using embryonic stem cell lines -- as long as it does not involve creating, harming or destroying embryos" (Washington Post, 6/20).

John Gearhart, a stem cell researcher at Johns Hopkins University, said, "It is not an alternative for embryonic stem cell research because some of these alternative procedures still have ethical issues associated with them," adding that no one has figured out when an embryo can be declared clinically dead. White House officials said federal agencies would have to come up with the standards.

Douglas Melton, a stem cell researcher at Harvard University, said that research using skin cells, which has not been replicated in humans, "should be pursued just as actively as we pursue human embryonic stem cell research ... but it doesn't need any special attention from the White House. All we've ever asked is to let human embryonic stem cell research vie for public funding like all other research" (New York Times, 6/20).

"Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

Minn. Medical School Switches To Mannequins To Teach Pelvic Exams

Starting this semester, second-year students at the University of Minnesota Medical School will practice pelvic exams on mannequins instead of human patients, the AP/Minneapolis Star Tribune reports. According to school officials, one reason for the switch is to reduce costs. The school has been spending more than $150,000 annually to recruit and train practice patients for the students to examine in class (AP/Minneapolis Star Tribune, 2/18).

Under the new curriculum, students will work with plastic models and observe as a faculty member conducts a pelvic exam on a patient. Previously, students had one opportunity to practice on a patient during their second year, with the next opportunity coming six months to one year later, during their third-year obstetrics and gynecology clerkship, USA Today reports. Sharon Allen -- a professor of family medicine and community health and course director of the class called, "Physician and Patient" -- said, "They were doing [the pelvic exam] once, as more of a comfort and exposure type of experience, but not really learning the skill until their clerkship." The Patient and Physician class is students' introduction to interviewing and examining patients. Allen added, "We looked at the cost-benefit ratio and didn't think it was worth it" to have real patients.

Linda Perkowski, associate dean for curriculum and evaluation, said the decision was not solely financial, adding, "Money is important but we would never decide something just based on money" (Epstein, USA Today, 2/19). Jan van Dis, an assistant professor, said school officials are aware of students' concerns that the change might affect the quality of their education, adding that the decision could be reversed if the new curriculum is not effective (AP/Minneapolis Star Tribune, 2/18).


Reprinted with kind permission from nationalpartnership. You can view the entire Daily Women's Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women's Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.


© 2010 The Advisory Board Company. All rights reserved.

Time To Move Beyond 'Language Of Blame' In Discussing HIV/AIDS, New York Times Column Argues

On the subject of HIV/AIDS, "the fact is that for most new infections, the language of culpability and blame simply no longer applies," infectious disease expert Abigail Zuger writes in a New York Times opinion piece. Although "[y]ou don't hear much about AIDS in America anymore," the disease "endures right here in the U.S.A.: our outpatient clinics are bursting at the seams, and new cases show up daily," Zuger states.

"A million domestic stories are languishing untold, but they are not the operatic tragedies we have grown used to," Zuger continues. Rather, "these are nuanced and complicated fables, with morals that extend beyond the disease itself," she writes.

As an example, Zuger cites a Florida case in which Olympic athlete Darren Chiacchia "was charged a few months ago with what is a first-degree felony in Florida: repeatedly exposing a sexual partner to HIV." Many states have similar laws that were enacted "back in the hysterical old days of AIDS, a period lasting roughly from 1981, when the first reports of the syndrome were published, to 1996, when combination drug 'cocktails' proved remarkably effective against HIV," Zuger writes. Today in the U.S., for a person with HIV "to die of AIDS in the future would probably require a substantial amount of bad judgment or back luck: the medications, if properly prescribed and properly taken, appear almost infallible," according to Zuger.

Despite the scientific advances, Zuger acknowledges that HIV "still sows terror, uncertainly, shame and endless complications." However, "at the same time, we believe deeply in prevention," she says. Zuger asks, "And so whose fault is a new HIV infection, really? Is it mine, for giving it to you, or is it yours, for being stupid and cavalier enough to get it?"

Zuger continues that an article published last month in the New England Journal of Medicine demonstrates that new HIV infections are "increasingly concentrated in specific pockets" of the U.S., "among the poorest of the poor, the disenfranchised and socially marginalized, where substandard education means no escape." The prevalence of HIV is "so high" in these places "that simply living brings risk of infection," according to Zuger. "In other words, if you are a woman in some ZIP codes, falling in love and getting married, with no sexual partner but your husband, puts you at risk for HIV," Zuger states, concluding, "We see these women in our clinics, more and more of them, but you won't find them in court. Whom would they sue?" (Zuger, New York Times, 4/20).


Reprinted with kind permission from nationalpartnership. You can view the entire Daily Women's Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women's Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.


© 2010 The Advisory Board Company. All rights reserved.

New York State To Cover Nonprescription Plan B Under Medicaid

New York state on Feb. 1 will begin covering Barr Laboratories' emergency contraceptive Plan B purchased without a prescription up to six times per year by women ages 18 and older who are Medicaid beneficiaries, the Albany Times Union reports (Benjamin, Albany Times Union, 1/25). FDA in August 2006 approved the Barr's application to allow nonprescription sales of Plan B to women ages 18 and older. The company in December 2006 announced that Plan B, which can prevent pregnancy if taken within 72 hours of sexual intercourse, is available for nonprescription sales at pharmacies across the country (Kaiser Daily Women's Health Policy Report, 12/8/06). Women under age 18 need a prescription to purchase Plan B, which costs between $25 and $95 and is unaffordable for many Medicaid beneficiaries in New York, according to the Times Union. Former Gov. George Pataki (R) in December 2006 changed state's Medicaid rules to allow Plan B coverage for Medicaid beneficiaries. Gov. Eliot Spitzer (D) is carrying out the new rule. A Spitzer aide said that the cost of providing Plan B initially will be picked up by the state but added that New York plans to make arrangements with the federal government for reimbursement. Christina Tenuta, director of EC programs for NARAL Pro-Choice New York, said the new rule would prevent unintended pregnancies, adding, "It's unfair and not good health policy to block [Plan B] access for low-income women." Dennis Poust, a spokesperson for the New York State Catholic Conference, said the new rule would make it "too easy to abuse" the drug. New York is the third state, after Washington and Illinois, to provide EC coverage to Medicaid beneficiaries, according to Tenuta (Albany Times Union, 1/25).

"Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

BJOG Release: Study Finds Higher Incidence Of Gynaecological Cancers In Urban Areas

New research to be published in BJOG: An International Journal of Obstetrics and Gynaecology has found a higher incidence of gynaecological cancers (uterine, ovarian and cervical cancer) in urban areas of Egypt, as compared to rural areas. The incidence of uterine cancer among urban women was six times higher than that of rural women. The study suggests that women in urban areas may have a higher exposure to environmental xenoestrogens (industrially made compounds that have an oestrogenic activity), which may increase the risk of developing hormone-related cancers.


Cancers specific to female organs such as the breasts and uterus, are associated with higher long term exposure to estrogen. Numerous studies around the world have shown that environmental xenoestrogen presence and exposure is higher in urban areas.


Previous research has shown a three to four times higher urban incidence of breast cancer and estrogen receptor positive breast cancer. In this study, the researchers investigated the urban-rural incidences of gynaecological cancers (uterine, ovarian and cervical cancer) to see if they demonstrate the same trend.


The researchers analysed data from the Gharbiah Cancer Registry for the 4-year period of 1999-2002. The study population consisted of all women diagnosed with uterine, ovarian and cervical cancer in the Gharbiah Province of Egypt during this time.


The key findings indicate that the incidence of all three cancers (uterine, ovarian and cervical cancer) was higher in urban areas. The most striking finding was the almost six times higher incidence of uterine cancer among urban women. The researchers found a gradient of increasing urban-rural differences for all female cancers. Cancers such as leukaemia (which are mainly genetically determined) had the lowest urban-rural difference, followed by that seen for all non-hormonally related cancers. The inclusion of cancers that are largely hormonally dependent increased the urban-rural difference by almost 70% (the urban-rural difference increased by 146% when only hormonal cancers were considered).


Lead author, Dr. Amr Soliman, Associate Professor of Epidemiology at the University of Michigan School of Public Health, said "In this population, there is no significant urban-rural difference among women with respect to other risk factors for uterine and breast cancer, healthcare access, and behaviour. There is also very low use of hormonal pills or therapy among Egyptian women. The higher exposure of urban women to man-made chemicals in the environment that act as hormones is the probable risk factor."


Prof. Philip Steer, BJOG editor-in-chief, said "This study adds to a growing body of literature demonstrating the impact of environmental chemicals on human health. The findings suggest that urban women have a much higher exposure to hormonal agents that increase the risk of them developing hormone-dependent cancers. Further research is warranted to confirm and investigate in more detail the association between xenoestrogens and hormone-related cancers.


Notes


BJOG: An International Journal of Obstetrics and Gynaecology is owned by the Royal College of Obstetricians and Gynaecologists (RCOG) but is editorially independent and published monthly by Wiley-Blackwell. The journal features original, peer-reviewed, high-quality medical research in all areas of obstetrics and gynaecology worldwide. Please quote 'BJOG' or 'BJOG: An International Journal of Obstetrics and Gynaecology' when referring to the journal and include the website: bjog as a hidden link online.


Reference


Dey S, Hablas A, Seifeldin I, Ismail K, Ramadan M, El-Hamzawy H, Wilson M, Banerjee M, B|offetta P, Hartford J, Merajver S, Soliman A. Urban-rural differences of gynaecological malignancies in Egypt (1999-2002). BJOG 2009; DOI: 10.1111/j.1471-0528.2009.02447.x.

Source
Royal College of Obstetricians and Gynaecologists

Mothers Can Pass Depression On To Children

According to a US study, mothers can pass depression on to their children. On the other hand, if the mother is successfully treated for depression, the chances of her children developing psychiatric disorders goes down significantly.


This is the first study to look at a link between a child's mental health and his/her mother's (successful or not) treatment for depression.


Sadly, if the mother's depression continues, her children run a sizeable risk of having mental health problems.


The author of the study, Myrna Weissman, said "If you have a depression mother, you ought to do everything you can to get her better, because there's a double effect…. While depression may be a genetic disorder, it has a strong environmental component. And, for a child, a parent's illness is a very strong environmental effect. You want to reduce that effect so that you can have a beneficial effect on the child."


The study looked at 151 mothers with depression and 151 of their children, aged 7-17, during 2001 - 2004.


At the start of the study over 30% of the children had mental health problems, such as depression, anxiety and behavioural problems. Three months later one third of the mothers were successfully treated for depression. Among those mothers, the number of children with mental health problems fell by 11%. However, after three months there was an 8% increase in the number of children with mental health problems among the mothers whose depression did not go into remission (did not get better).


The researchers also noticed that the mother's depression tends to effect the whole family.


Post Natal Depression (PND) or Post Natal Illness (PNI)?


Many organisations that help women with Post Natal Illness, prefer to use this term, rather than Post Natal Depression. The reason being that many women who experience this illness found that the term 'depression' did not reflect how it felt for them.


Many find the term Post Natal Depression misleading and unhelpful and prefer the use of Post Natal Illness as a descriptive and useful name.


For a description of Post Natal Illness, go to
www.pni

Exploring The Roles Of The Pituitary Gland And Sympathetic Nervous System In The Inflammatory Process

University of Iowa researchers are ready to find the causes of interstitial cystitis, thanks to a five-year, $4.8 million grant from the National Institute of Diabetes and Digestive and Kidney Diseases, part of the National Institutes of Health. The grant is the largest ever received by the University of Iowa Department of Urology.



Interstitial cystitis is a painful bladder condition that causes excessively frequent urination and associated pain. An estimated 1.3 million Americans have the condition, more than one million of them women, according to an NIH report published in 2007.



"Some people with interstitial cystitis can't work because their symptoms are so severe. The condition has been difficult to treat because we don't know the causes," said the grant's principal investigator Karl Kreder, M.D., professor of urology at the University of Iowa Carver College of Medicine.



"This NIH grant will allow us to explore inflammatory factors in the bladder and, as some recent evidence suggests, whether interstitial cystitis is a total body condition," said Kreder, who also is director of urodynamics, female and reconstructive urology in the Department of Urology at University of Iowa Hospitals and Clinics.



The funding makes the UI a "Discovery Site" for the NIH's Multidisciplinary Approach to the Study of Chronic Pelvic Pain Research Network. In particular, the UI researchers will explore the roles of the pituitary gland and sympathetic nervous system in the inflammatory process. Kreder said the project involves five different, but interrelated, projects and will draw on the UI's Institute for Clinical and Translational Science.



One project, led by Susan Lutgendorf, Ph.D., professor of psychology in the UI College of Liberal Arts and Sciences, examines the hypothalamic pituitary-adrenal axis, which helps regulate temperature, the immune system, mood, sexuality, and energy, as well as reactions to stress and injury.



A second project examining brain pathways that may govern painful syndromes is led by Satish Rao, M.D., Ph.D., UI professor of internal medicine.



Catherine Bradley, M.D., UI associate professor of obstetrics and gynecology, leads a third project that is focused on the epidemiology of interstitial cystitis and categorizes it by pain mapping.



The research is rounded out by two basic sciences projects -- one to develop animal models that mimic the disorder, led by Yi Luo, Ph.D., UI assistant professor of urology, and one, led by Michael O'Donnell, M.D., UI professor of urology, that examines how certain bladder factors may predispose a person to interstitial cystitis.







Click here to learn more about interstitial cystitis.



Source: Becky Soglin


University of Iowa

ACOG Calls On Health Care Providers, Employers To Support Women Who Choose To Breast-Feed

The American College of Obstetricians and Gynecologists on Wednesday in a committee opinion called on health care providers, employers and hospitals to support women who choose to breast-feed their infants in an effort to increase the number of women in the U.S. who breast-feed, Reuters Health reports (Reuters Health, 1/31). According to the committee opinion -- titled "Breast-feeding: Maternal and Infant Aspects" and published in this month's issue of the journal Obstetrics & Gynecology -- breast-feeding is the "preferred method of feeding for newborns and infants, and nearly every woman can breast-feed her child." A woman should not breast-feed if she uses illicit drugs or is a heavy drinker; if she has HIV or certain other viruses; or the infant has galactosemia, an uncommon condition involving high galactose sugar levels in the blood, the group said. ACOG recommends that women exclusively breast-feed their infants for at least the first six months after birth (ACOG release, 2/1). The goal of the federal government's Healthy People 2010 campaign is to have 50% or more of women breast-feeding at six months and 25% at one year. According to ACOG, this goal can be achieved if women receive proper support services and education. "Women should be supported in integrating breast-feeding into their daily lives in the community and in the workplace to enable them to continue breast-feeding as long as possible," ACOG said (Reuters Health, 1/31).

"Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

Marriage Good For Men Physically And Women Mentally, Both Live Longer

Marriage does not only increase male and female longevity, but also tends to benefit wives mentally and husbands physically, researchers from Cardiff University, Wales, wrote in the BMJ (British Medical Journal. The authors include both the "smug marrieds" and those in long-term committed relationships.


Authors David Gallacher and John Gallacher wrote:


". . . on balance, it is probably worth making the effort."


The authors believe males benefit from long-term stable relationships because their lifestyles are conducive to better health, compared to other men, and. . . . :


". . . . the mental bonus for women may be due to a greater emphasis on the importance of the relationship."


True love does not necessarily run smoothly in all cases, the authors added, relationships during the teen years are linked to a greater risk of adolescent depressive symptoms, this improves as people get older.


18 to 25 year olds tend to enjoy better mental but not physical health if they are in a romantic relationship.


Single individuals enjoy better mental health than their counterparts in strained relationships. It would be wrong to assume that any kind of relationship is better than being on one's own.


Splitting up can also have a negative impact on the mental and physical health of both men and women - "exiting a relationship is distressing".


Those with several partners tend to have shorter lifespans than people in long-term relationships.


The investigators concluded that it is not advisable to avoid relationships to prevent damage to health if they go wrong. It might be better to focus on avoiding bad relationships, because the benefits of a good one far outweigh any fallout risks from unpleasant ones.


A one-billion person years' study across seven European nations found that those in stable relationships had age adjusted mortality rates that were ten to fifteen percent lower than the general population's, indicating that on balance making the effort is likely to be worth it.


"Are relationships good for your health? Choose your partners carefully"

David Gallacher, John Gallacher

Student BMJ 2011;19:d404

GOP House Members Send Obama Letter Asking Him To Reinstate 'Conscience' Rule

House GOP members on Tuesday sent a letter to President Obama praising him for saying that he wants to "honor the conscience of those who disagree with abortion" during his commencement address at the University of Notre Dame last weekend, The Hill reports. The Republican lawmakers -- Reps. James Sensenbrenner (Wis.), Chris Smith (N.J.) and John Fleming (La.) -- said Obama's speech indicated to them that he would reinstate the HHS provider "conscience" rule, which expanded the ability of health workers to refuse to provide services or information they objected to on moral or religious grounds and prohibited federal funding for health entities that do not comply.

In March, Obama began the process for rescinding the Bush-era rule, and it is currently undergoing a White House review. In the letter, the representatives said that they "agree with [Obama] that pro-life health care providers should have the right to refuse to participate in procedures that they find morally reprehensible." Smith said he has "renewed hope, hopefully not false" that Obama will "completely forgo the rescinding of this rule" after his remarks during Sunday's speech (Hooper, The Hill, 5/19).


Reprinted with kind permission from nationalpartnership. You can view the entire Daily Women's Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women's Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.


© 2009 The Advisory Board Company. All rights reserved.

Girls, Women Trafficked In Asia For Commercial Sex Work Emerging As HIV/AIDS Risk Factor, Report Says

Young women and girls in Asia who are trafficked for commercial sex work are emerging as an HIV/AIDS risk factor, according to a report released by the United Nations Wednesday at the 8th International Congress on AIDS in Asia and the Pacific, the AP/PR-Inside reports (Nessman, AP/PR-Inside, 8/22). The conference brings together more than 2,500 delegates from Asian countries to discuss fighting the spread of HIV/AIDS, as well as providing treatment and support to people living with the disease. An estimated 8.6 million people living in the Asia-Pacific region are HIV-positive (Kaiser Daily HIV/AIDS Report, 8/23).

The report, titled "Human Trafficking and HIV," focused on the estimated 150,000 to 200,000 people from South Asia trafficked and forced into labor annually, usually as sex workers. According to the AP/PR-Inside, the number represents only 50% of the people who are trafficked in all of Asia. The report examined the intersection between HIV and trafficking in Afghanistan, Bangladesh, India, Nepal, Pakistan and Sri Lanka, the AP/PR-Insider reports.

Although there are few reliable statistics about HIV among trafficked people, one study estimated that 25% of trafficked women in Mumbai, India, are HIV-positive, Caitlin Wiesen-Antin, United Nations Development Programme regional HIV/AIDS coordinator in Asia and the Pacific, said. She added that another study found 60% to 70% of 218 trafficked sex workers from Nepal who were later rescued in Mumbai were HIV-positive. According to Wiesen-Antin, the increase in the number of infrastructure projects across the region, as well as the sex work that accompanies project workers, has the potential to further spread HIV across the Asia-Pacific.

The report recommended that governments work to merge their anti-trafficking and HIV prevention efforts. It also called for a renewed focus on issues that make women more vulnerable to both trafficking and HIV transmission, including gender inequality, violence, poverty and a lack of education (AP/PR-Inside, 8/22).

"Both human trafficking and HIV greatly threaten human development and security," Wiesen-Antin said, adding, "Neither HIV/AIDS nor human trafficking have been integrated or mainstreamed adequately, either at policy or programmatic levels" (Sirilal, Reuters, 8/22). Wiesen-Antin said that it is "absolutely critical that we take action now" (AP/PR-Inside, 8/22).

Conflict, Stigma Hindering Fight Against HIV/AIDS in Region, UNAIDS Official Says
Increasing conflict, stigmatization of HIV-positive people and conservative social attitudes are hindering efforts to fight the virus in the region, Prasada Rao, UNAIDS Asia-Pacific regional director, said at the conference. "The harsh reality is that the grim march of the epidemic in our region continues unabated," Rao said.














According to Rao, recent international HIV/AIDS efforts have focused on India and Thailand, but Bangladesh, China, Indonesia and Pakistan could be the next front lines in the fight against the disease. "These are large countries, and they have the potential of an epidemic to take root, so they need a strong program," he said. Rao added that although there have been some successes in the region, there also are alarming trends, such as efforts from people who oppose condom use and sex education. In addition, increasing conflict in the Asia-Pacific region is hindering HIV prevention and treatment efforts, according to Rao. During the last regional conference two years ago, Nepal was the only Asia-Pacific country experiencing significant conflict, Rao said. He added that eight additional countries currently are experiencing political instability and conflict (Nessman, AP/Guardian, 8/22).

Compulsory Licensing
Rao at the conference also praised Thailand's decision to issue compulsory licenses for two antiretroviral drugs. "Thailand has made a strong statement by invoking a compulsory license for the production of second-line antiretroviral drugs," Rao said. He added, "I urge countries in Asia and the Pacific region to use" World Trade Organization "flexibilities to do more and show more commitment to AIDS responses" (Sathitphattarakul/Treerutkuarkul, Bangkok Post, 8/23).

Colombo Declaration
Representatives at the close of the ICAAP conference on Thursday signed and released the Colombo Declaration, Xinhua/People's Daily reports. The declaration said that countries in the Asia-Pacific have a mix of low and high HIV/AIDS prevalences, adding that countries with low prevalences should work to maintain their statuses by:
Addressing the disease as a development issue;

Employing community-based organizations and residents living with HIV/AIDS to campaign against the disease; and

Implementing specific strategies for prevention.

Countries also should promote voluntary HIV testing and counseling and provide universal access to antiretroviral treatment, according to the declaration. The document also calls on governments and policymakers to address poverty, gender inequality, social marginalization of vulnerable populations and stigmatization, Xinhua/People's Daily reports.

Conference participants said governments should recognize the rights of women, adding that countries should work to strengthen sexual and reproductive education and reduce mother-to-child HIV transmissions, child marriage and gender violence (Xinhua/People's Daily, 8/23).

Samlee Plianbanchang, WHO's Southeast Asia regional director, said, "In the Asia-Pacific region, we are at high risk of a massive spread of HIV," adding, "This is not only due to the large size of the population and the high burden of sexually transmitted infections, but also due to the prevailing risk behaviors and vulnerabilities as well as inherent social stigma." Experts at the close of the conference said that safeguarding the rights of vulnerable groups -- including sex workers, injection drug users, and trafficked women and children -- is vital and should be done in conjunction with prevention efforts. Conference Chair A.H. Sheriffdeen said, "Governments should recognize rights and listen to the voice of women," adding, "They ... should stop treating drug use as a criminal offence and treat it as [a] public health issue" (Sirilal, Reuters, 8/23).

"Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

Consultant, Former Member of FDA Advisory Panel Resigns Over Handling of Plan B Application

A consultant and former member of FDA's Nonprescription Drug Advisory Committee, Frank Davidoff, has resigned in protest of the agency's action to indefinitely postpone a decision on Barr Laboratories' application for nonprescription sales of its emergency contraceptive Plan B to women ages 17 and older, the AP/San Jose Mercury News reports. Davidoff, editor emeritus of the Annals of Internal Medicine, was a member of the advisory panel when it voted to recommend approval of Plan B for nonprescription sales in 2003 (AP/San Jose Mercury News, 10/6). FDA in May 2004 issued a "not approvable" letter in response to Barr's original application to allow Plan B to be sold without a doctor's prescription and in January delayed a ruling on Barr's revised application, which would allow EC to be sold without a doctor's prescription only to women ages 17 and older. Former FDA Commissioner Lester Crawford at a press conference in August opened a 60-day public comment period on Barr's application and said that science supports giving nonprescription access to Plan B to women ages 17 and older but added that the application presented FDA "with many difficult and novel policy and regulatory issues," including how to keep girls age 16 and younger from obtaining the drug (Kaiser Daily Women's Health Policy Report, 9/26). Davidoff said that FDA is favoring politics over science in delaying approval of the drug for nonprescription sales, adding, "There wasn't any observable scientific or procedural reason for them to first decline and then further delay the decision. ... [I]t seemed to me that [this] was unacceptable." Davidoff, who resigned in September, had served as a consultant to the committee since his term ended earlier this year. He is the second person to publicly leave FDA over the Plan B decision (AP/San Jose Mercury News, 10/6). Former FDA Assistant Commissioner for Women's Health Susan Wood in late August resigned her position (Kaiser Daily Women's Health Policy Report, 9/1).


"Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

10 Tips For Breast Cancer Prevention

Throughout October, National Breast Cancer Awareness Month, experts from Fred Hutchinson Cancer Research Center and its clinical care partner, the Seattle Cancer Care Alliance, are offering a series of weekly research-based tip sheets regarding a variety of topics related to breast cancer, including breast cancer prevention, screening and early detection, treatment, and survivorship.


The series launches today with "10 Tips for Breast Cancer Prevention" provided by Anne McTiernan, M.D., Ph.D., director of the Hutchinson Center's Prevention Center, a member of the Center's Public Health Sciences Division, and author of "Breast Fitness" (St. Martin's Press).


Other upcoming tip sheets will include:


Oct. 8 - "10 Tips for Breast Cancer Screening and Early Detection" by Constance Lehman, M.D., Ph.D., director of Breast Imaging and medical director of Radiology at the Seattle Cancer Care Alliance.


Oct. 15 - "10 Tips for Breast Cancer Patients During Treatment" by Julie Gralow, M.D., director of Breast Medical Oncology at the Seattle Cancer Care Alliance and co-author of "Breast Fitness" (St. Martin's Press).


Oct. 22 - "10 Tips for Breast Cancer Survivors" by Karen Syrjala, Ph.D., director of Biobehavioral Sciences and co-director of the Survivorship Program at Fred Hutchinson Cancer Research Center.


The first of four tip sheets in the series follows:


10 Tips For Breast Cancer Prevention


1. Avoid becoming overweight. Obesity raises the risk of breast cancer after menopause, the time of life when breast cancer most often occurs. Avoid gaining weight over time, and try to maintain a body-mass index under 25 (calculators can be found online).


2. Eat healthy to avoid tipping the scale. Embrace a diet high in vegetables and fruit and low in sugared drinks, refined carbohydrates and fatty foods. Eat lean protein such as fish or chicken breast and eat red meat in moderation, if at all. Eat whole grains. Choose vegetable oils over animal fats.


3. Keep physically active. Research suggests that increased physical activity, even when begun later in life, reduces overall breast-cancer risk by about 10 percent to 30 percent. All it takes is moderate exercise like a 30-minute walk five days a week to get this protective effect.


4. Drink little or no alcohol. Alcohol use is associated with an increased risk of breast cancer. Women should limit intake to no more than one drink per day, regardless of the type of alcohol.


5. Avoid hormone replacement therapy. Menopausal hormone therapy increases risk for breast cancer. If you must take hormones to manage menopausal symptoms, avoid those that contain progesterone and limit their use to less than three years. "Bioidentical hormones" and hormonal creams and gels are no safer than prescription hormones and should also be avoided.


6. Consider taking an estrogen-blocking drug. Women with a family history of breast cancer or who are over age 60 should talk to their doctor about the pros and cons of estrogen-blocking drugs such as tamoxifen and raloxifene.


7. Don't smoke. Research suggests that long-term smoking is associated with increased risk of breast cancer in some women. Need help quitting? Consider participating in WebQuit, the Hutchinson Center's online smoking-cessation study.


8. Breast-feed your babies for as long as possible. Women who breast-feed their babies for at least a year in total have a reduced risk of developing breast cancer later.


9. Participate in a research study. The Hutchinson Center is home to several studies that are looking at ways to reduce the risk for breast cancer. Check our website periodically for studies that might be appropriate for you. Just go here and click on "How You Can Help."


10. Get fit and support breast cancer research at the same time. Regular physical activity is associated with a reduced risk of breast cancer. Ascend some of the world's most breathtaking peaks while raising vital funds for and awareness of breast cancer research by participating in the Hutchinson Center's annual Climb to Fight Breast Cancer.


Source:

Fred Hutchinson Cancer Research Center

Dozens Of Women In Southwest China Say They Underwent Forced Abortions, Government Investigation Finds Claims Fabricated, NPR Reports

Dozens of women in Southwest China recently have reported being forced to undergo abortions as late as nine months into their pregnancies, NPR's "Morning Edition" reports. Some women from the region's Guangxi Province say they were forced to have abortions because they were unmarried, while other women were married and pregnant with their second child (Lim [1], "Morning Edition," NPR, 4/23). China's one-child-per-family policy seeks to keep the country's population, now 1.3 billion, at about 1.7 billion by 2050. Ethnic minorities and farmers are the only groups legally exempt from the rule nationwide. Methods of enforcing the policy, such as fines and work demotions, vary among Chinese provinces and cities (Kaiser Daily Women's Health Policy Report, 3/2). According to NPR, Liang Yage and Wei Linrong, a married couple from Baise City with one child, last week contacted a Christian group based outside of China after they said Liang was forced to have an abortion at seven months' gestation. Other unnamed individuals have reported that several dozen women underwent similar procedures at Youjiang District Maternity Hospital in Baise City last week, NPR reports. A Baise City family planning official named Nong said forcing women to undergo abortions against their will would be against the law. He said that an investigation into the reports had already been concluded and that officials determined the reports of forced abortions were fabricated. According to NPR, reports from China's Xinhua News Agency show that the Baise City government last year missed its family planning target by a fraction of 1%. The figures "shed some light on why a forced abortion campaign might be judged necessary," NPR reports (Lim [2], "Morning Edition," NPR, 4/23). Audio and a partial transcript of the segment are available online.

"Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

Type Of Treatment For Miscarriage Does Not Have An Effect On Long Term Fertility

A study published on bmj today reports that the type of treatment a woman receives after an early miscarriage does not affect subsequent fertility. Around 80 percent of women have a live birth within five years of their miscarriage.


It is established that fifteen per cent of pregnancies end in early miscarriage. For decades the typical management of early miscarriage was surgical evacuation of retained products of conception. However, this was increasingly questioned. Now women are usually offered expectant (watch and wait) and medical management as well.


Earlier studies, including the largest published trial (the MIST trial), have indicated that all three methods are probably similar in terms of gynecological infection. However, the long term effects on fertility are unknown.


Researchers based in the South West of England decided to compare fertility rates for the three management methods (expectant, medical or surgical).


A total of 762 women who had taken part in the original MIST study were surveyed. They had randomly received surgical, medical or expectant management for an early miscarriage (less than 13 weeks gestation).


These women answered a questionnaire about the succeeding pregnancies and live births after this miscarriage. The age factor, previous miscarriage and previous birth history were considered.



Among the survey respondents, 83.6 percent reported a subsequent pregnancy, with 82 percent having a live birth.


The time to subsequently give birth was very similar in the three management groups: 79 percent of those randomized to expectant management, 78.7 percent of the medical group and 81.7 percent of the surgical group, all had a live birth five years after their miscarriage.


On the other hand, older women and those suffering three or more miscarriages had considerably less probabilities to subsequently give birth.


In closing, the authors confirm that the method of miscarriage management does not affect subsequent pregnancy rates. In addition, around four in five women have a live birth within five years of a miscarriage.


They write: "Women can be reassured that long term fertility concerns need not affect their choice of miscarriage, management method."


"Incidence of pregnancy after expectant, medical, or surgical management of spontaneous first trimester miscarriage: long term follow-up of miscarriage treatment (MIST) randomised controlled trial"

Lindsay F P Smith, research lead, Paul D Ewings, director of Peninsula RDSU, Catherine Quinlan, research administrator

BMJ 2009; 339:b3827

doi:10.1136/bmj.b3827

bmj


Stephanie Brunner (B.A.)

Many Women Delay, Skip Care Because of Cost, Survey Says, USA

Twenty-seven percent of women under age 65 and 67% of uninsured women delayed or went without needed medical care in the last year because they did not think they could afford it, according to a new survey from the... Kaiser Family Foundation, the Minneapolis Star Tribune reports (O'Rourke, Scripps Howard/Minneapolis Star Tribune, 7/7). For the survey, researchers questioned 2,766 women ages 18 and older by telephone from July though September 2004 (Reuters/New York Post, 7/8). According to the survey, 17% of women with private insurance delayed or went without care because of cost concerns (CQ HealthBeat, 7/7). One in three Latinas -- who are the least likely among all U.S. women to have a regular physician -- said they delayed or forwent health care because of cost, the survey finds (Scripps Howard/Minneapolis Star Tribune, 7/7). Eight in 10 mothers or legal guardians said they had the responsibility for health care decisions in a family, and 12% of women said they are caregivers for sick or aging relatives, according to the survey (Powell, Akron Beacon Journal, 7/8).

Prescription Drugs
Among uninsured women, 41% reported that they did not fill a prescription because of costs, compared with 17% of women with private insurance and 19% of women enrolled in Medicaid. Fourteen percent of women also reported that they skipped or took smaller doses of their medicines in the past year to make them last longer, the survey shows (Kaiser Family Foundation release, 7/7). Women are more likely than men to use a prescription drug on a regular basis, and they also are more likely to report difficulties affording such medications, the survey finds (Scripps Howard/Minneapolis Star Tribune, 7/7). Moreover, 38% of women have chronic conditions such as diabetes, asthma or hypertension, compared with 30% of men (Akron Beacon Journal, 7/8). Thirty-four percent of women in poor health did not fill a prescription because they could not afford it, the study shows (Kaiser Family Foundation release, 7/7).

Physician Communication
According to the survey, about one-third of women reported that they spoke to a physician in the past three years about smoking, 20% spoke to a doctor about alcohol use and 43% discussed calcium intake (CQ HealthBeat, 7/8). Fifty-five percent of women discussed diet, exercise and nutrition with their physicians. Thirty-one percent of women of reproductive age said they discussed sexual history, sexually transmitted diseases and HIV/AIDS with their physician (Portillo, Knight Ridder/Detroit Free Press, 7/8).

Preventive Care
The survey also found that the rate of women receiving a mammogram decreased from 73% in 2001 to 69% in 2004 among women ages 40 to 64 (CQ HealthBeat, 7/8). Three-quarters of women with private insurance coverage in 2004, 73% of Medicare beneficiaries and 40% of uninsured women received a mammogram in the last year (Kaiser Family Foundation release, 7/7). In addition, the rate of women ages 18 to 64 who received a Pap test decreased from 81% in 2001 to 76% in 2004 (Scripps Howard/Minneapolis Star Tribune, 7/7). Thirty-eight percent of women age 50 and older reported having had a colon cancer screening test in the past two years and 37% of women age 45 and older said they received an osteoporosis test in the past two years, the survey shows (CQ HealthBeat. 7/8).

Comments
Alina Salgagnicoff, director of women's health policy at the Kaiser Family Foundation and a foundation vice president, said, "We're finding that cost is increasingly becoming a barrier for women. The cost is more of an issue for women than men" (Akron Beacon Journal, 7/8). She added, "A sizeable share of women are falling though the cracks, either because they don't have insurance or even with insurance can't afford to pay for medical care or prescription drugs" (Scripps Howard/Minneapolis Star Tribune, 7/7). Carolyn Clancy, director of the Agency for Healthcare Research and Quality, said during a panel discussion on the survey that women should be more proactive about speaking with their physicians and should prepare a checklist of things to ask before appointments (CQ HealthBeat, 7/7).

The survey is available online.

A HealthCast of the panel discussion on the survey also is available online at kaisernetwork.


"Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

Pope Benedict XVI Says Catholic Politicians 'Especially' Obliged To Defend Church Beliefs On Issues Such As Abortion

Pope Benedict XVI in a 130-page "apostolic exhortation" released on Tuesday wrote that "values" such as opposition to abortion, euthanasia and gay marriage are "non-negotiable," and that Roman Catholic politicians are "especially" obligated to defend the church's beliefs on the issues, the New York Times reports. The exhortation, which is a synopsis of opinion from a 2005 global meeting of bishops at the Vatican, said, "Catholic politicians and legislators, conscious of their grave responsibility before society, must feel particularly bound on the basis of a properly formed conscience to introduce laws inspired by values grounded in human nature" (Fisher, New York Times, 3/14). The pope also wrote that there is an "objective connection" between the stance a Catholic politician takes on abortion or gay marriage and receiving Communion, the Irish Times reports. "Bishops are bound to reaffirm constantly these values as part of their responsibility to the flock entrusted to them," the pope wrote. Cardinal Angelo Scola, when asked if the pope's statement meant that Catholic politicians could be refused Communion, said the document "doesn't say what it doesn't say" (McGreevy, Irish Times, 3/14). The United States Conference of Catholic Bishops in June 2004 at a closed meeting in Colorado voted to approve a statement saying that the decision to deny Communion to Roman Catholic politicians who support abortion rights is up to the local bishop. The statement also says that Catholic politicians should work against legalized abortion "lest they be guilty of cooperating in evil and in sinning against the common good" (Kaiser Daily Women's Health Policy Report, 11/15/06).

"Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

Study Shows Women's Race And Class Impact Contraception Recommendations

A woman's race/ethnicity and socioeconomic status impact whether health care providers recommend one of the most highly effective forms of contraception, a UCSF study confirms. The results also indicate that the interaction of both factors plays a role in clinicians' decisions.



Recommendations by health care providers previously have been found to vary by patients' race and socioeconomic status, contributing to health disparities, according to the researchers. The team investigated the effect of these factors on recommendations for contraception.



Study results appear in the October print edition of the American Journal of Obstetrics and Gynecology and are available online here. An editorial commenting on the study also is included in the Journal.



In the study, clinicians' recommendations for intrauterine devices (IUDs), considered among the most effective forms of contraception, were affected by both the patient's class and her race/ethnicity.
Clinicians were less likely to recommend IUDs to white women of low socioeconomic status than to white women of high socioeconomic status.
Socioeconomic status had no significant effect on recommendations for IUDs for Latinas and black women.
But when the researchers evaluated the groups by race/ethnicity, clinicians were more likely to recommend IUDs to Latinas and black women of low socioeconomic status than to white women of low socioeconomic status.

"Understandably, people want simple answers but the complexity of the results is not surprising. We live in a complex world where race and class are intertwined, " said Christine Dehlendorf, MD, MAS, assistant professor in the UCSF Department of Family and Community Medicine and the UCSF Department of Obstetrics, Gynecology & Reproductive Sciences. "Clinicians need to be cognizant of how their patients' characteristics may influence the care they provide."



In the study, one of 18 videos depicting patients with varying socioeconomic and racial characteristics was shown to 524 healthcare providers, who then were asked whether they would recommend an IUD to the patient. The study group was drawn from medical physicians, osteopathic physicians, nurse practitioners and physician assistants who attended meetings of professional societies of family medicine and gynecology.



Previous research on the effect of patient race/ethnicity and class on clinicians' behaviors has focused on patient-provider interactions involving medical decisions about diseases, such as coronary artery disease, for which there is general consensus about appropriate treatments. Decisions about family planning, in contrast, involve multiple clinically appropriate options. The most effective choice may depend on a patient's personal preference, the team states.
















"Providing contraceptive services is a particularly sensitive area of health care, both because of the intimate nature of the discussion of sexual behavior and because of the historical relationship of efforts to promote contraception with attempts to limit the fertility of minority and poor women in the United States," Dehlendorf said. "Family planning providers should work to ensure that they provide quality, patient-centered care to all women."



The inconsistency in health care provider recommendations for such an effective contraception method suggests a need for further research into the influence of clinicians' recommendations on family planning and ways to prevent the differences in care, she said.



The IUD, a small, plastic device that is inserted and left inside the uterus to prevent pregnancy, is more effective than most other forms of birth control, according to the American Congress of Obstetricians and Gynecologists.



"This is an especially important area of research given the high rate of unintended pregnancy in the US. It is critical that we provide comprehensive contraceptive counseling and equitable access to highly effective long-acting reversible contraceptives such as the IUD to all women," said Jody Steinauer, MD, MAS, senior study author and associate professor in the UCSF Department of Obstetrics, Gynecology and Reproductive Sciences.



Notes:



Co-authors are Rachel Ruskin, MD, of the UCSF Department of Obstetrics, Gynecology and Reproductive Sciences; Kevin Grumbach, MD, of the UCSF Department of Family and Community Medicine; Eric Vittinghoff, PhD, of the UCSF Department of Epidemiology and Biostatistics; Kirsten Bibbins-Domingo, MD, PhD, of the UCSF Department of Epidemiology and Biostatistics and UCSF Department of Medicine; and Dean Schillinger, MD, of the UCSF Department of Medicine.



The study was funded by the Fellowship in Family Planning and by the National Institutes of Health.



UCSF is a leading university dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care.



Source:

Karin Rush-Monroe

University of California -- San Francisco

Health Insurers Pledge Commitment To Greater Equality In Women's Coverage Under Health Reform

In testimony before the Senate Health, Education, Labor and Pensions Committee on Thursday, America's Health Insurance Plans President and CEO Karen Ignagni said the insurance industry supports health reform proposals that would prohibit charging women higher premiums or denying coverage based on gender, age or pre-existing conditions, including pregnancy or previous caesarean sections, CQ HealthBeat reports.

Ignagni also defended AHIP's recent study projecting that the Senate Finance Committee's reform bill would increase premiums. The study's methodology was widely criticized, but Ignagni said the message is that "costs are going to go up for individuals and working families if we don't have everyone participate." She repeatedly called for Congress to include a provision in health reform legislation requiring all U.S. residents to obtain health insurance.

The hearing's focus was "equal health care for equal premiums" regarding women's health coverage, and it included testimony from both liberal and conservative groups. National Women's Law Center Co-President and founder Marcia Greenberger said that women face many challenges in the individual insurance market, including finding affordable maternity coverage. A 2008 NWLC report found that 12% of individual policies offered comprehensive maternity coverage, while others offered riders costing as much as $1,000 per month in addition to regular premiums. Sen. Al Franken (D-Minn.) said it is "a top priority" that health reform includes "access to affordable family planning services," which he called "a crucial women's health services." Franken added, "Access to contraception is a fundamental right of adult Americans."

Sen. Barbara Mikulski (D-Md.) said a 25-year-old woman can be charged up to 45% more than a man of the same age for the same individual health insurance plan. She added that the disparity increases to 140% or more when women reach age 40. Women can also be denied coverage because they are pregnant, have had a c-section or have experienced domestic violence, Mikulski said. A witness at the hearing testified that she was denied coverage because she had undergone a c-section and was then told by the insurance company that she could receive coverage if she underwent a sterilization procedure. Mikulski said the testimony was "bone chilling," adding, "No one, no one, in the United States of America, in order to get health insurance, should ever be coerced into getting a sterilization" (Norman, CQ HealthBeat, 10/15).

ABC 'World News' Covers HELP Committee Hearing

ABC's "World News with Charles Gibson" on Thursday included a segment on the hearing (Gibson, "World News with Charles Gibson," ABC, 10/15).


Reprinted with kind permission from nationalpartnership. You can view the entire Daily Women's Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women's Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.


© 2009 The Advisory Board Company. All rights reserved.

Study Shows People Not Only Judge Mothers Based On Work Status, But Also Judge Their Kids

Although a woman's role in the home varies, a recent study shows that people favor not only a mother, but also her child and their relationship when she is not employed outside the home full time.



A Kansas State University study evaluated the perceptions people have of women and their children based on the woman's work status. The findings showed that people value, and do not differentiate between, mothers who stay in the home full time and mothers who find a compromise between working and at-home motherhood after they have a child. People also devalue mothers employed full time outside the home, relative to their non-employed counterparts, and perceive their children to be troubled and their relationships to be problematic.



"The most interesting, and potentially dangerous, finding is the view that if a child has a working mother, people don't like that child as much," said Jennifer Livengood, a K-State graduate student in psychology from Sweet Springs, Mo. "People really devalue a mom who works full time outside the home in comparison to a mom who doesn't. People like mothers who fulfill traditional stereotypes, like staying at home. That's just not a reality and not a preference for women as much as it used to be."



Livengood did the study for her master's thesis and collaborated with K-State's Mark Barnett, professor of psychology. The research was presented by Tammy Sonnentag, doctoral student in psychology from Edgar, Wis., at the Society for Personality and Social Psychology conference in January.



Previous research has shown that people rate stay-at-home moms as more likeable than mothers employed outside the home. While studies have shown that many women now would like more of a compromise between staying home full time and working outside the home full time, Livengood said there is little research on the perceptions of mothers who pursue this middle ground.



"I've always been interested in how women are viewed based on their choice to work outside the home, or not, after they have a child," Livengood said.



The researchers did a study involving undergraduate students, all of whom were single, and 99 percent of the sample had no children. Each participant first listened to one of three interviews that reflected a working mother, a stay-at-home mother and what the researchers called a middle mother.



The working mother said in the interview that she went back to work two weeks after giving birth and worked more than 40 hours per week. The stay-at-home mother reported having stopped working outside of the home after giving birth. The middle mother described taking 18 months away from work after giving birth and then going back to work part time and gradually increasing her work hours.



"As a cover story, the participants were led to believe that there were many mother-child pairs being evaluated to see if people could tell if there were problems in the relationship," Livengood said.
















Then, each participant watched the same video of a mother and her 4-year-old son completing a puzzle and playing a game together. Because of the audiotape, the participants either thought she was a working mother, a stay-at-home mother or a middle mother.



The participants then filled out a questionnaire that evaluated their perception of the mother. They rated statements like, "She does a good job as a mom." They also filled out a questionnaire about their perceptions of the child and responded to statements like, "This child is well-adjusted." The last questionnaire regarded their perception of the mother-child relationship, such as if they thought the pair worked well together.



The findings showed that the participants didn't differentiate between the stay-at-home mother and middle mother, but they did devalue the working mother in comparison. Livengood said the similar ratings for the two mothers might indicate that individuals understand women need a compromise. Findings also showed that not only did the participants devalue the mother who worked outside the home full time, but they also extended that negative perception to the child and their relationship.



"By just telling them the mother's work status -- by just manipulating that one variable -- it was strong enough for participants to discriminate between the children of working mothers and the other two mothers, as well as between their relationships," Livengood said.



She said these findings might indicate that people perceive the child of a working mother to have a higher incidence of behavioral and adjustment problems and their relationship to be relatively cold and troubled.



She said this perception might be specific to the sample of undergraduate students. If not, it could mean that people treat children of working mothers differently and have negative expectations, which could initiate a self-fulfilling prophecy with the child.



"Women are going to continue working, and they're going to continue having children," Livengood said. "Knowing how their decisions in these arenas are perceived by others may help us understand the foundations of these potential biases and identify ways to support mothers in their work-family decisions."



Source:

Jennifer Livengood

Kansas State University

Why Is Breast Milk Best? It's All In The Genes, Study

Is breast milk so different from infant formula? The ability to track which genes are operating in an infant's intestine has allowed University of Illinois scientists to compare the early development of breast-fed and formula-fed babies. They say the difference is very real.



"For the first time, we can see that breast milk induces genetic pathways that are quite different from those in formula-fed infants. Although formula makers have tried to develop a product that's as much like breast milk as possible, hundreds of genes were expressed differently in the breast-fed and formula-fed groups," said Sharon Donovan, a U of I professor of nutrition.



Although both breast-fed and formula-fed babies gain weight and seem to develop similarly, scientists have known for a long time that breast milk contains immune-protective components that make a breast-fed infant's risk lower for all kinds of illnesses, she said.



"The intestinal tract of the newborn undergoes marked changes in response to feeding. And the response to human milk exceeds that of formula, suggesting that the bioactive components in breast milk are important in this response," she noted.



"What we haven't known is how breast milk protects the infant and particularly how it regulates the development of the intestine," she said.



Understanding those differences should help formula makers develop a product that is more like the real thing, she said. The scientists hope to develop a signature gene or group of genes to use as a biomarker for breast-fed infants.



Many of the differences found by the scientists were in fundamental genes that regulate the development of the intestine and provide immune defense for the infant.



In this small proof-of-concept study, Donovan used a new technique patented by Texas A&M colleague Robert Chapkin to examine intestinal gene expression in 22 healthy infants - 12 breast-fed, 10 formula-fed.



The technique involved isolating intestinal cells shed in the infants' stools, then comparing the expression of different genes between the two groups. Mothers in the study collected fecal samples from their babies at one, two, and three months of age. Scientists were then able to isolate high-quality genetic material, focusing on the RNA to get a gene expression or signature.



Donovan said that intestinal cells turn over completely every three days as billions of cells are made, perform their function, and are exfoliated. Examining the shed cells is a noninvasive way to examine intestinal health and see how nutrition affects intestinal development in infants.



Understanding early intestinal development is important for many reasons, she said.



"An infant's gut has to adapt very quickly. A new baby is coming out of a sterile environment, having received all its nutrients intravenously through the placenta. At that point, babies obviously must begin eating, either mother's milk or formula.
















"They also start to become colonized with bacteria, so it's very important that the gut learns what's good and what's bad. The baby's body needs to be able to recognize a bad bacteria or a bad virus and fight it, but it also needs to recognize that even though a food protein is foreign, that protein is okay and the body doesn't want to develop an immune response to it," she said.



If anything goes wrong at this stage, babies can develop food allergies, inflammatory bowel disease, and even asthma. "We're very interested in frequent sampling at this early period of development," she added.



Donovan also would like to learn how bacteria in the gut differ in formula- and breast-fed babies, and this technique should make that possible. "Now we'll be able to get a complete picture of what's happening in an infant - from the composition of the diet to the microbes in the gut and the genes that are activated along the way."



Of potential clinical importance: The gene expressed most often in breast-fed infants is involved in the cell's response to oxygen deprivation. Lack of oxygen is a factor in the development of necrotizing enterocolitis (NEC), a kind of gangrene of the intestine that can be fatal in premature babies. NEC is a leading cause of disease and death in neonatal intensive care units, with a reported 2,500 cases occurring annually in the United States and a mortality rate of 26 percent.



The study will appear in the June 2010 issue of the American Journal of Physiology, Gastrointestinal and Liver Physiology. Co-authors are Robert S. Chapkin, Chen Zhao, Ivan Ivanov, Laurie A. Davidson, Jennifer S. Goldsby, Joanne R. Lupton, and Edward R. Dougherty, all of Texas A&M University, Rose Ann Mathai and Marcia H. Monaco of the U of I, and Deshanie Rai and W. Michael Russell of Mead Johnson Nutrition. The study was funded by Mead Johnson Nutrition.



Source:

University of Illinois College of Agricultural, Consumer and Environmental Sciences

Breast Cancer And Hormone Therapy - New Study Examines Whether Trends In Breast Cancer Incidence And Use Of HT May Be Directly Linked

The medical community has been debating for many years whether, and to what extent, postmenopausal hormone therapy (HT) use is associated with a higher risk of breast cancer, says Professor Amos Pines, President of the International Menopause Society. Although it is agreed that long-term HT slightly increases that risk, the definition of long-term use is still unclear, particularly in view of data showing that it may vary significantly by type of HT (estrogen-alone vs. estrogen-progestin, brand of progestin, dosage). A new study from the Kaiser Permanente health plan[1] raises the question whether trends in breast cancer incidence and use of HT over the past 25 years may be directly linked.



The Women's Health Initiative (WHI) trial was a landmark in menopause medicine since it provided information based on the best available study methodology[2]. By adopting its results as the ultimate source of information, many organizations, medical societies and health authorities actually declared that data derived from observations in the postmenopausal population are less valuable. Nevertheless, during the past few months, several studies have used databases on the incidence of breast cancer, on the one hand, and sales of HT on the other hand, in order to suggest a direct link between trends of hormone use and the number of newly diagnosed breast cancer patients. While such information, by itself, is very important and interesting, conclusions must be drawn with great caution. It is tempting to simplify the observed year-by-year figures on HT use and breast cancer incidence and establish a 'mirror glass' equation: the more postmenopausal hormone use, the more breast cancer, and vice versa. But human biology is far too complicated and the pathophysiology of breast cancer is far too complex to adopt such a mechanistic approach, as the authors of those studies and related Editorials rightly say.



The mere fact that the incidence of lung cancer is higher among people carrying a lighter in their pocket does not mean that lighters cause lung cancer. Thus, having two parallel time trends, for breast cancer incidence and for hormone use, still makes it necessary to investigate further in order to better understand if and how those trends could be linked. For example, a third important player has now been added, namely the rate of mammography screening, which has proved to have similar fluctuations as HT use and breast cancer incidence1. According to the Kaiser Permanente registry[1], the rate of women aged 45-59 undergoing screening mammography in 2002-2004 (post-WHI period) decreased from 48% to 44%. Thus, awareness of the need for periodic breast examinations may ease, and the likelihood of women coming to be examined may decrease in a population that uses HT less frequently, which could lead to under-diagnosis of breast cancer.
















On the other hand, the 28% increase in breast cancer incidence between the early 1980s and the early 1990s observed in the Kaiser Permanente cohort probably reflects the outcome of implementation of the mammography screening program during that period. The largest group among HT users in most of the countries (excluding the USA) has always been women younger than 60 years. The Kaiser Permanente data show that, for women aged 45-59, the 70% drop in HT use (defined as dispensation of at least one hormonal prescription) in the year 2006 (post-WHI period) as compared to the year 2000 (pre-WHI period) was associated with a non-significant decrease of 4.9% in breast cancer incidence, which translates into a reduction of less than one case of breast cancer per 10,000 women per year. Furthermore, a welcome but unexplained fact is that, in younger women (age groups < 45 years and 45-59 years), the incidence of invasive breast cancer started to decrease before the year 2000 (see Figure 1 in Glass et al.[1]). The same has been shown for the incidence of localized cancers (Figure 2[1]) and the age-adjusted annual incidence rate of both estrogen receptor-positive and -negative breast cancers (Figure 3[1]). Therefore, the decrease of breast cancer incidence analyzed from different angles by Glass and colleagues cannot be attributed simply to the drop in HT use, which started after the publication of the WHI study. There must be another, non-hormonal and still unknown factor explaining, at least in part, these changes in incidence since 1998.



Professor Pines concludes that the new epidemiological data coming from the Kaiser Permanente study do have scientific merits, but may be confusing when interpreted for the lay public. Health-care providers should stay with the first-grade information coming from the WHI study when discussing this issue with their patients: breast-wise, in women younger than 60, HT (particularly estrogen-alone) is safe. Long-term use may be associated with a small increased risk, in the order of one extra case per 1000 women per year. Discontinuation of HT brings this risk back to the values for age-matched non-users after 3-5 years. Weighing the overall benefits and risks of HT in the younger postmenopausal population clearly favors the use of HT for symptomatic women.







References



1. Glass AG, Lacey JV Jr, Carreon D, Hoover RN. Breast cancer incidence, 1980-2006: combined roles of menopausal hormone therapy, screening mammography, and estrogen receptor status. J Natl Cancer Inst 2007;99:1152-61



2. Rossouw JE, Anderson GL, Prentice RL, et al. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women's Health Initiative randomized controlled trial. JAMA 2002;288:321-33



THE INTERNATIONAL MENOPAUSE SOCIETY



The aims of the Society (IMS) are to promote knowledge, study and research on all aspects of aging in men and women; to organize, prepare, hold and participate in international meetings and congresses on menopause and climacteric; and to encourage the interchange of research plans and experience between individual members. The Society is a non-profit association, within the meaning of the Swiss Civil Code. It was created in 1978 during the first World Congress on the Menopause. In addition to organizing congresses, symposia, and workshops, the IMS owns its own journal: Climacteric.



For further information please go to: imsociety



Source: Jean Wright

International Menopause Society

Louisville Courier-Journal Examines Efforts To Reduce Gynecological Cancer Disparities In Rural Kentucky

The Louisville Courier-Journal on Monday examined a program that is providing gynecological cancer treatment in areas of rural Kentucky that otherwise would lack specialists. According to the Courier-Journal, Kentucky has the third-highest cervical cancer rate in the nation, driven by a high number of cases in the state's rural areas. There are only 10 gynecological oncologists in the state, all of whom are located in the urban areas of Louisville and Lexington.

The program -- a partnership between Trover Health System and the University of Louisville's James Graham Brown Cancer Center -- offers surgeries, radiation treatments and chemotherapy to women with gynecological cancers, who are referred to the program by their local physicians. Gynecological oncologists from other areas travel to the center to provide the care. Between 2006 and 2009, the program recorded 610 patient visits.

The Courier-Journal reports that there were 16.2 deaths per 100,000 cases of gynecological cancers in the far-western part of Kentucky from 2001 through 2005, compared with a state average of 15.8 deaths per 100,000 cases. According to Thomas Tucker, director of the Kentucky Cancer Registry, and Robert Hilgers, executive director of the Kentucky Cervical Cancer Coalition, the disparities can be attributed to poverty, poor access to care, and lack of education and awareness. Low-income women are more likely to be uninsured or underinsured and unable to afford care. In addition, women with low education levels or incomes below the poverty level are less likely than other women to receive regular Pap tests to detect signs of cervical cancer (Ungar, Louisville Courier-Journal, 3/29).


Reprinted with kind permission from nationalpartnership. You can view the entire Daily Women's Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women's Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.


© 2010 The Advisory Board Company. All rights reserved.

Gene With Possible Link To Infertility Identified In Mice

Virginia Commonwealth University researchers have identified the role of a gene in regulating molecular signals involved with ovarian follicle development, which may one day help shed light on some of the causes of fertility issues in humans.



The steps involved with conception and pregnancy are delicate and complex - particularly the process of folliculogenesis. In females, fertility is dependant on the growth of a follicle, a structure that ultimately transforms to release a mature egg. In an ordinary cycle, one follicle, known as the dominant follicle, matures to release an egg, while the rest of the eggs produced in that cycle will die. Disruption at any stage in the development of the follicle can prevent this maturation and impair fertility, as well as alter the production of hormones in the ovaries.



In the study, published online in the Oct. 1 issue of the journal Biology of Reproduction, researchers used a mouse model to examine the role of a gene known as Smad-3 in the early stages of follicular growth to better understand the molecular mechanisms that could influence fertility. Specifically, they looked at the signaling pathways involved in the follicles' response to follicle stimulating hormone, or FSH. FSH is one of the most important hormones involved in fertility and is responsible for helping a woman's body develop a mature egg.



The team, led by principal investigator Elizabeth McGee, M.D., associate professor of obstetrics and gynecology in the VCU School of Medicine, reported that female mice missing the Smad-3 gene did not experience normal ovulation and were infertile because there is a reduced ability of the follicle to respond to FSH stimulation. Further, the team concluded that Smad-3 regulates follicle growth and an important family of proteins that are essential for follicle development.



"Learning precisely how the FSH receptor is regulated is an important step in understanding the subtle defects in signal transduction that can interfere with follicle development and female fertility and could lead to new types of fertility treatments," said McGee, who is director of reproductive endocrinology and infertility at the VCU Medical Center.



This work was supported by a grant from the National Institutes of Health.

About 1.2M Brazilian Women Hospitalized In Last Five Years For Illegal Abortion-Related Complications, Report Says

About 1.2 million women in Brazil have been hospitalized in the last five years with infections, vaginal bleeding and other complications resulting from illegal abortions, according to a report released on Wednesday by the International Planned Parenthood Federation, Reuters reports.

The report, based on data from Brazil's Ministry of Health, found that about one million abortions are conducted in the country annually, including illegal abortions and miscarriages. About 230,000 women seek treatment from the country's health system annually for abortion-related complications, including hemorrhaging and perforation of the vaginal wall and uterus. The report also found that about five women die from complications that arise from unsafe procedures for every 100,000 live births.

Maria Jose Araujo, a member of the panel of health experts that presented the report, said the number of illegal abortions among young women is increasing. According to the report, about 3,000 girls ages 10 to 14 were hospitalized for complications resulting from abortions in 2005 and more than 46,000 girls ages 15 to 19 sought treatment. Araujo added that black, indigenous and lower-income women disproportionately seek abortions in Brazil.

"Legal prohibition does not eliminate the practice of abortion, everybody knows this," Carmen Barroso, director of IPPF's Western Hemisphere Region, said, adding that IPPF is in favor of developing a program to offer pregnant women information and counseling even if abortion remains illegal in the country.

Brazilian Health Minister Jose Gomes Temporao on Monday at a ceremony for a new family planning program renewed his promise to initiate a debate on abortion. "The government will get the issue rolling so women can decide," Temporao said (Welsh, Reuters, 5/30).

"Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

Blogs Comment On Coakley Victory, Nelson Amendment, Incarcerated Pregnant Women

The following summarizes selected women's health-related blog entries.

~ "Pregnant, in Prison and Denied Care," Rachel Roth, The Nation: In 2009, "incarcerated women and their allies have achieved a remarkable string of victories against inhumane treatment, ... send[ing] a strong signal to the rest of the country to stop subjecting women to [the] dangerous and degrading practice" of shackling pregnant prisoners during childbirth, Roth writes. However, the "pain and humiliation they endure" during childbirth "likely caps months of difficulty from being pregnant behind bars, months without adequate prenatal care or nutrition, or even basics like a bed to sleep on or clothes to accommodate their changing shape," Roth continues, adding that the "denial of appropriate care to pregnant women is part and parcel of the general state of medical neglect in prisons" in the U.S. She writes, "Until elected officials mandate" reporting of pregnancy outcomes in prisons, "we will have to rely on the efforts of imprisoned women, journalists, human rights investigators, researchers, lawyers and advocates to document the reality of life for pregnant women inside prison walls" (Roth, The Nation, 12/10).

~ "Deconstructing Harry," Robert Costa, National Review: In an entry examining 10 things "to watch in the Senate health care debate," Costa writes that there are several questions surrounding abortion coverage and the outcome of the final vote on the bill, including whether Sen. Ben Nelson (D-Neb.) will "play hardball and push for his amendment's language to be included in the bill via" Senate Majority Leader Harry Reid's (D-Nev.) manager's amendment. Costa writes that his "prediction" is that "Nelson talks about walking away, only to be cajoled back" by Reid, who "knows how to sweeten pots" (Costa, National Review, 12/10).

~ "Does Ireland's Abortion Law Violate Human Rights?" Delia Lloyd, Politics Daily: The outcome of a "potentially landmark" case before the European Court of Human Rights "may very well end up changing abortion law in Ireland, ... may also affect abortion law in other parts of Europe" and "might well impinge on American jurisprudence domestically," Lloyd writes. The case challenges abortion laws in Ireland, a country that Lloyd says "has one of the most restrictive abortion laws in the world." Ireland outlawed abortion in 1861, and subsequent laws allow life sentences for women who undergo the procedure, as well as maintain that fetuses have explicit rights beginning at contraception, according to Lloyd. The lawsuit alleges that Irish laws violate the European Convention on Human Rights, which guarantees rights to life and privacy, and also prohibits torture and discrimination. "If the court rules in favor of the three women, this would establish a new minimum degree of protection to which a woman seeking an abortion would be entitled under the European Convention," Lloyd writes, adding that the ruling could be binding to all member states, including nations with very strict abortion laws (Lloyd, Politics Daily, 12/10).














~ "Stupak's NYT Op-Ed: Congresswoman Capps Responds," Rep. Lois Capps (D-Calif.), RH Reality Check: Capps counters assertions made by Rep. Bart Stupak (D-Mich.) in a New York Times opinion piece on Dec. 9. Stupak in the opinion piece examines whether an amendment he sponsored with Rep. Joe Pitts (R-Pa.) that restricts access to abortion services is consistent with current law and public opinion. The Stupak-Pitts amendment "goes well beyond current law by contracting access to abortion services and is in no way the simple extension of the Hyde amendment its proponents claim," Capps writes, adding that an amendment she sponsored would have barred federal funding for abortions but allowed plans offered in proposed insurance exchanges to fund abortions using private money from premiums. Allowing insurers to segregate federal and private funding would be consistent with current laws that permit churches and military contractors to do the same, Capps writes. Capps also cites recent polls showing that 54% of U.S. residents oppose reform plans that would bar private insurers from covering abortion and that 52% of voters "support the 'Capps compromise'" (Capps, RH Reality Check, 12/10).

~ "Nelson Amendment Fails, but More Obstacles Remain for Pro-Choicers," Jessica Grose, Double X's "XX Factor": "On the surface," the defeat of an amendment to the Senate's health care reform bill (HR 3590) sponsored by Sen. Ben Nelson (D-Neb.) that mirrors language in the Stupak amendment "seems like a victory for pro-choice forces in the Senate," Grose writes. However, she adds that Senate Majority Leader Harry Reid (D-Nev.) has indicated that "the fight is not over." To placate Nelson, who has said he would filibuster the bill if his language is not adopted by the Senate, Reid has indicated that he would consider including different language that restricts abortion rights. This "is not the only disappointing news for women's health" because neither the Senate bill nor the House (HR 3962) bill requires coverage of all components of a typical gynecological "well visit," according to Grose. She concludes, "If essential care isn't part of a health insurance reform, getting the bill passed is a pyrrhic victory for women at best" (Grose, "XX Factor," Double X, 12/9).

~ "Five Unresolved Questions on Abortion in Health Care Debate," Dan Gilgoff, U.S. News & World Report's "God & Country": Gilgoff addresses five lingering questions concerning the progress of health reform. First, Gilgoff questions whether a Democratic senator who opposes abortion rights -- Sens. Robert Casey (Pa.) or Ben Nelson (Neb.) -- will "withhold a cloture vote on the Senate health care bill because it lacks a strict ban on federal dollars for abortions." Next, he wonders whether the House would approve a bill that lacks "a sweeping Stupak-Pitts ban on federal dollars available to health care plans that offer abortion coverage." Third, Gilgoff considers whether the U.S. Conference of Catholic Bishops has enough power to prevent passage of a reform bill that omits the Stupak-Pitts language. Fourth, Gilgoff asks whether "segregating federal money from personal premiums in funding abortion coverage [constitutes] a ban on federally funded abortion" in a government-managed insurance plan. Finally, he wonders whether a compromise will emerge that goes beyond the Capps plan's segregation of private and federal funding for abortion services but "stops short of preventing government-subsidized plans from covering the procedure" (Gilgoff, "God & Country," U.S. News & World Report, 12/9).

~ "Coakley Wins, Nelson Loses: A Victory for Women," Ellen Malcolm, Politics Daily: Women "certainly understand" the concept of "trying to change the world for the better, periodically celebrating small victories, when all of the sudden a convergence of events creates huge and significant change," Malcolm, president of EMILY's List, writes. For example, Dec. 8 marked "a convergence of events [that] resulted in tremendous victories for women," including Massachusetts Attorney General Martha Coakley winning the U.S. Senate Democratic primary and the defeat of Sen. Ben Nelson's (D-Neb.) amendment, which would have banned federally subsidized insurance plans from covering abortion services. Malcolm adds, "One victory shows women know how to win. One victory shows why women need to win." The events on Dec. 8 make "it clear that women see the world differently than men" and that their "perspectives need to be represented in our representative democracy," Malcolm writes, adding, "When we succeed in electing more women" like Coakley, abortion-rights opponents "won't have the power to define, create or expand the 'status quo' for women" (Malcolm, Politics Daily, 12/11).


Reprinted with kind permission from nationalpartnership. You can view the entire Daily Women's Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women's Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.


© 2009 The Advisory Board Company. All rights reserved.