Women's Health Task Force

Interview: Joann Donnellan

Argentina Backtracking on Reproductive Rights, Human Rights Watch Report Says

August 11, 2010 — Since Argentine President Cristina Fernandez de Kirchner took office in 2007, her administration has eroded protections for reproductive rights, including a reversal of the government's intention to guarantee access to legal abortion services, according to a report released Tuesday by Human Rights Watch, the New York Times reports.

Abortion is "strictly" limited in the predominantly Catholic nation, with exceptions only in cases of rape or physical or mental risk to the woman, the report said. Despite the restrictions, an estimated 40% of pregnancies in 2005 ended in abortion, most of which were illegal and unsafe. Unsafe abortion is the leading cause of maternal mortality in the country, contributing to more than 20% of deaths recorded as a result of obstetric emergencies in 2008, according to government figures cited in the report.

Marianne Mollmann, the report's author, wrote that opponents of abortion rights continue to influence policy decisions. In July, the Health Ministry "backtracked on its declared intention to guarantee access to legal abortion" after strong questioning by the Argentine press, the report said (Barrioneuvo, New York Times, 8/10). At the time, Health Minister Juan Manzur said that he never approved new guidelines on how doctors should comply with exceptions to the abortion ban. "We have said this before: We are against abortion. The president has said the same thing," Manzur said (Huber, AP/San Francisco Examiner, 8/10). However, earlier that month, a ministry official said Manzur had signed a resolution supporting the guidelines, which would have allowed doctors to perform abortions for rape survivors without securing a police report.

Access to Contraception

The report also noted that Argentine women continue to face "barriers to making independent decisions" about their reproductive health, such as domestic and sexual violence, and economic barriers that the government has failed to address.

The country's Congress in 2002 enacted the National Law on Sexual Health and Responsible Protection, which ended an 11-year ban on the use and sale of contraceptives and called for universal access to contraception and information on reproductive health. However, "[l]ittle has changed for the women and girls who depend on the public health system," the report said. Public officials who failed to uphold the law have not been penalized by the government, the report said (New York Times, 8/10). Mollmann said, "It really is just about providing information and contraception to give women real choices. That's not happening."

The report said Argentina has made improvements in two areas since HRW's last report in 2005: Sex education is now mandatory in public schools, and the country has removed obstacles for women who seek sterilization (AP/San Francisco Examiner, 8/10).

Antiabortion-Rights Groups Step Up Attacks on Democrats as Midterm Elections Near

August 11, 2010 — Continuing its campaign against antiabortion-rights House Democrats who voted for the federal health reform law (PL 111-148), the Susan B. Anthony List on Tuesday launched a bus tour through 23 cities in swing states to rally support from social conservatives, the Washington Independent reports. The bus -- dubbed the "Votes Have Consequences Express" -- will travel to Indiana, Ohio and Pennsylvania. According to former U.S. Rep. Marilyn Musgrave, project director for SBA List, in the districts the bus will visit, "more than three-quarters of the voters say they oppose taxpayer-funded abortion."

Antiabortion-rights advocates' arguments concern a decision by a bloc of House Democrats to vote for the health reform law after President Obama pledged to issue an executive order reiterating that federal funds would not be used for abortion services. Although legal and health care experts -- and even some Republican lawmakers -- say the reform law will not provide taxpayer money for abortion services, Musgrave and other abortion-rights opponents maintain that the restrictions are too lax. They argue that a provision in the law requiring private money for abortion coverage to be kept in a separate account from federal dollars is an "accounting gimmick," according to the Independent. The groups say that the executive order could be rescinded in the future and does not carry the same weight as a law.

Timothy Jost, a health law expert and law professor at Washington and Lee University, said that the groups targeting Democrats who voted for the law "have a political agenda, and it's a partisan political agenda, and they're not particularly interested in the truth." He added, "What they want to do is elect Republicans" (Zwick, Washington Independent, 8/11).

U.S. Maternity Leave Policy Lags Far Behind International Standard, Columnist Writes

August 11, 2010 — The U.S. "has the stingiest maternity leave almost anywhere in the world," Boston Herald columnist Margery Eagan writes in reaction to the Massachusetts Supreme Court's ruling that state law does not protect women from job loss after more than eight weeks of maternity leave, "even if bosses promise more time" (Eagan, Boston Herald, 8/10). The Massachusetts law mainly applies to small businesses with at least six employees. Under the 1993 federal Family and Medical Leave Act, companies with 50 or more employees are required to provide women with 12 weeks of unpaid leave and job protection after the birth of a child (Women's Health Policy Report, 8/10).

According to Eagan, in most of Europe, Africa, Asia and the Pacific, the standard maternity leave is about three months off from work with full pay. Although some people might argue that U.S. companies cannot afford lengthy maternity leaves because of the poor economy, Germany which has an even weaker economy offers 14 weeks of leave with full pay, while Bangladesh offers 12 weeks with full pay.

The larger issue, Eagan continues, is why U.S. women accept these maternity leave terms. She asks, "Why are we, the richest nation on earth, so nasty to newborns and their mothers? How come we never hear from Mama Grizzly Sarah Palin (R) and the family values crowd on this one?"

Eagan suggests a "modest proposal" of 12 weeks of maternity leave with 75% pay. She concludes, "We'd still lag way behind Bangladesh (12 weeks, full pay). But it's a start" (Boston Herald, 8/10).

Technique To Stimulate Egg Cell Maturation Has Implications for Infertility, Stem Cell Research

Aug. 11, 2010 — U.S., Chinese and Japanese scientists have discovered a way to prompt immature eggs in mice to develop into mature eggs, a method that could eventually be used to help infertile women, according to a paper recently published in the Proceedings of the National Academy of Sciences, the New York Times reports.

An accidental finding by other researchers -- that removing a certain gene in mice stimulated all of the animals' immature eggs to mature -- provided the "impetus for the discovery" in the recent study, according to the Times. Researchers from Stanford University and colleagues used a similar process to get immature mouse eggs to develop for their study. They inhibited an enzyme called PTEN and added a protein fragment to help spur immature egg cells to develop into mature eggs that can be fertilized.

The researchers then fertilized the mature eggs, allowed them to develop into mice and proved that those offspring were fertile later in life. The scientists also successfully applied their method to human eggs, although they did not fertilize them. A Japanese scientist now plans to use the technique to mature women's primordial follicles and eventually fertilize the eggs.

The findings could have implications for treating infertility in perimenopausal women who do not produce mature eggs or women who have cancer treatments that cause ovarian failure, according to the Times. Scientists also hope to use the method to generate embryonic stem cells, which often are difficult to obtain because of a lack of available mature human eggs. For example, one scientist said he intends to develop immature eggs from ovary tissue removed from women for other reasons, then prompt the eggs to mature (Kolata, New York Times, 8/9).

Toronto Star Investigation Finds Deceptive Counseling Practices at Canadian Crisis Pregnancy Centers

Aug. 10, 2010 — Workers at crisis pregnancy centers in Toronto, Canada, frequently provide women who have unintended pregnancies with misleading or inaccurate information about abortion -- such as that it causes breast cancer, infertility or emotional trauma -- according to an investigation by the Toronto Star. The article explains that CPCs are pro-life agencies that "describe themselves as non-judgmental sources of support for women with unplanned pregnancies but use misleading information to discourage [women] from choosing abortion." A Star reporter, posing as a woman who was six weeks pregnant and considering abortion, visited eight CPCs in the Toronto area. The paper later returned to contact leaders of the CPCs, who either defended their practices or did not comment.

At one CPC the Star visited, a counselor falsely purported that having an abortion was more risky than carrying a pregnancy to term and that clinics sell "pieces of babies" for medical research. Some CPCs used images to create a "terrifying description" of an aborted fetus with "limbs lying in a bloody mess," the Star reports. The centers also warned of supposed psychological problems and reactions -- such as "abortion trauma syndrome" and "anniversary grief" -- that are not legitimate medical conditions.

CPCs outnumber abortion clinics in Canada, with 197 centers and 151 abortion facilities operating in 2008, according to Canadians for Choice, a reproductive-rights group in Ottawa that tracks abortion services nationwide. Most CPCs are affiliated with the Canadian Association of Pregnancy Support Services in Alberta or Birthright International in Ontario.

Agathe Grametz-Kedzior, program manager at Canadians for Choice, said, "The greatest concern that we have ... is that crisis pregnancy centers are offering misleading information to women who are faced with an unplanned pregnancy." Canadians for Choice has established a helpline, which often receives calls from women are upset about information they received from a CPC (Smith, Toronto Star, 8/7).

Ga. GOP Gubernatorial Race Hinges on Abortion, Other Social Issues

Aug. 10, 2010 — Abortion rights have become a critical issue in Georgia's GOP gubernatorial primary between former Georgia Secretary of State Karen Handel -- a "relatively centrist Republican" -- and former U.S. Rep. Nathan Deal, a more conservative candidate, the Wall Street Journal reports. Handel leads by five percentage points in the polls heading into today's primary.

According to the Journal, the race mirrors many GOP contests this election. Some candidates are moving far to the right to secure the support of various Republican leaders and tea party groups, but they risk alienating more moderate GOP and independent voters, who could be necessary for victories in the November general elections.

Handel has battled charges from staunch conservatives that she does not sufficiently oppose abortion rights because she believes in exceptions for rape, incest and to save the life of the woman. In addition, Handel opposes limiting the number of embryos that physicians can produce for in-vitro fertilization procedures.

Deal opposes abortion rights in all cases except endangerment to the woman's life. Georgia Right to Life leaders have endorsed Deal and said Handel should not refer to herself as "pro-life." They also said her views on IVF are skewed because she is "barren," a reference to her public comments that she cannot have children. The group's comment prompted Handel to call for its leadership to resign. Deal said he endorses some limits on the number of embryos created for IVF, if the decisions were made with physician input.

While Deal has strong support from many conservative legislators, Handle recently received an endorsement from former Alaska Gov. Sarah Palin (R), who said Handel is a "pro-life, pro-Constitutionalist with a can-do attitude" (Blackmon/Bauerlein, Wall Street Journal, 8/9).

Blogs Comment on Health Reform Repeal Attempts, Crisis Pregnancy Centers, Other Topics

Aug. 10, 2010 — The following summarizes selected women's health-related blog entries.

~ "None of Your Business: Bus Driver Refuses To Bring Women to Planned Parenthood," Micole Allekotte, National Women's Law Center's "Womenstake": Allekotte, a health fellow at NWLC, writes that a Texas bus driver is suing a transportation company that allegedly fired him because he refused to drive women to a Planned Parenthood affiliate. The driver "claims that the employer must accommodate his religious beliefs against abortion by allowing him to refuse to do his job," Allekotte states. She continues, "The driver's prejudice against Planned Parenthood and the women who go there is especially egregious because Planned Parenthood performs many services in addition to abortion, including routine gynecological exams, cancer and [sexually transmitted infection] screenings, family planning counseling, birth control distribution, and men's sexual health screenings." Ultimately, "[i]t is none of a bus driver's business where his passengers are going or why," Allekotte writes, adding, "We should all promote the principle that each person is entitled to make his or her own medical decisions free of imposed impediments from those who disagree" (Allekotte, "Womenstake," National Women's Law Center, 8/6).

~ "Republicans Plan To Exploit Abortion Issue To Defund Health Law," Igor Volsky, Think Progress' "Wonk Room": Conservative critics of the federal health reform law (PL 111-148) "are now focusing on defunding some of the most unpopular provisions" of the legislation through the appropriations process, Volsky writes, adding that a recent American Spectator article by Philip Klein shows that "the idea is picking up some serious traction." According to Volsky, Republicans might attempt to add abortion-related language to the defunding amendments to "peel off the votes of several old members of the so-called Stupak coalition" -- antiabortion-rights Democrats who opposed related provisions of the law until the last minute. Klein wrote that this tactic "would provoke a fight in which pro-choice Democrats would once again have to choose between" the reform law and limiting private coverage of abortion services. Volsky continues, "Depending on how the midterm elections turn out, some of these strategies may, in fact, prove successful," he cautions that if Republicans do attempt this strategy "it's far from certain that they'll succeed." He notes that Gail Wilensky, a CMS administrator under President George H.W. Bush, said recently that "it has been very difficult historically to do this type of a starving unless you have a very large majority behind you" (Volsky, "Wonk Room," Think Progress, 8/9).

~ "Little Women: Early Puberty and What It Means for Girls," Melanie Abrahams, International Women's Health Coalition's "Akimbo": "In recent years, the transition from girlhood to womanhood has seemed to come faster" and placed "the sexual maturity of young girls in the spotlight," Abrahams writes. A new study showing that U.S. girls are reaching puberty at younger ages "complicates the issue," she continues. While "there's been a lot of brouhaha over naming the culprit of early physical maturation of girls," Abrahams argues that "instead of pointing fingers, we need to face the facts and focus on the changing need of girls in our lives and around the world." She writes that the urgency of providing "early, age appropriate and comprehensive sexuality education" is "far greater when a girl is already menstruating and could be at risk for early pregnancy, or is having to negotiate sexual pressures." In addition, "early puberty illuminates the crucial need to fight child marriage on a global scale," she argues, noting that in some countries, puberty is considered the benchmark for when girls are ready for intercourse. "People might not like the idea that little girls are, physically speaking, growing up faster -- but that doesn't mean we can afford to simply stick our heads in the ground or focus only on how to stop early maturation," Abrahams states, concluding, "Puberty is scary and confusing at any age -- and as girls face it earlier and earlier, it's our responsibility to offer them any help we can" (Abrahams, "Akimbo," International Women's Health Coalition, 8/9).

~ "Unmasking Fake Clinics: The California Edition of '12th and Delaware,'" Alexa Cole, RH Reality Check: The premiere of the HBO documentary "12th and Delaware" "gave vivid examples of threats [crisis pregnancy centers] pose to women's freedom and privacy," Cole writes. Although the documentary was filmed in Florida, Cole writes that a NARAL Pro-Choice California Foundation investigation into CPCs "demonstrate[s] that the pro-choice state of California is under attack from the 'fake clinic' arm of the anti-choice movement." According to Cole, 91% of California counties have at least one CPC, while only 59% of counties have an abortion provider. "What's happening in Florida, as seen in '12th and Delaware,' is not only happening here in California but all over the country," she continues. The investigation "highlights that though California has long been considered the top state for respecting women's reproductive privacy, it is not immune to the threats that are being documented around the country" (Cole, RH Reality Check, 8/10).

Health Reform Law Offers No-Cost Mammograms, Other Preventive Services for Seniors

August 10, 2010 — Starting in January, seniors enrolled in Medicare will be able to receive no-cost preventive services -- including breast cancer screening -- under a provision of the federal health reform law (PL 111-148), the Washington Post/Kaiser Health News reports. The provision applies to annual wellness visits -- which assess a person's health risks and examine functional and cognitive abilities -- as well as all preventive services and screenings that the U.S. Preventive Services Task Force has given an A or B recommendation for the age group.

Currently, seniors enrolled in traditional Medicare pay 20% of the cost for most preventive care. Beneficiaries enrolled in Medicare Advantage plans will not be eligible for the no-cost screenings and services, although most MA plans already offer no-cost services.

According to the Post/KHN, cost remains a "stumbling block" to accessing preventive care. A 2008 study published in the New England Journal of Medicine found that a $12 copayment for a mammogram in Medicare's managed-care plans resulted in screening rates that were eight to 11 percentage points lower compared to women in plans that did not require a copay. Another study found that a copay increase of $10 for physician office visits resulted in a 20% decline in appointments among seniors (Andrews, Washington Post/Kaiser Health News, 8/10).

Mass. Court Limits Job Protection for Unpaid Maternity Leave to Eight Weeks

August 10, 2010 — On Monday, the Massachusetts Supreme Judicial Court ruled that women are entitled to eight weeks of unpaid maternity leave without risking job loss under state law but that they are not protected after that time, the Boston Globe reports.

The decision was praised as a victory for business interests by John Barter, a lawyer representing telecommunications firm Global NAPs, Inc. A woman sued the president of the company in 2005 after she was fired upon returning from about 10 weeks of unpaid maternity leave. The woman claimed that her employer gave her permission to take more than eight weeks of unpaid leave.

The ruling is limited to women whose maternity leave falls under the state law, generally those who work for small businesses with at least six employees. The federal Family and Medical Leave Act of 1993 allows up to 12 weeks of unpaid leave and job protections for people who work for employers with 50 or more employees. Monday's ruling does not affect federal leave protections.

The court ruled 4-3 that the 1972 Massachusetts Maternity Leave Act guarantees eight weeks off to women who give birth or adopt a child, after which they are legally allowed to return to their job or a comparable one. However, "[o]nce a female employee is absent from employment for more than eight weeks, she is no longer within the purview of the [law] and, consequently, is not afforded the protections conferred by the statute," Justice Francis Spina wrote for the majority (Saltzman, Boston Globe, 8/10). Women who are promised longer maternity leaves by their employers can sue for breach of contract if they are later fired for taking more than eight weeks, the ruling said (AP/Boston Herald, 8/9).

The ruling clarifies some uncertainty about interpretation of the law. Business advocates had argued that the Massachusetts Commission Against Discrimination, the state agency that enforces the law, had given workers flexibility in applying the law, exposing businesses to lawsuits. MCAD countered that a firm cutoff at eight weeks could allow employers to offer women longer leaves and fire them when they returned (Boston Globe, 8/10).

In a dissenting opinion, Justice Margot Botsford also argued that the ruling could allow employers to renege on leave offers after employees return by citing the eight-week limitation in the state law. "An employer following such a course is using the statutory limitation as a shield to 'affect' -- that is, to ignore -- its own agreement to offer a longer leave and a job on return, a course of action plainly prohibited by the statute's third paragraph," Botsford wrote (AP/Boston Herald, 8/9).

State Senate Approves Postpartum Depression Bill

Meanwhile, the state Senate on Monday gave final approval to a bill (S 527) that aims to help women with postpartum depression, thus sending the bill to Gov. Deval Partick (D), the Boston Globe reports. The bill would require Massachusetts health insurers to submit annual reports on their efforts to screen for postpartum depression. The bill also would create a special commission tasked with determining the most effective ways to prevent, detect and treat postpartum depression, and making recommendations on public policies. The Department of Public Health also would develop policies and regulations to address postpartum depression, including the use of screening tools and the creation of public and professional education programs (Boston Globe, 8/9).

Boston Globe Opinion Piece Considers Ethics of Passing on Defective Genes Through Infertility Techniques

Aug. 10, 2010 — As the first generation of children born using the fertility technique intra-cytoplasmic sperm injection "enters adolescence, one side effect of the technology has become clear: it enables the passing down of genetic defects from parent to child," Sylvia Pagan Westphal writes in a Boston Globe opinion piece. ICSI, developed 18 years ago, "revolutionized the treatment of male infertility" by allowing a technician to inject sperm directly into an egg, thus enabling otherwise infertile men to conceive, Westphal explains. The technique is now used in more than half of in-vitro fertilization procedures in the U.S.

"It is becoming increasingly clear that there is a higher rate of genetic issues ... among infertile men and women," Westphal writes, adding that IVF and "ICSI children also harbor abnormalities in their chromosomes at a higher rate" than children conceived the conventional way. According to Westphal, "hundreds -- perhaps thousands -- of boys around the world are believed to have inherited the genetic error that caused their father's infertility," which will leave them with "severely impaired sperm production" and could prevent some boys from ever being able to produce sperm.

Unlike other medical techniques, which can be tested for efficacy and safety before they are employed, "fertility techniques, by design, can't be tested on the resulting babies until after they are born," Westphal continues, adding that "we've chosen as a society to carry out a big safety experiment on the first generation of children we've created with these methods." She suggests that all men be evaluated for chromosomal errors before agreeing to ICSI and that physicians perform simple blood tests to detect major chromosome abnormalities before using the technique. "A big part of the problem is that ICS makes having a baby so much easier that many fertility clinics are bypassing a thorough male checkup when the patient comes in," she writes.

"Questioning the appropriateness of a highly popular status quo is a hard thing to do -- hard for society, doctors and policymakers -- because we can all empathize with the deep and unwavering sorrow that comes from longing for a child and not being able to have one," Westphal states. However, "we owe it to the children who are born" to thoroughly consider whether it is ethical to knowingly pass on genetic abnormalities and whether "a couple's right to reproduce trump[s] that of their future children" (Westphal, Boston Globe, 8/8).

La. Abortion Clinics File Suit To Block State Ultrasound, Malpractice Laws

Aug. 9, 2010 — On Friday, six abortion clinics filed a federal lawsuit challenging two Louisiana abortion laws, including one (SB 528) that requires women seeking abortions to receive ultrasound exams and another (HB 1453) that prevents doctors who perform elective abortions from obtaining medical malpractice insurance, the AP/New Orleans Times-Picayune reports. Both laws were overwhelmingly approved by the state Legislature last session, marking the latest development in an "annual ritual" lasting nearly two decades whereby lawmakers typically pass at least one law imposing abortion restrictions and abortion-rights supporters challenging it in court, according to the Times-Picayune.

 

Previously, Louisiana state law required ultrasounds for women seeking abortion services with pregnancies beyond 20 weeks' gestation. Under the new law, all women seeking abortion services must receive an ultrasound exam, and the ultrasound technician must offer women a chance to hear a description of the image, to receive a photograph of it and to view it on a video screen.

The suit argues that the ultrasound law is "unconstitutionally vague" because it does not clearly state whether the person performing the ultrasound must try to compel a woman to accept an envelope containing the ultrasound picture. In addition, the law could violate a patient's confidentiality by exposing private patient information to a third party, the suit states.

The suit also contends that the law banning medical malpractice coverage for doctors who perform abortions improperly treats abortion providers differently from other health professionals and denies them equal legal protection. According to the suit, the law is intended to deter doctors from performing abortions, which would impose "a substantial obstacle in the path of women seeking abortions."

Attorney William Rittenberg and the Center for Reproductive Rights filed the suit in federal court in Baton Rouge. The suit names state Attorney General Buddy Caldwell, the state health secretary and people who serve on two medical boards charged with enforcing the laws as defendants.

Rittenberg said that no "state is close to Louisiana in the number of statutes that have tried to restrict Roe v. Wade," and he noted that he has filed similar suits every year since the 1990s. The attorney general's office and the health department have not received official copies of the suit and did not comment (AP/New Orleans Times-Picayune, 8/7).

Signs of Puberty Beginning Earlier in Girls, Study Finds

Aug. 9, 2010 — A new study provides further support to previous research suggesting that signs of puberty are appearing earlier in girls today than in the past, the Wall Street Journal reports. Earlier puberty onset could have lasting physical and mental health consequences for girls, experts said.

The study of 1,239 girls -- conducted by researchers from the University of Cincinnati College of Medicine, Mount Sinai School of Medicine in New York and Kaiser Permanente in San Francisco -- examined whether participants' breasts had begun to develop, which marks the technical start of puberty, according to the Journal. Among seven-year-old girls, 10% of whites, 15% of Hispanics and 23% of blacks had some breast tissue. Among eight-year-olds, the numbers increased to 18% of whites, nearly one-third of Hispanics and roughly 50% of blacks. In past decades, the average age of breast development was between 10 and 11 years.

Several previous studies have shown a drop in the average age of breast development compared with the average age from 15 years ago (Wang, Wall Street Journal, 8/9). Early puberty onset -- when measured by age of first menstruation -- can increase a girl's likelihood of developing breast cancer later in life, probably because of increased estrogen and progesterone exposure, which can spur tumor growth. Researchers fear that early breast development might carry similar risks (Grady, New York Times, 8/9).

Physicians also are concerned that earlier breast development can promote psychological problems such as lower self-esteem and poorer body image (Wall Street Journal, 8/9). Girls whose physical development outpaces their emotional development might not be "ready to deal with sexual advances from men and boys, or cope with [their] own hormone-spiked emotions and sexual impulses," according to the New York Times (New York Times, 8/9).

The authors of the study, which was published Monday in the journal Pediatrics, suggest that rising obesity rates and exposure to certain chemicals might play a role in the decreasing age of puberty onset (Wall Street Journal, 8/9). Lead author Frank Biro, director of adolescent medicine at Cincinnati Children's Hospital Medical Center, said parents might be able to influence the age of puberty onset by promoting healthy diets, active lifestyles and avoiding products like shampoo that contain phthalates, which are known to disrupt endocrine functions (Roan, Los Angeles Times, 8/8).

Georgetown Hospital Shuts Lab After Problems With Genetic Testing for Breast Cancer

Aug. 9, 2010 — Georgetown University Hospital has closed a genetics analysis laboratory that performs testing for breast cancer patients after two women were falsely told they do not have an aggressive form of breast cancer known as HER2-positive, the Washington Post reports. CMS officials are investigating allegations by an employee of the lab that hospital administrators did not respond to a request to notify patients of a failed quality-control inspection and recommend that they undergo retesting.

After the failed inspection, an independent lab retested tissue samples for 249 women and found that the two women were falsely told they did not have HER2-positive breast cancer, which occurs in about 15% to 20% of patients and increases the risk that tumors will spread or recur. According to hospital officials, neither of the women's treatment was adversely affected by the delayed diagnoses.

The alleged improper testing began in May 2009 and lasted for roughly 11 months, according to the Post. Georgetown officials confirmed problems with the tests but said the lab has maintained a 99% accuracy rate overall. Stephen Evans, the hospital's chief medical officer, said this week that the hospital learned earlier this year that staff members did not use proper temperature, timing and tissue embedding methods when processing patient samples. As a result, the lab failed quality-control tests administered by the College of American Pathologists, which accredits medical labs. The hospital is adding more quality-control workers and reviewing the "roles, responsibilities and decision-making" of lab personnel, Evans said, adding that the lab should resume testing in four to eight weeks.

Meanwhile, CMS and CAP are investigating procedures at the lab. Unaddressed deficiencies can lead to a lab's loss of accreditation (Leonnig/Sun, Washington Post, 8/6).

Regulation of IVF Procedures at Issue in Ga. GOP Gubernatorial Primary

Aug. 9, 2010 — Georgia Republican gubernatorial candidates Karen Handel and Rep. Nathan Deal (Ga.) have different opinions on whether they would support efforts to restrict the number of embryos created for in-vitro fertilization procedures, the AP/Macon Telegraph reports. Handel and Deal will face each other in an Aug. 10 runoff for the GOP nomination.

Georgia Right to Life, the state's largest antiabortion-rights group, believes legislation is needed to limit the number of embryos doctors can create for a single IVF procedure, arguing that the practice of creating more embryos than will be implanted in a single IVF attempt leads to the destruction of unused embryos.

Last year, Georgia legislators considered a bill (SB 169) that would have limited the number of embryos doctors can create and implant. The "Ethical Treatment of Human Embryos Act" was prompted by the birth of octuplets in California and backed by GRTL, the AP/Telegraph reports. The bill was amended to restrict embryonic stem cell research in Georgia and eventually passed the Senate but did not advance in the state House.

In recent interviews with the Associated Press, Handel, a former Georgia secretary of state, and Deal explained their positions. Handel, who underwent fertility treatments herself, said she would oppose any efforts to restrict doctors or their patients. "I could never look another family in the face and say that I was going to do something that would take away their ability -- their hope -- of having a child," she said.

Deal, who is endorsed by GRTL, told the AP, "We should not be creating life that is then going to be used for other purposes whereby it's going to be destroyed." He said he would support some limits developed in collaboration with physicians, adding, "I'm not going to tell you that you can just arbitrarily say this many embryos versus that many embryos."

Renee Whitley, co-chair of the infertility group Resolve, said Deal consistently has supported so-called "personhood" amendments that would define life as beginning at the point of fertilization (McCaffrey, AP/Macon Telegraph, 8/5).

'Rachel Maddow' Examines GOP Candidates' 'Extreme' Antiabortion Positions

Aug. 9, 2010 — MSNBC's "The Rachel Maddow Show" recently examined the increasingly "extreme" antiabortion-rights positions of Republican Senate candidates, a topic Maddow calls a "sleeper issue" in this year's campaigns. According to Maddow, Nevada candidate Sharron Angle, Kentucky candidate Rand Paul and Colorado candidate Ken Buck have said abortion should not even be allowed in cases of rape and incest. Paul and Buck have said they would consider exceptions if the woman's life is in danger.

The candidates' position was "beyond the pale even in fringe antiabortion politics not very many years ago," Maddow said. She added that the candidates are campaigning "as small government conservatives," but "all maintain that government should be big enough that it should monitor every single pregnancy in the country to ensure that every single woman who becomes pregnant is forced by the government to carry that pregnancy to term."

The segment also included a discussion with Melissa Harris-Lacewell, a Princeton University professor and columnist for The Nation, who said that "every time we move more aggressively against women's reproductive rights, the more we will see the consequences show up in everything from health care policy to ... potentially actually moving towards reducing the opportunities for women to ... find healthy, safe termination services." When asked by Maddow why Democrats "have been gun-shy" about discussing the positions of some candidates, Harris-Lacewell said that "it's very important to take those who have a religious and moral objection to abortion very seriously when they say that they believe that a pregnancy termination is murder."

In addition, Democrats "just haven't done a very good job about redefining ethical questions and normative questions from a progressive agenda perspective," Harris-Lacewell said. She added that Democrats "continue to kind of cede this ground to conservatives. It's still more of the same work we've been needing to do for a decade" (Maddow, "The Rachel Maddow Show," MSNBC, 8/5).

Sens. Coburn, Hatch Introduce Bill To Extend Restrictions on Federal Abortion Funding

August 6, 2010 — On Thursday, Republican Sens. Tom Coburn (Okla.) and Orrin Hatch (Utah) introduced a bill, "Excluding Abortion Coverage from Health Reform Act," that would prohibit any health insurance plan, public or private, that receives federal subsidies from covering abortion services, The Hill's "Healthwatch" reports. The bill aims to eliminate a provision of the health reform law that allows federally subsidized insurance plans to offer abortion coverage if consumers pay for it with their own funds and requires that private funds used to pay for abortion services are kept separate from funds used to pay for other health care services. Antiabortion-rights critics of the provision argue that because money is fungible, it is "impossible" to completely segregate federal and private money, "Healthwatch" reports.

In a statement, Coburn said that the Obama administration's "track record of ambiguity in this area underscores the need for federal legislation clarifying, once and for all, that public funds will not be used to pay for abortion services under the new health law" (Lillis, "Healthwatch," The Hill, 8/5).

Large Pregnancy Weight Gains May Increase Child's Obesity Risk, Study Funds

August 6, 2010 — Women who gain a high level of weight during pregnancy are more likely than women who gain less weight to give birth to high-birthweight infants, which can increase the infants' likelihood of eventually becoming obese, a new study published in the Lancet found, USA Today reports (Hellmich, USA Today, 8/5).

The study analyzed natality records for more than 513,000 women and more than 1.1 million infants born during a 15-year span in New Jersey and Michigan. To reduce the role of genetics in assessing the links between pregnancy weight gain, birthweight and eventual obesity in the infant, researchers studied birth records for women who gave birth to more than one child. The methodology allowed researchers to consider different pregnancy weight gains for the same women.

Researchers determined that women who gained more than 53 pounds during pregnancy were twice as likely to give birth to infants heavier than 8.8 pounds -- considered to be high birthweight -- as women who gained between 18 and 22 pounds.

The most recent guidelines from the Institute of Medicine suggest that women considered to be of healthy weight gain between 25 to 35 pounds during pregnancy, that overweight women gain between 15 and 25 pounds, and that obese women -- who represent 27% of women of childbearing age -- gain between 11 and 20 pounds (Elton, Time, 8/5). Roughly one-third of U.S. women of "normal" weight and half of overweight and obese women gain more than their physicians recommend during pregnancy (Cheng, AP/Google News, 8/4).

Study Has Limitations

Experts caution that the study had multiple limitations. The study did not consider women's pre-pregnancy weight, instead solely focusing on their weight gain during pregnancy. Researchers also did not assess the birth composition of the infants, such as whether a child had more lean mass or fat. The study did not consider that longer babies might have higher birth weights, and it did not follow children after birth to see if they became obese.

Experts also note that high birthweight is "at best a proxy for potential obesity," according to Time (Time, 8/5). While researchers have observed for decades that children with high birthweights are more likely to gain weight later in life, further studies may be needed to establish the link between gestational weight gain and childhood obesity (USA Today, 8/5). According to Anna Maria Sieg-Rix, a professor of epidemiology and nutrition at the University of North Carolina, "What this study says is that high maternal weight gain leads to high birthweight. And that's where this study's conclusions need to stop" (Time, 8/5).

Time Examines Efforts To Monitor Crisis Pregnancy Centers

August 6, 2010 — An abortion clinic and a crisis pregnancy center on opposite sides of the street are the subjects of a new HBO documentary, "12th and Delaware," which illustrates the "newest front line" in the abortion-rights debate, Time reports. The film documents the various strategies used by the CPC featured in the film "to persuade clients to continue an unintended or unwanted pregnancy," according to Time. There are more than 4,000 CPCs in the U.S -- more than five times the number of abortion clinics -- and "many are in close proximity," according to Time. "Both types of clinics are often vaguely named, and women setting out to go to an abortion provider sometimes mistakenly walk into a CPC," Time reports. Some CPCs offer comprehensive adoption counseling and financial aid to women who decide to continue their pregnancies.

The HBO documentary "shows what some view as manipulative practices to influence prospective mothers," such as describing abortion procedures in explicit detail or writing "Hi, Mommy" on an ultrasound image, Time reports. CPCs also frequently inform women that abortion increases a woman's risk for breast cancer, which is inaccurate. A 2010 report from NARAL Pro-Choice Virginia found that 67% of Virginia CPCs gave women some kind of inaccurate or misleading medical information, such as "all condoms have flaws" or that condoms do not protect against pregnancy or HIV.

The release of the film coincides with accelerated efforts by policymakers to monitor the advertising of CPCs, which abortion-rights advocates say is deceptive. On the federal level, a bill (HR 5652) introduced in late June by Rep. Carolyn Maloney (D-N.Y.) and Sen. Bob Menendez (D-N.J.) would prohibit CPCs from portraying themselves as abortion providers. NARAL Pro-Choice America estimates that 2.5% of CPCs falsely advertise their services on the Internet. NARAL this summer launched a campaign to ensure that such CPCs are not advertised under abortion referrals or services or listed as medical clinics unless they are medically licensed facilities (Dias, Time, 8/5).

 

Weekly Video Round Up

August 5, 2010 — The following summarizes selected women's health related videos.

Exposing Unsafe Abortion in the Philippines: A video from the Center for Reproductive Rights tells the consequences of the Philippines' absolute abortion ban through the story of a woman who has had two illegal abortions and 10 pregnancies. This week, the Center released a report showing how the abortion ban violates women's human rights in the poverty-stricken country, where contraception is discouraged and clandestine abortion is widespread (Center for Reproductive Rights, 7/29).

Reviewing Birth Control for Older Women: Women older than age 40 have some of the highest rates of sexually transmitted infections and unintended pregnancy, in part because they might not think they can get pregnant and forgo birth control. On the "Today Show," Rebecca Brightman -- an ob-gyn in New York City -- and Julie Bain -- health director of Ladies' Home Journal -- discussed the best options for middle-aged women who are newly single, peri-menopausal or have other reasons to re-evaluate their birth control methods (Gifford/Kotb, "Today Show," NBC, 8/4).

Jibing at Palin's 'Mama Grizzlies': Jon Stewart and Kristen Schaal of the "Daily Show" poked fun at Sarah Palin's recent video describing conservative mothers as "mama grizzlies" who will defend their cubs by voting in the November elections. "Don't somehow liberal women care about their children as well?" Stewart asks (Stewart/Schaal, "Daily Show," Comedy Central, 8/3).

Achieving MDG 5: Marie Stopes International's latest YouTube video explains the significance of family planning and abortion to reducing maternal mortality, which is part of Millennium Development Goal 5. According to Marie Stopes, family planning and abortion often" receive the least attention" in this area, even though "adopting innovative approaches and developing new ways of working in these areas can make a real difference" (Marie Stopes International, 7/30).