Daily Women's Health Policy Report

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Daily Women's Health Policy Report by the National Partnership for Women & Families
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Ky. Senate Approves Ultrasound Requirements for Women Seeking Abortion

Mon, 02/09/2015 - 15:58

The Kentucky Senate on Thursday voted 31-5 to approve a measure that would require physicians to perform ultrasounds and describe the ultrasound images to women before an abortion, the AP/Sacramento Bee reports.

Ky. Senate Approves Ultrasound Requirements for Women Seeking Abortion

February 9, 2015 — The Kentucky Senate on Thursday voted 31-5 to approve a measure that would require physicians to perform ultrasounds and describe the ultrasound images to women before an abortion, the AP/Sacramento Bee reports.

Under the measure, physicians who do not comply with the requirements could be fined up to $100,000 for a first offense and up to $250,000 for any subsequent offenses.

The state Senate has approved similar measures in the past, but the proposals died in the Democratic-led state House (AP/Sacramento Bee, 2/5).

Derek Selznick of the American Civil Liberties Union of Kentucky said the bill was "designed to keep Kentucky women from seeking abortions." He noted that courts have overturned similar laws in other states (Schreiner, AP/Biloxi-Gulfport Sun Herald, 2/5).


Early Findings Suggest Hormonal IUDs, Implants Remain Effective Beyond FDA-Approved Time Frame

Mon, 02/09/2015 - 15:55

Intrauterine devices and contraceptive implants that contain hormones could prevent pregnancy for at least a year beyond their FDA-approved length of use, according to early findings in an ongoing study, HealthDay/U.S. News & World Report reports.

Early Findings Suggest Hormonal IUDs, Implants Remain Effective Beyond FDA-Approved Time Frame

February 9, 2015 — Intrauterine devices and contraceptive implants that contain hormones could prevent pregnancy for at least a year beyond their FDA-approved length of use, according to early findings in an ongoing study, HealthDay/U.S. News & World Report reports.

Study Details

The findings, published Thursday in Obstetrics & Gynecology, are from a continuing study examining whether hormonal long-acting reversible contraceptives could be effective for up to three years beyond their approved length of use. Currently, hormonal IUDs are approved for up to five years of use, while contraceptive implants are approved for up to three years of use.

Researchers from the Washington University School of Medicine in St. Louis plan to enroll a total of 800 women in the study. The early results are from a group of 263 women who used the Mirena hormonal IUD and 237 women who used the Implanon and Nexplanon contraceptive implants. All of the women were ages 18 through 45 and were using contraceptives that were within six months of expiring when the study started.

Early Findings

According to the study, none of the women in the implant group became pregnant while using the contraceptives beyond their expiration date, while one woman in the IUD group became pregnant. According to the researchers, the IUD failure rate in the study was similar to that within the approved five years of IUD use.

Researchers will continue to track the participants from the initial phase of the study, as well as the newly enrolled women.

Comments

Study first author Colleen McNicholas, an assistant professor of obstetrics and gynecology at the medical school, said the findings are "important because extended use of these devices will reduce cost to both the individual and insurer and improve convenience for women, who can delay removal and reinsertion."

Other experts noted that IUDs and implants also have the benefit of reduced menstrual bleeding for many women and that the possibility of extended use could encourage uptake of the methods, which are underutilized in the U.S. (Preidt, HealthDay/U.S. News & World Report, 2/5).


Va. House Panel Withdraws 20-Week Abortion Ban Proposal

Mon, 02/09/2015 - 15:50

A Virginia House subcommittee on Friday withdrew a proposal (HB 2321) that would have banned abortions in the state after 20 weeks of pregnancy, the Richmond Times-Dispatch reports.

Va. House Panel Withdraws 20-Week Abortion Ban Proposal

February 9, 2015 — A Virginia House subcommittee on Friday withdrew a proposal (HB 2321) that would have banned abortions in the state after 20 weeks of pregnancy, the Richmond Times-Dispatch reports.

Proposal Details

State Delegate David LaRock (R) introduced the bill, which was modeled after legislation drafted by the antiabortion-rights group National Right to Life Committee and based on the disputed notion that a fetus can feel pain at 20 weeks of development. The bill is also similar to a federal measure that conservatives in Congress delayed voting on last month amid a split among GOP lawmakers over the measure (Schmidt, Richmond Times-Dispatch, 2/6).

The American College of Obstetricians and Gynecologists has said that there is no legitimate scientific evidence showing that fetuses are capable of feeling pain at 20 weeks (Women's Health Policy Report, 1/28).

According to the Times-Dispatch, the Virginia bill would have allowed exemptions in cases of rape or incest, but not for fetal anomalies.

Proposal Withdrawn

LaRock withdrew the bill because of a legal issue, even though most of the subcommittee members supported the measure.

According to the Times-Dispatch, the bill would have conflicted with and superseded a current state law under which performing a specific abortion procedure late in pregnancy is a Class 4 felony, punishable by two to 10 years in prison.

Committee Chair David Albo (R) said LaRock had "a laudable goal" but that the bill would have "had the unintended consequence" of reducing the punishment in the existing law "down to a civil penalty and an injunction."

The Times-Dispatch reports that LaRock included a civil penalty in the bill because crafting it as a criminal law measure would have failed due to a lack of funding.

Abortion-Rights Supporters Applaud Withdrawal

Anna Scholl, director of ProgressVA, welcomed the measure's withdrawal. She said in a statement that women seeking abortions after 20 weeks "may be facing extremely complicated pregnancies and must have every medical option -- including ending the pregnancy -- available to them to consider in consultation with their doctor and family."

NARAL Pro-Choice Virginia Executive Director Tarina Keene also noted that "abortion after 20 weeks is incredibly rare and happens most often under complex circumstances," adding that the group is "relieved" the measure was withdrawn.

Meanwhile, LaRock said the committee process helped supporters to learn about the measure so that they can "come back with a much better bill next year" (Richmond Times-Dispatch, 2/6).


Idaho Bill Would Mandate Medication Abortion Protocols

Mon, 02/09/2015 - 15:46

An Idaho House committee on Thursday voted to introduce legislation (H 88) that would require health care providers to follow certain requirements when prescribing medication abortion, Northwest Public Radio reports.

Idaho Bill Would Mandate Medication Abortion Protocols

February 9, 2015 — An Idaho House committee on Thursday voted to introduce legislation (H 88) that would require health care providers to follow certain requirements when prescribing medication abortion, Northwest Public Radio reports.

Bill Details

The antiabortion-rights group Idaho Chooses Life proposed the legislation. Under the bill, providers would have to conduct a physical exam before administering medication abortion drugs, be capable of providing surgical intervention and attempt to schedule a follow-up appointment, among other requirements.

Further, the measure would allow a patient, her spouse or, if the patient is deceased, her parents to seek damages against the provider for alleged violations of the legislation. In addition, county prosecutors could call for an injunction against the provider.

Reaction

A Planned Parenthood spokesperson noted that medical malpractice laws already exist in the state, adding that the bill attempts to legislate a "one-size-fits-all" approach to care, according to NWPR (Robinson, Northwest Public Radio, 2/5).


Featured Blog

Fri, 02/06/2015 - 19:17

"Criminalizing Pregnancy: Indiana Woman Found Guilty of Feticide and Neglect for Having a Miscarriage" (Dusenberry, Feministing, 2/5).

February 6, 2015

FEATURED BLOG

"Indiana Woman Found Guilty of Feticide and Neglect for Having a Miscarriage," Maya Dusenbery, Feministing: Dusenbery describes a recent trial involving an Indiana woman's miscarriage as an example of how "giving 'personhood' rights to fetuses" through laws that hold women "accountable" for pregnancy outcomes "means that every miscarriage must be treated as a potential crime." According to Dusenbery, the woman, Purvi Patel, faces a maximum sentence of 70 years after a jury found her guilty of "two mutually contradictory charges -- feticide and felony neglect," even though the prosecution "was unable to prove that Patel took" pills to induce abortion and "the only evidence that the fetus had been born alive ... was weak." Further, Dusenbery writes that if Patel did take medication abortion drugs, "it's likely because Indiana has made getting a legal abortion very difficult." She notes that "only four cities in Indiana have abortion clinics" and that "women must submit" to mandatory delays and biased counseling before they can obtain the procedure (Dusenberry, Feministing, 2/5).

Plaintiffs Argue Okla. Medication Abortion Restrictions Illegally Delegate Authority to FDA

Fri, 02/06/2015 - 19:03

Abortion-rights supporters in Oklahoma last week filed a motion for partial summary judgment in a case challenging the state's medication abortion restrictions, arguing that the law (HB 2684) illegally delegates authority to FDA, the Courthouse News Service reports.

Plaintiffs Argue Okla. Medication Abortion Restrictions Illegally Delegate Authority to FDA

February 6, 2015 — Abortion-rights supporters in Oklahoma last week filed a motion for partial summary judgment in a case challenging the state's medication abortion restrictions, arguing that the law (HB 2684) illegally delegates authority to FDA, the Courthouse News Service reports (Lee, Courthouse News Service, 2/4).

Background

The Center for Reproductive Rights is challenging the law. The law would require physicians to administer medication abortion drugs according to FDA protocol and ban use of the method after 49 days of pregnancy, which goes against common medical practice.

In October 2014, Oklahoma District Court Judge Roger Stuart allowed the underlying law to take effect but granted the plaintiffs' request to block portions of the measure that would have made abortion providers liable if they did not follow the law.

In November 2014, the Oklahoma Supreme Court temporarily blocked enforcement of the law, which had taken effect on Nov. 1, 2014, until it is "fully and finally litigated." The judges noted that the decision was not an opinion on the legality of the law (Women's Health Policy Report, 11/5/14).

Motion Details

The plaintiffs filed the motion for partial summary judgment on Jan. 29. In the motion, the plaintiffs argue that the law illegally delegates authority to FDA by requiring providers to follow out-of-date FDA protocols when administering medication abortion drugs.

Specifically, the motion states that the law "prohibits physicians from prescribing these medications according to 'off-label' protocols" and makes providers who fail to do so "subject to civil liability, as well as a host of other statutory and regulatory consequences."

According to the plaintiffs, FDA should not be granted such authority because it lacks the power to regulate how providers prescribe medications. They noted that the Oklahoma Constitution grants lawmaking authority only to the state Legislature, not FDA.

According to the News Service, the state Attorney General's Office did not immediately respond to requests for comment on the motion (Courthouse News Service, 2/4).


Okla. House Advances 72-Hour Mandatory Delay Bill, Embryonic Stem Cell Restrictions

Fri, 02/06/2015 - 18:55

An Oklahoma House committee on Wednesday voted 6-4 to advance a bill (HB 1409) that would require women to undergo biased counseling with a physician at least 72 hours before an abortion, up from 24 hours under current state law, the Tulsa World reports.

Okla. House Advances 72-Hour Mandatory Delay Bill, Embryonic Stem Cell Restrictions

February 6, 2015 — An Oklahoma House committee on Wednesday voted 6-4 to advance a bill (HB 1409) that would require women to undergo biased counseling with a physician at least 72 hours before an abortion, up from 24 hours under current state law, the Tulsa World reports (Hoberock, Tulsa World, 2/5). The bill now moves to the full House for consideration.

The state's biased counseling law requires health care providers to provide certain information to women before an abortion, including the current length of gestation of the pregnancy and that fetal heartbeat monitoring and ultrasound services are available.

Debate

State Rep. Doug Cox (R), an emergency department physician, said the bill would increase government interference in a decision that should be made between a woman and her physician (AP/Minneapolis Star Tribune, 2/4). Cox pointed out that the bill would create additional barriers to abortion access for low-income women, particularly from rural areas, because of the associated travel costs.

In addition, state Rep. Jeannie McDaniel (D) asked bill author state Rep. Lisa Billy (R) whether the legislation, which covers three subjects, would violate a state constitutional requirement that all legislation involve a single subject. McDaniel pointed out that courts have struck down some of the state's other abortion restrictions.

Billy said she thought the bill would withstand a court challenge (Tulsa World, 2/5). She added that her bill is about "empower[ing] women."

Ban on Embryonic Stem Cell Research

The same House committee on Wednesday also voted to advance a bill (HB 1379) that would make it a felony to perform research with embryonic stem cells in certain cases, the AP/Star Tribune reports (AP/Minneapolis Star Tribune, 2/4). The measure passed by a vote of 5-4.

Specifically, the measure "would prohibit 'nontherapeutic research' involving embryonic stem cells," with such research defined as "research that is not intended to help preserve the life and health of the particular embryo subjected to risk."

The bill text also states that nontherapeutic research "does not include in vitro fertilization and accompanying embryo transfer to the body of a female, nor any diagnostic test which may assist in the future care of a child subjected to the tests, nor the extraction of adult stem cells."

Cox noted that embryonic stem cell research is not currently being conducted in the state. However, he warned that the measure could inhibit attempts to find cures for certain diseases, such as Parkinson's or Alzheimer's.

State Rep. Dan Fisher (R), who authored the bill, countered that it would not hamper scientific research and is only intended to address intentional destruction of such cells (Tulsa World, 2/5).

The bill now proceeds to the floor of the state House. According to the AP/Star Tribune, similar measures have failed in previous sessions (AP/Minneapolis Star Tribune, 2/4).

Plaintiffs Argue Okla. Medication Abortion Restrictions Illegally Delegate Authority to FDA

Fri, 02/06/2015 - 18:29

Abortion-rights supporters in Oklahoma last week filed a motion for partial summary judgment in a case challenging the state's medication abortion restrictions, arguing that the law (HB 2684) illegally delegates authority to FDA, the Courthouse News Service reports.

Plaintiffs Argue Okla. Medication Abortion Restrictions Illegally Delegate Authority to FDA

February 6, 2015 — Abortion-rights supporters in Oklahoma last week filed a motion for partial summary judgment in a case challenging the state's medication abortion restrictions, arguing that the law (HB 2684) illegally delegates authority to FDA, the Courthouse News Service reports (Lee, Courthouse News Service, 2/4).

Background

The Center for Reproductive Rights is challenging the law. The law would require physicians to administer medication abortion drugs according to FDA protocol and ban use of the method after 49 days of pregnancy, which goes against common medical practice.

In October 2014, Oklahoma District Court Judge Roger Stuart allowed the underlying law to take effect but granted the plaintiffs' request to block portions of the measure that would have made abortion providers liable if they did not follow the law.

In November 2014, the Oklahoma Supreme Court temporarily blocked enforcement of the law, which had taken effect on Nov. 1, 2014, until it is "fully and finally litigated." The judges noted that the decision was not an opinion on the legality of the law (Women's Health Policy Report, 11/5/14).

Motion Details

The plaintiffs filed the motion for partial summary judgment on Jan. 29. In the motion, the plaintiffs argue that the law illegally delegates authority to FDA by requiring providers to follow out-of-date FDA protocols when administering medication abortion drugs.

Specifically, the motion states that the law "prohibits physicians from prescribing these medications according to 'off-label' protocols" and makes providers who fail to do so "subject to civil liability, as well as a host of other statutory and regulatory consequences."

According to the plaintiffs, FDA should not be granted such authority because it lacks the power to regulate how providers prescribe medications. They noted that the Oklahoma Constitution grants lawmaking authority only to the state Legislature, not FDA.

According to the News Service, the state Attorney General's Office did not immediately respond to requests for comment on the motion (Courthouse News Service, 2/4).


Okla. House Advances 72-Hour Mandatory Delay Bill, Embryonic Stem Cell Restrictions

Fri, 02/06/2015 - 18:28

An Oklahoma House committee on Wednesday voted 6-4 to advance a bill (HB 1409) that would require women to undergo biased counseling with a physician at least 72 hours before an abortion, up from 24 hours under current state law, the Tulsa World reports.

Okla. House Advances 72-Hour Mandatory Delay Bill, Embryonic Stem Cell Restrictions

February 6, 2015 — An Oklahoma House committee on Wednesday voted 6-4 to advance a bill (HB 1409) that would require women to undergo biased counseling with a physician at least 72 hours before an abortion, up from 24 hours under current state law, the Tulsa World reports (Hoberock, Tulsa World, 2/5). The bill now moves to the full House for consideration.

The state's biased counseling law requires health care providers to provide certain information to women before an abortion, including the current length of gestation of the pregnancy and that fetal heartbeat monitoring and ultrasound services are available.

Debate

State Rep. Doug Cox (R), an emergency department physician, said the bill would increase government interference in a decision that should be made between a woman and her physician (AP/Minneapolis Star Tribune, 2/4). Cox pointed out that the bill would create additional barriers to abortion access for low-income women, particularly from rural areas, because of the associated travel costs.

In addition, state Rep. Jeannie McDaniel (D) asked bill author state Rep. Lisa Billy (R) whether the legislation, which covers three subjects, would violate a state constitutional requirement that all legislation involve a single subject. McDaniel pointed out that courts have struck down some of the state's other abortion restrictions.

Billy said she thought the bill would withstand a court challenge (Tulsa World, 2/5). She added that her bill is about "empower[ing] women."

Ban on Embryonic Stem Cell Research

The same House committee on Wednesday also voted to advance a bill (HB 1379) that would make it a felony to perform research with embryonic stem cells in certain cases, the AP/Star Tribune reports (AP/Minneapolis Star Tribune, 2/4). The measure passed by a vote of 5-4.

Specifically, the measure "would prohibit 'nontherapeutic research' involving embryonic stem cells," with such research defined as "research that is not intended to help preserve the life and health of the particular embryo subjected to risk."

The bill text also states that nontherapeutic research "does not include in vitro fertilization and accompanying embryo transfer to the body of a female, nor any diagnostic test which may assist in the future care of a child subjected to the tests, nor the extraction of adult stem cells."

Cox noted that embryonic stem cell research is not currently being conducted in the state. However, he warned that the measure could inhibit attempts to find cures for certain diseases, such as Parkinson's or Alzheimer's.

State Rep. Dan Fisher (R), who authored the bill, countered that it would not hamper scientific research and is only intended to address intentional destruction of such cells (Tulsa World, 2/5).

The bill now proceeds to the floor of the state House. According to the AP/Star Tribune, similar measures have failed in previous sessions (AP/Minneapolis Star Tribune, 2/4).

Rep. Speier, Sen. Shaheen Reintroduce Bill To End Contraception Copays for Military Women

Fri, 02/06/2015 - 18:23

Rep. Jackie Speier (D-Calif.) and Sen. Jeanne Shaheen (D-N.H.) on Wednesday introduced legislation (HR 742, S 358) that would require the military's health plan, TRICARE, to cover contraceptive services and counseling without copayments, The Hill reports.

Rep. Speier, Sen. Shaheen Reintroduce Bill To End Contraception Copays for Military Women

February 6, 2015 — Rep. Jackie Speier (D-Calif.) and Sen. Jeanne Shaheen (D-N.H.) on Wednesday introduced legislation (HR 742, S 358) that would require the military's health plan, TRICARE, to cover contraceptive services and counseling without copayments, The Hill reports (Wong, The Hill, 2/5).

Bill Details

Speier and Shaheen introduced similar legislation last year.

Currently, active-duty servicewomen have access to prescription drugs, including contraceptives, without copays. However, women who are not on active duty and other women covered through TRICARE have varying levels of copays, depending on the type of contraceptive. The plan covers nearly 10 million individuals, including service members, military retirees and their families (Women's Health Policy Report, 9/22/14).

Speier noted in a statement that while the Affordable Care Act (PL 111-148) "guarantees civilian women coverage of women's health preventive services, such as access to ... FDA-approved contraception and counseling without cost sharing, this policy does not apply to many servicewomen and dependents covered through TRICARE."

She added that recent studies have found unplanned pregnancy rates are about 50% higher among female services members compared with the general population.

The House bill has 65 co-sponsors, all of whom are Democrats.

Comments

Service Women's Action Network Interim CEO Erica Hunt said in the statement with Speier that "servicewomen do not have access to the reproductive health care and education they need," adding that the legislation would "help meet the health needs of the entire force, including servicewomen, and is critical to the military's ability to accomplish its mission."

Speier added, "We owe female servicemembers the same access to contraception and family planning services as the women they fight to protect."

Women's and health groups also support the legislation, The Hill reports (The Hill, 2/5).

Blogs Comment on Obama Budget, Purvi Patel Case, Hyde Amendment, More

Fri, 02/06/2015 - 17:33

Read the week's best commentaries from bloggers at the New York Times, RH Reality Check and more.

Blogs Comment on Obama Budget, Purvi Patel Case, Hyde Amendment, More

February 6, 2015 — Read the week's best commentaries from bloggers at the New York Times, RH Reality Check and more.

CONTRACEPTION: "Contraceptive Coverage for Women in the Military," Dorothy Samuels, New York Times ' "Taking Note": Samuels writes about legislation (HR 742, S 358) proposed in Congress this week that "would make the full range of F.D.A.approved contraceptive methods available with no co-pay to the millions of women who rely on the military for their health care, including dependents." She notes that such coverage is already the case for "civilian federal employees and required in most health insurance plans under the Affordable Care Act [PL 111-148]." Samuels explains, "While active-duty military currently have no cost-sharing for prescriptions, service members not on active duty and dependents must pay a portion of the cost of birth control obtained outside a military treatment facility." She adds that the legislation "would also improve access to emergency contraception for survivors of sexual assault and the quality and accessibility of family planning counseling services" and "require military health facilities to stock 'a broad range' of contraception methods." However, she flags that no conservative lawmakers have sponsored the measure so far, adding, "The question now for [conservative lawmakers] is whether their ... antipathy to supporting contraception access extends to disrespecting the contributions and sacrifices of women serving their country in the military" (Samuels, "Taking Note," New York Times, 2/5).

OBAMA BUDGET PROPOSAL: "President Obama's 2016 Budget Draws Praise, Criticism From Women's Health Advocates," Emily Crockett, RH Reality Check: Crockett highlights several positive proposals in President Obama's 2016 budget, including measures that would expand "paid sick and maternity leave," "fund evidence-based teen sex education" and "increase funding for Title X family planning programs" by $13.5 million, to $300 million. In addition, she says that advocacy groups also praised the inclusion of a provision that would end "the ban on Washington, D.C., using its own funds to pay for abortion coverage through Medicaid -- which it has year after year despite annual Republican moves to put the ban back into place." However, Crockett adds that women's health advocates criticized Obama for not reversing "the Hyde Amendment -- which has prohibited federal funds from covering abortion care except in cases of rape, incest, or life endangerment since 1976." She notes that 20 House lawmakers who support abortion rights had called on the president last month to not include the amendment in his budget (Crockett, RH Reality Check, 2/3).

What others are saying about Obama's budget proposal:

~ "Budgeting Away Women's Reproductive Rights," Georgeanne Usova, American Civil Liberties Union's "Blog of Rights."

CRIMINALIZING PREGNANCY: "Indiana Woman Found Guilty of Feticide and Neglect for Having a Miscarriage," Maya Dusenbery, Feministing: Dusenbery describes a recent trial involving an Indiana woman's miscarriage as an example of how "giving 'personhood' rights to fetuses" through laws that hold women "accountable" for pregnancy outcomes "means that every miscarriage must be treated as a potential crime." According to Dusenbery, the woman, Purvi Patel, faces a maximum sentence of 70 years after a jury found her guilty of "two mutually contradictory charges -- feticide and felony neglect," even though the prosecution "was unable to prove that Patel took" pills to induce abortion and "the only evidence that the fetus had been born alive ... was weak." Further, Dusenbery writes that if Patel did take medication abortion drugs, "it's likely because Indiana has made getting a legal abortion very difficult." She notes that "only four cities in Indiana have abortion clinics" and that "women must submit" to mandatory delays and biased counseling before they can obtain the procedure (Dusenberry, Feministing, 2/5).

ABORTION RESTRICTIONS: "Codifying Racial Injustice: The Hyde Amendment and H.R. 7," David Grimes, Huffington Post  blogs: Grimes, former head of CDC's Abortion Surveillance Branch, writes about how "[t]he Hyde Amendment and H.R. 7," a bill recently approved in the House that would codify the Hyde Amendment, "punish America's poor." Grimes explains that the amendment "has prohibited use of federal Medicaid funds to pay for abortion, with the rare exceptions of rape, incest and life endangerment" since the 1970s. He discusses how the amendment disproportionally affects low-income and minority populations, noting that African-Americans and Hispanics are more likely than whites to have low incomes, rely on Medicaid health benefits, experience unintended pregnancy and require abortion services. The amendment and bill essentially "establish a two-class system of medical care" by "[d]epriving large numbers of citizens equal access to constitutionally-protected health care," Grimes writes, adding that President Obama has pledged to veto the bill (Grimes, Huffington Post blogs, 2/4).

What others are saying about abortion restrictions and access:

~ "Montana Supreme Court Says State Can Defend Parental Involvement Statutes," Jessica Mason Pieklo, RH Reality Check.

~ "It's Already Difficult To Get an Abortion at Missouri's Only Clinic. This Bill Might Make It Harder," Megan Thielking, Vox.


Study: Modern Contraceptive Use Could Prevent 15M Unintended Pregnancies in Certain Countries

Fri, 02/06/2015 - 17:27

Increased access to modern forms of contraception could have prevented 15 million unintended pregnancies in low- and middle-income countries over a seven-year period, according to a report by WHO epidemiologists published in Human Reproduction, Medical News Today reports.

Study: Modern Contraceptive Use Could Prevent 15M Unintended Pregnancies in Certain Countries

February 6, 2015 — Increased access to modern forms of contraception could have prevented 15 million unintended pregnancies in low- and middle-income countries over a seven-year period, according to a report by WHO epidemiologists published in Human Reproduction, Medical News Today reports (MacGill, Medical News Today, 2/5).

Unintended pregnancies in the countries studied can have many "serious" consequences, such as death, disability, disease, and reduced educational and employment opportunities, according to HealthDay/U.S News & World Report.

Report Details

Researchers investigated the use of contraception and the reasons for contraceptive choices among women ages 15 to 49 in 35 countries from 2005 to 2012. They asked women about the forms of contraception they used and classified the methods as either "modern" or "traditional."

According to the study, modern contraceptive methods include condoms, intrauterine devices, oral and injectable contraceptives, implants and sterilization (Preidt, HealthDay/U.S. News & World Report, 2/4). Intercourse while a woman was exclusively breastfeeding and had not resumed menstruation since birth, a period when she is assumed unable to conceive, was also considered a modern method (Medical News Today, 2/5).

The study classified withdrawal and planning intercourse around the woman's menstrual cycle as traditional methods.

Key Findings

Women who used traditional methods of contraception had a risk of unintended pregnancy that was 2.7 times higher than women who used modern methods, while women who did not use any contraceptive method had a risk that was 14.5 higher than those using modern methods.

In total, the study found the risk of using traditional methods or opting not to use contraception results in roughly 16 million unplanned pregnancies per year across the 35 countries. According to the study, the use of modern contraception could have prevented 15 million of those pregnancies.

In addition, the researchers found that 13.5 million women were not using modern contraception, and 1.5 million of those who did were using it incorrectly.

The study found that 37% of women who did not use any contraceptive methods but who did not want to get pregnant said they were concerned about potential side effects or health concerns. By contrast, 22% of women who did not use any contraception cited opposition to birth control; around 18% underestimated their risk of pregnancy; 2.4% cited cost; and 2.4% cited a lack of awareness about how to obtain contraceptives or about available methods.

Comments

Howard Sobel -- a study author and regional coordinator in WHO's Western Pacific Regional Office's reproductive, maternal, newborn, child and adolescent division -- called for "national strategies" that would "address unfounded health concerns, fear of side effects, opposition and underestimated risk of pregnancy." He suggested such measures "need to be coupled with good quality contraception that is available and affordable" (HealthDay/U.S. News & World Report, 2/4).


Video Round Up: Planned Parenthood's Fight for a New Orleans Clinic, House Lawmaker Discusses Reversal on Abortion Rights, More

Fri, 02/06/2015 - 17:16

In today's clips, Cosmopolitan's Jill Filipovic delves into efforts by abortion-rights opponents to stop the opening of a new comprehensive Planned Parenthood clinic in New Orleans. Elsewhere, Rep. Tim Ryan (D-Ohio) explains why, in a reversal, he has come to support abortion rights.

Video Round Up: Planned Parenthood's Fight for a New Orleans Clinic, House Lawmaker Discusses Reversal on Abortion Rights, More

February 6, 2015 — In today's clips, Cosmopolitan's Jill Filipovic delves into efforts by abortion-rights opponents to stop the opening of a new comprehensive Planned Parenthood clinic in New Orleans. Elsewhere, Rep. Tim Ryan (D-Ohio) explains why, in a reversal, he has come to support abortion rights.



MSNBC's Melissa Harris-Perry talks with a panel about how Planned Parenthood Gulf Coast, in its attempt to open a new clinic in New Orleans, "has faced just about every obstacle imaginable" from opponents of abortion rights. The clinic will offer a comprehensive slate of reproductive health care services.

Cosmopolitan's Jill Filipovic, who investigated abortion-rights opponents' interference in the construction project and opening of the clinic, explains that while many New Orleans residents "realize that Louisiana has a whole slew of health care challenges, and they want this clinic built," antiabortion-rights opponents, particularly outside groups, have fought against the clinic, including by threatening businesses that might support PPGC's efforts (Harris-Perry, "Melissa Harris-Perry," MSNBC, 1/24).




Rep. Tim Ryan (D-Ohio) and MSNBC's Lawrence O'Donnell discuss why, in a reversal, Ryan now supports abortion rights. Ryan explains, "I just feel like Uncle Sam should not be sitting in the doctor's office ... having any role in making" decisions about abortion (O'Donnell, "The Last Word," MSNBC, 1/28).




Slate's Aisha Harris speaks with Paul Weitz, director of the film "Grandma," and Lily Tomlin, who plays a woman in the film who becomes closer with her granddaughter after she asks Tomlin's character for financial help to obtain an abortion. Tomlin notes that the topic of abortion used to be far more "taboo" in the 1960s and 1970s, but that more people are open to talking about the subject now (Harris, Slate, 1/30).

Some Insurers Charging Copays for Generic Contraceptives Under ACA

Fri, 02/06/2015 - 15:45

Some insurers that are subject to Affordable Care Act (PL 111-148) rules requiring coverage of all FDA-approved contraceptives without cost-sharing are charging their members copayments for some generics, Kaiser Health News reports.

Some Insurers Charging Copays for Generic Contraceptives Under ACA

February 6, 2015 — Some insurers that are subject to Affordable Care Act (PL 111-148) rules requiring coverage of all FDA-approved contraceptives without cost-sharing are charging their members copayments for some generics, Kaiser Health News reports.

KHN cites an example of an insurer that moved a woman's generic birth control from a tier in the plan's drug formulary that requires no copay to another tier requiring $19 per month in cost-sharing (Andrews, Kaiser Health News, 2/6).

Federal guidance on the contraceptive coverage rules states that most insurers must cover the full range of FDA-approved methods without cost-sharing. Insurers are permitted to use "reasonable medical management techniques" to curb costs, such as only covering the generic version of an approved contraceptive (Women's Health Policy Report, 8/22/14).

However, that does not mean that an insurer can charge for certain generics simply because it offers others without copays, according to Adam Sonfield, senior public policy associate at the Guttmacher Institute.

Sonfield said, "All generics aren't the same. All of the different [generic] formulations should be on the zero [cost-sharing] tier, but that isn't clear in the current guidelines." Some insurers also have argued that they should not have to cover the contraceptive patch or vaginal ring because the same hormones are used in birth control pills, KHN reports. However, HHS officials have said that because they are different types of methods, they all must be covered (Kaiser Health News, 2/6).


Nev. Bill Would Require HPV Vaccination Before Enrolling in School

Thu, 02/05/2015 - 19:56

Nevada lawmakers on Monday introduced a bill (SB 117) that would add vaccinations against human papillomavirus and meningitis to the list of inoculations children must receive prior to enrolling in daycare, public school or private school, the AP/Miami Herald reports.

Nev. Bill Would Require HPV Vaccination Before Enrolling in School

February 5, 2015 — Nevada lawmakers on Monday introduced a bill (SB 117) that would add vaccinations against human papillomavirus and meningitis to the list of inoculations children must receive prior to enrolling in daycare, public school or private school, the AP/Miami Herald reports.

Current state law already requires most schoolchildren to follow medically recommended immunization schedules for several vaccines, including those for measles, polio and whooping cough. Parents are allowed to obtain exemptions for their children for medical or religious reasons (Rindels, AP/Miami Herald, 2/3).

Background

HPV is the most common sexually transmitted infection in the U.S. It is linked to cervical, vaginal, vulvar, oral, penile and anal cancers, as well as genital warts.

CDC recommends that girls and boys begin the three-dose HPV vaccination series at age 11 or 12 and receive the three doses over an eight-month period. The vaccine can prevent the most common cancer-causing strains of the virus (Women's Health Policy Report, 11/13/14).

About 27% of girls and 7% of boys ages 13 to 17 in Nevada have received all three doses of the vaccine, which is below the national average, according to the AP/Herald.

Comments, Next Steps

Opponents of requiring HPV vaccination have argued that the vaccines promote promiscuity. However, Immunize Nevada Executive Director Heidi Parker said, "Studies have shown that it does not increase promiscuity," adding, "The important message is that [the] HPV vaccine is cancer prevention."

State Sen. Joe Hardy (R), chair of the state Senate committee that sponsored the bill, said, "If we vaccinate people, we can prevent diseases that are not only horrific but deadly."

According to the AP/Herald, the bill will be referred to the state Senate Education Committee (AP/Miami Herald, 2/3).


Mont. Supreme Court Reverses Ruling on Parental Involvement Laws

Thu, 02/05/2015 - 19:56

The Montana Supreme Court on Tuesday reversed a lower court decision that found the state could not defend two parental involvement laws (LR 120, HR 391) because a prior case had found similar restrictions unconstitutional, the Missoulian reports.

Mont. Supreme Court Reverses Ruling on Parental Involvement Laws

February 5, 2015 — The Montana Supreme Court on Tuesday reversed a lower court decision that found the state could not defend two parental involvement laws (LR 120, HR 391) because a prior case had found similar restrictions unconstitutional, the Missoulian reports.

The ruling sends the case back to state district court for consideration (Dennison, Missoulian, 2/4).

Background

One law, which was approved through a ballot measure in 2012, mandates that minors younger than age 16 notify their parents before obtaining an abortion. The law includes exceptions for medical emergencies and for minors who petition a youth court for a waiver.

The other law requires minors under age 18 to obtain notarized parental consent before abortions.

In a lawsuit filed in May 2013, Planned Parenthood of Montana noted that a Montana court in the 1999 struck down a parental involvement law for violating a minor's right to abortion. PPMT argued that the current measures restrict minors' rights in a similar way.

In 2014, state District Judge Jeffery Sherlock ruled in favor of PPMT, noting that the state had to drop its defense of the two laws because the requirements had already been struck down by the 1999 ruling (Women's Health Policy Report, 2/6/14).

Following Sherlock's ruling, the state appealed to the Montana Supreme Court.

Latest Ruling

In a 4-1 decision, the state Supreme Court said that the issues in the 1999 case and the latest challenge were not identical, the AP/Seattle Post-Intelligencer reports.

The majority noted differences between the laws, pointing out that the law in the 1999 challenge applied to all minors, whereas the ballot measure applied only to those under 16. In addition, the justices pointed out that the law enacted in 2013 requires consent, whereas the law in 1999 case required notification (AP/Seattle Post-Intelligencer, 2/3).

Justice Patricia Cotter dissented, writing that both cases essentially relate to the constitutional question of whether the state's interests justify impinging a pregnant minors' right to decide to have an abortion, according to the Missoulian.

She wrote that questions in the 1999 case about the state's interest in "protecting minors against their own immaturity" and "protecting the constitutional rights of parents to rear children who are members of their household" are the same to those presented by the new laws. She noted the differences between the laws are "immaterial" and do not factor into the constitutional questions Missoulian (Missoulian, 2/4).

Comments

PPMT CEO Martha Stahl said, "We remain fully confident that these laws are not only bad health policy, but also clear violations of young Montana women's constitutional rights."

Separately, Montana Attorney General Tim Fox (R) said, "Today's ruling means we can move forward in vigorously defending the fundamental rights of parents to be involved in the decisions their children face" (AP/Seattle Post-Intelligencer, 2/3).


Video Round Up: Planned Parenthood's Fight for a New Orleans Clinic, House Lawmaker Discusses Reversal on Abortion Right

Thu, 02/05/2015 - 19:44

In today's clips, Cosmopolitan's Jill Filipovic delves into efforts by abortion-rights opponents to stop the opening of a new comprehensive Planned Parenthood clinic in New Orleans. Elsewhere, Rep. Tim Ryan (D-Ohio) explains why, in a reversal, he has come to support abortion rights.

Video Round Up: Planned Parenthood's Fight for a New Orleans Clinic, House Lawmaker Discusses Reversal on Abortion Rights, More

February 5, 2015 — In today's clips, Cosmopolitan's Jill Filipovic delves into efforts by abortion-rights opponents to stop the opening of a new comprehensive Planned Parenthood clinic in New Orleans. Elsewhere, Rep. Tim Ryan (D-Ohio) explains why, in a reversal, he has come to support abortion rights.



MSNBC's Melissa Harris-Perry talks with a panel about how Planned Parenthood Gulf Coast, in its attempt to open a new clinic in New Orleans, "has faced just about every obstacle imaginable" from opponents of abortion rights. The clinic will offer a comprehensive slate of reproductive health care services.

Cosmopolitan's Jill Filipovic, who investigated abortion-rights opponents' interference in the construction project and opening of the clinic, explains that while many New Orleans residents "realize that Louisiana has a whole slew of health care challenges, and they want this clinic built," antiabortion-rights opponents, particularly outside groups, have fought against the clinic, including by threatening businesses that might support PPGC's efforts (Harris-Perry, "Melissa Harris-Perry," MSNBC, 1/24).




Rep. Tim Ryan (D-Ohio) and MSNBC's Lawrence O'Donnell discuss why, in a reversal, Ryan now supports abortion rights. Ryan explains, "I just feel like Uncle Sam should not be sitting in the doctor's office ... having any role in making" decisions about abortion (O'Donnell, "The Last Word," MSNBC, 1/28).




Slate's Aisha Harris speaks with Paul Weitz, director of the film "Grandma," and Lily Tomlin, who plays a woman in the film who becomes closer with her granddaughter after she asks Tomlin's character for financial help to obtain an abortion. Tomlin notes that the topic of abortion used to be far more "taboo" in the 1960s and 1970s, but that more people are open to talking about the subject now (Harris, Slate, 1/30).

Blogs Comment on Anti-Choice 'Playbook,' IUD Facts, More

Thu, 02/05/2015 - 19:32

Read the week's best commentaries from bloggers at ANSIRH, Ms. Magazine and more.

Blogs Comment on Anti-Choice 'Playbook,' IUD Facts, More

January 30, 2015 — Read the week's best commentaries from bloggers at ANSIRH, Ms. Magazine and more.

ABORTION RESTRICTIONS: "Will Abortion Opponents Use a Familiar Playbook To Push for a 20 Week Ban?" Carole Joffe, Advancing New Standards in Reproductive Health's "ANSIRH Blog": Although the House earlier this month canceled a vote on a 20-week abortion ban (HR 36), it "is not the end of the story for the federal 20 week ban" because "a modified version of this bill will be voted on at a later date," Joffe writes. Joffe explains that abortion-rights opponents' justification behind such bans, "that the fetus can feel pain at 20 weeks," has been widely dismissed "by medical experts, and by organizations such as the American College of Obstetricians and Gynecology." She writes that in pushing for the ban, "anti-abortion politicians are following a tried and true playbook: choose an aspect of abortion provision that is unsettling to a public that is not informed about the science, ignore the testimony of leading medical experts on the abortion issue, and instead, rely on arguments made by alternative 'experts,' who may lack the credentials or research background in their purported areas of expertise or draw on so-called junk science" (Joffe, "ANSIRH Blog," ANSIRH, 1/27).

What others are saying about abortion restrictions:

~ "Who Has Late Abortions -- And Why?" David Grimes, Huffington Post blogs.

CONTRACEPTION: "IUD Expulsion: Is it as Scary as it Sounds?" Claire Tighe, Ms. Magazine blog: Tighe comments on the various ways an intrauterine device can become "expelled," which, according to an article by Corinne Rocca, "'is a fancy way of saying that an IUD has been pushed out of its ideal location at the top of the uterus.'" According to Tighe, expulsion is rare, occurring between 0.05% and 8% of the time, but "[t]here are a few different factors that can affect the possibility of expulsion, like your age and pregnancy history, how long it's been since the IUD was inserted, and even how well your health care provider inserted the IUD in the first place." She notes the IUDs are more likely to be expelled during menstruation than other times in a woman's cycle and are "most likely" to become expelled during "the first three months" following insertion. Tighe writes that women concerned about a possible expulsion should check to see if they can feel the IUD's strings and call a provider, among other care suggestions (Tighe, Ms. Magazine blog, 1/27).

What others are saying about contraception:

~ "Salon's Guide to Where Babies (Don't) Come From: Let's Talk About IUDs!" Katie McDonough, Salon.

ABORTION PROVIDERS: "Threats Against Abortion Providers Have Doubled Since 2010, Report Finds," Teddy Wilson, RH Reality Check: "[T]here has been significantly higher levels of threats and targeted intimidation of doctors and staff in recent years" across the U.S., according to the National Clinic Violence Survey, Wilson writes. According to Wilson, the report found the "[i]ncidents of wanted-style posters of abortion providers, pamphlets targeting doctors and clinic staff, and harmful information and pictures of doctors posted on the Internet have all significantly increased over the past four years." Further, the survey found that 8.7% of clinics reported stalking in 2014, an increase from 6.4% in 2010, and 19.7% of clinics reported "severe violence." He adds, "Increases in the incidents of harassment of abortion clinics appear to coincide with the increasing amount of legislation passed to restrict access to reproductive health care" (Wilson, RH Reality Check, 1/28).

What others are saying about abortion providers:

~ "The Disturbing Levels of Stalking and Intimidation Plaguing Abortion Doctors," Tara Culp-Ressler, Center for American Progress' "ThinkProgress."

MEDICATION ABORTION: "Study: Evidence-Based Protocols for Medication Abortion are Safe, Effective," Emily Crockett, RH Reality Check: A new study has found "evidence-based alternatives to the [FDA]-approved regimen for medication abortion are safe and effective," Crockett writes. She notes that the five-year study found that "the protocols were more than 98 percent effective for pregnancies of up to 42 days' gestation, and more than 95 percent effective up to 63 days." By contrast, FDA protocols "only recommend using medication abortion up until 49 days of gestation ... and are less than 85 percent effective after 49 days," in addition to requiring a "higher dose of medication and more doctor's visits," she writes. According to Crockett, the study adds to the "robust body of evidence" that laws restricting medication abortion by requiring physicians adhere to FDA protocol "have no scientific basis" (Crockett, RH Reality Check, 1/28).


N.C. Abortion-Rights Supporters Warn Against More Clinic Regulations

Thu, 02/05/2015 - 19:32

North Carolina abortion-rights groups and their legislative allies are urging antiabortion-rights state lawmakers to not make ideologically driven changes to clinic regulations proposed by Gov. Pat McCrory's (R) administration, the AP/Winston-Salem Journal reports.

N.C. Abortion-Rights Supporters Warn Against More Clinic Regulations

February 2, 2015 — North Carolina abortion-rights groups and their legislative allies are urging antiabortion-rights state lawmakers to not make ideologically driven changes to clinic regulations proposed by Gov. Pat McCrory's (R) administration, the AP/Winston-Salem Journal reports (AP/Winston Salem Journal, 1/29).

Background

The rules were developed under a 2013 law (SL 2013-366) requiring the state Department of Health and Human Services to assess regulations for abortion providers and propose revised measures relating to safety, the Fayetteville Observer reports (Woolverton, Fayetteville Observer, 1/29). The proposed changes were announced in December, and the period for public comment closed Jan. 30 (Walton, Asheville Citizen-Times, 1/30).

Response to Proposal

Abortion-rights supporters opposed the underlying law out of concern that it would result in onerous restrictions that could force clinics to close. However, Democratic state lawmakers and abortion-rights groups said at a press conference last week that the state appears to have taken medical facts and patient safety into account and developed reasonable rules.

Planned Parenthood provided input on the rules (AP/Winston Salem Journal, 1/29). Under the proposal, clinics would be required to have a defibrillator on site, a 24-hour phone line to handle calls, quality assurance committees and emergency-transfer agreements with area hospitals.

State Rep. Rick Glazier (D) said he was "pleasantly surprised and happy at the process [DHHS] used" to create the rules (Campbell, Raleigh News & Observer, 1/29).

Obstetrician Matthew Zerden, who works with University of North Carolina hospitals, said, "It appears that the right balance was struck between protecting access to a critical reproductive health care service and overseeing clinic safety" (AP/Winston Salem Journal, 1/29).

State Rep. Susan Fisher (D) noted that there are already many barriers to abortion in North Carolina. Currently, there is no abortion provider in the western part of the state (Asheville Citizen-Times, 1/30).

Look Ahead

Conservative lawmakers have said the proposed regulations do not go far enough or follow the intent of the law. Two antiabortion-rights Republican lawmakers said on Thursday that they are considering proposing additional regulations but that they would probably be incremental revisions, as changes at this point would set back the implementation process, according to the AP/Journal (AP/Winston Salem Journal, 1/29).

Abortion-rights supporters in the state Legislature said they would oppose any efforts to add additional restrictions, if they arise. "It is time for the legislature to stay in its own lane and let the medical professionals do their jobs," Glazier said (Raleigh News & Observer, 1/29).


Ark. House Approves Measure To Restrict Medication Abortion

Thu, 02/05/2015 - 19:31

The Arkansas House on Monday voted 83-4 to approve a measure (HB 1076) that would require physicians to administer medication abortion drugs in person, the Southwest Times Record reports.

Ark. House Approves Measure To Restrict Medication Abortion

February 4, 2015 — The Arkansas House on Monday voted 83-4 to approve a measure (HB 1076) that would require physicians to administer medication abortion drugs in person, the Southwest Times Record reports.

The bill now heads to the state Senate for consideration. According to the Times Record, 20 of the 34 state senators are co-sponsoring the measure (Lyon, Southwest Times Record, 2/3).

Bill Details

The measure, introduced by state Rep. Julie Mayberry (R), would require providers to administer the drugs in person and "make all reasonable efforts" to see a woman who took the drugs within 12 to 18 days for a follow-up. The bill would allow the woman who received the abortion or the man involved in the pregnancy to sue a physician who does not follow the requirements (Women's Health Policy Report, 2/2).

Comments

During debate on the measure, Mayberry said the bill would preemptively ban the use of telemedicine in abortion care, which does not currently take place in the state (Southwest Times Record, 2/3).

Separately, state Rep. John Walker (D), who voted against the measure, said the bill would "mak[e] it very difficult for people of low means, where medical care is limited, to have equal access to health care" (Reed, AP/Gulfport Sun Herald, 2/2).