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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Pope Francis Urges Vigorous Debate Over Contraception, Other Issues at Meeting of Catholics

Thu, 10/09/2014 - 16:58

Pope Francis on Monday encouraged bishops, cardinals and priests gathered for a two-week meeting on the relationship between the church and the family to engage in a vigorous debate about contraception and other issues, AP/Fox News reports.

Pope Francis Urges Vigorous Debate Over Contraception, Other Issues at Meeting of Catholics

October 8, 2014 — Pope Francis on Monday encouraged bishops, cardinals and priests gathered for a two-week meeting on the relationship between the church and the family to engage in a vigorous debate about contraception and other issues, AP/Fox News reports.

Background

To help inform the debate on such issues, Francis last year sent a 39-point questionnaire to Catholic bishops' conferences around the globe, looking for input from lay Catholics and clergy (AP/Fox News, 10/6).

Its intention was to gain a better sense of how people understand and adhere to the church's teachings on contraception, divorce, sexuality and marriage.

The "vast majority" of respondents said the Vatican's moral evaluations on birth control methods are an "intrusion in the intimate life of the couple." In addition, many Catholics said they believe that the "concept of 'responsible parenthood'" means people should be given "the shared responsibility in conscience to choose the most appropriate method of birth control."

Many respondents also felt the church lacked the credibility to dictate their decisions. A report from the questionnaires read, "[T]he clergy sometimes feel so unsuited and ill-prepared to treat issues regarding sexuality, fertility and procreation that they often choose to remain silent" (Women's Health Policy Report, 6/30).

Details of Synod

The meeting, called a synod, will include 191 church dignitaries, in addition to about 60 experts and lay Catholics, according to the Los Angeles Times (Kington, Los Angeles Times, 10/5).

Addressing those gathered on Monday, Francis said, "You have to say what you feel the Lord tells you to say, without concerns of human respect and without fear." He also urged them to listen to their fellow participants "and welcome with an open heart what our brothers say."

Church reform groups have expressed optimism that the synod could lead to significant changes, particularly considering the pope's recent comments that the church needs to be more merciful and a "'field hospital' for wounded souls." However, conservative members of the Catholic Church have urged for the synod to not change doctrinal issues, but rather help to message the Church's stances to be better understood by lay Catholics (AP/Fox News, 10/6).

The synod will begin with a week of speeches, after which participants will hold private meetings on the issues involved before presenting the pope with a final document (Los Angeles Times, 10/5).

According to NPR's "Weekend Edition Sunday," the synod is the first stage of the process and a forum for discussions, but no formal decisions will be made until a second assembly convenes in a year (Poggioli, "Weekend Edition Sunday," NPR, 10/5).


Four Major U.S. Cities Have Thousands of Untested Rape Kits, Report Finds

Thu, 10/09/2014 - 16:57

Four major U.S. cities have thousands of untested rape kits in police storage facilities, according to data released Friday by the Joyful Heart Foundation, Reuters reports.

Four Major U.S. Cities Have Thousands of Untested Rape Kits, Report Finds

October 7, 2014 — Four major U.S. cities have thousands of untested rape kits in police storage facilities, according to data released Friday by the Joyful Heart Foundation, Reuters reports.

Background

According to Reuters, only a limited number of states -- but no federal agencies -- mandate that law enforcement track rape kit backlogs. Last month, President Obama signed into law the Debbie Smith Reauthorization Act of 2014 (HR 4323), which allocates $151 million annually through fiscal year 2019 to the Department of Justice to assist police departments with lowering their rape kit backlogs via a grant program.

Data Details, Findings

In a pro bono collaboration with law firms Goodwin Procter and Weil, Gotshal & Manges, the foundation acquired the data using public records requests. The data release is part of JHF's The Accountability Project, which aims to reveal the number of backlogged untested rape kits across the U.S. (Caspani, Reuters, 10/3).

The foundation found that Las Vegas reported 4,385 untested rape kits in police storage facilities, after only 16% of the rape kits collected from 2004 to 2014 were sent to be analyzed at a lab.

Meanwhile, the Milwaukee data showed that the city had a rape kit backlog of 2,655 (Joyful Heart Foundation release, 10/3). The Wisconsin Attorney General also reported that the state had an additional 3,351 untested rape kits.

In addition, Tulsa, Okla., records showed that the city had 3,783 untested rape kits that dated from 1989 to 2011.

Further, Seattle records indicated that the city had 1,276 untested rape kits, after only 22% of rape kits collected from 2004 to 2014 were sent to a crime lab for analysis.

Reaction

Sarah Tofte, director of policy and advocacy at the Joyful Heart Foundation, said, "This new data reminds us that we still have so much more to learn about the extent of the rape kit backlog in the United States."

Foundation founder Mariska Hargitay, an actress and advocate, added, "To me, the rape kit backlog is one of the clearest and most shocking demonstrations of how we regard sexual assault in our society. A rape kit can bring justice, so often an integral part of a survivor's healing. Testing rape kits sends a fundamental and crucial message to victims of sexual violence: You matter" (Reuters, 10/3).


Notre Dame Petitions Supreme Court To Review Challenge to Contraceptive Coverage Rules

Thu, 10/09/2014 - 16:56

The University of Notre Dame has asked the Supreme Court to review its case challenging the Affordable Care Act's (PL 111-148) contraceptive coverage rules, MSNBC reports.

Notre Dame Petitions Supreme Court To Review Challenge to Contraceptive Coverage Rules

October 8, 2014 — The University of Notre Dame has asked the Supreme Court to review its case challenging the Affordable Care Act's (PL 111-148) contraceptive coverage rules, MSNBC reports.

According to MSNBC, if the university or a similar plaintiff eventually wins their case, the scope of businesses that are allowed to claim religious exemptions from the law would grow significantly (Carmon, MSNBC, 10/7).

Background

HHS originally crafted an accommodation to the federal contraceptive coverage rules that allows not-for-profits with religious objections to contraception to avoid providing the coverage directly, while also ensuring that members of their health plans have access to the contraceptive coverage benefits under the ACA. The not-for-profits are required to inform HHS of their objections, but some objected to the process for doing so.

In August, HHS in an effort to address court challenges against the requirement announced a new rule that maintains the accommodation but creates a second way for those entities to provide notice of their objections. Under the new option, religiously affiliated not-for-profits can use the original accommodation or send a letter to HHS stating that they object to offering contraceptive coverage in their health plans. The rule took effect immediately upon publication, but HHS said it would take comments.

Notre Dame appealed case to the high court by Oct. 4 after a lower court denied its request for an injunction against the accommodation (Women's Health Policy Report, 9/18).

Appeal Details

Attorneys for Notre Dame asked the Supreme Court to require the lower courts to reconsider its case against the accommodation in light of the high court's ruling in the Hobby Lobby case (MSNBC, 10/7). In Hobby Lobby, the high court said closely held corporations cannot be required to provide contraceptive coverage to their employees if the corporations' owners have religious objections to contraception (Women's Health Policy Report, 6/30).

Notre Dame in its petition wrote that "[u]nder the accommodation, religious organizations must take actions that they believe make them complicit in the delivery of the very coverage they find objectionable." They added, "What may seem like an 'administrative' burden to a court may mean much more to a believer."

The university also argued that its continued decision to offer health insurance is an "exercise of religion," and that the contraceptive coverage rules do not serve a compelling public interest (MSNBC, 10/7).


Washington Post, USA Today: TRAP Laws' 'Real Goal' Is To Limit Abortion Access

Thu, 10/09/2014 - 16:54

Editorials from the Washington Post and USA Today argue that while abortion restrictions are often pushed by abortion-rights opponents as ways to protect women's health, the laws actually make women less safe.

Washington Post, USA Today: TRAP Laws' 'Real Goal' Is To Limit Abortion Access

October 9, 2014 — Editorials from the Washington Post and USA Today argue that while abortion restrictions are often pushed by abortion-rights opponents as ways to protect women's health, the laws actually make women less safe. Summaries of the pieces appear below.

~ Washington Post: "[T]here is little doubt" that the "rationale driving states' restrictive laws on abortion clinics -- the health of patients -- is a sham," a Post editorial states, arguing that the recent federal appeals court panel ruling on a Texas antiabortion-rights law (HB 2) "is a cautionary tale for other states where abortion rights are under assault." According to the editorial, "The effect of the ruling is that nearly a million women of reproductive age in the Lone Star State now live more than 150 miles from an abortion provider." Further, a "disproportionate number" of those women "live in poor, rural and heavily minority parts of the state, especially the Rio Grande Valley," and many now will "seek abortions, or abortion-inducing drugs, across the border in Mexico," which is likely to pose a "severe threat" to women's health, the Post adds. The editorial states, "The transparent agenda behind [such abortion restrictions] is to gut abortion rights that the Supreme Court extended in Roe v. Wade. That shouldn't be allowed to happen" (Washington Post, 10/8).

~ USA Today: While HB 2 and other laws requiring "that all providers have admitting privileges at a nearby hospital and maintain the same hospital-like standards as ambulatory surgery centers," might "sound reasonable on the surface ... a deeper look reveals the real goal: to make clinics so expensive to run, or standards so hard to attain, that clinics shut down," a USA Today editorial states. The editorial notes that having to travel long distances to the nearest abortion clinic as a result of such restrictions can be "an insurmountable obstacle ... for [women] with low-wage jobs, no paid sick days, child care issues or transportation problems." Further, the editorial states that with "clinics overloaded, more abortions will occur later, when earlier is safer" and that "[w]omen unable to travel might turn to dangerous alternatives." If the Supreme Court justices are asked to rule on the constitutionality of such restrictions, they "ought to recognize that a right burdened by so many unnecessary obstacles ceases at some point to be a right at all," the editorial says (USA Today, 10/8).


Texas Clinics Petition Supreme Court To Reinstate Injunction After HB 2 Ruling

Thu, 10/09/2014 - 16:54

Texas abortion clinics on Monday filed an emergency application asking the Supreme Court to reinstate an injunction against a provision of a Texas antiabortion-rights law (HB 2) that has left many women in the state hundreds of miles away from the nearest abortion provider, Politico reports.

Texas Clinics Petition Supreme Court To Reinstate Injunction After HB 2 Ruling

October 7, 2014 — Texas abortion clinics on Monday filed an emergency application asking the Supreme Court to reinstate an injunction against a provision of a Texas antiabortion-rights law (HB 2) that has left many women in the state hundreds of miles away from the nearest abortion provider, Politico reports.

If the request is approved, Texas abortion facilities that had been forced to close under the measure would be allowed to remain open as the court case proceeds (Haberkorn, Politico, 10/6).

Background

The 5th U.S. Circuit Court of Appeals on Thursday lifted a hold on a provision of HB 2, originally scheduled to take effect on Sept. 1, that requires abortion clinics to meet the same standards as ambulatory surgical centers.

Thirteen clinics were forced to close immediately to comply with the ruling, and there are no abortion clinics currently open to the west or south of San Antonio. All of the remaining providers are in Austin, Houston and two additional metropolitan areas (Women's Health Policy Report, 10/3).

Emergency Application Details

The Center for Reproductive Rights filed the emergency appeal on behalf of clinics forced to close under the provision.

According to the New York Times, the injunction argues that the ambulatory surgical center provision imposed an unconstitutional "undue burden" on women's abortion rights. Further, the injunction contends that the provision does not serve a medical purpose and has resulted in nearly one million Texas women of reproductive age being more than 150 miles from the nearest abortion facility (Eckholm, New York Times, 10/6).

Specifically, the request states, "Many women's constitutional rights will be extinguished before the appellate process runs its course, and their lives will be permanently and profoundly altered by the denial of abortion services" (Herskovitz, Reuters, 10/6).

Center for Reproductive Rights President and CEO Nancy Northup said, "Women's constitutional rights and access to safe, legal abortion care have been dealt a devastating blow. We look now to the U.S. Supreme Court to immediately reinstate the injunction, allow the clinics to reopen and put an end to the irreparable and unjustifiable harm to Texas women that is happening right now."

Potential for Injunction Approval, SCOTUS Hearing of Abortion Cases

According to Politico, it is not clear whether the Supreme Court will grant the request, or whether it would hear the full case if it were to be appealed to the high court.

However, if the high court were to consider the Texas law or one of several similar restrictions in other states, it would "mark the most significant Supreme Court" ruling on abortion since 2007, when it ruled on certain abortions performed later in pregnancy, Politico reports. According to Politico, such a ruling could "draw the line" between states' authority to regulate abortion and their responsibility to maintain access to the procedure.

Jennifer Dalven, director of the American Civil Liberties Union's Reproductive Freedom project, said the issue of state abortion restrictions "is crying out for Supreme Court resolution." She added that such restrictions have "mean[t] that for many, many women, the constitutional right to an abortion is just not a right anymore" (Politico, 10/6).


Last Texas Clinic West of San Antonio Stops Abortions After HB 2 Confusion; More Private Physician Offices Might Offer Abortions

Thu, 10/09/2014 - 16:46

The only abortion clinic in Texas currently open to the west of San Antonio has stopped performing abortions amid confusion following a federal appeals court ruling that allows the state to enforce a provision of an antiabortion-rights law (HB 2), the AP/Sacramento Bee reports.

Last Texas Clinic West of San Antonio Stops Abortions After HB 2 Confusion; More Private Physician Offices Might Offer Abortions

October 9, 2014 — The only abortion clinic in Texas currently open to the west of San Antonio has stopped performing abortions amid confusion following a federal appeals court ruling that allows the state to enforce a provision of an antiabortion-rights law (HB 2), the AP/Sacramento Bee reports (Carlos Llorca, AP/Sacramento Bee, 10/7).

Last week, the 5th U.S. Circuit Court of Appeals lifted a hold on a provision of HB 2, originally scheduled to take effect on Sept. 1, that requires abortion clinics to meet the same standards as ambulatory surgical centers.

Thirteen clinics were forced to close immediately to comply with the ruling, and the Center for Reproductive Rights filed an emergency appeal on the clinics' behalf (Women's Health Policy Report, 10/7).

Confusion Over Ruling

Immediately following the ruling, Hilltop Women's Reproductive Center in El Paso stopped performing abortions and referred women to another Hilltop-operated clinic about 10 miles from the city in Santa Teresa, New Mexico.

However, the Texas Department of State Health Services incorrectly told the clinic on Friday that it was exempt from the ruling and could continue providing abortions. According to the AP/Bee, the 5th Circuit panel's ruling had exempted a now-closed El Paso clinic, Reproductive Services, but not the El Paso Hilltop clinic.

The Hilltop clinic stopped offering abortions after learning it was not exempt. It will remain open to take phone calls and walk-ins, and will recommend that women seeking an abortion go to their New Mexico facility (AP/Sacramento Bee, 10/7).

Texas Women Might Seek More Abortions From Private Physicians' Offices

In related news, the HB 2 ruling might cause more women in Texas to seek abortions from physicians' offices, the Texas Tribune/Kaiser Health News reports.

According to the Texas Tribune/KHN, state law does not require a physicians' office to obtain an abortion license unless the provider performs more than 50 abortions per year. As a result, physicians' offices that do not have an abortion license are exempt from many of HB 2's provisions.

Dan Grossman -- principal investigator for the University of Texas at Austin's Texas Policy Evaluation Project -- said that abortions performed in physicians' offices might increase only slightly because few physicians currently perform the procedure.

However, Tony Dunn, a Waco ob-gyn and former steering committee chair for the Texas Women's Healthcare Coalition, said that the recent clinic closures could prompt more physicians to begin offering abortions. He said, "We'll have to wait and see whether physicians in underserved areas are going to step up and include that as part of the services that they offer" (Ura, Texas Tribune/Kaiser Health News, 10/7).


Washington Post, USA Today: TRAP Laws' 'Real Goal' Is To Limit Abortion Access

Thu, 10/09/2014 - 15:32

Editorials from the Washington Post and USA Today argue that while abortion restrictions are often pushed by abortion-rights opponents as ways to protect women's health, the laws actually make women less safe.

Washington Post, USA Today: TRAP Laws' 'Real Goal' Is To Limit Abortion Access

October 9, 2014 — Editorials from the Washington Post and USA Today argue that while abortion restrictions are often pushed by abortion-rights opponents as ways to protect women's health, the laws actually make women less safe. Summaries of the pieces appear below.

~ Washington Post: "[T]here is little doubt" that the "rationale driving states' restrictive laws on abortion clinics -- the health of patients -- is a sham," a Post editorial states, arguing that the recent federal appeals court panel ruling on a Texas antiabortion-rights law (HB 2) "is a cautionary tale for other states where abortion rights are under assault." According to the editorial, "The effect of the ruling is that nearly a million women of reproductive age in the Lone Star State now live more than 150 miles from an abortion provider." Further, a "disproportionate number" of those women "live in poor, rural and heavily minority parts of the state, especially the Rio Grande Valley," and many now will "seek abortions, or abortion-inducing drugs, across the border in Mexico," which is likely to pose a "severe threat" to women's health, the Post adds. The editorial states, "The transparent agenda behind [such abortion restrictions] is to gut abortion rights that the Supreme Court extended in Roe v. Wade. That shouldn't be allowed to happen" (Washington Post, 10/8).

~ USA Today: While HB 2 and other laws requiring "that all providers have admitting privileges at a nearby hospital and maintain the same hospital-like standards as ambulatory surgery centers," might "sound reasonable on the surface ... a deeper look reveals the real goal: to make clinics so expensive to run, or standards so hard to attain, that clinics shut down," a USA Today editorial states. The editorial notes that having to travel long distances to the nearest abortion clinic as a result of such restrictions can be "an insurmountable obstacle ... for [women] with low-wage jobs, no paid sick days, child care issues or transportation problems." Further, the editorial states that with "clinics overloaded, more abortions will occur later, when earlier is safer" and that "[w]omen unable to travel might turn to dangerous alternatives." If the Supreme Court justices are asked to rule on the constitutionality of such restrictions, they "ought to recognize that a right burdened by so many unnecessary obstacles ceases at some point to be a right at all," the editorial says (USA Today, 10/8).


Study: Robotic Surgery for Ovary, Cyst Removal Has Higher Costs, More Complications

Thu, 10/09/2014 - 15:32

Robotic surgery for removing ovaries and ovarian cysts results in a higher rate of complications and costs significantly more than regular minimally invasive surgery alternatives, according to a study published Tuesday in Obstetrics & Gynecology, the Wall Street Journal reports.

Study: Robotic Surgery for Ovary, Cyst Removal Has Higher Costs, More Complications

October 9, 2014 — Robotic surgery for removing ovaries and ovarian cysts results in a higher rate of complications and costs significantly more than regular minimally invasive surgery alternatives, according to a study published Tuesday in Obstetrics & Gynecology, the Wall Street Journal reports.

According to some experts, robotic surgery, which involves tiny incisions, offers such benefits as less blood loss, pain and postoperative pain medication compared with traditional open surgery. Other experts have argued that regular laparoscopic surgery has those same benefits and does not involve any additional investment like robotic surgery.

Study Details

For the study, researchers from Columbia University examined "records of more than 87,000 women who had their ovaries or ovarian cysts removed at 502 hospitals between 2009 and 2012." The researchers reviewed use of the da Vinci Surgical System, which consists of robotic arms equipped with surgical equipment that surgeons operate via computer.

Key Findings

The study found that 7.1% of patients who had their ovaries removed with robotic surgery experienced complications, compared with 6% of those who underwent regular laparoscopic surgery. Meanwhile, 3.7% of the women who had ovarian cysts removed using robotic surgery had complications, compared with 2.7% of those who had regular laparoscopy.

In addition, robotic surgery was more costly than laparoscopy for both procedures, according to the study. Specifically, compared with the laparoscopic method, ovary removal using robotic surgery was $2,504 more and cyst removal with robotic surgery cost $3,311 more (Beck, Wall Street Journal, 10/7).

The percentage of surgeries to remove ovaries that used robotic surgical equipment increased from 3.5% to 15% and jumped to 12.9% from 2.4% for ovarian cyst removal during the study period.

Lead study author Jason Wright said, "The big take-home point is that from a hospital's perspective, it's much, much, much more expensive" (Hernandez, "Capsules," Kaiser Health News, 10/7). He added, "People need to stop and critically analyze whether using this expensive technology will really add any benefit for patients" (Wall Street Journal, 10/7).


Sen. McCaskill Solicits Feedback From Mo. Schools on Legislation Addressing Campus Sexual Assault

Thu, 10/09/2014 - 14:45

Sen. Claire McCaskill (D-Mo.) visited the University of Missouri on Tuesday as part of a statewide tour to collect feedback on how to bolster the Campus Accountability and Safety Act (S 2692), which was introduced earlier this year, the AP/Washington Times reports.

Sen. McCaskill Solicits Feedback From Mo. Schools on Legislation Addressing Campus Sexual Assault

October 9, 2014 — Sen. Claire McCaskill (D-Mo.) visited the University of Missouri on Tuesday as part of a statewide tour to collect feedback on how to bolster the Campus Accountability and Safety Act (S 2692), which was introduced earlier this year, the AP/Washington Times reports (Ballentine, AP/Washington Times, 10/7).

Act's Details

The legislation would require every college and university in the U.S. to conduct an anonymous survey of students about their experiences with sexual assault on campus and post the results online.

In addition, the measure would increase penalties levied against schools that fail to address sexual assault on campus. The bill also would increase penalties under the Clery Act, a federal law that requires universities that receive federal funding to disclose campus crime information.

The measure also would mandate that universities designate an adviser to act as a confidential resource for students who have been sexually assaulted.

Under the bill, colleges would not be allowed to penalize students who in good faith reveal other violations, such as underage drinking, while reporting a sexual assault.

In addition, the bill would bar athletic departments or other campus groups from handling sexual assault complaints for participants in their own division. The bill also aims to coordinate response efforts with local law enforcement authorities (Women's Health Policy Report, 7/31).

Comments From McCaskill, Students

McCaskill said during the appearance, "The step that's most important is making sure students are in that room and students are aware and that students are fully participating, that students take on some ownership of improving this whole system."

Some students who attended the discussion said that policy changes are not enough to stop the assaults. University of Missouri Relationship & Sexual Violence Prevention Center Presentation Coordinator Kelsey Burns said she was sexually assaulted during her first week on campus and noted that survivors of such attacks often do not report the assaults because they fear they will be mistreated. She said she "didn't think it would matter" if she reported her assault.

The University of Missouri has been criticized for its handling of sexual assault cases in the past and recently implemented some changes to try to address the issue (AP/Washington Times, 10/7).


Abortion Clinics in Maine Seeing More Canadian Women

Wed, 10/08/2014 - 18:15

Abortion clinics in Maine have been serving more women from Canada after a reproductive health facility in Fredericton, New Brunswick, closed in July, CBC News reports.

Abortion Clinics in Maine Seeing More Canadian Women

October 8, 2014 — Abortion clinics in Maine have been serving more women from Canada after a reproductive health facility in Fredericton, New Brunswick, closed in July, CBC News reports.

Background

The Morgentaler Clinic, which performed about 600 abortions annually, was the only private clinic in the Maritimes. In April, it announced that it would shut down by the end of July because of a lack of government funding.

Under Regulation 84-20 of the New Brunswick Medical Services Payment Act, only abortions that are determined medically necessary by two physicians and performed in one of two hospitals are covered.

Effects of Closure

As a result of the clinic's closure, many New Brunswick women are seeking abortions in Maine. New Brunswick women accounted for about half of the 12 appointments at a clinic in Bangor last week.

According to CBC News, providers in the U.S. have been welcoming such women. Specifically, some clinics have been providing financial assistance to women who cannot afford the $500 fee.

Abortion Access Under Review

In the meantime, U.S. providers are urging premier-designate Brian Gallant to ensure access to abortion services in New Brunswick. Gallant said he plans to create a group of experts to address barriers to abortion (CBC News, 10/7).


Trial Date Set for La. Admitting Privileges Case; State Still Blocked From Enforcing Measure

Wed, 10/08/2014 - 18:14

The trial date for a federal judge to consider a lawsuit filed by Louisiana abortion clinics against the state's admitting privileges law (HB 388) has been set for March 30, the AP/Sacramento Bee reports.

Trial Date Set for La. Admitting Privileges Case; State Still Blocked From Enforcing Measure

October 8, 2014 — The trial date for a federal judge to consider a lawsuit filed by Louisiana abortion clinics against the state's admitting privileges law (HB 388) has been set for March 30, the AP/Sacramento Bee reports.

The lawsuit was originally filed by abortion facilities in Bossier City, Metairie and Shreveport, with clinics in Baton Rouge and New Orleans later joining the case (AP/Sacramento Bee, 10/8).

The law requires abortion providers at the five clinics in the state to have admitting privileges at hospitals within 30 miles of the facility where they practice. In September, U.S. District Judge John deGravelles said the law could take effect as scheduled on Sept. 1, but he granted a temporary restraining order that blocked the state from enforcing the law for now (Women's Health Policy Report, 9/3).

According to the AP/Bee, the temporary restraining order will continue to stay in effect while the underlying challenge to the law continues (AP/Sacramento Bee, 10/8).


Abortion Clinics in Maine Seeing More Canadian Women

Wed, 10/08/2014 - 14:52

Abortion clinics in Maine have been serving more women from Canada after a reproductive health facility in Fredericton, New Brunswick, closed in July, CBC News reports.

Abortion Clinics in Maine Seeing More Canadian Women

October 8, 2014 — Abortion clinics in Maine have been serving more women from Canada after a reproductive health facility in Fredericton, New Brunswick, closed in July, CBC News reports.

Background

The Morgentaler Clinic, which performed about 600 abortions annually, was the only private clinic in the Maritimes. In April, it announced that it would shut down by the end of July because of a lack of government funding.

Under Regulation 84-20 of the New Brunswick Medical Services Payment Act, only abortions that are determined medically necessary by two physicians and performed in one of two hospitals are covered.

Effects of Closure

As a result of the clinic's closure, many New Brunswick women are seeking abortions in Maine. New Brunswick women accounted for about half of the 12 appointments at a clinic in Bangor last week.

According to CBC News, providers in the U.S. have been welcoming such women. Specifically, some clinics have been providing financial assistance to women who cannot afford the $500 fee.

Abortion Access Under Review

In the meantime, U.S. providers are urging premier-designate Brian Gallant to ensure access to abortion services in New Brunswick. Gallant said he plans to create a group of experts to address barriers to abortion (CBC News, 10/7).


Young Pregnant Woman Are Not Receiving Proper Oral Health Care, Study Finds

Wed, 10/08/2014 - 14:52

Young pregnant women on average have worse oral health and had gone to the dentist less recently than several other groups, according to a study published in CDC's Preventing Chronic Disease, Reuters reports.

Young Pregnant Woman Are Not Receiving Proper Oral Health Care, Study Finds

October 8, 2014 — Young pregnant women on average have worse oral health and had gone to the dentist less recently than several other groups, according to a study published in CDC's Preventing Chronic Disease, Reuters reports.

Background

According to Peter Milgrom -- a professor of Dental Public Health Sciences and Pediatric Dentistry at the University of Washington's School of Dentistry -- gum disease during pregnancy has been found to be associated with certain pregnancy outcomes, including low birth weight and premature birth. In addition, Milgrom, who was not involved in the study, said that hormonal changes during pregnancy can lead to an increased risk of gingivitis and other oral health problems.

Study Details

For the study, researchers analyzed data from the 1999 to 2004 National Health and Nutrition Examination Surveys. The results included 897 pregnant women and 3,971 nonpregant women ages 15 to 44. The researchers evaluated survey responses to three questions, in which women evaluated the health of their teeth and mouth, when they had last gone to the dentist and why they last went to the dentist (Doyle, Reuters, 10/3).

Key Findings

The study found that 57% of pregnant women ages 15 to 24 said their teeth were in good condition, compared with 86% of pregnant women ages 35 to 44. However, the trend reversed among nonpregnant women, with 75% of nonpregnant women ages 15 to 24 saying their teeth were in good condition, compared with 67% of nonpregnant women ages 35 to 44 (Azofeifa, Preventing Chronic Disease, 9/18).

In addition, the study also found that young pregnant women are less likely than young nonpregnant women to report having gone to a dentist during the past year. Further, among both pregnant and nonpregnant women, those with higher family incomes or higher education levels were more likely to report having gone to the dentist to receive preventive care.

Comments, Recommendations

Senior study author Eugenio Beltrán-Aguilar of CDC said, "There are still some OB/GYNs and dentists who hesitate to give pregnant women dental treatment for fear of putting the child or mother at risk." However, he said that there is "no evidence that dental treatment harms the woman in any way."

He added that the findings on dental health disparities among certain groups, including minorities and low-income women, match "what we see with other aspects of health disparities as well."

Beltrán-Aguilar recommended that women schedule an appointment with a dentist shortly after confirming the pregnancy.

In addition, the study authors recommended that providers use prenatal visits to meet with pregnant women, evaluate their oral health and discuss the importance of dental health to health care overall (Reuters, 10/3).


Pope Francis Urges Vigorous Debate Over Contraception, Other Issues at Meeting of Catholics

Wed, 10/08/2014 - 14:51

Pope Francis on Monday encouraged bishops, cardinals and priests gathered for a two-week meeting on the relationship between the church and the family to engage in a vigorous debate about contraception and other issues, AP/Fox News reports.

Pope Francis Urges Vigorous Debate Over Contraception, Other Issues at Meeting of Catholics

October 8, 2014 — Pope Francis on Monday encouraged bishops, cardinals and priests gathered for a two-week meeting on the relationship between the church and the family to engage in a vigorous debate about contraception and other issues, AP/Fox News reports.

Background

To help inform the debate on such issues, Francis last year sent a 39-point questionnaire to Catholic bishops' conferences around the globe, looking for input from lay Catholics and clergy (AP/Fox News, 10/6).

Its intention was to gain a better sense of how people understand and adhere to the church's teachings on contraception, divorce, sexuality and marriage.

The "vast majority" of respondents said the Vatican's moral evaluations on birth control methods are an "intrusion in the intimate life of the couple." In addition, many Catholics said they believe that the "concept of 'responsible parenthood'" means people should be given "the shared responsibility in conscience to choose the most appropriate method of birth control."

Many respondents also felt the church lacked the credibility to dictate their decisions. A report from the questionnaires read, "[T]he clergy sometimes feel so unsuited and ill-prepared to treat issues regarding sexuality, fertility and procreation that they often choose to remain silent" (Women's Health Policy Report, 6/30).

Details of Synod

The meeting, called a synod, will include 191 church dignitaries, in addition to about 60 experts and lay Catholics, according to the Los Angeles Times (Kington, Los Angeles Times, 10/5).

Addressing those gathered on Monday, Francis said, "You have to say what you feel the Lord tells you to say, without concerns of human respect and without fear." He also urged them to listen to their fellow participants "and welcome with an open heart what our brothers say."

Church reform groups have expressed optimism that the synod could lead to significant changes, particularly considering the pope's recent comments that the church needs to be more merciful and a "'field hospital' for wounded souls." However, conservative members of the Catholic Church have urged for the synod to not change doctrinal issues, but rather help to message the Church's stances to be better understood by lay Catholics (AP/Fox News, 10/6).

The synod will begin with a week of speeches, after which participants will hold private meetings on the issues involved before presenting the pope with a final document (Los Angeles Times, 10/5).

According to NPR's "Weekend Edition Sunday," the synod is the first stage of the process and a forum for discussions, but no formal decisions will be made until a second assembly convenes in a year (Poggioli, "Weekend Edition Sunday," NPR, 10/5).


Notre Dame Petitions Supreme Court To Review Challenge to Contraceptive Coverage Rules

Wed, 10/08/2014 - 14:51

The University of Notre Dame has asked the Supreme Court to review its case challenging the Affordable Care Act's (PL 111-148) contraceptive coverage rules, MSNBC reports.

Notre Dame Petitions Supreme Court To Review Challenge to Contraceptive Coverage Rules

October 8, 2014 — The University of Notre Dame has asked the Supreme Court to review its case challenging the Affordable Care Act's (PL 111-148) contraceptive coverage rules, MSNBC reports.

According to MSNBC, if the university or a similar plaintiff eventually wins their case, the scope of businesses that are allowed to claim religious exemptions from the law would grow significantly (Carmon, MSNBC, 10/7).

Background

HHS originally crafted an accommodation to the federal contraceptive coverage rules that allows not-for-profits with religious objections to contraception to avoid providing the coverage directly, while also ensuring that members of their health plans have access to the contraceptive coverage benefits under the ACA. The not-for-profits are required to inform HHS of their objections, but some objected to the process for doing so.

In August, HHS in an effort to address court challenges against the requirement announced a new rule that maintains the accommodation but creates a second way for those entities to provide notice of their objections. Under the new option, religiously affiliated not-for-profits can use the original accommodation or send a letter to HHS stating that they object to offering contraceptive coverage in their health plans. The rule took effect immediately upon publication, but HHS said it would take comments.

Notre Dame appealed case to the high court by Oct. 4 after a lower court denied its request for an injunction against the accommodation (Women's Health Policy Report, 9/18).

Appeal Details

Attorneys for Notre Dame asked the Supreme Court to require the lower courts to reconsider its case against the accommodation in light of the high court's ruling in the Hobby Lobby case (MSNBC, 10/7). In Hobby Lobby, the high court said closely held corporations cannot be required to provide contraceptive coverage to their employees if the corporations' owners have religious objections to contraception (Women's Health Policy Report, 6/30).

Notre Dame in its petition wrote that "[u]nder the accommodation, religious organizations must take actions that they believe make them complicit in the delivery of the very coverage they find objectionable." They added, "What may seem like an 'administrative' burden to a court may mean much more to a believer."

The university also argued that its continued decision to offer health insurance is an "exercise of religion," and that the contraceptive coverage rules do not serve a compelling public interest (MSNBC, 10/7).


Trial Date Set for La. Admitting Privileges Case; State Still Blocked From Enforcing Measure

Wed, 10/08/2014 - 14:50

The trial date for a federal judge to consider a lawsuit filed by Louisiana abortion clinics against the state's admitting privileges law (HB 388) has been set for March 30, the AP/Sacramento Bee reports.

Trial Date Set for La. Admitting Privileges Case; State Still Blocked From Enforcing Measure

October 8, 2014 — The trial date for a federal judge to consider a lawsuit filed by Louisiana abortion clinics against the state's admitting privileges law (HB 388) has been set for March 30, the AP/Sacramento Bee reports.

The lawsuit was originally filed by abortion facilities in Bossier City, Metairie and Shreveport, with clinics in Baton Rouge and New Orleans later joining the case (AP/Sacramento Bee, 10/8).

The law requires abortion providers at the five clinics in the state to have admitting privileges at hospitals within 30 miles of the facility where they practice. In September, U.S. District Judge John deGravelles said the law could take effect as scheduled on Sept. 1, but he granted a temporary restraining order that blocked the state from enforcing the law for now (Women's Health Policy Report, 9/3).

According to the AP/Bee, the temporary restraining order will continue to stay in effect while the underlying challenge to the law continues (AP/Sacramento Bee, 10/8).


Featured Blogs

Tue, 10/07/2014 - 17:27

"'Students for Life' Tries To Shut Down Sex Week at the University of New Mexico," (Marcotte, RH Reality Check, 10/6); "The Worst Phone Call of My Career: I'm Sorry Clinics, You Have to Close," (Amiri, "Blog of Rights," American Civil Liberties Union, 10/3); "More Than 3,000 People Have Signed Up for the First Online Abortion Class," (Culp-Ressler, "ThinkProgress," Center for American Progress, 10/6).

October 7, 2014

FEATURED BLOG

"'Students for Life' Tries To Shut Down Sex Week at the University of New Mexico," Amanda Marcotte, RH Reality Check: Marcotte recaps the controversy around "what should be an utter non-controversy at the University of New Mexico: The fact that sex was being talked about during Sex Week," She writes that while the week's events had "racy titles and content," the reason for them "is simple enough: It's a way to draw attention to material that actually offers serious lessons about safety and consent." However, she notes, "Anti-choice activists have been at the forefront" of the backlash and "ire -- even though abortions didn't get a single mention in the program schedule," with Students for Life Vice President Sade Patterson instead urging "a workshop on 'how to say no' or how to handle a date-rape situation." Marcotte concludes that comments by such groups are representative of "the anti-choice movement in a nutshell: The belief that sex is 'gross,' and that should be reason enough for you to screw up other people's lives in a futile effort to make them stop doing it" (Marcotte, RH Reality Check, 10/6).

FEATURED BLOG

"The Worst Phone Call of My Career: I’m Sorry Clinics, You Have to Close," Brigitte Amiri, American Civil Liberties Union's "Blog of Rights:" Amiri, of the American Civil Liberties Union's Freedom Project, writes that she "had to make a phone call ... that [she has] been dreading [her] entire career," in which she was forced to tell "amazing abortion clinics" that they had to "close their doors after serving Texas women for more than 30 years." The clinics had to close after an appeals court allowed Texas' sweeping antiabortion-rights law (HB 2) to take effect. A provision of the law "requires abortion clinics to make medically unnecessary and prohibitively costly renovations" that left just "eight abortion clinics" operating in a state that is "home to more than 5.5 million women of childbearing age." Amiri explains that "[a]ll other clinics have been forced to immediately shut down, including two of" the Freedom Project's clients. Amiri concludes that she "can only hope that justice will prevail eventually and that [the clinics] will be able to go back to providing high quality care that women need and deserve" (Amiri, "Blog of Rights," American Civil Liberties Union, 10/3).

What others are saying about abortion restrictions:

~ "Fifth Circuit Allows More Limits on Abortion in Texas," Lyle Denniston, SCOTUSblog.

~ "Closing Down Abortion Clinics, Giving Fetuses Lawyers," Andrew Rosenthal, New York Times' "Taking Note."

 

FEATURED BLOG

"More Than 3,000 People Have Signed Up for the First Online Abortion Class," Tara Culp-Ressler, Center for American Progress' "ThinkProgress": More than 3,000 people have registered for the "first online course on abortion care that's ever been offered by a U.S. school," Culp-Ressler writes, adding that the course's creator -- Jody Steinauer from the University of California-San Francisco -- wants to "dedicate more time to a topic that often gets overlooked in medical school." The online class will include lectures from more than 20 faculty members from different institutions to "'place abortion within the context of public health and fill in the gaps left by its exclusion from mainstream curricula in health professions,'" according to the course description. While it is "possible that Steinauer's course will spark some pushback," it also "could make a big difference for female patients who want to be able to talk to their health providers about the procedure," Culp-Ressler writes (Culp-Ressler, "ThinkProgress," Center for American Progress, 10/6).


UCSF To Offer Online Class Addressing Abortion Access and Care

Tue, 10/07/2014 - 17:21

The University of California-San Francisco, for the first time ever among U.S. universities, is offering an online class focused on abortion care and access, the Daily Beast reports.

UCSF To Offer Online Class Addressing Abortion Access and Care

October 7, 2014 — The University of California-San Francisco, for the first time ever among U.S. universities, is offering an online class focused on abortion care and access, the Daily Beast reports.

Background

According to a 2005 review published in the American Journal of Obstetrics & Gynecology, less than one-third of U.S. medical schools offered at least one lecture focused on abortion during students' clinical years. In addition, a 2009 survey published in Contraception found that one-third of medical schools in North America excluded abortion education in preclinical courses.

Jody Steinauer, director of the new course, which will be offered at no cost, said abortion is often not taught because of a misconception that the procedure is uncommon. Further some professors "fee[l] safer" not discussing abortion because it "sometimes makes people feel emotional," Steinauer said.

Class Details

The class, titled "Abortion: Quality Care and Public Health Implications," runs over six weeks starting Oct. 13, and it will be offered via the online platform Coursera. The course will focus on abortion care during and after the first trimester before addressing obstacles that hinder access to safe abortion and abortion access worldwide.

Steinauer said, "I think that if we can inspire even a small portion of the people who take the course to take steps in their communities to increase access to safe abortion and decrease stigma about abortion, then we have been totally successful."

According to Steinauer, more than 3,000 people have enrolled in the class so far. She added that offering it online will allow for a "global audience of learners" rather than restricting it to students in the U.S. She noted that it is important that the class has a global reach because about 13% of maternal deaths worldwide are associated with unsafe abortions (Allen, Daily Beast, 10/6).


Mo. 72-Hour Mandatory Delay Likely To Take Effect Without Legal Challenges

Tue, 10/07/2014 - 17:21

Missouri's lone abortion clinic is not expected to challenge a new state law (HR 1307) that requires a 72-hour mandatory delay before women seeking abortions can obtain the procedure, the AP/Sacramento Bee reports.

Mo. 72-Hour Mandatory Delay Likely To Take Effect Without Legal Challenges

October 7, 2014 — Missouri's lone abortion clinic is not expected to challenge a new state law (HR 1307) that requires a 72-hour mandatory delay before women seeking abortions can obtain the procedure, the AP/Sacramento Bee reports.

The law is scheduled to take effect on Friday (Lieb, AP/Sacramento Bee, 10/5).

The law triples the state's current mandatory delay of 24 hours and does not allow exceptions in cases of rape or incest. Women with medical emergencies are exempt under the 24-hour mandatory delay and will continue to be exempt under the new legislation. The law also includes a provision that will require the state to revert to the 24-hour delay if a court strikes down the 72-hour delay (Women's Health Policy Report, 9/29).

Planned Parenthood, ACLU Unlikely To File Suit

According to the AP/Bee, Planned Parenthood and the American Civil Liberties Union have both indicated that they will not file suit because they think they are unlikely to win a legal challenge against the law before it goes into effect.

Planned Parenthood of the St. Louis Region and Southwest Missouri President Paula Gianino said, "We've had our national attorneys from all of the leading women's health organizations in the country work with us, and we have a consensus that we do not have a route at this time to go to court and to stop this law from going into effect -- as disappointing and as frustrating as that is."

Similarly, an ACLU attorney said the group, which has before challenged abortion restrictions, does not plan to try to block the law before it takes effect.

However, the groups' officials said they are still open to challenging the law after it takes effect. ACLU attorney Tony Rothert said to do so, the organizations would have to locate a woman who is willing to serve as a plaintiff in the case, such as a woman who became pregnant as the result of rape or incest and was particularly burdened by the mandatory delay.

Meanwhile, Denise Burke, vice president of legal affairs for Americans United for Life, said such delays "have been consistently upheld as constitutional by the U.S. Supreme Court and other federal and state courts" (AP/Sacramento Bee, 10/5).


Texas Clinics Petition Supreme Court To Reinstate Injunction After HB 2 Ruling

Tue, 10/07/2014 - 17:20

Texas abortion clinics on Monday filed an emergency application asking the Supreme Court to reinstate an injunction against a provision of a Texas antiabortion-rights law (HB 2) that has left many women in the state hundreds of miles away from the nearest abortion provider, Politico reports.

Texas Clinics Petition Supreme Court To Reinstate Injunction After HB 2 Ruling

October 7, 2014 — Texas abortion clinics on Monday filed an emergency application asking the Supreme Court to reinstate an injunction against a provision of a Texas antiabortion-rights law (HB 2) that has left many women in the state hundreds of miles away from the nearest abortion provider, Politico reports.

If the request is approved, Texas abortion facilities that had been forced to close under the measure would be allowed to remain open as the court case proceeds (Haberkorn, Politico, 10/6).

Background

The 5th U.S. Circuit Court of Appeals on Thursday lifted a hold on a provision of HB 2, originally scheduled to take effect on Sept. 1, that requires abortion clinics to meet the same standards as ambulatory surgical centers.

Thirteen clinics were forced to close immediately to comply with the ruling, and there are no abortion clinics currently open to the west or south of San Antonio. All of the remaining providers are in Austin, Houston and two additional metropolitan areas (Women's Health Policy Report, 10/3).

Emergency Application Details

The Center for Reproductive Rights filed the emergency appeal on behalf of clinics forced to close under the provision.

According to the New York Times, the injunction argues that the ambulatory surgical center provision imposed an unconstitutional "undue burden" on women's abortion rights. Further, the injunction contends that the provision does not serve a medical purpose and has resulted in nearly one million Texas women of reproductive age being more than 150 miles from the nearest abortion facility (Eckholm, New York Times, 10/6).

Specifically, the request states, "Many women's constitutional rights will be extinguished before the appellate process runs its course, and their lives will be permanently and profoundly altered by the denial of abortion services" (Herskovitz, Reuters, 10/6).

Center for Reproductive Rights President and CEO Nancy Northup said, "Women's constitutional rights and access to safe, legal abortion care have been dealt a devastating blow. We look now to the U.S. Supreme Court to immediately reinstate the injunction, allow the clinics to reopen and put an end to the irreparable and unjustifiable harm to Texas women that is happening right now."

Potential for Injunction Approval, SCOTUS Hearing of Abortion Cases

According to Politico, it is not clear whether the Supreme Court will grant the request, or whether it would hear the full case if it were to be appealed to the high court.

However, if the high court were to consider the Texas law or one of several similar restrictions in other states, it would "mark the most significant Supreme Court" ruling on abortion since 2007, when it ruled on certain abortions performed later in pregnancy, Politico reports. According to Politico, such a ruling could "draw the line" between states' authority to regulate abortion and their responsibility to maintain access to the procedure.

Jennifer Dalven, director of the American Civil Liberties Union's Reproductive Freedom project, said the issue of state abortion restrictions "is crying out for Supreme Court resolution." She added that such restrictions have "mean[t] that for many, many women, the constitutional right to an abortion is just not a right anymore" (Politico, 10/6).