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Healthcare Prof:

Article Opinions:1 posts
Two New York Times editorials examine the existing “wars” over abortion within the states and within the federal government. Also, Center for Reproductive Rights President Nancy Northup addresses potential court challenges to state abortion legislation.

~ The Two Abortion Wars: A Highly Intrusive Federal Bill: The House Republican-backedbill (HR 3) “is so broad that it could block insurance coverage for abortions for countless American ladies,” the editorial states. According to the editorial, the bill “would bar outright the use of federal subsidies to buy any insurance that covers abortion, properly beyond” the ban on federal funding for abortion coverage within the new insurance exchanges. The editorial adds that the bill would prohibit tax credits for small businesses that present insurance to their employees from being utilised to buy wellness plans covering abortion and also would prohibit individuals who buy their own well being insurance from claiming a tax deduction for premiums of wellness plans covering abortion or the cost of an abortion. Further, men and women who use tax-preferred well being savings accounts would not be able to pay for an abortion with out paying taxes, the editorial says. The editorial calls the legislation and other efforts to restrict abortion access “far far more extreme” than other legislation proposed at the federal level, adding, “Lawmakers who otherwise rail against big government have made it 1 of their highest priorities to take the decision about a legal medical procedure out with the hands of individuals and turn it more than to the government” (New York Times, 1/29).

~ The Two Abortion Wars: State Battles More than Roe v. Wade: An increase inside the number of governors and legislatures that are “solidly anti-abortion” considerably raises the prospect of “extreme efforts to undermine abortion access with Big Brother measures that require physicians to read scripts about fetal development and offer ultrasound images, and that impose mandatory waiting periods or create other unnecessary regulations,” the editorial states. It specifically notes two efforts by antiabortion-rights activists — bans on health insurance coverage of abortion and on abortion later in pregnancy. On the latter problem, even though “[r]eigning Supreme Court precedent” restricts the government from banning abortion prior to what is considered viability — 22 to 26 weeks’ gestation — a brand new Nebraska law (LB 1103) challenges the “viability standard” by banning abortions after 20 weeks’ gestation, the editorial states. The objective with the Nebraska law and “[c]opycat laws” in other states would be to “provide the Supreme Court’s conservative majority with a brand new vehicle for further tampering with Roe v. Wade‘s insight that the choice about regardless of whether to terminate a pregnancy is best left to ladies and their doctors pre-viability.” The editorial concludes, “Americans who support women’s reproductive rights and oppose this kind of outrageous government intrusion need to respond with rising force and clarity to this real and immediate danger” (New York Times, 1/29).

~ In a letter towards the editor, Center for Reproductive Rights President Nancy Northup writes, “Anti-choice lawmakers across the country might be heralding a new era in which they plan to mount aggressive campaigns to limit abortion,” but those that oppose abortion rights “won’t necessarily have the last word.” She continues that within the last couple years, “anti-choice state legislators have pushed especially ambitious agendas, enacting some with the most extreme anti-choice legislation in current memory.” Nonetheless, “[j]udges have declared these laws unconstitutional” time following time, she says, because “[t]hey violate women’s rights by profoundly intruding on their private medical decisions and by imposing trumped-up regulations on abortion providers so they can no longer realistically present women’s services” (Northup, New York Times, 1/29).

Reprinted with kind permission from http://www.nationalpartnership.org. You can view the entire Daily Women’s Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women’s Wellness Policy Report is actually a free service with the National Partnership for Ladies & Families.

? 2010 National Partnership for Females & Families. All rights reserved.

five (3 votes)

Healthcare Prof:

5 (four votes)

Article Opinions:1 posts
Planned Parenthood’s Guttmacher Institute has disclosed that a Delaware abortion provider has admitted to greatly underreporting the number of abortions it performs every single year-including in statistics that it supplied to Delaware’s Department of Well being and Social Services (DHSS).

“For too long abortion providers have been allowed to practice with out regulation or safeguards, and it now appears that the scope of their operations has been hidden by false reports to government authorities, at the same time. Delawareans need to know the whole truth behind our state’s abortion industry.”

Surrounding evidence points in the scandal-plagued Atlantic Women’s Medical Services, which has recently been linked to indicted abortionist Kermit Gosnell and only this week was suspended from the national abortion provider network.

The Guttmacher Institute’s 2008 statistics also reveal that Delaware now has the highest abortion rate in the nation, at 40 abortions annually per 1,000 females aged 15 to 44. The state’s abortion rate is higher than those of New York, New Jersey, and California, long the leaders in abortion.

Guttmacher further states that 7,070 abortions were performed in Delaware in 2008 (the last year for which figures are available)1.

In its “Delaware Vital Statistics Annual Report 2008,” DHSS lists Delaware’s total number of abortions at 4,603, only 65% of Guttmacher’s total2.

In an attempt to discover the cause for the enormous discrepancy, Ellen Barrosse, President of A Rose and a Prayer (ARAAP), spoke yesterday to Dr. Rachel Jones, Senior Research Associate for the Guttmacher Institute. Dr. Jones confirmed that her researchers received data from each abortion provider in Delaware.

Dr. Jones revealed that for 2007 and 2008, 1 provider supplied numbers that had been substantially higher than the number it had given in previous years. When asked to explain the sudden and dramatic increase, the provider indicated that it had not been reporting all the abortions accomplished at the facility, and that the actual number of abortions had not increased at all.

That’s an additional 2,467 abortions per year, or more than 200 additional abortions per month.

Dr. Jones declined to identify the provider. The fact that abortions procured by Delaware residents increased by only 530, although abortions procured by out-of-state residents increased by almost 2,000, suggests that the provider that falsified its records is in New Castle County, which is nearer to large population centers in other states.

There are only two providers in New Castle County-Planned Parenthood of Delaware and Atlantic Women’s Medical Services.

Just across the state line from Pennsylvania, which requires that minors get parental consent for abortions, Delaware has long officially reported out-of-state abortions at approximately 25% with the total for the state. The new numbers supplied by Guttmacher indicate that 46%-almost half-of all abortions completed in Delaware are performed on out-of-state women-many of whom may be minors evading parental consent laws in their home states.

Unfortunately, due to the fact the Guttmacher statistics for Delaware don’t include age data and since the state data are clearly flawed, we don’t know how a lot of of those who seek abortions here are young girls trying to avoid their parents’ involvement.

Dr. Jones told Ms. Barrosse that a female staff member of DHSS spoke to her to make an effort to uncover the reason for the large discrepancy between Guttmacher’s numbers and DHSS’s. Dr. Jones said that she supplied the very same data to the caller as she did to A Rose and a Prayer, but DHSS has yet to update its numbers to reflect the details it received.

A Rose and a Prayer asks that Attorney General Beau Biden quickly investigate what appears to be a clear case of offering false details to a state agency by an abortion provider.

Ms. Barrosse stated that “Attorney General Biden needs to make use of his subpoena power to find out why DHSS was provided with materially false and misleading info and regardless of whether this was carried out to obscure from the General Assembly and also the community at large what has been going on in New Castle County’s abortion clinics.

“For too long abortion providers have been allowed to practice with no regulation or safeguards, and it now appears that the scope of their operations has been hidden by false reports to government authorities, also. Delawareans need to know the whole truth behind our state’s abortion industry.”

A Rose and a Prayer will probably be working with concerned members of Delaware’s General Assembly to determine how to deal using the revelation that Delaware has become a destination for abortions for minors from other states-and regardless of whether the State’s failure to regulate abortion clinics has led to this problem.

A Rose and a Prayer and its African-American Advisory Board will probably be holding a joint press conference at Theater N inside the Nemours Building (1007 N. Orange St., Wilmington, DE) on Friday, February 4th, at 10 AM.

1. See table from Guttmacher Institute’s Create a Table attached

2. Table D-13, page 140

Source:
Planned Parenthood’s Guttmacher Institute

2.33 (three votes)

Healthcare Prof:

4.67 (three votes)

Secretary Of State Urged To Amend Class Of Place For Abortions Says Sexual Health Charity FPA Reacting To Today’s High Court Judgement

Reacting to today’s ruling in the High Court that rejected the bpas legal challenge to re-interpret the 1967 Abortion Act to allow girls to take the second stage of a medical abortion at home, Julie Bentley, Chief Executive FPA said:

“Denying females the chance to complete the second stage of their abortion at home is out of touch with modern clinical practice. Following today’s judgement, we would urge the Secretary of State to amend the class of place exactly where abortions can take place as soon as is practically possible. Today’s NHS is about providing locally-based, cost-effective services tailored to patient needs. There’s no justifiable reason why ladies needing an abortion should be excluded from this. “

Source:
FPA

5 (two votes)

Healthcare Prof:

5 (two votes)

Rates of unintended pregnancies and abortions decrease significantly when ladies receive a one-year supply of oral contraceptives, instead of becoming prescribed one- or three-month supplies, a UCSF study shows.

Researchers observed a 30 percent reduction within the odds of pregnancy and a 46 percent decrease within the odds of an abortion in girls given a one-year supply of birth manage pills at a clinic versus ladies who received the standard prescriptions for one – or three-month supplies.

The researchers speculate that a larger supply of oral contraceptive pills may allow a lot more consistent use, given that females need to make fewer visits to a clinic or pharmacy for their next supply.

“Women need to have contraceptives on hand so that their use is as automatic as using safety devices in cars, ” said Diana Greene Foster, PhD, lead author and associate professor inside the UCSF Department of Obstetrics, Gynecology and Reproductive Sciences. “Providing 1 cycle of oral contraceptives at a time is similar to asking individuals to visit a clinic or pharmacy to renew their seatbelts each month.”

Foster also is director of investigation for Advancing New Standards in Reproductive Wellness, part of the UCSF Bixby Center for Global Reproductive Wellness. Her study’s findings appear online here.

The researchers linked 84,401 ladies who received oral contraceptives in January 2006 through Family members PACT (Planning, Access, Care, Treatment), a California loved ones planning program, to Medi-Cal data showing pregnancies and births in 2006. Via Loved ones PACT, some family preparing clinics are able to dispense a one-year supply of pills on-site.

Oral contraceptive pills are the most commonly utilised method of reversible contraception in the United States, the team states. Whilst extremely effective when used correctly (three pregnancies per 1,000 girls inside the very first year of use), approximately half of women regularly miss 1 or much more pills per cycle, a practice associated with a much higher pregnancy rate (80 pregnancies per 1,000 females within the initial year of use), in accordance with the team.

The findings of this study have implications for women using oral contraceptives across the country. Most oral contraceptive users in the United States get fewer than four packs at a time; nearly half need to return every month for resupply, in accordance with a 2010 study published in Contraception.

Making oral contraceptive pills far more accessible could reduce the incidence of unintended pregnancy and abortion, while saving taxpayers’ dollars, the researchers state. If the 65,000 women in the analysis who received either one or three packs of pills at a time had experienced the same pregnancy and abortion rates as girls who received a one-year supply, almost 1,300 publicly funded pregnancies and 300 abortions would have been averted, according to the team.

“The evidence indicates that health plans and public wellness programs may possibly steer clear of paying for costly unintended pregnancies by increasing dispensing limits on oral contraceptives,” stated Foster. “Improving access to contraceptive methods reduces the need for abortion and helps females to plan their pregnancies.”

Co-authors are Denis Hulett, Mary Bradsberry, Phillip Darney, MD, MSc, and Michael Policar, MD, MPH, all using the Bixby Center for Global Reproductive Wellness, UCSF Department of Obstetrics, Gynecology, and Reproductive Sciences, and San Francisco General Hospital.

Source:
Karin Rush-Monroe
University of California – San Francisco

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4.57 (7 votes)

Healthcare Prof:

5 (1 votes)

In the subsequent 20 years in large parts of China and India, there will likely be a 10% to 20% excess of young men due to sex selection and this imbalance will have societal repercussions, states an analysis in CMAJ (Canadian Medical Association Journal).

A preference for sons in China, India and South Korea combined with easy access to sex-selective abortions has led to a significant imbalance between the number of males and females born in these countries. The sex ratio at birth (SRB) – the number of boys born to every single 100 girls – is consistent in human populations in which about 105 males are born to every single 100 females. Nevertheless, with the advent of ultrasounds that enable sex-selection, the sex ratio at birth in some cities in South Korea climbed to 125 by 1992 and is more than 130 in numerous Chinese provinces from Henan inside the north to Hainan within the south.

In 2005 in China, “it was estimated that 1.1 million excess males had been born across the country and that the number of males below the age of 20 years exceeded the number of females by about 32 million,” writes Professor Therese Hesketh, UCL Centre for International Health and Development, London, United Kingdom with coauthors.

In India, similar disparities exist, with sex ratios as high as 125 in Punjab, Delhi and Gujarat within the north but normal sex ratios of 105 within the southern and eastern states of Kerala and Andhra Pradesh.

“A consistent pattern in all three countries is the marked trend related to birth order as well as the influence of the sex of the preceding child,” state the authors. If the initial or second born are girls, couples will often sex select to ensure the second or third child is really a boy.

The societal implications mean that a significant percentage of the male population will not be able to marry or have children as a result of a scarcity of women. In China, 94% of unmarried folks aged 28 to 49 are male, 97% of whom have not completed high school, and you can find worries the inability to marry will result in psychological problems and possibly increased violence and crime.

Policy makers in China, India and South Korea have taken some steps to address the problem, such as instituting laws forbidding fetal sex determination and selective abortion, but a lot more may be accomplished.

“To successfully address the underlying problem of son preference is hugely challenging and requires a multifaceted approach,” state the authors.

The relaxation of China’s one-child policy, especially in rural areas, could have some impact on sex ratios. But much more essential is to change underlying and long-standing attitudes towards son preference. Public awareness campaigns have had an impact. In South Korea and China, awareness campaigns have helped reduce the sex ratio at birth (for example, 118 in 1990 in South Korea to 109 in 2004).

“However, these incipient declines will not filter through to the reproductive age group for another two decades, and also the SRBs in these countries remain high. It is most likely to be several decades before the SRB in countries like India and China are within normal limits,” conclude the authors.

Link to Analysis

Source
Canadian Medical Association Journal

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1 (1 votes)

Healthcare Prof:

5 (3 votes)

Article Opinions:1 posts
Properly trained auxiliary nurse midwives and nurses can offer early medical abortions* as safely and effectively as doctors in developing countries, concludes an Article published Online Initial in The Lancet. These findings could expand women’s access to secure abortion services in developing countries where unmet need is greatest, and support save the lives of some of the estimated 47 000 females worldwide who die as a result of unsafe abortions every single year.

Nearly all (98%) of the 22 million unsafe abortions every single year take place in developing countries. Despite early first-trimester medical abortion getting a safe and effective alternative to surgical abortion, it remains underused in several developing countries partly due to the fact only doctors are currently authorised to administer medical abortion services. Even so, midlevel health-care workers including midwives and nurses could have an crucial role in expanding access to low-cost, life-saving abortion services in developing countries where abortion is legally permitted under broad conditions or on request and doctors are scarce.

Dr IK Warriner from the World Well being Organisation, Geneva, Switzerland and colleagues designed a trial to establish regardless of whether medical abortions could be provided as safely and effectively by midlevel healthcare workers as doctors in Nepal.

Between April 2009 and March 2010, girls searching for early abortion from five rural district hospitals in Nepal were randomly assigned to get medical abortion by a midlevel healthcare worker (542) or a doctor (535 ladies).

The clinical outcomes had been similar with 97.3% complete abortions performed by midlevel healthcare workers and 96.1% by doctors, and no serious complications were recorded.

The authors say: “Appropriately trained providers can administer safe, low-technology medical abortion services for girls who might otherwise turn to unsafe abortion, exposing themselves to the risks of disabilities and death.”

In a Comment, Yap-Seng Chong from the National University of Singapore in Singapore and Eng-Kien Tan from The National University Hospital, Singapore point out: “For many routine but potentially life-saving medical services, the best health-care provider might not always be a doctor. Encounter, commitment, training, and, most essential, availability are often more crucial than is actually a medical qualification. As we begin the countdown to 2015, task-shifting to midlevel health-care providers along with the upgrading of their skills to offer safer care in pregnancy and reproductive health could be important to achievement of the fifth UN Millennium Development Aim.”

*Early first-trimester medical abortion is available up to 9 week’s of pregnancy and involves the administration of two sets of pills, an antiprogestagen (mifepristone) followed by a prostaglandin analogue (usually misoprostol).

Link to Article and Comment

Source
The Lancet

five (3 votes)

Healthcare Prof:

2 (1 votes)

The National Collaborating Centre for Mental Health (NCCMH) in the Royal College of Psychiatrists is starting a 12-week consultation on a systematic review of the mental well being impact of induced abortion.

The review has been commissioned by the Academy of Medical Royal Colleges and is funded by the Department of Health. The review is being carried out by the NCCMH.

The purpose with the systematic review is to examine the evidence with the impact of abortion upon women’s mental wellness. Comments are invited on the overall quality with the report, search strategies, data synthesis, and interpretation of the evidence. Whilst the moral and ethical concerns relating to induced abortion are critical, they’re not within the brief of this review.

The consultation closes on Wednesday 29 June 2011, and all comments should be submitted by 5pm on this date.

Click here for far more details and to view the consultation documents.

Source:
Royal College of Psychiatrists

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