Archive for the 'Reproductive Health' Category

After 39 Years, Let’s End the War on Women

Published on January 22, 2012 in Debra Ness and Reproductive Health. 5 Comments

Debra Ness, President, National Partnership

It’s been 39 years since the U.S. Supreme Court decided Roe v. Wade – but the battles over access to the full range of reproductive health care services still rage on.

In 2011, the number of abortion restrictions introduced in state legislatures reached a three-decade high. But such laws – like the ultrasound law in Texas, which requires providers to perform ultrasounds, describe the fetus and give women the option to hear the fetal heartbeat – aren’t just problematic in that they put barriers between women and their health care.  They are affirmatively bad for women’s health. They require unnecessary and invasive procedures not recommended by doctors. This is especially problematic when women are directed or tricked into seeking care at crisis pregnancy centers – which often have no qualified medical professionals on staff.

Women deserve sound medical advice from actual medical professionals.

The Texas sonogram law is just one example of the attacks on women’s reproductive health over the past year. They have been far-reaching and dangerous – and anti-choice extremists show no signs of letting up.

Not only is access to abortion services out of reach for many women, but so is birth control, maternity care, and social services to help them raise healthy families. It’s time to recommit to protecting and expanding common sense policies that improve women’s health by providing access to affordable, high quality reproductive health services. The National Partnership has joined the Trust Women Silver Ribbon Campaign virtual march to make sure our elected officials know that restricting women’s health services is unacceptable. Join us!

Birth Control Under Attack

Published on November 22, 2011 in Debra Ness and Reproductive Health. 5 Comments

Debra Ness, President, National Partnership

Anti-choice extremists are trying to undermine women’s right to birth control under the Affordable Care Act. The health reform law covers preventive services, including birth control, without copays, deductibles or other added cost. For most women of reproductive age, contraception and birth control are the care they need most, the care they get most regularly, and their main reason for interacting with health providers, so this is one of the greatest benefits to women from the new law.

We were thrilled in August when the Department of Health and Human Services (HHS) agreed and announced that women will have access to all approved contraceptive methods without co-pays or added cost under the Affordable Care Act.

But all women need this coverage. The administration included an unfair, broad — and potentially terribly harmful — exemption for certain religious employers, who would not have to provide coverage for contraception to their employees.

Too much is on the line for these women who rely on insurance to pay for their birth control. That’s why we’re urging President Obama to do what’s right for women’s health — to remove this religious refusal provision and not leave any women behind.

Tell President Obama that all women need access to contraception without co-pays or added cost, including women who work for religious employers!

Let’s not leave any woman to fend for herself.

In Science v. Politics, Science Scores a Win

Published on July 21, 2011 in Debra Ness, Health Care, Reform and Reproductive Health. 0 Comments

Debra Ness, President

A milestone for women’s health is finally within reach: On Tuesday, the Institute of Medicine (IOM) identified the full range of FDA-approved contraception and birth control options as preventive health services – and recommended that they be made available to women without additional fees or co-payment under health care reform. IOM’s decision, which was based on strong scientific evidence, finally confirms what most women already know: that birth control is basic preventive care.

Preventive care is at the heart of the Affordable Care Act, so IOM’s recommendation is an encouraging step toward realizing the promise of health care reform for women. For most women of reproductive age, contraception and birth control are the care they need most, the care they get most regularly, and their main reason for interacting with health providers and thereby receiving other kinds of health care they need. Timely access to contraceptive services vastly improves maternal and child health, and it has been the driving force in reducing rates of unintended pregnancy in this country.

On average, women spend at least 30 years being sexually active but trying to avoid pregnancy. But with 30 years of fertility comes 30 years of expensive contraception – and studies show that even minimal co-pays deter individuals from obtaining the care they need. [1] In fact, one study found that low-income Americans reduced their use of effective health care by 44 percent when required to make co-pays. [2] In 2008, 36 million women — more than half of women of reproductive age — needed contraceptive services and supplies. [3] Of that group, 17.4 million needed publicly funded contraception. [4] For these women, eliminating expensive co-pays is the key to ensuring they have access to the care they need. So IOM’s recommendation is vital to the health of millions of individual women — and of our country as a whole.

At long last, it’s time to put politics aside. These science-based recommendations must guide policy, and politics should not intrude.  Secretary Sebelius should move quickly to make these recommendations policy under the Affordable Care Act, so women are able to access the contraceptive services they truly need. It’s about time.

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[1] Solanki G and Schauffler HH, Cost-sharing and the utilization of clinical preventive services, Am J Prev Medicine 17, no.2 (Aug 1999) 127-133.
[2] Ku L, Charging the Poor More for Health Care: Cost-Sharing in Medicaid, Washington, DC: Center on Budget and Policy Priorities, 2003.
[3] Frost JJ, Henshaw SK and Sonfield A, Contraceptive needs and services: national and state data, 2008 update, New York: Guttmacher Institute, 2010.
[4] Frost JJ, Henshaw SK and Sonfield A, Contraceptive needs and services: national and state data, 2008 update, New York: Guttmacher Institute, 2010.

Cause for Hope in North Carolina

Published on July 12, 2011 in Lee Partridge and Reproductive Health. 1 Comment

Lee Partridge, Senior Health Policy Advisor

Infant mortality rates are widely used in this country and internationally as a barometer of the quality of a community’s, or a nation’s, health care system – and with good reason. Despite our sophisticated and expensive health resources, the infant mortality rate in the United States is significantly higher than that of many other countries.  In 2005, for example, our infant mortality rate of 6.9 per thousand births put us above that of most European countries, Canada, Australia, New Zealand, Hong Kong, Singapore, Japan and Israel.[1]

Our maternal mortality rate – the measure of women dying in childbirth – is also shockingly high compared to that of European countries.  What’s worse, it is rising.  In 1990 in the United States, 343 women died in childbirth; by 2007 that number had increased to 548.[3] A report[4] released July 6 by the National Institute of Child Health and Human Development documents some progress on reducing the incidence of preterm birth, down from 12.8 percent in 2006 to 12.2 percent in 2009.  But that rate is still woefully behind the U.S. Healthy People 2010 target of 7.6 percent of all live births.

Taken together, these statistics should be a cause of major concern and inspire action to reverse that trend.

One state, North Carolina, has set out to address these problems.  In March, North Carolina opened a Pregnancy Medical Home program for women eligible for Medicaid.   Working with their medical community, local health departments, and a network of community support organizations called Community Care of North Carolina (CCNC), state health leaders combined payment incentives and specific care requirements into a package they believe will improve pregnancy outcomes throughout the state.

Here’s how the new program works.

Maternity care providers – obstetricians, family practitioners, nurse midwives, community clinics – can apply to be designated as a Pregnancy Medical Home.  They must agree to do four things:

  1. At the first obstetric visit, administer a standardized pregnancy risk tool that provides not only clinical health history but other information about the woman and her situation that could indicate she is at risk of a poor outcome.  The questions include poor nutrition, smoking status, use of alcohol or possible physical violence.   If a women looks like a high risk, the provider must contact his or her CCNC network and arrange for care management services for that patient throughout her pregnancy.  The provider and patient also develop a plan for managing her care.
  2. Ensure that none of the providers in the Pregnancy Medical Home perform “elective” deliveries – deliveries for which there is no medical reason to induce labor — prior to 39 weeks of gestation.  Early deliveries increase the likelihood of infant death, admission to a Neonatal Intensive Care Unit, or life-long health problems for the child.
  3. Provide the drug 17 alpha hydroxyprogesterone caproate (commonly called 17P) to patients at risk of preterm delivery.
  4. Aim for a caesarean-section rate for low-risk, singleton births below 20 percent.  C-sections expose both mother and child to surgical risk and possible infection, and can create complications for future pregnancies.

To encourage providers to enroll in the Pregnancy Medical Home program, the state Medicaid agency will pay Pregnancy Medical Home practices $200 more per patient over the state’s usual maternity fee.  $50 of this money is paid upon completion of the pregnancy risk tool, and the remaining $150 for managing the care is paid once the women has had her post-partum visit.  The post-partum visit must include screening for depression, reproductive life planning, and referral for ongoing care if necessary.  The state expects to offset the cost of the additional reimbursement through savings in hospital costs.

North Carolina is not the only place trying to improve maternity outcomes; projects are underway, for example, in California, Ohio and Washington state.  But to my knowledge, North Carolina is the first to employ the patient-centered medical home model in that effort.    This is a promising program, and we will all likely learn a lot from the state’s experience.

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[1] NCHS Data Brief, #23, November 2009; www.cdc.gov/nchs/data/databriefs/db23.htm.

[2] NCHS Health US 2010, Table 36; http://cdc.gov/nchs/data/hus/hus10.pdf#glance.

[3] Child Health USA 2010, Health Resources and Services Administration, U.S.DHHS; www.mchb.hrsa.gov/chusa10/hstat/hsi/pages/202lbw.html.,

[4] America’s Children: Key National Indicators of Well-Being 2011; http://childstats.gov.

Relentless. Deceptive. Dangerous.

Published on May 5, 2011 in Debra Ness, Health Care and Reproductive Health. 2 Comments

Debra Ness, President

The “war on women” in the House of Representatives rages on.

We’re only four months into the new Congress, and already the House has attempted to defund and repeal health care reform; defund Planned Parenthood; and eliminate the Title X family planning program that provides comprehensive preventive health care services to millions of low-income women. The majority in the House was even willing to shut down the federal government in order to get their way.

They are relentless – and they are just getting started.

Yesterday, the House passed H.R. 3,  deceptively called the ‘No Taxpayer Funding for Abortion Act. This callous bill threatens women’s health by eliminating insurance coverage for abortion care for millions of women. It would permanently deny insurance coverage for abortion care in federally supported health plans and then impose this extreme anti-choice ideology on the private insurance market. The bill would raise taxes and increase costs on   individuals and small businesses with private health plans that cover this basic service.

If women’s lives and the well-being of women and their families mattered to the majority in the House, Members would have rejected this appalling bill – but instead they took one more step down the road that puts women in danger and denies our access to basic reproductive health care.

We must prevent this legislation from becoming law. We can’t let opponents take away our access to the full range of reproductive health services.

The ‘No Taxpayer Funding for Abortion Act’ is deceptive, politically-motivated and dangerous to women. It isn’t just about ensuring that taxpayers don’t pay for insurance coverage of abortion.  Unjust federal laws already do that – and for decades these policies have  been causing grave harm to low-income women, military women, and other women who face unintended pregnancies and rely on federally supported health insurance plans. H.R. 3 would make those restrictions permanent in U.S. law and extend these harmful restrictions to the private market.

The bottom line:  H.R. 3 is about making abortion and other reproductive health care less accessible for all women. Its supporters don’t want abortion to be legal, so they are doing all they can to make it more difficult and costly for women to safely get this legal and routine medical procedure. Restricting insurance coverage of abortion does not reduce the need for abortion; such policies simply force women seeking abortion care to obtain services later in pregnancy when it is more costly and difficult.

Please join us in urging the Senate to reject this dangerous bill.

Let’s Not Reverse Our Progress on Stopping HIV/AIDS

Published on March 10, 2011 in Health Care, Laura Hessburg and Reproductive Health. 0 Comments

Laura Hessburg, Senior Health Policy Advisor

Today is National Women and Girls HIV/AIDS Awareness Day, when we should all pause to remember that the HIV/AIDS epidemic is still shaping and taking too many lives, in the United States and around the globe.

Unfortunately, the callous “war on women” being waged by leaders in the House of Representatives, which includes shameful attempts to defund Planned Parenthood and Title X family planning services, threatens to cause grave harm to people who are HIV-positive.

Consider this: In the United States, HIV affects nearly 280,000 women. Analyses by the Centers for Disease Prevention and Control (CDC) show that HIV is most prevalent among those living in low-income communities. There are strong links between HIV and poverty. The American HIV/AIDS epidemic is also characterized by strong racial and ethnic disparities, with people of color significantly more likely to be infected than those who are White.

Women with low incomes and women of color rely even more heavily than others on Title X-funded clinics as their health care safety net.

Title X clinics are indispensable in the fight against HIV. A government review by the White House Office of Management and Budget (OMB) once concluded that “[w]omen who utilize Title X… services as their primary source of health care have significantly greater odds of receiving contraceptive services and/or care for sexually transmitted diseases (STDs) than women who utilize private physicians or HMOs.”

In 2009, Title X providers performed more than six million tests for STIs, including nearly one million HIV tests.  Services funded through Title X  include essential counseling and education on HIV and other reproductive health issues.  This education is key to preventing the further spread of HIV, especially at a time when the CDC estimates that one in five people living with HIV infection in the United States do not know they are infected.

If Congress eliminates funding for Title X and Planned Parenthood, women’s health will suffer terribly. Efforts to stem the HIV/AIDS epidemic will be hampered.  New HIV and other STI infections will go undetected.  Even more people with HIV will go without the treatment that can save their lives.

We are counting on the Senate and President Obama to stand strong for women and their families, and block all measures that will harm women’s health.

Please tell your Senators to prioritize women’s health and ensure that all women have access to the reproductive health services they need.

Just When You Think You’ve Seen It All

Published on February 28, 2011 in Debra Ness, Health Care, Reform and Reproductive Health. 21 Comments

Debra Ness, President

Sometimes I think there’s not much that can surprise me. But last week proved that theory wrong: the U.S. House of Representatives voted to prohibit federal funds for health care services provided by Planned Parenthood, and eliminate funding for all Title X family planning services, which are the sole source of health care for millions of low-income and uninsured women in this nation. And because, apparently, even that wasn’t enough, they also voted to defund the federal agencies and personnel that are working to implement health reform, which is the greatest advance for women’s health in a generation.

House leaders are willing to risk shutting down the federal government in order to advance their anti-woman, anti-reform agenda.

If these measures pass the Senate, unintended pregnancies in this country will skyrocket, fewer women will be screened for breast and cervical cancers and sexually transmitted infections, and women’s health will suffer terribly because millions of women will lose their primary source of health care. Planned Parenthood clinics in communities across the country will be at risk for closing.

Representatives Jackie Speier and Gwen Moore helped remind us about what is at stake with these votes when they shared their personal stories. They drove home the stakes in this debate, and the human impact of what the House is trying to do.  Their courage made it even more appalling to watch a majority of their colleagues callously vote to take away women’s health care.

We are counting on our Senators and President Obama to block these short-sighted, dangerous cuts, and to stand strong for women and their families. Tell your Senators: hands off my health care (and family planning too)!

Time to Protect Common Sense.

Published on January 22, 2011 in Debra Ness, Health Care and Reproductive Health. 5 Comments

Debra Ness, President

On this day in 1973, the U.S. Supreme Court issued its landmark ruling in Roe v. Wade, which established a woman’s right to privacy and to make her own reproductive health decisions. 38 years later, that right – and women’s ability to access it – are at risk.

The November election put in place more federal and state lawmakers who oppose a woman’s right to choose. The extreme measures proposed by these lawmakers are at odds with the majority of Americans who do not want women to lose access to reproductive health services.

For the majority of Americans who do not want to return to the days when abortion was illegal, there is a lot of work ahead. We have opponents in Congress who are determined to undermine our right to choose and deny us access to reproductive health care.  Our goal, quite simply, must be to ensure that all women — regardless of their income, where they live, whether they serve in the military — can access a full range of reproductive health services that includes abortion care.

We urge Congress to reject the outrageous “No Taxpayer Funding for Abortion Act,” which would reduce the availability of abortion coverage in the private insurance market nationwide, narrow the already limited rape and incest provisions in the Hyde Amendment, and permanently deny low-income and military women access to health coverage that includes this essential care.

Lawmakers should end the divisive efforts to take away women’s right to choose and impede women’s access to basic health care, and instead focus on preventing unintended pregnancies. Today, half the pregnancies in our country are unintended and by age 45, about one-third of women will have had an abortion. Making family planning services available to everyone who needs them, and offering all youth unbiased and comprehensive sexuality education, are essential to effective efforts to reduce our nation’s staggering rates of unintended pregnancy. That should be a top priority.

Currently, the Institute of Medicine (IOM) is considering whether to include birth control services and supplies in the package of preventive services that health plans will be required to cover without deductibles or co-pays, as provided for in the Affordable Care Act. A decision to include birth control services without cost-sharing would be a welcome step in the work to reduce unintended pregnancy.

At the National Partnership, we will continue to work tirelessly to protect and expand common sense policies that improve women’s health by providing access to affordable, high quality reproductive health services – and there are ways you can help. Please start by telling your Senators to prioritize women’s health and ensure that women have access to the reproductive health services they need.

How Far Have We Come When it Comes to Covering Women’s Birth Control? We Shall See.

Published on December 14, 2010 in Marya Torrez and Reproductive Health. 2 Comments

Marya Torrez, Senior Reproductive Health Policy Counsel

Ten years ago today, the Equal Employment Opportunity Commission (EEOC) ruled that refusing to cover prescription contraception in an employee health plan – if other similar preventive services and prescription drugs were covered in that plan –violated Title VII of the Civil Rights Act of 1964 and the amendment to Title VII, the Pregnancy Discrimination Act. It was a monumental victory for women, many of whom spend the majority of their reproductive lives (approximately three decades) trying to avoid an unintended pregnancy.  Women rely on contraception to plan their families, and appropriately and safely space their children.

Before this important ruling, things were pretty bleak on the contraceptive coverage front.  At that time, half of traditional indemnity plans for large groups did not cover any reversible prescription methods of contraception and only 39 percent of health maintenance organizations (HMOs) covered all five leading methods. [i] This meant that many women were paying for contraceptives themselves or – as was often the case – were at high risk for unintended pregnancy because they could not access affordable and effective contraception.

Now we find ourselves, 10 years after the EEOC victory, with an opportunity to expand contraceptive use by ensuring affordable access to contraceptives in all health plans. The EEOC ruling did much to advance women’s equality in health coverage, but cost still leaves many women without access to birth control. But now, the Affordable Care Act (ACA) requires that preventive services be covered by insurers at no cost. The Women’s Health Amendment to the ACA specifically requires coverage of preventive services for women.

There’s one catch.  The law didn’t specify which women’s health services qualify as preventive. Instead, a committee appointed by the Institute of Medicine (IOM) has been charged with making a recommendation to the Department of Health and Human Services (HHS) on what services should make the list. Whatever is ultimately decided will have a huge impact on women because, while the EEOC ruling 10 years ago expanded access to prescription birth control for women with insurance coverage, women still bear a significant burden of expense through co-pays and other cost-sharing.  If there’s one thing we know for sure, it’s that cost is a barrier to contraceptive access and use. Studies show that even minimal co-pays for preventive services deter consumers from obtaining the care they need.[ii]

Health reform has the potential to expand affordable access to prescription contraceptives to women in all 50 states and the District of Columbia.  Not surprisingly, this potential expansion of contraceptive coverage breathed new life into the attacks on family planning in this country.  At a recent IOM hearing on the issue, anti-choice organizations lined up to testify – without any  real evidence – that “birth control poses serious health risks to women and adolescents” and that mandating coverage would violate the rights of employers and insurers.  (These claims don’t pass the laugh test, and the only silver lining to this debate is that it exposes the real agenda of these groups.  The public generally knows them only as anti-abortion.  They try to hide their anti-contraception views, because birth control has such overwhelming public support.)

The National Partnership for Women & Families testified at the hearing (as did a number of other women’s health experts) that family planning is basic health care for women and should be treated like any other preventive service under ACA.  Period.

In its ruling ten years ago, the EEOC rectified a long-standing inequity for women. The only forms of FDA-approved prescription contraceptives available today are for women –and pregnancy is a condition unique to women.  So the failure to cover contraceptives, when other prescription drugs are covered, has a disproportionate and discriminatory impact on women.

As the IOM considers whether to recommend to HHS that prescription contraceptives be included in the menu of preventive services that health plans are required to cover without cost sharing – and as HHS makes its final decision – let’s hope we take the next step in promoting contraceptive access and use.

Health reform promises a giant step forward for the country. For women, that step forward must include affordable access to contraception. But that will only happen if the IOM and HHS continue the progress begun by the EEOC ten years ago.

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[i] Dailard, Cynthia. (March 2003). Special Analysis: The Cost of Contraceptive Insurance Coverage. Retrieved from http://www.guttmacher.org/pubs/tgr/06/1/gr060112.pdf.

[ii] Solanki, G and Schauffler, HH. (1999) Cost-sharing and the utilization of clinical preventive services. American Journal of Preventive Medicine, 17, no.2, 127-133.

It’s Politics v. Science. Again.

Published on December 1, 2010 in Judith Lichtman and Reproductive Health. 1 Comment

Judith L. Lichtman, Senior Advisor

It’s a fact: Contraceptive use improves overall health. It enables women to plan and space their pregnancies. It has contributed to dramatic declines in maternal and infant mortality. And it has been a driving force in reducing unintended pregnancies and the need for abortion.

But things don’t always work out as planned. Emergency contraception (EC) is a safe, effective way to prevent pregnancy after contraceptive failure or unprotected sex, such as when women are sexually assaulted. Although EC is not a substitute for regular contraceptive use, it can help reduce unintended pregnancy if women are able to access it in a timely manner. At the National Partnership, we want EC to be accessible to all women who need it.  That’s why we’re so disappointed by a recent decision by the Food and Drug Administration (FDA).

Here’s some background: In 2006, after years of delay in making a decision on whether to make the emergency contraceptive Plan B available without a prescription, the FDA decided to limit over-the-counter sales to women ages 18 and older. It was a highly controversial decision because it directly contradicted an independent panel of experts who voted unanimously in 2003 that Plan B was safe for non-prescription use. That expert panel also voted 23-4 to recommend that Plan B be available without prescription or age restriction.

Thanks to a lawsuit filed by the Center for Reproductive Rights, a U.S. District Court finally ruled in 2009 that the FDA’s decision to limit access of Plan B was politically-motivated and scientifically-flawed. The Court ordered the FDA to lower the age limit and re-examine whether Plan B should be available to women of all ages without prescription.

However, the FDA merely reduced the age limit for accessing Plan B to 17 – and it recently announced that it does not plan to reconsider expanding its availability. Read the entire timeline here (link to RHTP timeline).

We are disappointed by that announcement. As FDA officials know, reproductive health services – including easy access to emergency contraceptives – are basic health services for women of all ages.

Politics should never get in the way of meeting women’s health care needs. Please contact the FDA and ask its leaders to make emergency contraception available without a prescription to women of all ages.

Unintended pregnancy does not discriminate- women of all ages need access to emergency contraception so they can prevent unintended pregnancy.

Take action today. Make your voice heard.