NEWSREPRODUCTIVE HEALTH

Earlier this month, Emily "Amy" Medwin, a Certified Professional Midwife (CPM), was arrested in North Carolina for practicing in the state without proper certification. Although Medwin is educated in home and out-of-hospital births, authorities say she was not licensed to practice midwifery in North Carolina, only in Virginia.

But the problem isn't hers alone. CPMs are only legally recognized in 27 states, so even if she tried to obtain the proper licensure in North Carolina, she couldn't. The state doesn't license CPMs, so they can be criminally prosecuted for unlicensed health care practice, despite their legality in neighboring states.

The threat of criminal prosecution has led many advocates and mothers to speak out on her behalf, including Lindsay Fisher, who started a petition calling on the state legislature to legalize midwifery in North Carolina. Advocates in the state are also part of the "The Big Push for Midwives" campaign, a larger effort aiming to pass legislation to license CPMs in all 50 states.

For many, the fight over midwives pits a woman's choice to have her child at home against the medical establishment. According to Katie Prown, Campaign Manager for the Big Push for Midwives, "the medical lobby spends millions of dollars all over the country each year to defeat pro-midwife legislation and to keep CPMs, who are specially trained as experts in the provision of out-of-hospital maternity care, illegal and underground."

Last Friday's decision by the House GOP to defund Planned Parenthood wasn't surprising, but it was a major blow to women's health advocates across the country. Now, hopes are pegged on the Senate to stand up against this and other controversial bills, collectively known as the "war on women."

It's generally believed that the Democratic-majority Senate will shoot down three pieces of legislation moving through the house. They include H.R. 3, the "No Taxpayer Funding for Abortion Act," which gained notoriety for its attempts to redefine rape; H.R. 358, the "Protect Life Act," which protects doctors and health care providers that refuse to perform abortions, even if it means saving a woman's life; and the proposal to eliminate funds for Title X family planning programs, including the Pence Amendment, which specifically defunded Planned Parenthood.

But, according to a petition by CREDO Action, a victory in the Senate isn't so clear-cut. The anti-choice Senators outnumber pro-choice Senators by 46-40, and 41 votes are needed to sustain a filibuster of the bills.

As the GOP claims to move us toward a more "sustainable" financial future by slashing funding for numerous health programs, someone might want to clue them in on the old adage, "an ounce of prevention is worth a pound of cure."

Under attack are family planning clinics like Planned Parenthood, community health centers, farm-to-school lunch programs and tobacco prevention measures. It doesn't take more than a rudimentary understanding of population health to understand that cutting programs like these will almost certainly lead to more spending in the future, as preventable disease and health care costs rise.

One of their targets is the Prevention and Public Health Fund, which backs scientifically-supported measures for disease prevention, like halting tobacco use, curbing the obesity epidemic, promoting better nutrition and physical activity. The Fund supports programs that increase fruit and vegetable consumption in schools, improves physical education programs for kids and helps communities source healthful food locally.

Last year, we brought you the news that the Internal Revenue Service wouldn't allow nursing mothers to use their tax-sheltered health care accounts to pay for breast pumps and breastfeeding supplies.  This was a shock to mothers and health advocates alike, who recognize the numerous benefits a baby gains through mom's breast milk.

The biggest insult, however, was the IRS' reason for denying the exemption -- it didn't believe that breastfeeding had "enough health benefits to qualify as a from of medical care."

That inspired many groups to fight back, including 920 Change.org users who signed a petition calling on Congress to pass legislation that would, among other things, provide tax relief for breastfeeding equipment.

And the IRS finally recognized their oversight last week, deciding to allow women to deduct the cost of breast pumps and other supplies and pay for them with their tax-sheltered health care accounts.

As much as our country fawns over babies and the unborn, pregnant women are often treated like second-class citizens, at least by the insurance industry. For those women not covered in an employer group insurance policy, access to care is parsed to the point of non-existence.

Last year, an investigation by the House Energy and Commerce Committee found that the individual health insurance market regularly denies pregnant women coverage and limits their ability to purchase maternity care. The four largest for-profit insurance companies listed pregnancy as a medical condition "that would result in automatic denial of individual health insurance coverage."

In California, one legislator is looking to change that. Senator Noreen Evans has introduced SB 155, which would ensure health insurance access for pregnant women. Currently, group insurers and HMO's are required by law to cover maternity services, but individual plans aren't. As a result, the number of individual health plans that included maternity coverage dropped from 82 percent in 2004 to just 19 percent in 2009.

It was no surprise when the House GOP voted to repeal health care reform this Wednesday. But what is less certain is their vision for the future of health care. The inklings so far have been nothing short of frightening, especially for women.

Their first order of business was to deregulate health insurance sales. The goal of deregulation is to lower premium costs, but it will also allow the insurance industry to skirt regulations intended to improve wellness. As noted in the LA Times, cutting costs would be done "by avoiding requirements in many states that insurers cover certain services, such as maternity care, cancer screenings and mastectomies."

All of these services could ultimately save money by preventing unnecessary and costly care. While it's ridiculous that states have to mandate coverage for something as commonsense as maternity care, it's even more ludicrous that the Republicans believe that an "improved" health care system means undoing these regulations.

Rather than focusing on improving health care or creating jobs (their purported main goal in office), the GOP's second order of business was to attack abortion access.

In 2009, St. Joseph's Catholic Hospital in Phoenix, AZ made a brave choice to save a woman's life.

A woman who was 11 weeks pregnant faced complications that put her life at risk. She had an almost 100 percent chance of dying without the recommend emergency abortion (the fetus was also almost 100 percent likely to die as well), so the woman and her doctor decided to terminate the pregnancy to save her life.

The Catholic's Church's response? That the life-saving medical procedure is absolutely unacceptable in a Catholic hospital. The Bishop in Phoenix, Thomas Olmsted, gave the hospital an ultimatum: promise to never perform an abortion again, regardless of the medical need, or end the hospital's affiliation with the Catholic Church.

St. Joseph's Hospital chose to stand up for what they know is right - life.

St. Joseph’s released this statement about the Bishop’s demands: “Morally, ethically, and legally we simply cannot stand by and let someone die whose life we might be able to save.”

The case in Pheonix highlights a growing point of tension between Catholic hospitals and religious leadership.

Most pregnant women are fastidious about avoiding certain substances, like alcohol, tobacco smoke and caffeine. But that may not be enough.  A study released today found that the majority of pregnant women carry a slew of potentially hazardous chemicals, many that were phased out decades ago.

Researchers at the University of California, San Francisco found that 43 of the 163 chemicals they tested were present in the blood and urine of almost all the pregnant women enrolled in the study. These 43 substances included such notorious bad guys as polychlorinated biphenyls (PCBs), which were phased out in the 1970s due to their association with cancer and neurobehavioral problems; organochlorine pesticides; polybrominated diphenyl ethers (PBDEs); polycyclic aromatic hydrocarbons (PAHs); and phthalates. BPA, an endocrine disruptor that is found in food linings, receipts and some plastics, was found in 96 percent of the women.

Because many of the chemicals found in the women's blood were banned before they were even born, the study shows the prevalence and persistence of many of these compounds, which can linger in the environment and in the body.

In the debate over how to teach sex education in schools, young people's voices often go unheard. But in Boston, a group of students from the Jamaica Plains neighborhood are making sure they get a say in the matter. In conjunction with the nonprofit Hyde Square Task Force, the students have launched a campaign to demand that a comprehensive sex education program be implemented in all the city's high schools.

The group made an informative and funny video (after the jump) that interviews students, politicians and public health leaders. In it, they point out that there's no standardized sexual education in Boston schools, despite the state's high rate of STDs and teen sexual activity.

In addition to the video, the group is running a Facebook campaign, "Sex in School: Does Ignorance Keep Us Safe?" Among other things, they are demanding a standardized comprehensive sexuality education program beginning in 9th grade, free condom distribution in Boston Public high schools and a student awareness campaign to promote safe sex in all the high schools. One of the main goals of the campaign is to ensure that students are able to weigh-in on the curriculum development and implementation.

Innovative, cost-saving methods for medicine dispersal should be applauded, not eliminated. But in Iowa, a novel telemedicine program that allows women access to the abortion pill without having to go to a clinic for the drug to be dispensed is under attack.  As covered previously on Change.org, the program helps women, particularly in rural areas, access the pill. Instead of an in-person meeting, the doctor consults with the patient via a video teleconference, and then unlocks a container by remote control to release the pill. It saves time, increases access and reduces costs.

But as covered on the Women's Rights blog, Iowa state legislators are working to ban the practice, and Nebraska, which doesn't even offer the service yet, is planning to introduce a bill that would require doctors to be in the same room when the pills are dispensed.

This would serve to restrict access to the abortion pill for women in areas where there may not be a doctor willing to provide a surgery. Although the pill, marketed as Miseprex, hasn't increased the number of abortions in the U.S., more and more women are chosing medication abortions when they do have them. But even though use of the pill has become widespread, it has not susbstantially improved women's geographic access to abortion -- most medication abortions are provided at or near facilities that already offer surgical abortions. The telemedicine option would help to solve that.