women’s health

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New Spending Bill Adds Abortion Coverage For Peace Corps Rape Victims

File this under: “About #$@%&*! Time.

Tucked away in the recently passed $1.1 trillion federal spending bill is a provision that, according to women’s health and abortion rights advocates, is long overdue, ending a 35-year-old ban. The new measure offers abortion coverage to Peace Corps volunteers victimized by rape, incest or facing a life-threatening pregnancy; similar coverage is already provided to federal employees.

Bryan Dwyer, director of Peace Corps and Training in Kigali, Rwanda, and a Peace Corps volunteer in El Salvador from 2000-2002, expressed his strong approval for the new measure:

As both an RPCV [Returned Peace Corps Volunteer] and staff member, I am very pleased that PC [Peace Corps] Volunteers will now be afforded this protection, even as I earnestly hope that no one ever needs to avail herself of it.

Another former Peace Corps employee I talked to was a bit more blunt:

In a long overdue concession to reality, conservative members of Congress no longer forced their abusive “no choice no matter what” policy on women in the Peace Corps. For far too many years, they had prevailed in insisting that women who choose to serve our country who had been raped and impregnated should be repaid with no health care coverage to end those pregnancies. I am glad this truly appalling policy is finally at an end.

Edson Chilundo/flickr

Edson Chilundo/flickr

Here are more details and background in a Glamour magazine report:

Over the weekend, the Senate passed a $1.1 trillion spending bill that includes a provision to provide abortion coverage for Peace Corps volunteers in cases of rape, incest, or life endangerment.

It’s an important win for reproductive rights advocates in a year plagued by restrictions on abortion and other women’s health measures. President Obama is expected to sign the bill into law, granting Peace Corps volunteers and trainees the same type of abortion coverage offered to federal employees….

Currently, just over 60 percent of Peace Corps volunteers are female, and many of them work in areas with little to no access to safe, reliable health care. Continue reading

Why To Exercise (Outdoors) Today: Tranquility For Aging Ladies

(frodrig/Flickr)

(frodrig/Flickr)

It’s cold, it’s dark, it’s uninviting out there. So, all the more reason to drag yourself outside and do something.

In yet another study on how exercise can combat the bad physical and mental effects of aging, new research suggests that women who can get out the door, fight the elements and exercise might find some nifty benefits. Those benefits include alleviating depression and increasing adherence to an exercise program.

The small study, published in the journal Menopause, asserts it’s the outside air that really helps (as opposed to the stuffy gym or the treadmill in your basement, though I’ve found that when you’re desperate, those work too):

“Between baseline and week 12, depression symptoms decreased and physical activity level increased only for the outdoor group…” write the authors, led by Isabelle Dionne of the University Institute of Geriatrics of Sherbrooke in Quebec.

From the Reuters report:

Outdoor workouts left women in a better mood and kept them exercising longer than counterparts who exercised indoors, according to a small study from Canada.

Results of the three-month trial involving women in their 50s and 60s suggest that outdoor exercise programs should be promoted to help older women keep active, the researchers conclude…Only about 13 percent of Canadian women older than 59 years and less than 9 percent of older American adults get at least 150 minutes of physical activity each week… Continue reading

Culture Clash: U.K. Embraces Homebirth As Best For Some Women

Sarah Parente shortly after the homebirth of her daughter Fiona (Courtesy of Leilani Rogers)

Sarah Parente shortly after the homebirth of her daughter Fiona (Courtesy of Leilani Rogers)

By Jessica Alpert

Sarah Parente, an Austin, Texas-based doula and mother of four, gave birth to her first child in the hospital with no complications. But then she decided to make a shift: Parente delivered her next three babies at home. “For women with low-risk pregnancies, home birth can be a great choice,” she says. “You have less stress because you are in your own home surrounded by a birth team of your choosing.”

Though home birth has recently gained cache in the U.S. — with some celebrities trumpeting the benefits of having their babies at home  — the practice remains uncommon and the majority of pregnant women give birth in a hospital setting. Still, Parente may be getting a little more company, albeit slowly. Data released by the Centers for Disease Control (CDC) earlier this year shows the rate of homebirths in the U.S. has increased to 0.92 percent in 2013 and the rate of out-of-hospital births (including home) has increased 55 percent since 2004.

Experts in the United Kingdom are saying that’s a good thing.

The London-based National Institute for Health and Care Excellence (Nice) recently released recommendations that homebirths and midwife-led centers are better for mothers and often just as safe for babies as hospital settings, the BBC reports. Of the 700,000 babies born in England and Wales each year, nine out of 10 are born in obstetric-led units in hospitals. Continue reading

Brain Science, Dangerous? Not So Fast, Says Poverty Expert

Back in June, we wrote about a novel program in Boston that seeks to lift women and their families from poverty, in part by using the latest research in neuroscience. Specifically, the program (developed by the nonprofit Crittenton Women’s Union) takes into account recent studies that reveal how trauma, and poverty, can rewire the brain and potentially undermine executive function.

In an Op-Talk piece in this week’s New York Times headlined “Can Brain Science Be Dangerous?” writer Anna North cites our story, and then goes on to question whether this type of approach might be problematic. In the article, North refers to sociologist Susan Sered:

Dr. Sered…says that applying neuroscience to problems like poverty can sometimes lead to trouble: “Studies showing that trauma and poverty change people’s brains can too easily be read as scientific proof that poor people (albeit through no fault of their own) have inferior brains or that women who have been raped are now brain-damaged.”

She worries that neuroscience could be used to discount people’s experiences: “In settings where medical experts have a monopoly on determining and corroborating claims of abuse, what would happen when a brain scan doesn’t show the expected markers of trauma? Does that make the sufferer into a liar?”

We asked Elisabeth Babock, president and chief executive officer of Crittenten Women’s Union, to respond to the Times piece. Here, lightly edited, is what she wrote:

Moving out of poverty in the U.S. today is an extremely complicated and challenging process. It involves trying to maintain a roof over your head when the minimum wage doesn’t cover the minimum rent; and trying to get a better paying job when almost all those jobs require education beyond high-school and the costs of that education, in both money and time, are well beyond the means of most low-wage workers. It involves trying to care for a family while filling in the gaps in what the minimum wage will buy with increasingly-frayed public supports. It involves a lot of juggling.

We at Crittenton Women’s Union (CWU) understand this process all too well because we work with hundreds of people trying to navigate their way out of poverty every day: homeless families living in our transitional housing and domestic violence shelters, and people who are living on the edge of homelessness, struggling to make ends meet. What we at CWU see is that the stress of this everyday struggle creates an additional set of monumental challenges for those we serve.

Our families often describe themselves as feeling “swamped” by their problems to the point that they can only think about how to deal with the crisis of the moment. And in those moments, they may not have the mental bandwidth to strategize about how to change their current circumstances or help them get ahead.

One of the most valuable things brain science research does for this struggle is that it validates what our families share about the way being in poverty affects them. Instead of saying that stress leaves people “irrevocably debilitated”, or worse still, that people should somehow rise above this crippling stress to “just move on” the science actually suggests something much more important. It calls upon all of us to understand that poverty, trauma, and discrimination are experiences whose cumulative effects impact our health, decision-making, and well-being in tangible and predictable ways, and because of this, we as a society can and must do our best to remediate it. Continue reading

Til Stress Do Us Part: Marriage Angst Can Be Hard On Your Heart

(Neil Moralee/Flickr)

(Neil Moralee/Flickr)

By Alvin Tran
Guest Contributor

Marriage is hard even in the best of circumstances. But new research suggests that if things are particularly hard, the stress can take a toll on your heart — especially if you’re older and female.

In a study published this week in the Journal of Health and Social Behavior, researchers found that older couples in bad marriages have a higher risk for heart disease compared to those in good marriages. This link between the quality of a marriage and the risk of heart-related problems, such as high blood pressure, is even more pronounced among female spouses.

“The strain and stress from the marital relationship has a strong negative effect on people’s heart,” said Hui Liu, an associate professor of sociology at Michigan State University and the study’s lead author. “If the marriage is very stressful, it’s really hard on your heart.”

Liu, along with co-author Linda Waite of the University of Chicago, analyzed data from an ongoing nationally representative project that followed nearly 1,200 older men and women, ages 57 to 85, for a period of five years.

After comparing participants at the beginning of the study to the end of the five-year follow-up period, they found a significant link between an increase in negative marital quality with higher risk of hypertension among women. Not-so-hot marriages were marked by less spousal support and with husbands and wives spending less time with each other.

“The effect of marriage quality on cardiovascular risk is stronger for women than for men. It also becomes stronger as people get older,” Liu said during an interview. “We think marriage is one of the social factors that may affect the risk of cardiovascular disease.” Continue reading

Caution: ‘Acceptable’ Black Women’s Hairstyles May Harm Health

(U.S. Army)

(U.S. Army)

This spring, the Pentagon issued Army Regulation 670-1, which included bans on several hairstyles worn mainly by black women, including twists and multiple braids. After a major backlash that included accusations of racial bias, that grooming policy is now under review. Here, researchers at the Connors Center for Women’s Health at Brigham and Women’s Hospital argue that this is more than an issue of racial fairness; it could also cause harm to women’s health — and disproportionately impact black women, whose life expectancy is already five years less than white women’s.

By Tamarra James-Todd and Therese Fitzgerald
Guest contributors

We are encouraged by the news that the Pentagon is reviewing the Army’s grooming policy, Army Regulation 670-1, which many deemed to be racially biased because it banned hairstyles worn primarily by black women.

Such policies set unreasonable standards for what is appropriate or acceptable in our society, and promote the idea that natural “black” hair is somehow inappropriate and unacceptable.

But perhaps most disturbing is the growing evidence that the process involved in straightening curly hair and maintaining acceptable hairstyles is harmful to women’s health, disproportionately affecting black women and making the pervasive practice of banning “black” hair styles a major health equity issue.

Nearly half of black women and girls use hair products that contain endocrine-disrupting chemicals compared to just 8 percent of whites.

The military’s previous position on this reflects a precedent that unfortunately continues to exist in corporate and private sector settings throughout the country. Labeled as “grooming” issues, companies have fired employees for wearing dreadlocks and a private school in Orlando, Florida, threatened to expel a young girl if she refused to straighten or cut her natural black hair.

The public discourse around these biased policies should not only focus on the racism they perpetuate but also on the potential harmful health outcomes and health disparities they may leave in their wake now and for future generations.

In order to conform to the standards of appearance that these policies demand, black women and girls are often encouraged to straighten or otherwise change the texture of their natural “black” hair. Unfortunately, many of the hair relaxers, oils, creams and other products used to straighten or alter curly hair contain synthetic chemicals that disrupt the normal functioning of the human body’s endocrine system, which regulates and secretes hormones.

Based on hair product labels, nearly half (49 percent) of black women and girls use hair products that contain endocrine-disrupting chemicals compared to just 8 percent of whites, which could leave blacks with higher levels of these chemicals in their bodies compared to whites.

For example, phthalates, a class of endocrine-disrupting chemicals used in hair products, are known to be found at higher levels in blacks than whites. Research led by Dr. Tamarra James-Todd at the Connors Center for Women’s Health at Brigham and Women’s Hospital has revealed that higher phthalate levels are associated with a variety of poor health outcomes that disproportionately impact black women and girls including:

Type 2 diabetes, a condition twice as common among black women compared to white women, as well as insulin resistance and other associated conditions. Continue reading

AP: Supreme Court Strikes Down Buffer Zone For Abortion Clinics

(Update from the AP: “Attorney General Martha Coakley, whose office argued before the justices to keep the 35-foot zone, did not immediately say whether officials would seek to create a different buffer zone or take some other steps. But she said the ruling appeared to leave open other alternatives and called on lawmakers to act quickly.

“Every day that we don’t change the rules and make it safer for people to get access, people are put at risk,” said Coakley, a Democratic candidate for governor.

Senate President Therese Murray, D-Plymouth, said she expected lawmakers to act before the July 31 end of the legislative session, but would not speculate on what changes might be sought.”)

The AP reports that the U.S. Supreme Court today struck down a 35-foot protest-free zone outside abortion clinics in Massachusetts (read the court’s “slip opinion” here). We’ll update the news and add reactions as they come in, but for now, here’s the Associated Press, with reactions below:

The justices were unanimous in ruling that extending a buffer zone 35 feet from clinic entrances violates the First Amendment rights of protesters.

Chief Justice John Roberts said authorities have less intrusive ways to deal with problems outside the clinics.

While the court was unanimous in the outcome, Roberts joined with the four liberal justices to strike down the buffer zone on narrow grounds. In a separate opinion, Justice Antonin Scalia criticized Roberts’ opinion for carrying forward “this court’s practice of giving abortion-rights advocates a pass when it comes to suppressing the free-speech rights of their opponents.”

The case began when Boston-area grandmother Eleanor McCullen and other abortion opponents sued over the limits on their activities at Planned Parenthood health centers in Boston, Springfield and Worcester. At the latter two sites, the protesters say they have little chance of reaching patients arriving by car because they must stay 35 feet from the entrance to those buildings’ parking lots.

Planned Parenthood provides health exams for women, cancer screenings, tests for sexually transmitted diseases, birth control and abortions at its clinics.

The organization said that the buffer zone has significantly reduced the harassment of patients and clinic employees. Before the 35-foot zone went into effect in 2007, protesters could stand next to the entrances and force patients to squeeze by, Planned Parenthood said. Continue reading

Good News-Bad News On PMS and Menopause

Young women, take heart: if you are among the vast majority of us who suffer from PMS —  the irritability, anxiety, headaches, breast tenderness, or bloating — it doesn’t mean you’re doomed to suffer from hot flashes when you hit menopause.

But don’t go out and celebrate just yet.

Because this is a good news/bad news kind of report:

pixel pro photography/flickr

pixel pro photography/flickr

The Good: Researchers found no connection between having a history of PMS and then experiencing hot flashes during menopause.

The Bad: They did find a connection between PMS and other seriously annoying problems shortly after menopause —  including impaired memory and concentration, poor sleep and depression.

Oh well.

The study of 150 recently menopausal woman published in the journal Menopause, claims its findings — linking a history of PMS with worsened so-called “health-related quality of life” measures, but not with hot flashes — are “novel.”

Here’s more on the mechanics of the connection, from the study:

The resemblance between premenstrual and menopausal symptoms raises a question on whether they also share similar physiological characteristics. One mechanism that has been suggested to contribute to premenstrual symptoms is deficiency in, or abnormal functioning of, neurotransmitters in the central nervous system, Continue reading

WSJ: Women At Risk, Doctors Split On Procedure Linked To Rare Cancer

Here’s another excellent Wall Street Journal report on the controversial procedure known as “morcellation.”  Reporter Jennifer Levitz notes that even after the FDA issued a warning on the practice (which involves a “laparoscopic power morcellator” that allows for less invasive surgery to remove fibroids by slicing them up, but can also potentially spread a rare type of cancer through the body) doctors are split on how to proceed.

According to the report:

The FDA said women undergoing surgery for what look like benign fibroids actually have a 1 in 350 risk of hosting an undetected cancer called a uterine sarcoma. Morcellating these tumors can spread cancerous tissue internally and significantly worsen the odds of long-term survival, the agency said.

So what are women to do when the medical community itself is divided? From the WSJ:

(wikimedia commons)

(wikimedia commons)

A number of doctors believe the FDA overreached, and think the cancer risk is so small that gynecologists can go an entire career without seeing a case. Others call the advisory a necessary precaution.

Hospitals and private practices are taking an array of approaches. The University of Pittsburgh Medical Center system, which has more than 50 obstetrics and gynecology practices, opted to continue using the device.

The medical system changed its informed-consent forms to include wording on cancer risk and told doctors to discuss the risk with patients. But Allen Hogge, chairman of obstetrics, gynecology and reproductive sciences there, questioned the data behind the FDA’s estimate. The FDA began looking at the issue after media reports late last year about a prominent Boston doctor who discovered she had sarcoma after morcellation.

“I think this is mostly public relations and not science,” Dr. Hogge said. In response, the FDA said it conducted a rigorous analysis of published literature.

The common practice of morcellation, which is often used for hysterectomies, came under fire when Dr. Hooman Noorchashm, a cardiothoracic surgeon at Brigham and Women’s Hospital and his wife, Dr. Amy Reed, an anesthesiologist at Beth Israel Deaconess Medical Center launched a publicity campaign aimed at stopping the procedure, Continue reading

A Victory For Women And Medical Research

The New York Times reports that a pair of influential scientists are calling for an end to gender bias in medical research, starting with a warning that researchers must “begin testing their theories in female lab animals and in female tissues and cells.”

From the article:

Name a new drug or treatment, and odds are researchers know far more about its effect on men than on women. From sleeping pills to statins, women have been blindsided by side effects and dosage miscalculations that were not discovered until after the product hit the market.

Now the National Institutes of Health says that this routine gender bias in basic research must end.

In a commentary published on Wednesday in the journal Nature, Dr. Francis Collins, director of the N.I.H., and Dr. Janine A. Clayton, director of the institutes’ Office of Research on Women’s Health, warned scientists that they must begin testing their theories in female lab animals and in female tissues and cells.

The N.I.H. has already taken researchers to task for their failure to include adequate numbers of women in clinical trials. The new announcement is an acknowledgment that this gender disparity begins much earlier in the research process.

“Most scientists want to do the most powerful experiment to get the most durable, powerful answers,” Dr. Collins said in an interview. “For most, this has not been on the radar screen as an important issue. What we’re trying to do here is raise consciousness.”

Women now make up more than half the participants in clinical research funded by the institutes, but it has taken years to get to this point, and women still are often underrepresented in clinical trials carried out by drug companies and medical device manufacturers.

Dr. Paula Johnson (courtesy)

Dr. Paula Johnson (courtesy)

Score a point for Dr. Paula Johnson, executive director of the Connors Center for Women’s Health and Gender Biology
and a professor of medicine at Harvard Medical School and Brigham and Women’s Hospital. Johnson, earlier this year, led a coalition of doctors, policymakers and others calling for an overhaul of clinical trials and medical research to address the gender gap.

I asked Johnson for her take on the new NIH stance, and she offered this update:

In March of 2014, the National Policy Summit on Women’s Health brought together policymakers, practitioners, advocates and academics who, for the first time, gathered specifically on the issue of sex and gender inequity in biomedical science. For discussion was a new report, “Sex Specific Medical Research: Why Women’s Health Can’t Wait.” Continue reading