We’ve learned that restricting abortions leads to an increase in illegal abortions and an increase in complications from unsafe illegal abortions. Chile prohibited abortion in 1989. However, the number of hospitalizations due to abortion complications has declined by two percent every year since 2001. What do you think could be some reasons for this paradox?
http://dailydigestnews.com/2014/11/the-chilean-paradox-great-maternal-health-despite-abortion-prohibitions/
Part of the reason I am posting this is to know if anyone else knows anything about this? I am incredibly intrigued by this. I would like to see a study that outweighs the stress of parenting versus these biological benefits. And since the study was easier with males I would like to see more with females to see what the difference is, if any (they said it was more costly to study with female babies).
“There’s so much [epidemiological] observation out there,” Kamper-Jørgensen said. “Having kids protects you from breast cancer, but we don’t really know why. If you have kids, you live longer, but we don’t really know why. Women live longer than men, but we don’t know why. This phenomenon, this may be it.” I feel like this quote encompasses the mystique around the phenomenon, and therefore I believe there is much more to be studied. I am wondering if anyone else finds this interesting or even useful, or just a natural occurrence of no value?
http://http://www.huffingtonpost.com/2014/11/05/paolo-patruno_n_6101602.html
So when I saw the title of this article I expected to see women in absolutely unfit conditions to give birth. Now while these may not be ideal settings, I keep thinking of the idea that comes up in class that women have, and will continue to give birth. This comes to mind, because even with the limited resources associated with the locations of these countries, these women are still able to give birth to babies that look fairly healthy and the women look like they are in decent condition. The midwives and doctors serving them looked to be trained birth attendants as well. So while I think the article wanted to say these pictures are supposed to make one shocked at how poor the conditions are, for me it was a reminder that life finds a way. Now with this being said there is so much work that can be done to improve the birthing conditions in this part of the world as we discuss at length in class. Yet, I just wanted to post this article because the pictures are striking, but not for the reasons I expected.
Raine’s presentation on illicit drug use and alcohol consumption during pregnancy intrigued me a great deal. However, I left the class wondering about the relationship between over-the-counter medications and pregnancy. Thus, I perused the literature and the internet to learn about various medications’ effects on the fetus.
As Raine explained, the mother passes chemicals to the fetus through the placenta. Therefore, some medications that may benefit a mother’s ailment has the potential to harm the fetus. As a result, the U.S. Food and Drug Administration has developed a system for categorizing medications based on their potential to cause birth defects to the fetus. As a way to filter the information for pregnant women, various sources have posted lists of “safe” medications to consume during pregnancy. The first link contains a table of such medications. For example, the website states that acetaminophen (Tylenol), guaifenesin (Mucinex), and loratadine (Claritin) pose low risk to the fetus. Unfortunately, however, these websites may misguide pregnant women. According to the study in the second link, sufficient evidence and research on the medications’ harmless effects on the fetus does not exist. Therefore, the “safe medication lists” mislead women to believe that an increase in risk for birth defects will not occur. Furthermore, as shown in the third link, the Centers for Disease Control and Prevention also report that sufficient information on the relationship between medication consumption and birth defects does not exist, stemming from the lack of studies including pregnant women to test the safety of the medications. Thus, various credible sources criticize the “safe medication” lists floating around the internet.
The idea of internet sources or media misleading pregnant women reminded me of Raine’s discussion about the Cosmopolitan article that promoted alcohol consumption during pregnancy. As we discussed in class, a woman may read that article without further investigation and assume that she can consume alcohol during pregnancy. The same situation may occur with these “safe medication lists”, for women may not conduct additional research or read the fine print that explains that the over-the-counter medications on the lists may actually increase the risk of birth defects.
http://www.babycenter.com/0_chart-over-the-counter-medications-during-pregnancy_1486462.bc
http://onlinelibrary.wiley.com/doi/10.1002/pds.3410/abstract
The other day I watched a documentary screenings from NOVA entitled “Vaccines: Calling the Shots” The movie was essentially about parents, even though it mainly featured mothers, withholding or spacing out vaccines for their children. Due to the decrease in vaccines, infectious diseases that had all but disappeared, such as measles, are cropping back up in North America.
The films overarching purpose was to convert non-believers to the vaccine train. From the production and editing you go the sense of them sending the message that vaccines do more good then harm and parents need to understand that and set aside their fears. As I said, it was mothers being showcased as the voice of the anti-vaccin charge. Some of the reasons they gave for not wanting to spacing out vaccines and not following the physician recommended schedule is because they did not want to tax their child’s immune system. One woman also attested that one of her children had a seizure (which happens sometimes, but usually has no recurrence or adverse affects) after receiving a vaccine so she did not complete the vaccine regimen or vaccinate her subsequent children. Viewers are also shown the tale of a mother who’s 4 month old child is suffering from whooping cough. We watch as the new born falls into fits of coughing so severe he has to be propped up and given oxygen.
I think this film is relevant to birth and global health because of some of the biases that were apparent in the film Some things that were not addressed. For instance, most of the mothers portrayed were white, middle to upper class woman who have the privilege to decide whether or not to vaccinate a child. Other mothers of different racial and ethnic backgrounds were not shown. But I imagine infants in those households may miss vaccination as well but not by choice. Or there are others who don’t vaccinate for religious and cultural reasons, their stories were also left out of the film.
All that said, I am someone who was vaccinated as a child and will more than likely be vaccinating my children. I am curious to know what others opinion’s are on not vaccinating a child. If the child ends up contracting a preventable infectious disease and suffering or worse passing away do you feel this is grounds to make vaccines required? Should it be a mothers decision whether or not to inoculate her child and/or forego the vaccine schedule?
http://www.pbs.org/wgbh/nova/body/vaccines-calling-shots.html if you are interested in watching the film, heres a link to what its about.
I came across this article online and the story was also featured on NPR: All Things Considered. It discussed the reality of maternal health in an epidemic as deadly as Ebola. Most of us probably are aware of the effects of this outbreak and the implications it is having on the countries in West Africa. What’s important to remember is that this disease is not only taking lives, but it is causing damage to entire communities, economics, health systems, and much more.
As most people know, Ebola is transmitted through bodily fluids, including amniotic fluids, vaginal secretions, placenta, and blood, and so can be transmitted very easily through OB and OR cases. Ebola has been stated as a “death sentence” for pregnant women as this article states that “one small study found a fatality rate around 95 percent” (NPR, 2014). Usually the fetus dies before labor or immediately after birth because the virus not only infects mom, but infects the fetus and the amniotic fluid that surrounds the baby.
As one could imagine, the death of healthcare workers in this outbreak has been significant and even more so with healthcare workers helping with deliveries. Because of this, there is a huge fear and stigma of pregnant women in Ebola infected countries. Many women are refused to be treated at healthcare centers just because of the possibility that they could be infected. As a result, many women are dying due to childbirth or having stillborn babies. Many are not supported at all during their pregnancy. That said, if the virus doesn’t kill them, many times their pregnancy will due to lack of healthcare.
This among many other healthcare situations are going untreated because of the stigma against Ebola and the fear of the disease. Even if the global community can begin to contain this outbreak, there will be huge repercussions to the communities and health systems in the countries. I believe the more we can educate and spread awareness of these realities, the more we can help to fight this stigma. What do you think about how we can move forward to support these women to get the access to care that they need?
Doucleff, M. (2014, November). Dangerous Deliveries: Ebola Leaves Moms and Babies Without Care. NPR: National Public Radio. Retrieved from http://www.npr.org/blogs/goatsandsoda/2014/11/18/364179795/dangerous-deliveries-ebola-devastates-womens-health-in-liberia
Last Thursday, President Obama announced an executive order that will protect approximately 4 million United States immigrants from deportation. The executive action will also grant those protected- those who have lived in the country for 5 years or more or who are parents to American citizens- temporary visas, which will allow them to legally work in the country.
What does this mean for reproductive health of immigrant women in the U.S.? Well, it increases the likelihood that immigrants will receive insurance benefits, if they have an employer who provides health insurance to employees. Hopefully, it will mean that many more immigrant women have access to affordable contraception, gynecological care, and maternal care.
However, I don’t think this executive order does enough to protect immigrant women’s sexual and reproductive health. The 4 million immigrants that are protected will still not be eligible for Obamacare. Although able to legally work, many of them will have low-wage jobs that do not offer insurance benefits. Although this order will improve the lives of the immigrants it protects, it does not fully address their right to healthcare. As the National Latina Institute for Reproductive Justice commented, Obama “can and should do more” to protect immigrants as he seeks to expand universal healthcare.
Since my view on this issue is pretty clear, I was wondering what you all think. Do you think universal healthcare should apply to immigrant women? Why is it important (or not) to provide healthcare to immigrant women?
Sources:
A Washington Post Article with some general information about Obama’s executive action (including a short video of his speech): http://www.washingtonpost.com/blogs/wonkblog/wp/2014/11/19/your-complete-guide-to-obamas-immigration-order/
Center for Reproductive Right’s reaction to the decision: http://reproductiverights.org/en/press-room/administrative-action-on-immigration-provides-relief-to-millions&s_src=E15SOC111419F&s_subsrc=datasync&utm_medium=social&utm_source=twitter&utm_campaign=E15SOC111419F
A Politico “blurb” about the decision: http://www.politico.com/politicopulse/1114/politicopulse16205.html
Family Planning is an issue that we have discussed briefly in this class, especially in the beginning. Although this is not a large issue in the US, developing countries are really struggling to control this. Nigeria is one of those countries, seeing as I did my presentation on the birthing practices in Nigeria, I decided to share this.
I read an article on Family Planning in Nigeria recently. The UN was advising that family planning be encouraged so that population growth can be managed. With a population of over 170 million (A figure that is expected to double in about 20 years and surpass the US in 2050), living in a country thats only a bit over two times the size of California, Nigeria is quickly becoming overpopulated.
The article also discussed how the country could benefit economically if family planning was promoted and encouraged. According to the director of the United Nations Population Fund Babatunde Osotimehin, Nigeria would benefit a great deal from a “Demographic Dividend” This demographic dividend occurs when “The working population of a country is larger than the younger dependent population” According to Osotimehin “A slight decline in fertility would raise output per capita by 5.6 percent over a span of 20 years and 11.9 percent over a 50 year span”
What are some policies that can be put in place to encourage family planning in Nigeria?
http://abcnews.go.com/Health/wireStory/agency-encourages-family-planning-nigeria-27002356
As Dr. Foster mentioned on Monday, prematurity is now the leading cause of child mortality. Looking into some of the links I came across the Every Preemie: SCALE (Scaling, catalyzing, advocating, learning, and evidence-driven). This really got me thinking about our Shiffman reading on political priority for global health initiatives. Before reading this article and looking to SCALE I did not truly realize how much went into advocating for specific causes and the work that goes into getting an initiative started. I knew there was a lot to it but I did not know how much political backing and the actors involved dictated the success of an initiative. In terms of premature births, SCALE aims to catalyze global uptake of preterm/low birth weight interventions, overcome bottlenecks and significantly increase coverage to decrease newborn mortality. Having political and global support is key in receiving funding and quicker implementation of intervention programs. I’m curious to see how the finding that pre-term birth is the number one cause of child mortality is going to influence upcoming policies in the Post-2015 Agenda.
Every Preemie: SCALE Facts
SCALES Expected Outcomes:
1. Improved translation of evidence into action through consolidation of evidence and focused implementation research to advance global understanding of how to implement and scale up preterm/LBW services and commodities.
2. Increased capacity of local, national and global entities (health care providers, community groups) to scale up and sustain the utilization of high impact interventions.
3. Increased prioritization of preterm/low birth weight with in-country decision makers and policy makers and other stakeholders at global and national levels.
SCALE Strategic approaches
1. A core package/toolkit of preterm material that will be offered to all USAID-supported countries
2. A country demonstration package for up to four countries that will serve as learning laboratories for scaling up high impact preterm interventions.
3. A custom package to respond to request from countries for specialized technical assistance.
Prematurity Number 1 Cause of Child Mortality:
-Every year, 1.09 million children under the age of 5 die due to health complications that are linked to premature birth (gestational age <37 weeks).
-The baby’s organs aren’t fully developed. Immature lungs don’t open as well.
-They are more fragile and susceptible to infection.
-In well-developed countries these babies can survive with neonatal intensive care, but in low-income countries this care is not available.
-The study suggests Kangaroo mother care as an easy and cost-effective way to prevent preterm newborn deaths.
Link to original article/study: http://ac.els-cdn.com/S0140673614616986/1-s2.0-S0140673614616986-main.pdf?_tid=ea63920a-7078-11e4-ac0d-00000aacb360&acdnat=1416462716_2aed48b562461ae0b3bcd2658a925878
Link to Every Preemie: SCALE information: http://www.usaid.gov/what-we-do/global-health/maternal-and-child-health/every-premie-scale-scaling-catalyzing-advocating
Hey, all.
During my presentation, a few of you inquired about pregnancies in prisons in other countries. Thus, I conducted some research on the treatment and outcomes in other systems. While perusing the literature, I came across some intriguing articles. Although I could not determine whether or not the prison systems in other countries operated comparably to the state prison system in the United States, the treatment of and outcomes for the pregnant prisoners appeared rather similar.
To begin with, I discovered a powerful article about shackling. The first link tells the story of Meriam Ibrahim, a Sudanese woman. She claims that she gave birth to her daughter while shackled to the floor of a prison. As a result, the child may suffer from various disabilities. Although the United States’ prison system does not require a woman to give birth shackled to the floor, the majority of the states do not have policies that prohibit shackling during labor and delivery. Thus, I pose the following question: Should the United States implement the same practices as a war-torn, developing country?
In addition to treatment during labor and delivery, I researched information on the postpartum period. The second link discusses residential childcare programs in the United Kingdom, as shown in Washington State for example. It states that the United Kingdom allows women to raise their children in special units as well. However, the prisons only accept children up to eighteen months of age to live in the “mother and baby” units, with the exception of one prison that prohibits children greater than nine months old. Furthermore, it appears that the child does not have to be born in the prison.Thus, the mother can raise her children (up to eighteen months old) from her life before incarceration in the programs as well. Again, this scenario raises the same question from my presentation. Should a child suffer for his or her mother’s crime? Even though the mother has parental rights, should a child be confined to the walls of a prison (especially if a relative could raise the child)?
Due to the similarities between the United States’ prison programs and the United Kingdom’s prison programs, I chose to research the birth outcomes of incarcerated women in the UK. The last link leads to an article in the Lancet that compares the birth outcomes of incarcerated women and women on probation. The study reports that the prison experienced 669 live births and 6 stillbirths. On the other hand, the women on probation only had 426 live births and 12 stillbirths. Thus, the women in prison had a higher percentage of live births, better outcomes, than the women on probation. As speculated in my presentation, the study concludes that the greater outcomes stem from the cessation of alcohol and drugs and greater access to healthcare among populations of similar socioeconomic status.
http://www.theguardian.com/world/2014/jul/01/meriam-ibrahim-child-disabled-born-shackled-floor
https://www.gov.uk/life-in-prison/pregnancy-and-childcare-in-prison