Fibroids are benign tumors that come in different sizes and can be found in different locations in the uterus. Fibroids may or may not show signs and symptoms thereby most of the time it is left undetected and unattended. It is only when its respective signs and symptoms worsen that a visit to one’s medical health practitioner is done by most of the affected women.

Fibroids are generally classified and named according to its location in the uterus. Subserosal Fibroids are those fibroids whose growths are perceived on the surface of the uterus. On the other hand, Intramural Fibroids are those that grow in the most muscular parts of the uterine wall. And Submucosal Fibroids are those that grow in the uterine cavity.

These fibroids differ in sizes as well. There are those small fibroids that cause no health problems thereby left unnoticed and needs not to be treated. In the meantime, there are those big fibroids that would cause the signs and symptoms that may prompt an individual to subject oneself to treatment and medical management by his/her medical health practitioner.

So to answer the question if small fibroids hurt, the answer is NO. Pain is one of the many signs and symptoms that an affected individual may experience. But pain can only become apparent if the fibroids have already grown so big that it already puts pressure on other bodily organs and structures.

Pain can be experienced in the different sites of the body – at the lower back, the lower abdomen, and the pelvis. Pain is due to the compression of the big and still growing fibroids. This compression does not only bring about pain but also other health problems such as frequent urination, urinary urgency, or the inability to urinate if it is the urinary bladder that is being placed with great pressure. Constipation, on the other hand, may also result from the pressure to the rectum.

Because pain is brought about by the pressure from the big and still growing fibroids in the uterus, it is therefore a must to know why these fibroids grow bigger and what its cause is. This is essential so as to avoid further enlargement of the fibroids in the uterus, thereby curtailing the discomforts brought about by pain due to the fibroids.

Estrogen is a hormone produced by the pituitary gland, a pea-sized endocrine gland. This hormone when present in high levels in the system may cause the fibroids to grow and enlarge. Estrogen levels may increase with respect to one’s weight. Obesity, one of the contributory factors of fibroids, increases the estrogen level to cater to the body’s needs, thereby feeding the fibroids allowing it to grow bigger. It is for this reason that medical health practitioners advise women to keep their ideal weight constant, starting from the age of 18.

Hormone therapy reduced risk for breast cancer after hysterectomy

Postmenopausal women who have undergone hysterectomy had a reduced incidence of breast cancer and cardiovascular events after treatment with conjugated equine estrogens, according to results from the Women’s Health Initiative.

However, researchers said estrogen did not have any effect on coronary heart disease, deep vein thrombosis, stroke, hip fracture, colorectal cancer or total mortality.

Researchers set out to examine health outcomes associated with randomization to treatment with conjugated equine estrogens (Premarin, Wyeth) among women with prior hysterectomy after a mean of 10.7 years of follow-up through August 2009. In the analysis, 3,778 women were assigned to daily 0.625 mg hormone therapy, whereas another 3,867 were assigned to placebo.

Participants were postmenopausal women aged 50 to 79 years recruited at 40 US locations from 1993 to 1998.

Rates of invasive breast cancer were similar during the intervention (HR=0.79; 95% CI, 0.61-1.02) and postintervention phases (HR=0.75; 95% CI, 0.51-1.09) of the study. Women in the estrogen group had a statistically significant lower cumulative incidence of breast cancer compared with the placebo group, 0.27% vs. 0.35% (HR=0.77, 95% CI, 0.62-0.95).

Incidence of colorectal cancer did not differ between the two groups.

Although the risk for stroke, deep vein thrombosis and pulmonary embolism were elevated during the intervention phase for women assigned to estrogen, researchers said the increased risk factor disappeared postintervention. For all cardiovascular events, the HR was 2.26% in the estrogen group vs. 2.12% in the placebo group.

Writing in an accompanying editorial, Emily S. Jungheim, MD, MSCI, and Graham A. Colditz, MD, DrPH, said although these results show that adverse event rates are low and largely limited to current use of unopposed estrogen, there does not appear to be a substantial benefit associated with hormone therapy.

“There may still be a role for short-term use of unopposed estrogen for treating some women with menopausal symptoms, but this role may be vanishing as existing and emerging data continue to be better understood in terms of application to patients,” they wrote. “Despite the evidence linking unopposed estrogen [hormone therapy] use to breast cancer, many clinicians and patients make decisions to use hormone therapy. Clinicians must be aware of the implications of these decisions. They must interpret new and existing data, and must understand the value and limitations of the data when making recommendations.”

CI rains lathi blows on women

VIZIANAGARAM: In a blatant display of power and arrogance, a circle inspector indiscriminately beat up women health workers, including elderly persons, here on Thursday when they were demanding their pending wages.

The police official, T Trinadh, was suspended and an inquiry ordered by the government after women’s organisations raised a furore over his actions.

Trinadh rained lathi blows on Asha health workers at Mayuri junction here in a bid to stop them from laying a siege to the office of the district medical and health officer. Even before the injured women could recover from their shock, the CI kept targeting other women with his lathi.

What left the passersby gasping in shock was his brutal assault on a 60-year-old woman. Three other elderly women also suffered severe injuries. An elderly woman, who was sent reeling under an avalanche of lothi blows, pleaded for mercy but the CI would have none of it. She could not get up for almost 20 minutes because of a severe pain.

It all started when the Asha workers were staging a protest and involved in a tussle at Mayuri Junction with women constables. The agitators, who were conducting a peaceful rally, were stopped by the cops when they wanted to enter the DM&HO office. In the melee, two women constables fell down. Upon seeing this, the CI lost his cool and started beating up whoever came in his sight even as the terrorised women ran for cover.

Shockingly, nearly 350 constables, including 15 women cops, were deployed to `control’ the agitating workers. Sources said that not a single cop was involved in the lathicharge except the CI. “He was the only one who caned the women in a brutal manner. No civilised cop would treat women in such inhuman manner,” women’s activist Vimala said.

After public outcry and video footage continuously aired on various TV channels, home minister P Sabita Indra Reddy inquired about the incident and asked Vizianagaram SP Naveen Gulati to take immediate action against the official. The CI was suspended later.

Progressive Organisation of Women’s leader P Sandhya said that it was a vulgar display of brutal power of police, while Devi of Praja Natya Mandali said it had become a habit for cops to show their brute power on helpless women.

Meanwhile, Naveen Gulati agreed that the CI had over-reacted. “But the Asha workers had targeted the cops and two women home guards received injuries,” he said. Additional SP G Prem Babu would conduct a probe into the incident.

Religious Leaders Speak Out on Women’s Health

Are politicians ruining women’s health? That’s what some say, when it comes to issues like abortion. Today, advocates for women’s health care rallied in Washington. But locally, the religious community took a stand.

Newschannel 8′s Kim Jackson was there. Abortion and women’s choice were both topics a sanctuary today. Religious leaders were speaking out after a controversial abortion bill went too far, in their opinion.

Reverend Mary McAnally says she was compelled to tell her own story.

“Date raped at 16, 100 years ago, before Roe v Wade. I had to go to Arkansas for an illegal abortion. I was rendered unable to have children because of the damage,” she explained from the podium at All Souls Unitarian.

She and other religious leaders feel politicians are damaging women’s health. In Oklahoma, they are against a bill that bans abortions, after 20-weeks.

The bills author, says it’s because a fetus can feel pain—some here don’t buy that.

“The research is conclusive, not accurate,” said Kelly Jennings, who also co-heads up the Oklahoma Religious Coalition For Reproductive Choice.

The group invited other religious leaders to speak out against Oklahoma’s controversial bill. because they say it violates a woman’s religious rights.

“There are so many decisions that women have to make in healthcare and that needs to be between a woman and her doctor, and a woman and her faith leader,” said Jennings.

Faith leaders there, said lawmakers should back off. But the bill has been approved in the house and the senate so far.

Reverend McAnally says she went on to adopt two children, decades ago. But today, she speaks out and is pro-choice, from the pulpit.

“The support is for government to leave us alone, not to try to define what we should or shouldn’t do health wise,” she said.

Estrogen-Only Hormone Therapy Is Safer Than Previously Thought

A new study suggests that hormone therapy for menopausal women—long thought to be linked to health risks, particularly stroke—might not be so dangerous, at least in the case of women who have had hysterectomies. The Los Angeles Times is reporting that according to the Women’s Health Initiative, long periods of estrogen-only therapy can sometimes be appropriate:
Although many women have sworn off hormone therapy, a new analysis from the clinical trial that first unearthed the hormones’ risks shows taking estrogen alone for menopausal symptoms, even for several years, may be safer than first thought.

The new finding—the latest from the Women’s Health Initiative, a federally funded trial that tracked thousands of women taking hormones or placebo pills for years—looked at women who have had hysterectomies and thus can take estrogen unaccompanied by another hormone, progestin. (Women with a uterus take progestin to protect against uterine cancer.) It found that a heightened risk of stroke from taking estrogen faded with time, while a reduced risk of breast cancer held steady.

That news, published Tuesday in the Journal of the American Medical Assn., may weaken—for this group of women—the current recommendation from doctors that hormones to treat hot flashes and other menopausal symptoms should be taken in the smallest doses possible for the shortest amount of time.

Note to Congress: Planned Parenthood is Not a ‘Women’s Health’ Organization

As everyone waits with baited breath to see if there will be a federal government shutdown, few have closely examined one of the bigger sticking points in the budget debate: Funding for Planned Parenthood. In mid-February, the House voted to defund Planned Parenthood by a vote of 240 to 185. Meanwhile, in the upper chamber, forty-one senators have pledged to oppose any spending bill that threatens defund the organization.

The organization is deeply concerned about being losing federal funds. Startled by the intensity of the campaign on Capitol Hill to defund its work, Planned Parenthood is fighting back with a series of TV ads branding itself as a women’s health care organization. One ad features a middle-aged white woman who says she is alive today because Planned Parenthood diagnosed her cervical cancer. Contraception? Not even mentioned. Abortion? Nowhere in sight. Instead Planned Parenthoods describes itself as a leader in the fight against cancer and HIV.

Ads like these make an important point: Women have broader health care needs than abortion. But is women’s health care Planned Parenthood’s central identity? For decades Planned Parenthood and its political supporters have asked us to believe that the answer is “yes,” and that what’s good for Planned Parenthood (i.e. government funding) is good for women. Now appears to be an opportune moment to rise above culture war partisanship in order to take a serious look at this assertion. At the heart of opposition to continued government funding of Planned Parenthood are claims that the organization is extensively and aggressively involved with abortion. These claims are accurate. Planned Parenthood performs more than one out of every four abortions in the United States today. Its abortion revenues – based upon figures from its tax returns, annual reports and website – account for more than one third of all its medical services revenues. In the past decade, increases in government funding of Planned Parenthood have regularly corresponded with its performing increasing numbers of abortions.

Planned Parenthood’s stance on abortion is also fairly characterized as aggressive. A review of every reported lawsuit in which Planned Parenthood has been a party over the last 50 years indicates that they hold legal and cultural opinions on abortion very far removed from what Americans understand to be the “common ground” shared between most pro-life and pro-choice citizens. Planned Parenthood has sued to stop laws securing parents’ involvement in their minor girls’ abortions, laws requiring full informed consent and waiting periods before abortion, laws banning “intact dilation and extraction” (a.k.a. “partial-birth”) abortions, and safety regulations setting time-limits for the use of abortion-inducing drugs. They have also sued to limit the expansion of crisis pregnancy services offering free help to low-income, pregnant women who wish to give birth.

Planned Parenthood officials are even on record attacking the constitutionality of laws banning sex-selection abortion. They also seek to soften or avoid the impact of sex abuse reporting laws applicable to minor girls. In a 1986 lawsuit, Planned Parenthood opposed child abuse reporting law regarding minors under 14 on the grounds of minors’ “constitutional right to privacy,” alongside Planned Parenthood’s claimed duty to preserve patient confidentiality. Presently, Planned Parenthood is fighting a bill in Illinois which would require its staff and volunteers to be mandatory reporters when they suspect the sexual abuse of minors. Planned Parenthood claims that the bill is unnecessary because medical personnel are already obliged to report; they also wanted to spare the relevant government office from reporting “overload.” Interestingly, Planned Parenthood has removed this argument from its own website after various reports about it emerged. Only a “screenshot” of the correspondence preserved by pro-life groups remains searchable by the public.

Biggest Health Mistakes Women Make

Experts say the number one mistake women make is getting their health information from the wrong source and not doing their own homework when it comes to their bodies.

Dr. Holly Thacker, the Director of the Center for Specialized Women’s Health at the Cleveland Clinic stopped by Channel 3 to break down the misconceptions of women’s health.

U of A seeks women in the trades to study gender-specific health risks

Erin Meetoos is apprenticing to be a welder because she thinks it’s a fun, exciting, challenging and well-paid occupation, but she knows it will put her health at risk.

“I know I’m probably going to lose some of my hearing, and my sight, I suppose. And all the fumes I’m inhaling does worry me about how my breathing will be in a few years,” the 22-year-old NAIT student says, citing job-related hazards she’s been told about.

But she doesn’t know what other health issues await her as a female welder or what, if any, impact her job might have on the health of a baby, if she were to get pregnant again, or on her ability to become pregnant.

“It concerns me because I would like to have more children in the future,” says Meetoos, who has a two-year-old daughter.

“If I was pregnant, would I (weld) for maybe four months and then stop until the baby is born? Maybe I shouldn’t work at all if I’m pregnant.”

No one, not even Alberta Workplace Health and Safety, knows what to do with a pregnant welder, because the studies that are available deal only with male welders, and many of those date back to the 1960s, says David Hisey, chairman of the Canadian Standards Association’s safety committee.

A study from Finland in 2008 suggested babies of women and their male partners, if either were welders, were born small for the gestation period or premature, Hisey says. But the findings weren’t definitive because the study was based on the birth of only 13 babies.

That’s why the CSA has asked two University of Alberta professors in occupational medicine to do the research. Their project is called the WHAT-ME (Women’s Health in Alberta Trades-Metalworking and Electricians) study. Metal- working jobs include welders, pipefitters, steamfitters and boilermakers.

About 1,800 women work in these untraditional trades in Alberta, and lead researchers Nicola Cherry, who heads the occupational medicine program at the U of A, and Jeremy Beach want as many of them as possible to sign up for the study.

The study will follow the women for at least two years, keeping tabs on their health and looking for any effects possibly related to their work, including pregnancy problems, Cherry says.

Cherry was first approached to do the study seven or eight years ago, “but I was not enthusiastic at the time, because I’m always worried with these studies of women that it will backfire, and the easiest thing for an employer to do is say, ‘We won’t employ any women’.”

The women who have so far signed up for the study, ranging in age from 18 to 60, have expressed concern about what their trades jobs are doing to their health.

For example, welders of both sexes can develop respiratory problems and metal-fume fever (similar to the flu), and arc welders can have problems with their eyes and skin.

“It is a hazardous trade,” Cherry says.

With Alberta on the verge of another boom in the energy industry, and qualified trades workers already scarce, Hisey expects even more women to apprentice in these jobs in the next couple of years, making it more important than ever for them to know what health hazards come with the work.

When Hisey worked for Syncrude Canada in Fort McMurray, “we had an unwritten policy that we just took (pregnant welders) out of the workplace,” he says. “The downside is, if the person is an apprentice, they lose their trade hours, and unless the company provides alternative employment, they’re going to lay the individual off.

“Generally, the women decide to go back to work,” Hisey says.

Quebec has a policy that takes pregnant workers out of the workplace when they work in trades where there might be some harm to the unborn child, even though there may be no documented proof, Hisey says. But they are the only jurisdiction in Canada that does, he adds.

“In Scandinavian countries, if you are allowed 1.0 of some substances as a normal worker, you’re allowed 0.5 if you’re pregnant, whether it affects you or not,” Hisey says.

“In North America, we like to say, ‘How many babies died because of that?’ It’s a numbers game here.”

The U of A study won’t be the final word on the issue. It will provide another source of information that, when all are pulled together, will allow better decisions about what, if any, health hazards are related to the jobs women are doing in metalworking and electrical trades.

“I know there are lots of welders pregnant in Alberta, and they need to have the information currently available, and Dr. Cherry needs the data that their bodies will provide,” Hisey says.

“If there are problems with those pregnancies, if there are problems with child birth, if there are problems with the child after they’re born, that needs to be documented so we can prevent it from happening to others.”

Smoking doesn’t boost breast cancer risk

A new study has suggested that there is a significant link between smoking and breast cancer risk in postmenopausal women, but it depends on their body weight.

A significant association between smoking and breast cancer risk was observed in non-obese women, but not in obese women.

The results from an analysis of the Women’s Health Initiative observational study were similar regardless of whether obesity was defined by body mass index (BMI) or waist circumference.

Juhua Luo, assistant professor in the department of community medicine at West Virginia University, and colleagues examined the relationship between obesity, smoking and breast cancer risk.

“We found an association between smoking and breast cancer risk among non-obese women, which is understandable because tobacco is a known carcinogen,” she said.

“However, we did not find the same association between smoking and breast cancer risk among obese women. This result was surprising.”

The study included 76,628 women aged 50 to 79 years old who had no previous history of cancer. Participants were part of the Women’s Health Initiative observational study. They were recruited between 1993 and 1998 at 40 U.S. centers and were followed until 2009.

Obesity was measured by BMI and by waist circumference, and the results were adjusted for other breast cancer risk factors.

The study results indicated that non-obese women with a BMI less than 30 who had a history of smoking had a significantly higher risk for breast cancer. Those who smoked from 10 to 29 years had a 16 per cent excess risk; those with a 30- to 49-year history of smoking had a 25 per cent excess risk; and those with 50 or more years of smoking had a 62 per cent excess risk. However, this same association was not found among women with a BMI over 30.

The researchers then examined the data according to waist circumference to determine if the type of fat distribution – general compared with abdominal obesity – affected the results. When obesity status was defined by a waist circumference greater than 88 cm, similar results were found.

Despite the study’s finding that smoking did not affect breast cancer risk among obese postmenopausal women, Luo emphasized that she does not want to give the public the wrong message. Previous research has established that obesity alone is a risk factor for postmenopausal breast cancer.

“Smoking and obesity are among the leading causes of morbidity and mortality, both of which have substantial consequences on health,” she said.

“This is only the first study to examine the interaction between smoking, obesity and breast cancer risk. The main conclusion from this research is that more studies are needed to confirm these results,” she added.

The findings were presented at the AACR 102nd Annual Meeting 2011.

Is the NFL Bad For Women’s Health?

Just prior to the Super Bowl in 1993, a news conference was held by a coalition of women’s groups informing reporters of substantial evidence that domestic violence rose significantly (as much as 40 percent) on Super Bowl Sunday. The subsequent flurry of media attention resulted in this news becoming a “fact” (you’ll see why I have added the quotes shortly) in the psyches of professional football fans and detractors alike. It also led many people to affirm their belief, however inaccurate, that football fans were a bunch of knuckle-dragging misogynists who, out of frustration at seeing their team lose, beat their wives and girlfriends. However, several investigations reported by the urban-legend-debunking web site snopes.com demonstrated that “the claim that Super Bowl Sunday is ‘the biggest day of the year for violence against women’” was simply not true.

Now move ahead 18 years and a new scientifically rigorous study conducted by two economists offers compelling evidence that there is a significant link between the outcomes of professional football games and family violence (not the Super Bowl specifically), though only with certain game outcomes. Let me explain.

The researchers compared data compiled from the National Incident Based Reporting System of crime statistics from 750 law enforcement agencies with more than 900 NFL regular season game scores involving six teams (Carolina Panthers, Denver Broncos, Detroit Lions, Kansas City Chiefs, New England Patriots, and Tennessee Titans) over an 11-year period . But they went behind just wins and losses. They also looked at which team was favored, whether the opposing team was a traditional rival or in playoff contention, and whether the game was at home or away.

The results are disturbing, though not that surprising. The study reported that, in games that ended in an “upset loss” (the home team was favored to win by four or more points by the Las Vegas point spread), domestic violence spiked by ten percent. When the upset winner was a rival, domestic assault calls rose by 20 percent. These researchers are obviously real data hounds because they also reported that the rise in violence occurred when the fans’ teams were in playoff contention, were penalized significantly, and when the quarterback was sacked more than three times. Moreover, increases in reported violence occurred within a window of a few hours following the conclusion of the game.

Close games, away-game upset losses, and “upset wins” (when the home team wasn’t expected to win) didn’t have any impact on the rate of domestic violence. And there were no increases in violence by women against men.

I should note that this ten percent spike domestic violence is not nearly as high as that occurs on major holidays (New Year’s Day shows the greatest increase at 31 percent) and is about the same as occurs on hot days, another high point (or should I say low point) of family violence.

The researchers assert that emotional cues caused by the outcomes of NFL games have a significant effect on domestic violence, specifically the emotional shock and frustration that male fans experience when their team loses a game that it was expected to win. Additionally, they posit that the loss of control that occurs following their team’s unexpected loss can further trigger violent behavior. Though not addressed in the study, it’s also likely that the consumption of alcohol, a well-documented behavioral disinhibitor (sorry for the psych-speak), and the testosterone and adrenaline that often saturates the viewing environments of football games (sorry for the stereotype) may very well contribute to the increase in domestic violence.

What is particularly interesting, and perhaps controversial, is that they assert that “any difference between the rate of family violence following a win or loss as a causal effect (italics added by me) of the outcome of the game.” The researchers aren’t simply arguing that this relationship is just coincidental or correlational, rather they’re saying that the results of professional football games are the direct cause of the increase in domestic violence. They do, however, suggest that any activity that triggers strong emotional reactions, such as getting a speeding ticket, would have a similar effect. In conjunction with the theories they form the foundation of their analysis, they postulate that these scenarios increase the chances of such assaults occurring in families in which conflict is already present.

So what conclusions can we draw from this unsettling study? First, and I say this in dead seriousness, football fans need to get a grip and get a life. What causes the aforementioned emotional cues to have such a significant impact on fans is that they are so heavily invested in their teams. I studied fan violence a number of years ago and found that the line between fan and fanatic is crossed when fans “over-identify” with their teams, meaning their self-esteem becomes inextricably linked to the successes and failures of their team. Indications of this overinvestment may be in evidence when, for example, fans talk about “my” team or how “we” are doing, when their emotional reactions are out of proportion to the impact the team has on their lives, and when, I suppose, fans paint their houses the team colors.

I’m all for rooting for the home team. Following a favorite team is an exciting and bonding experience. And reveling vicariously in the team’s victories and mourning their defeats can be equally engaging. But when the line between being a fan and being a fanatic is crossed, that level of fandom strikes me as being pretty darned unhealthy. It should, at a minimum, be a sign to such fans that they may need step back, take a hard look in the mirror, and reflect on the role that watching football plays in their lives. At a maximum, these fans might consider finding fulfilling activities in which they can actually participate rather than just spectate.

Before I move on, I want to make it clear that I am not an authority on domestic violence, so the following suggestions are simply offered as common-sense steps for a very sad situation. Women whose husbands and boyfriends (or, for that matter, fathers, brothers, and uncles) are prone to violence should take this research to heart and ensure that they aren’t home for that short window of time following upset losses. It sure seems unfair that the onus has to be on the potential victims (e.g., find out who the team is playing, check the point spread, etc.) to avoid such egregious behavior; they shouldn’t have to live in fear of their significant others’ inexcusable behavior. But better control and proaction than falling victim to domestic violence.

Ob-Gyns And Midwives Seek To Improve Health Care For Women And Their Newborns

The American College of Nurse-Midwives (ACNM) and The American College of Obstetricians and Gynecologists (The College) are pleased to announce the publication of a new “Joint Statement of Practice Relations between Obstetrician-Gynecologists and Certified Nurse-Midwives/Certified Midwives.” The landmark document highlights key principles to facilitate improved communication, working relationships, and seamlessness in the provision of maternity care and other vital women’s health services.

“Health care is most effective when it occurs in a system that facilitates communication across care settings and among providers,” according to the joint statement. “Ob-gyns and CNMs/CMs are experts in their respective fields of practice and are educated, trained, and licensed, independent providers who may collaborate with each other based on the needs of their patients. Quality of care is enhanced by collegial relationships characterized by mutual respect and trust, as well as professional responsibility and accountability.”

The College and ACNM affirmed their shared commitment to the following:
- Support of evidence-based practice
- Promotion of the highest standards for education, national professional certification, and recertification
- Accredited education and professional certification preceding licensure as essential to ensure skilled providers at all levels of care across the United States
- Recognition of the importance of options and preferences of women in their health care
- Ob-gyns and CNMs/CMs must have access to affordable professional liability insurance coverage, hospital privileges, equivalent reimbursement, and support services in order to establish and sustain viable practices
- Ob-gyns and CNMs/CMs must have access to a system of care that fosters collaboration among licensed, independent providers to ensure highest quality and seamless care

The joint statement is part of an ongoing ACNM and College initiative to promote collaborative practice between obstetrician-gynecologists and certified nurse-midwives and/or certified midwives. Through The College’s 2011 Issue of the Year, “Successful Models of Collaborative Practice in Maternity Care,” The College and ACNM jointly called for papers describing sustainable models of collaborative practice involving both groups, noting that, “The impending maternity care workforce crisis necessitates focusing on best practices across the United States.” More than 60 papers were submitted for consideration; winning papers will be announced at The College’s upcoming Annual Clinical Meeting, April 30-May 4, in Washington, DC, and winners will also be honored at the ACNM 56th Annual Meeting, May 24-28, in San Antonio, TX.

“CNMs and CMs and ob-gyns are with women in some of the most important moments in their lives,” said ACNM president Holly Powell Kennedy, PhD, CNM, FACNM, FAAN. “By strengthening the way our independent professions work together, we believe that we can more effectively provide the highest quality care that women expect and deserve. We anticipate that this historic document will usher in a new era of enhanced cooperation between our professions.”

“Ob-gyns working collaboratively with midwives is a way to address the gap between the supply of ob-gyns and the demand for women’s health care services,” said Richard N. Waldman, MD, FACOG, president of The American College of Obstetricians and Gynecologists. “As a result, access to health care will be greatly improved.”

With roots dating to 1929, ACNM’s mission is to promote the health and well-being of women and newborns within their families and communities through the development and support of the profession of midwifery as practiced by certified nurse-midwives and certified midwives. Midwives believe every individual has the right to safe, satisfying health care with respect for human dignity and cultural variations.

Opinion: Protecting California women’s access to affordable care

March 23 marked the one-year anniversary of the enactment of the Patient Protection and Affordable Care Act (PPACA). In recent months, some states have become engrossed in the politics of congressional repeal efforts and the legal reasoning underlying federal judicial opinions. Meanwhile, in California, we are committed to maintaining an aggressive pace in implementing the federal health care law.
Even as there is uncertainty over the law’s implementation, by moving forward with policies that remove antiquated barriers to adequate health care coverage, California will remain well-positioned to advance long-sought goals regarding coverage expansion, affordability, and health status improvements. Although the people of California will realize the greatest benefits from the expansion and improvement of coverage beginning in 2014, several PPACA provisions have already been implemented and will provide important transitional support. Many of these early provisions particularly benefit women.

PPACA makes important advances for women’s health. The law offers many opportunities to improve access to care and coverage for California women of all ages, ranging from insurance system reforms, to lowering out-of-pocket costs, and securing comprehensive benefits packages that address women’s health needs across the course of their lives.

This landmark legislation would expand access to affordable coverage in several ways by 2014, but, if the law is repealed, California women will be further obstructed from obtaining timely, cost-effective care and preventive services. Because of challenges associated with enacting major changes to the health care system, it is shortsighted fiscal policy to curtail investment in preventive programs with long-term cost saving benefits. Furthermore, California’s rising healthcare spending has reached a tipping point. Implementing the law is a critical step towards curbing the Golden State’s skyrocketing medical costs and making health care truly accessible and affordable for the women of California.

Much of the work required to successfully implement effective strategies for promoting value in California’s health care spending requires advance planning. A prime example of a proactive solution to the financing and delivery of health care is the recent introduction of ACOG-backed legislation to ensure that women receive equitable access to comprehensive maternity health coverage in California. While PPACA mandates maternity coverage in all new policies sold to individuals as of 2014, if the law is repealed, plans will not be required to include coverage of comprehensive maternity care services. Equal access to affordable maternity coverage is vital to obtaining prenatal care, which is essential to ensuring the health of women and their pregnancies. A lack of prenatal care negatively impacts public health costs.

The implementation of PPACA is likely to stabilize and reverse California women’s growing exposure to health care costs. Even though the challenge of high health care costs is not exclusive to the Golden State, the health care needs of California’s women coupled with the state’s intricate health care landscape mandate that California continue to forge ahead with implementation.

The health care needs of women require specific attention, especially during their reproductive years, which leaves women more vulnerable to problems resulting from an inability to obtain coverage. Estimates peg the aggregate number of uninsured California women (ages 18-64) at nearly 3 million. Of these uninsured women, 92 percent are projected to qualify for federal assistance under PPACA. Despite the fact that the new law provides a major opportunity to advance a culture of coverage and improve the health of California women, successful implementation of PPACA in California will be shaped by several of the state’s distinctive features.

California is home to some of the world’s best hospitals and health care providers, but also has the largest total number of uninsured citizens – more than 7 million — of any state. California’s large size means that health care is organized, delivered, and financed differently throughout the state. Barriers to timely, cost-effective care present an enormous challenge to the state, particularly among California’s less populated and underserved regions. Even where health care services are readily accessible, financial barriers may delay or prevent low-income California women from receiving timely, cost-effective care.

In a state as complex as most countries, California’s aggressive push forward is necessary to take full advantage of opportunities to improve state health care programs vital to women’s health and to obtain federal funds to help carry out the numerous PPACA provisions that will benefit millions of California women. The imperative to move forward comes at a time of continued state fiscal distress and state and federal political transition. The California Legislature is in the process of implementing tough budget cuts – further decreases in federal health care funding would truly be catastrophic to California’s women.

If California is successful in its implementation, the Patient Protection and Affordable Care Act holds the potential to transform access to comprehensive, quality reproductive health care and accomplish other reforms that will strengthen the state’s existing health care system’s ability to serve millions of women.

Pence: De-Funding Planned Parenthood Won’t Hurt Women’s Health

Congressman Mike Pence, who is heading up the effort in the House to revoke taxpayer funding for the Planned Parenthood abrotion business says nothing in his amendment will hurt efforts to promote women’s health.

Pence, in a new opinion column at National Review Online, says the notion that women would be unable to have access to low-cost breast canccer screenings or other medical care and treatment is phony.

On Feb. 18, 2011, with bipartisan support, the House of Representatives passed the Pence Amendment, which would end taxpayer funding for Planned Parenthood. In response, Planned Parenthood used its vast resources to launch slick Madison Avenue television ads portraying the group — the nation’s largest abortion provider — as an altruistic organization that provides health-care services to the poor and has only an incidental interest in abortion.

Despite efforts to suggest otherwise, the Pence Amendment does not reduce funding for cancer screenings or eliminate one dime of funding for other important health services to women; the money that does not go to Planned Parenthood as a result of the Pence Amendment will go to other organizations that provide these services. If the Pence Amendment becomes law, thousands of women’s health centers, clinics, and hospitals will still provide assistance to low-income families and women. The Pence Amendment would simply deny any and all federal funding to Planned Parenthood.

Planned Parenthood clinics focus mainly on abortion — and because money is fungible, there is no way to fund the useful services without freeing up money for the organization to spend on abortion. In 2009, the group made only 977 adoption referrals and cared for only 7,021 prenatal clients, but performed a record 332,278 abortions. In other words, a pregnant woman entering a Planned Parenthood clinic was 42 times more likely to have an abortion than to either receive prenatal care or be referred for adoption. Planned Parenthood recently made plain the centrality of abortion to its mission by mandating that every one of its affiliates have at least one clinic that performs abortions within the next two years.

Advocates for the abortion industry have sought to portray efforts to defund Planned Parenthood as a “War on Women,” but the issue is big business, and that business is abortion. This legislative battle is about Big Abortion vs. American taxpayers. As Abby Johnson, a former Planned Parenthood director, recently said, “Planned Parenthood’s mission, on paper, is to give women quality and affordable health care and to protect women’s rights. In reality, their mission is to increase their abortion numbers and in turn increase their revenue.”

According to its most recent annual report, the organization raked in $1.1 billion in total revenue. Of that amount, $363.2 million came from taxpayers in the form of government grants and contracts. While current law prohibits Planned Parenthood from directly using tax dollars on abortions, taxpayers subsidize its overall operation, freeing up funds that can be diverted to direct spending on abortion.

And Big Abortion routinely puts profits over women’s health and safety. When women testify in favor of tightening safety standards at clinics, Planned Parenthood fights them. And despite the fact that 88 percent of Americans favor informed-consent laws that provide information about the risks of, and alternatives to, abortion for women, Planned Parenthood opposes these efforts and works to keep women in the dark. And tragically, in some instances, Planned Parenthood has refused to cooperate when law-enforcement officials have sought information to help girls they believed to be victims of child rape or molestation.

Society needs to prepare now for ageing

A ground-breaking report released today highlights the wide range of health care needs affecting older women.

It warns that individuals, communities and health care systems need to be prepared for major health and social changes associated with ageing.

The Women, Health and Ageing report, from the internationally-renowned Australian Longitudinal Study on Women’s Health (ALSWH), also highlights the increasing levels of serious health risks, illness and disability among future generations.

The joint University of Newcastle and University of Queensland study has repeatedly surveyed more than 40,000 women since 1996, and the current report focuses on changes in the health of women born between 1921 and 1926.

Significant findings of the study were:
• Most older women in the study were living with multiple conditions and increasing levels of disability
• Arthritis is a particularly common condition affecting most women in the study, leading to poor quality of life, pain, physical and social limitations and increased health care use
• Women with stroke or cancer have highest use of health care services and had a particularly poor quality of life
• Conditions such as diabetes could be better managed in accordance with current guidelines
• Some surgical interventions may have a profound effect on women’s continued well-being.

UQ’s Professor Annette Dobson said although extrapolation from one age group to the next was difficult, the situation may be substantially worse when today’s young women age, mostly because of the growing problem of obesity and higher uptake of smoking.

Professor Julie Byles, from the University of Newcastle, warned older women should not be treated as one homogenous group.

“While physical abilities have declined for many women in the study, large numbers continued to maintain quite high levels of good health. Likewise, even though women were ageing and had increasing levels of disability and needs for care, many were still providing care for others and making major contributions to their communities.

“Ageing well needs healthy inputs throughout life and requires starting early. The study findings also show clear trends according to women’s education levels, body weight, and past and current smoking.”

The study confirms from a long-term perspective, lifetime maintenance of low risk behaviours is the best prospect for reducing the impact of chronic conditions and associated health care costs.

The Women, Health and Ageing report was released at the Australian Association of Gerontology NSW Rural Conference at Cessnock today.

The study is funded by the Department of Health and Ageing and is available online.

The ALSWH is funded by the Australian Government through the Department of Health and Ageing.

Researchers based in Newcastle work in collaboration with HMRI – a partnership between Hunter New England Health, the University of Newcastle and the community.

Millions of Women Could Lose Insurance Coverage for Abortion

Amid celebrations marking the first anniversary of the health care law, there is serious concern about the future of insurance coverage for abortion for millions of women. As a direct result of the Affordable Care Act, an unprecedented drive to ban insurance coverage of abortion is sweeping across the country. This is a coordinated, opportunistic attack that is blind to women’s real lives and unjust to women’s real needs. If it succeeds, the damage to women’s health care may well exceed that of individual state laws such as mandatory counseling and sonograms, forced delays, and bans on specific procedures.

Few people are aware of how devastating this attack is, which is why education and advocacy are the main thrust of the Religious Coalition for Reproductive Choice’s national campaign, Insure Women, Ensure Our Future (http://rcrc.org/InsureWomen/index.html). Essentially it involves the insurance exchanges being set up by states, the marketplaces where millions of people will get and purchase insurance starting in 2014. Medicaid recipients will get insurance there, but so will people who pay for insurance and get insurance through their employer. After the health care law was signed, five states almost immediately passed bills to prohibit insurance plans on the exchanges from covering abortion except in dire circumstances such as to save the woman’s life. Now, a year later, 22 more states are considering similar bills. Nearly half of those are also considering making it illegal for all private plans to cover abortion.

Along with low-income women who receive Medicaid, an estimated 14.5 million women who are insured by their mid-sized and large employers would be affected by these restrictions, according to the Employee Benefits Research Institute. In addition, anti-choice Republicans have passed two bills to restrict coverage — HR 3 (the “No Taxpayer Funding for Abortion Act”) and HR 358 (the “Protect Life Act”). While these may not make it out of the Senate, they pose another threat.

Contrast that to the fact that about 80 percent of private plans now cover pregnancy termination and the impact becomes clearer.

The challenge now is to educate policymakers and voters about the extreme nature of these restrictions and stop these bans. This a pro-choice country at heart — some people may have reservations about abortion but they are firmly and consistently in favor of options that include family planning, contraception, and sexuality education and in favor of women making decisions with dignity and minimal governmental interference. One in three women will have an abortion procedure at some time in her life. Millions of women should not be penalized because some don’t approve of this procedure.

Insurance coverage for pregnancy termination has had a low profile until now because it was not threatened. Now that it is, it is critical to understand that insurance helps guarantee access to needed reproductive health care services. It is also critical to make it clear that there are already ample safeguards against taxpayer money being used for abortion except in limited, dire circumstances; that is a red herring, a tactic to divert attention from the real goal of further restricting access to a procedure that is an integral part of women’s reproductive health care.

Progress in expanding health care coverage to millions of Americans and doing away with injustices in the system is long overdue and should be celebrated. But victory at the expense of women’s comprehensive reproductive health care is no victory at all.