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Uganda: Pregnancy and Childbirth Mean Playing Russian Roulette With Women’s Lives

10:13 am in Uncategorized by RH Reality Check

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Written by Jessica Mack for RH Reality Check. This diary is cross-posted; commenters wishing to engage directly with the author should do so at the original post.

Sylvia Nalubowa’s surviving twin is two-and-a-half; Jennifer Anguko’s baby turned one this past winter. Both of their mothers died giving birth to them – they are orphans of maternal mortality, an epidemic that continues to plague Uganda as it does the rest of the developing world. But these babies are also children of history.

Their mothers have become the face of a landmark case in Uganda that seeks, for the first time, to assign blame to the government for the deaths of women in childbirth. Last March, Ugandan human rights groups joined families of the deceased to file Constitutional Petition 16, alleging that the Ugandan Government failed to protect the women’s constitutional rights to life and health by allowing them to die in ill-equipped and poorly managed public hospitals, or failing to provide them with basic maternal care.

“We are seeking a declaration that maternal deaths happening due to avoidable causes is a violation of the right to health,” said Primah Kwagala, a lawyer for the Centre for Health, Human Rights and Development (CEHURD), a lead petitioner of the case. “The government should own up and increase funding towards maternal Health, and fulfill the Abuja Declaration to give at least 15% of the annual budget to the Health Sector.”

One of the key complaints in the petition is the Government spends just one-quarter on maternal health of what it pledged to spend, per capita.

Each woman died of negligence, essentially, as do 1 in 35 Ugandan women during pregnancy or childbirth. From ill-equipped health workers untrained for obstetric emergencies to inaccessible clinics, birth control stock-outs, and unsafe abortions gone very wrong, women in Uganda are forced to play Russian Roulette with a failing health system.

The petition was filed in March and heard in October, garnering impressive and global attention from advocates and media around the world. It seemed a rare breakthrough in an endless news cycle that treats maternal deaths as sad, but inevitable.

“Maternal health has been overlooked, as people seem to look at it as the daily status quo. People do not know that they have a right to good health service provision; they think it is a privilege,” said Kwagala.

An objection was raised during the petitions hearing which derailed promising momentum, and which must first be ruled upon before the actual petition hearing can move forward. Since then, five months have elapsed and the global media has long since packed up. Read the rest of this entry →

South Dakota: What the Hell Are They Thinking?

7:04 am in Uncategorized by RH Reality Check

Written by Charlotte Taft for RHRealityCheck.org – News, commentary and community for reproductive health and justice.

Now that South Dakota has actually passed legislation requiring every woman seeking an abortion to be ‘counseled’ by a Fake Clinic, it’s obvious that, in all fairness, every pregnant woman who is considering having a baby has to be counseled at an abortion clinic. Of course that wouldn’t make any sense because, unlike the Fake Clinics, abortion clinics don’t have an agenda for the patient except that she make the best decision for herself!

What would happen if a woman who wanted a baby were counseled at an abortion clinic? The counselor or advocate would ask a few questions and then probably say something like “It sounds as though you know what you want. Congratulations. Can I help you find any community resources to help?”

What will happen when a woman who wants an abortion is counseled at a Fake Clinic? The monstrous deception that occurs in the Fake Clinics has been exposed in films such as the HBO Special 12th and Delaware. Because the Fakes have a well-hidden agenda, everything they do is designed to frighten and shame a woman who knows it is not the right time for her to have a baby. This fraudulence is clearly set out in the instructions given by the diabolical Robert Pearson, who came up with this brilliant and evil plan way back in 1967 when abortion was first legal in Hawaii. Pearson himself acknowledged and defended the deception in a 1994 speech: “obviously, we’re fighting Satan… A killer, who in this case is the girl who wants to kill her baby, has no right to information that will help her kill her baby. Therefore, when she calls and says, ‘Do you do abortions?’ we do not tell her, No, we don’t do abortions.” The volunteers in his centers and others like them don’t mind tricking women because they think they are following some ‘higher law’.  They don’t mind lying and misrepresenting things like the specious breast cancer-abortion link, the dangers of abortion, and most cruel of all, the help available to a woman who realizes that she honestly cannot support a child financially. … Read more

Rachel’s Sabbath and the Far Right’s Attack on Women

8:32 am in Uncategorized by RH Reality Check

Written by Sandy Eisenberg Sasso, and posted on RHRealityCheck.org – News, commentary and community for reproductive health and justice.

This article was originally published by the IndyStar.com.

In commemoration of the 100th anniversary of International Women’s Day, congregations across the country are designating the weekend of March 4-6 as Rachel Sabbath. In the Bible, Rachel is the matriarch who dies in childbirth.

The purpose of this day is to raise awareness of the crisis in reproductive health services and care around the world. Rachel Sabbath supports the United Nations goal of improving maternal health by doubling current global investments in family planning, reproductive and health services to women around the world. The effort could save $1.5 billion in long-term medical costs and it would save the lives of 400,000 women and 1.6 million infants each year.

Women in developing countries are at greatest risk. In Niger, the risk of women dying from pregnancy-related complications is one in seven, the highest in the world. The lowest-risk country is Ireland. Despite our exemplary medical care, 40 nations have a lower risk of maternal death than the United States.

So it is both shocking and appalling that in America, federal legislation is being proposed that would eliminate Title X funding, which covers family planning and preventive reproductive medical care. Federal and state legislation also is targeting Planned Parenthood funding.

What’s behind these efforts? … Read more

What Happens to Washington State Women if Title X Falls?

8:51 am in Uncategorized by RH Reality Check

Written by Amie Newman for RHRealityCheck.org – News, commentary and community for reproductive health and justice.

“It is my view that no American woman should be denied access to family planning assistance because of her economic condition. I believe, therefore that we should establish as a national goal the provision of adequate family planning services within the next five years to all those who want them but cannot afford them. This we have the capacity to do.”

– President Richard Nixon, 1970

We need to make population and family planning household words. We need to take sensationalism out of this topic so that it can no longer be used by militants who have no real knowledge of the voluntary nature of the program but, rather are using it as a political steppingstone. If family planning is anything, it is a public health matter.”

– Congressman George H.W. Bush, 1969

Now?

“What is more fiscally responsible than denying any and all funding to Planned Parenthood of America?” demanded Representative Mike Pence of Indiana, the chief sponsor of a bill to bar the government from directing any money to any organization that provides abortion services.

You’d think Rep. Mike Pence’s (R-IN) bill to defund Planned Parenthood, an organization which provides preventive health care to millions of Americans around the country, would be enough of a blow. They are going for the deep, painful cuts leaving many millions of Americans who are already at their most vulnerable even more exposed with a House leadership budget proposal to completely eliminate Title X, one of the most successful federal safety net programs this country has ever seen. It’s not a political game, as much as Live Action hoax video-makers Lila Rose and James O’Keefe seem to think it is. As states grapple with similar budget cutting, our friends, family and community members will find themselves without basic healthcare and as tax-payers we’ll literally pay the price of the decimation of a crucial public health safety net. In Washington State, with a multi-billion dollar budget shortfall, residents are already bracing for the impact of state cuts to family planning, maternity health services, health insurance for lower-income residents, prescription drug benefits for seniors and more. The elimination of the federal Title X program would be disastrous.

This may feel like a swipe out of nowhere but it’s been a long time in the making for the GOP. Read more

Addressing Obstetric Fistula: Towards a Just and Healthy Life for All

8:56 am in Uncategorized by RH Reality Check

Written by Kelly Castagnaro for RHRealityCheck.org – News, commentary and community for reproductive health and justice.

This article is part of a series by RH Reality Check in collaboration with EngenderHealth, Guttmacher Institute, the International Women’s Health Coalition, the Fistula Foundation, the United Nations Population Fund (UNFPA), and the Campaign to End Fistula.  All articles in this series can be found at this link.

The series is being published during a time of renewed efforts by advocates and the public health community to increase U.S. international support for efforts to address obstetric fistula, a wholly preventable but debilitating and sometimes deadly condition caused most immediately by prolonged labor and too early or too frequent childbearing, but generally rooted in lack of access to health care and discrimination against women.  Fistula affects the lives of individual women, their children and families, and also grossly undermines women’s economic productivity and participation in society. The global public health community has called for comprehensive strategies both to prevent new cases and treat existing cases of fistula.  Congresswoman Carolyn Maloney (D-NY) will soon introduce legislation intended to support a comprehensive U.S. approach to fistula as part of a broader commitment to reducing maternal mortality and morbidity worldwide.

It has been said that in an unequal world, women are the most unequal among equals.  Obstetric fistula—a condition driven by a range of inequities in access to basic health services, nutrition, education and other basic elements— is a living example of this statement.

Obstetric fistula is a tear or hole in the birth canal through to the urinary tract and/or rectum and caused by obstructed labor; left untreated, women become incontinent and may uncontrollably leak urine and feces.  With more than two million women living with obstetric fistula and between 50,000 to 100,000 new cases each year, we must do more collectively to prevent and treat this condition.

This requires a focus on the human rights dimensions of public health problems. 

Whether by choice, persuasion or coercion, many girls in the developing world have had sex before their 15th birthdays, often without adequate information or protection from unintended pregnancy or sexually transmitted infections (STIs), including HIV. For example, an estimated 60 million women between the ages of 20 and 24 in developing countries were married before 18.  The Population Council estimates that this number will increase by 100 million over the next decade if current trends continue.

For girls, sexual initiation is more likely to occur in the context of sexual violence and forced marriage, both of which place them at high risk of pregnancy, and STIs, including  HIV.  In Ethiopia, for example, nearly 70 percent of young married girls are forced to have sex before they have begun to menstruate. Because their bodies are not fully developed and ready to bear children, these young girls are at high risk for injury and death during pregnancy and childbirth. In fact, complications from pregnancy and childbirth are the leading causes of death among girls between the ages of 15 and19 in the developing world.

Read more

Human Rights-Based Approaches to Maternal Death in the U.S.

7:59 am in Uncategorized by RH Reality Check

Written by Cristina Finch for RHRealityCheck.org – News, commentary and community for reproductive health and justice.

This article is part of a series published by RH Reality Check in partnership with the Center for Reproductive Rights. It is also published in recognition of International Human Rights Day, December 10th, 2010.

Amnesty International released a report last spring entitled Deadly Delivery concerning the maternal health care crisis in the United States including how this crisis disproportionately affects marginalized communities.  This report is part of a series of reports that we are issuing as part of our Dignity campaign which is focused on fighting poverty with human rights.  The statistics are shocking; every 90 seconds a woman dies from pregnancy related causes.  Although the vast majority of these deaths are in the developing world, it is also an issue in the United States which spends more on health care than any other country in the world. On November 2, I presented Amnesty International’s findings during a panel discussion at the UN.

The Universal Declaration of Human Rights says, “Every human being has the right to health, including healthcare.” Unfortunately, the human right to health care, particularly maternal health care, is not being met in the US. The problem is especially severe in marginalized communities such as women of color. Since the vast majority of maternal deaths in the United States are preventable, maternal mortality is a human rights issue. Mahmoud Fathalla, past president of the International Federation of Obstetricians and Gynecologists, once said, “Women are not dying of diseases we can’t treat. [...] They are dying because societies have yet to make the decision that their lives are worth saving.”

Two to three women die each day in the US because of pregnancy-related causes. A further 34,000 more women experience “near misses” each year. Women in the US are more likely to die of complications resulting from pregnancy or childbirth than women in 49 other countries, including South Korea, Kuwait, and Bulgaria. In fact, according to recently released UN numbers, the maternal mortality rate nearly doubled between 1990 and 2008.

There are shocking inequities in maternal health in the US. Women of color, low-income women, Indigenous women, immigrant women and women with limited English proficiency all face additional risks. Read more

New Mother’s (False) Positive Drug Test Leads to Baby’s Removal…Poppy-Seed Bagel the Culprit

7:28 am in Uncategorized by RH Reality Check

Written by Amie Newman for RHRealityCheck.org – News, commentary and community for reproductive health and justice.

We all have nightmares from which we awaken, in the middle of the night, wiping our brows and silently thanking a deity of one sort or another that it was all just a dream.

But for some, as absurd as the events may seem, the nightmare is real. 

The ACLU of Pennsylvania filed a federal lawsuit today on behalf of a couple, Elizabeth Mort and Alex Rodriguez, who experienced such a nightmare.

In April of this year, Elizabeth Mort gave birth to a beautiful baby girl; her first child. The baby’s name is Isabella. The threesome (Mort, Rodriguez and Isabella) returned home on April 29th, 2010, from Jameson Hospital where Isabella was born, ready to settle into life as a family. One day later baby Isabella was taken from her parents by Lawrence County Child and Youth Services (LCCYS) and held for five days at an undisclosed location, because Mort had failed a drug test given to her while in the hospital.

Only, she wasn’t on drugs. Not even close.

Mort had eaten a poppy-seed bagel from Dunkin’ Donuts two hours prior to checking into the hospital before giving birth. The drug test picked up on the poppy seeds and came out positive. The agency, with two police officers present, acting on the information from the hospital-administered drug test, took Isabella from her parents. Read more

PersonhoodUSA’s Radical, Fetal-Separatist Agenda

6:57 am in Government, Health care, Legislature, State Government by RH Reality Check

Written by Lynn Paltrow for RHRealityCheck.org – News, commentary and community for reproductive health and justice.

Next week, people in Colorado will be voting on Amendment 62, a ballot measure sponsored by PersonhoodUSA. This organization seeks to establish the “pre-born,” including eggs, embryos and fetuses as separate “legal persons with protection under the law.”

This organization claims that its goal is to end the “injustice of abortion.” In fact they are promoting a Fetal Separatist movement, one that is trying to legally separate pregnant women and the fertilized eggs, embryos and fetuses inside of them. Their efforts are dangerous to all pregnant women including those who go to term, those who expect confidential medical care, and those who want to preserve their right to life and liberty.

The argument that eggs and fetuses may be treated as if they are legally independent of the women who carry them has been used to deprive pregnant women of their status as full constitutional persons.  Angela Carder was forced to have cesarean surgery to advance the rights of the fetus inside of her. Shortly after the surgery both the baby and Ms. Carder died. Ms. Carder was deprived of her right to life. Recently, a pregnant woman was kept prisoner in a Florida hospital because doctors believed that doing so would advance the rights and health of the fetus. She nevertheless suffered a stillbirth. Ms. Burton was deprived of her right to liberty. Although courts in both cases eventually held that these deprivations of life and liberty were wrong, adopting fetal separatist measures would allow outsiders to take similar actions whenever they disagreed with the pregnant woman.  . . . Read the rest of this entry →

Paging Dr. Paul: Medicaid Coverage for Births, Family Planning is Essential

6:17 am in Health care by RH Reality Check

Written by Cory Richards for RHRealityCheck.org – News, commentary and community for reproductive health and justice.

Rand Paul, a candidate for the U.S. Senate from Kentucky, caused a stir last week when he argued that too many births in Kentucky are paid for by Medicaid, the joint federal-state insurance program for low-income Americans. According to Kentucky’s Cabinet for Health and Family Services, Medicaid pays for about half of the state’s 57,000 annual births. Paul is quoted by the Associated Press as saying that “Half of the people in Kentucky are not poor. We’ve made it too easy.”

In reality, paying for a pregnancy can be anything but easy. According to the March of Dimes, maternity care costs more than $8,800, on average, and these costs can quickly escalate into the tens of thousands of dollars if complications arise (for instance, in the case of a premature birth). That’s why having insurance coverage is so critical. Employer-based group plans usually have good maternity care coverage, but most low-income women don’t get insurance through the workplace. And the National Women’s Law Center has documented that in the individual insurance market, few plans include maternity care coverage at all.

The recently enacted health care reform law would require all private insurance plans to cover maternity care starting in 2014. Meanwhile, however, insurance trends are moving in the wrong direction. Read more

The ‘State’ of Midwifery: Pushing for Legalization

6:36 am in Uncategorized by RH Reality Check

Written by Rebecca A. Spence for RHRealityCheck.org – News, commentary and community for reproductive health and justice.

This post is one in a series of pieces RH Reality Check is publishing to highlight National Midwifery Week 2010 (Oct 3- 9).

Women want out-of-hospital maternity care, and they deserve legal access to midwives trained to provide it. In 23 states, Washington D.C., Puerto Rico, and Guam, Certified Professional Midwives (CPMs) face prosecution for serving women who have decided not to give birth in a hospital. Families in these states are forced into an underground economy of providers whose training and credentials could be difficult to ascertain, and are left without any means to report a practitioner who lacks adequate skills. If they do opt to hire a midwife who is practicing illegally, smooth and efficient transfer to a higher level of care can be compromised in the event that it becomes necessary, putting mothers and babies at risk. That’s why more and more states, pushed by consumers and their allies who are part of The Big Push for Midwives Campaign, are passing legislation to license CPMs.

No federal law, Supreme Court decision, or Constitutional amendment can ensure that we have access to the maternity provider of our choice, because licensing and regulation of health professionals occurs at the state level. The Big Push for Midwives engages with consumers in state-by-state efforts to secure a path to legalization and integration of Certified Professional Midwives. Advocates have been on the ground doing this work for years, and are gradually achieving success. Groups like the Alabama Birth Coalition, Ohio Families for Safe Birth, North Carolina Friends of Midwives, the Coalition for Illinois Midwifery, and Massachusetts Friends of Midwives, and others, are tireless grassroots organizers for women and families who chose to give birth outside of the hospital.

Like other movements for social and reproductive justice, securing safe access to choice in childbirth demands solidarity from individuals and organizations not traditionally thought of as allies of midwives and out-of-hospital birth. The mainstream reproductive justice and women’s rights movements must actively stand by women who are demanding our rights as citizens and as mothers.  Aggressive, well funded forces of organized medicine are determined to keep Certified Professional Midwives  underground, threatening women’s autonomy and the public’s health.  This includes the American Congress of Obstetricians and Gynecologists (ACOG), a self-proclaimed “advocate for quality health care for women,” and the American Medical Association (AMA), organizations that wield their reputations and considerable financial influence over state legislators to keep birth in the hospital and make women outlaws.

The medical journal The Lancet recently published an editorial that concluded “Women have the right to choose how and where to give birth, but they do not have the right to put their baby at risk.” This is a familiar message to reproductive health activists: women don’t have the right to value our own lives when babies are involved. And, if the opinion of some doctor or judge about the wisdom of a particular woman’s choice for maternity care differs from her own, she may be forced to accept medical treatment that she doesn’t want or need.

Punitive attacks on women’s rights in birth are not the sole province of the medical establishment. Predictably, and tragically, paternalistic enforcement comes from many sources.  Child protective services in Illinois and Ohio have seized custody of the newborn babies of women who exercised their right to choose home birth with midwifery care — even though the babies born at home were perfectly healthy.  Families have lost custody of their children or faced CPS investigations simply because the mother gave birth at home with a midwife in a state where her legislators have failed to regulate and license Certified Professional Midwives.

Whether or not state legislatures respect the wishes of their constituents and vote to legalize CPMs, women will continue to choose home birth. So long as midwifery remains illegal in so many states, and even in our nation’s capital, these assaults on our rights will continue.  This is  why licensing and integrating CPMs, trained and experienced experts in out-of-hospital birth, makes sense for American women. Happy Midwifery Week, everyone. Won’t you join us?