Veterans’ column: VA hospitals doing more for women’s health

A special supplement of the journal Women’s Health Issues, published July 13, details the growth and diversity of women’s health research by the U.S. Department of Veterans Affairs in recent years.

Its publication coincides with the VA recognizing July as Women Veterans Month.

“VA has had a longstanding commitment to improving women’s health,” VA Secretary Eric Shinseki said in a news release. “This supplement shows the tremendous progress we’ve made by making that commitment to women veterans a top priority across the department.”

Titled “Health and Health Care of Women Veterans and Women in the Military: Research Informing Evidence-based Practice and Policy,” the supplement features commentaries examining the role, history, and future of women’s health research.

In an opening commentary, Elizabeth Yano, Ph.D., and Dr. Susan Frayne discuss the heightened focus on health-services research, with more articles published between 2004 and 2008, the first four years after the VA Office of Research and Development established its women’s health agenda, than in the previous 25 years combined.

The supplement also includes 18 peer-reviewed research articles addressing the changing demographics and demands of VA health care presented by the recent surge of women veterans into the VA system.

Among the topics addressed are: gender differences and disparities in care; mental health, including military sexual trauma and substance abuse; post-deployment health, including post-traumatic stress disorder; quality and delivery of care; and special populations, including homeless women veterans and those with traumatic brain injuries.

“With women expected to make up 10 percent of the veteran population by 2018,” said Dr. Robert A. Petzel, VA undersecretary for health, “our goal of excellence in health care for all of our nation’s veterans makes it imperative that we prepare now to meet future demands.”

Women’s Health Issues is a bimonthly peer-reviewed journal of the Jacobs Institute of Women’s Health at the George Washington University School of Public Health and Health Services. The journal focuses on applied research in women’s health care and policy issues.

Big step forward for women’s health

Adequate health insurance coverage has too long been out of reach for many women. Their health—and often the health of their families—has suffered.

That’s why the recommendations made last week by the medical and scientific experts convened by the Institute of Medicine are a major step forward for women. They help address some of the long-standing discriminatory practices and barriers women have faced in the health care system.

The experts determined that the full range of FDA-approved contraception, yearly well-woman visits, support for breast feeding, counseling for sexually transmitted infections, and screening and counseling for domestic violence are essential women’s preventive health services and should be covered by health insurers with no co-pays.

The Affordable Care Act requires all new health insurance plans to cover a list of preventive health services, as identified by the Department of Health & Human Services, and provide them with no out-of-pocket expenses for women. Based on the recommendations, HHS is to determine which screenings and services will be included.

These new guidelines are historic and will go a long way to protecting and promoting women’s health.

But opponents of contraception have sounded the alarm and are likely to make political demands to undermine this protection. The Institute of Medicine, however, merely acknowledged what most of us already know: Contraception is basic, essential health care. Overwhelming majorities of women use contraception to protect their health and prevent unintended pregnancy, and we virtually all are likely to use contraception at some point in our lives.

Nearly all women aged 15-44 who have had sexual intercourse have used at least one form of contraception, according to research from the non-partisan Guttmacher Institute. Among the 43 million fertile, sexually active women who don’t now want to become pregnant, 89 percent are using contraception. It is a normal, mainstream fact of life.

There is nothing new or novel about requiring health insurers to cover contraception. For more than 10 years, civil rights laws have made explicit that employers who provide health insurance plans that cover other preventive health care and prescription drugs must cover contraception. Twenty-eight states now require contraceptive coverage in private plans. The Medicaid program has also long required that contraceptives be included as part of the coverage for beneficiaries.

In addition to recognizing the fact that contraceptive coverage is already standard practice in both public and private health insurance plans, the non-partisan, independent panel of experts based its determination on a review of the medical and scientific evidence about unintended pregnancy; similar recommendations by numerous health care professional groups and other organizations, as well as the federal government itself, and the effectiveness of contraceptives.

Research also shows that costs—including co-payments and other cost-sharing requirements—play a key role in the contraceptive behavior of substantial numbers of women, often leading them to use less effective methods, or pay for contraception at the expense of other essential needs.

We are confident that Health and Human Services Secretary Kathleen Sebelius will follow this expert panel’s recommendations, and stand with the millions of women who depend on affordable, comprehensive health insurance.

Quest Diagnostics to Unveil Extensions to its Women’s Health and Personalized Medicine Test Offerings at the 2011 AACC Annual Meeting and Clinical Lab Expo

Athena Diagnostics’ spinal muscular atrophy (SMA) testing menu is broadly available nationally to Quest Diagnostics’ clients for the first time

Quest Diagnostics will also present novel scientific research and host the “What’s New in Laboratory Medicine?” scientific speaker series in booth 3130

MADISON, N.J., July 25, 2011 /PRNewswire/ — Quest Diagnostics Incorporated (NYSE: DGX), the world’s leading provider of diagnostic testing, information and services, today announced it will unveil extensions to its women’s health and AccuType® pharmacogenetic test menus, give eight scientific presentations and host six scientific speakers during the American Association of Clinical Chemistry (AACC) annual meeting and Clinical Lab Expo, to be held in Atlanta, July 26-28, 2011 (Exhibit number 3130).

Spinal Muscular Atrophy Testing Now Available Broadly in the U.S.

The extensions to the company’s women’s health menu feature Athena Diagnostics’ spinal muscular atrophy (SMA) testing menu, believed to be the most comprehensive in the diagnostics industry. The services, which include adult-carrier screening and pre- and post-natal disease assessment testing, are now nationally available for the first time to physicians, laboratory directors and other clients of Quest Diagnostics. The offerings also position Quest Diagnostics as the only national major laboratory to provide testing services to assess SMA disease severity based on Athena’s analysis of the number of copies of an SMA-associated gene.

Athena Diagnostics, which Quest Diagnostics acquired in April 2011, is the leader in neurology diagnostics and a pioneer in SMA testing, which it has performed since 1996. Prior to the acquisition, select Quest Diagnostics’ business units had offered Athena Diagnostics’ SMA testing services in select regions only.

The SMA adult-carrier screening test detects a defective survival motor neuron (SMN) 1 gene, which determines an individual’s risk of passing SMA to offspring. The pre- and post-natal disease assessment tests identify the number of copies of the SMN2 gene, which affects disease severity.

SMA, a neuromuscular disease, is the second most common fatal autosomal-recessive disorder, with an estimated prevalence of one in 10,000 live births and an estimated carrier prevalence of about one in 40 to 60 individuals. If each parent possesses a defective SMN1 gene, there is a one in four chance their offspring will inherit the disease. SMA disease severity is affected greatly by the number of SMN2 gene copies. While many affected individuals will die by the age of two, others may live well into adulthood with significant or mild disability, in part based on SMN2 copy-number status.

With the Athena Diagnostics offering, Quest Diagnostics is now the only major national laboratory in the U.S. to provide testing services for identifying the number of SMN2 gene copies. The company’s women’s health menu also includes testing, counseling and interpretation services for aiding the detection of several developmental disorders, including cystic fibrosis, fragile X syndrome and autism spectrum disorders.

“When it comes to personal and family health, women and their physicians rightly expect their clinical laboratory to offer the comprehensive testing options, expertise and quality needed to make well-informed decisions,” said Charles M. Strom, M.D., Ph.D., senior medical director, genetics, Quest Diagnostics, and a board-certified pediatrician. “The addition of Athena’s SMA tests to Quest Diagnostics’ menu enables us to offer the broadest range of genetic women’s health testing and expert interpretative counseling services.”

AccuType Pharmacogenomic Testing Now Includes Four Services

At its exhibit, Quest Diagnostics will also showcase its AccuType family of pharmacogenomic testing services for personalizing medicine. These include two tests Quest Diagnostics launched this year: AccuType Metformin, a service designed to help physicians predict if a patient with Type II diabetes or at risk for Type II diabetes will respond to metformin, and its AccuType IL28B test, designed to aid in the prediction of response to the widely used pegylated-interferon alpha-based therapy for treating hepatitis C virus infection. The AccuType line also includes tests introduced in recent years to aid in predicting patient response to the blood thinners clopidogrel (Plavix®) and warfarin.

Scientific Presentations and Speakers

In addition, the company’s medical experts will give eight poster presentations providing novel data on vitamin D by liquid chromatography tandem mass spectrometry (LC/MS/MS), free T4 method comparison, and CYPC219 allele prevalence by ethnicity. As part of the company’s “What’s New in Laboratory Medicine?” in-booth speaker series, Quest Diagnostics scientists and external academic and other experts will address topics of interest in clinical and laboratory medicine, including genetics and heart disease, vitamin D, endocrine disorders, infectious disease and prescription drug monitoring.

For a complete list of poster presentations and the speaker series agenda, please visit: QuestDiagnostics.com/2011AACC.

About Quest Diagnostics

Quest Diagnostics is the world’s leading provider of diagnostic testing, information and services that patients and doctors need to make better healthcare decisions. The company offers the broadest access to diagnostic testing services through its network of laboratories and patient service centers, and provides interpretive consultation through its extensive medical and scientific staff. Quest Diagnostics is a pioneer in developing innovative diagnostic tests and advanced healthcare information technology solutions that help improve patient care.

Women’s Health Care and Your Taxes

When it comes to government decisions about women’s health, women in the United States have not had a good year. Funding has been cut at the Federal level and in most states. Planned Parenthood, with its low cost health services, has been under sustained attack since the new congressional freshmen took over. New abortion restrictions have passed in a couple of dozen states. Any way you look at it, women’s rights, particularly the rights of poor women, have taken a beating.

So it was a complete and pleasant surprise when the Institute of Medicine announced its proposed guidelines for what women’s health services would be covered under the Affordable Care Act with no out of pocket expense to those covered. (As a side note ‘no out of pocket expense’ is not the same as ‘free’)

The guidelines proposed that eight services be covered for all US women. These include birth control (including sterilization), screenings for gestational diabetes, cervical cancer and HPV, counseling to help women prevent pregnancies and to help women space pregnancies further apart, counseling and equipment to promote breastfeeding, annual well-woman visits, counseling and screening for HIV and other STDs, and screening and counseling for domestic violence.

Women’s groups including Planned Parenthood praised the guidelines, while certain religious groups, including so-called ‘pro-life’ groups and the Family Research Council, condemned them.

I say ‘so-called’ pro-life in this context because by any standard, the guidelines would clearly save lives, and improve the lives of women and children. When an organization stands against improved health care for women, it cannot accurately be termed ‘pro-life’.

These groups are raising the old argument that they shouldn’t have to pay taxes for something they’re morally opposed to. Hey, what a great idea! I propose that those of us who are really pro-life stop paying our taxes toward:

Wars in Afghanistan and Iraq
The imprisonment of large numbers of US citizens for non violent drug offenses in the so-called ‘war on drugs
Subsidies to oil companies, mining companies, and others who through negligence cause the deaths of thousands of humans and other creatures on a regular basis
‘Faith based’ ‘pray away the gay’ therapy paid for with Medicaid funding that has been shown to actually be harmful to participants.
Part of living in a democracy (or democratic republic) is that our taxes sometimes pay for things we don’t approve of. It’s the nature of the beast. If you don’t like it, you’re free to lobby against it, you’re free to protest, you’re free to attempt to get representatives to lead you that will support your viewpoint – but you’re not free to pretend that a democratic republic is rule by consensus. It is not. Consensus requires 100% agreement.

A democracy rules by majority, and that means that no matter who you are, no matter what your political views are, sometimes you will not agree with the laws you live under. Deal with it or not, but don’t come crying martyr to me. I pay my taxes, too. And I happen to think that making it easier for women to get health care is seriously pro-life.

Hospital Merger To Affect Women’s Health Services

The merger of University Hospital with Jewish and St. Mary’s is creating some controversy.

The hospital group will be 70 percent owned by Catholic Health Initiatives, and the merging systems have agreed to honor the Catholic Church’s rule against sterilizations.

That means a woman having her tubes tied as part of a C-section delivery would not be an option at University Hospital.

“No one should fear that they will not be able to get the full range of reproductive health services. We are a public university and we will serve the people from whom that support comes,” said Dr. Edward Halperin of the UofL School of Medicine.

That’s one of several promises the University of Louisville has made in a pending merger with Jewish Hospital and St. Mary’s healthcare.

The university also says it will honor the Catholic Church’s rules against reproductive procedures, such as tubal ligations, vasectomies and in-vitro fertilization.

“How is it possible? The same way it’s been possible in multiple other mergers in US and their various structures one does to maintain CHI’s wish to not be in violation of the Council of Bishops and our promise to provide service,” Halperin said.

UofL said faculty will continue to conduct abortions, tubal ligations, vasectomies, and stem cell research, though not within the merged facilities.

Officials would not elaborate on how those hospitals have solved the issue of women delivering by C-section and wanting their tubes tied in the same surgery, saying they are still exploring a number of possibilities.

“That’s one of hundreds of questions to be solved, but it will be solved,” Halperin said.

“Obviously, women’s health is not a priority to the university of Louisville Hospital,” said Honi Goldman.

Goldman said since 10 a.m. Wednesday, hundreds of people have signed up protesting of the merger stipulation.

“It is just amazing what happens when you get when you have people that are angry about something and they band together, and that’s exactly what happened,” she said.

Their names will be displayed in an ad along with information on contacting the hospital leaders.

“We want UofL to go back to the table and say, ‘This provision, this stipulation is not going to happen; it’s off the books,’” she said.

Officials said it would be about a year before the merger takes effect.

The ad in protest runs this weekend.

Health Group: Get Mammograms At 40, Not 50

One of the nation’s biggest women’s health groups is changing its position on breast cancer screenings.

The American College of Obstetricians and Gynecologists is now telling women to start getting annual mammograms when they turn 40 years old rather than 50.

By making the change, the group is siding with the American Cancer Society and the American College of Radiology.

A government panel however, is standing by its controversial recommendation against routine screenings for women in their 40s.

Why One IOM Committee Member Dissented on Women’s Health Report

The Institute of Medicine’s much-anticipated recommendations for which women’s health services should be covered by health plans without co-pays or deductibles came out yesterday. Among the eight services it recommends insurers cover at no extra charge — HHS will make the final decision — are all forms of approved contraception, breastfeeding support and breast-pump rentals and domestic-violence screening.

One member of the committee charged with coming up with the recommendations, however, had several issues with how the report was developed — so much so that he filed a dissent rather than endorsing the report.

You can read the dissent by economist Anthony Lo Sasso, a professor and senior research scientist in the division of health policy and administration at the University of Illinois at Chicago’s School of Public Health, on p. 207 of the report. It’s followed by a response from the other 15 committee members.

We caught up with Lo Sasso by phone today and chatted with him about his objections. First, he thinks the time frame provided for coming up with recommendations was too short — “barely six months” from the time the group came together to when the final report was submitted, his dissent says.

Lo Sasso also objects to what he calls a lack of a systematic approach to weighing the evidence for different services. His dissent says it’s “impossible to discern what factors were most important in the decision to recommend one service versus another.”

And he tells us the recommendations reflect “a mix of objective evidence combined with subjective evidence” that reflected the preferences of committee members. Lo Sasso wouldn’t go into specifics, saying that the members of their committees and their affiliations are a matter of public record.

Lo Sasso also thinks cost-effectiveness and other non-clinical analyses, while not part of the committee’s charge, should have been considered. For example, one rationale for preventive services is that they will reduce the need for more intensive inpatient services later on. If that doesn’t actually happen in real life for a given service, that should be part of the conversation about whether to require it be covered, he says.

“In general, when you have mandates in health insurance coverage for particular services, one needs to … worry about unintended consequences,” he tells the Health Blog. Otherwise premiums could end up going up for everyone.

The committee’s response to the dissent notes that while cost considerations were “outside the scope” of the committee’s charge, HHS may consider cost when it develops its coverage decisions. It also says the dissent includes “inaccurate statements regarding the committee process and its approach.” And it notes that “no other member shares the opinion that report recommendations were not soundly evidence-based.”

Committee chair Linda Rosenstock, dean of the UCLA School of Public Health, noted on a conference call with reporters yesterday that there was “an extremely strong consensus” on the report’s findings.

RCOG calls for reform to women’s health services

A radical shake-up of women’s health services in the UK is necessary if the NHS is to cope with changing demands, according to a new report.

The Royal College of Obstetricians and Gynaecologists (RCOG) has published a document that highlights concerns over the effect financial pressures and wider NHS reforms will have on women’s healthcare, particularly in the face of demographic changes and rising complexity.

It is therefore recommending that a series of major changes are implemented, including services provided by managed clinical networks, universal standards and a life-course approach to health, leveraging every interaction women have with the NHS.

These and other initiatives have been recommended in order to ensure that a new healthcare paradigm is embraced that is centred on prevention, rather than intervention.

Dr Tony Falconer, president of the RCOG, said: “There is scope for significant improvement and an urgent need to elevate the standards of care in all parts of the UK.”

Last month, the organisation called for women with congenital heart disease to be referred to clinics where they can seek advice on contraception and fertility, which will help them to stay aware of potential risks.

Anti-abortion groups push for further restrictions in Kansas

Anti-abortion groups are planning to seize the momentum of spring victories in the Kansas Capitol and push for more restrictive measures, even ahead of the 2012 legislative session.

A petition has begun circulating for Gov. Sam Brownback to convene a special session this fall to consider a so-called “heartbeat bill” that would ban abortions when a fetal heartbeat is detected.

Another group plans to introduce a bill calling for a state constitutional amendment guaranteeing the rights of personhood to every human being from the beginning of biological development, including fertilization.

Both measures would defy Roe v. Wade, the 1973 U.S. Supreme Court decision that affirmed a woman’s right to have an abortion until the fetus would be viable outside the womb, usually at 22 to 24 weeks.

The measures are scorned by abortion-rights groups and considered controversial even among some abortion foes who say such measures overreach and would lead to setbacks in the courts.

But Mark Gietzen, board chairman of the Kansas Coalition for Life, who is pushing for the “heartbeat bill,” cited the numerous anti-abortion measures that Brownback recently signed into law and said, “What else can we do? We’ve got just about everything else covered.”

Kansas lawmakers passed bills that set new licensing requirements for medical facilities that provide abortions; banned abortions after 21 weeks based on the disputed notion that fetuses can feel pain then; required minors seeking an abortion to obtain the notarized written consent of both parents or a legal guardian; restricted private insurance coverage for abortions; and redirected federal family planning funds from Planned Parenthood to other health care agencies.

The new licensing requirements and the stripping of federal funds from Planned Parenthood already are in the courts.

Twin efforts to get more stringent laws such as a “heartbeat bill” and a personhood measure aren’t a surprise to opponents.

“It is the same as all of the other anti-reproductive rights legislation,” said Julie Burkhart, founder and director of Trust Women, which hopes to open a clinic offering first-trimester abortions and other women’s health services in Wichita in about a year.

“It’s about denying access to pregnant women who are in need of reproductive health care. It’s a further step toward the re-criminalization of abortion services for women.”

Will Kansas be first?

Attempts to get both bills passed are likely to keep Kansas at the forefront of the national debate over abortion. Although other states have considered each measure, none has passed one into law yet, and Kansas could be the first state to do so.

A “heartbeat bill” in Ohio made it through the House but must be voted on in the Senate.

Gietzen, who said a heartbeat law would stop about 85 percent of abortions in the state, thinks Kansas can beat Ohio with a special session, which he hopes to have Brownback convene in October.

Brownback’s office did not respond to questions about whether he would call for a special session.

Personhood petitions are active in all 50 states, but no state has approved an amendment yet.

Personhood amendments were soundly defeated in Colorado twice, in 2008 and 2010. One is up for vote in Mississippi in November.

Bruce Garren, committee chairman of Personhood Kansas, thinks Colorado wasn’t as receptive to personhood as Kansas, where a constitutional amendment would require a two-thirds vote in the House and Senate. If passed, it would then go before voters in the 2012 general election.

“We just think the people of Kansas ought to have the right to vote on this,” Garren said.

Passage of either measure would face potentially costly court challenges.

“These types of laws are just blatantly unconstitutional,” said Gretchen Borchelt, senior counsel for the National Women’s Law Center in Washington, D.C. “They’re just trying to provoke court challenges to Roe v. Wade.”

The goal is to overturn that decision, she said, but it’s an expensive undertaking for a state facing a severe budget crisis.

“There’s not the public support, there’s not the legal support. It’s just an extreme overreach to push a challenge,” Borchelt said.

A spokeswoman for the Center for Reproductive Rights in New York City, which filed a lawsuit against the state’s new clinic licensing regulations on behalf of the Center for Women’s Health in Overland Park, said the center “will monitor any measures that threaten to cut off women’s access to reproductive health services.”

The center doesn’t comment on its litigation plans, she said.

Planned Parenthood of Kansas and Mid-Missouri, which has sued the state to retain its federal funding, didn’t respond to questions about how it would respond to the proposals.

Conflict over strategy

Anti-abortion groups in Kansas disagree about pushing more restrictive measures.

Troy Newman, president of Wichita-based Operation Rescue, which came up with the personhood idea, doesn’t think personhood will pass in Kansas.

He cited its double defeat in Colorado, where opponents effectively argued it would outlaw women’s contraceptives such as IUDs, which prevent implantation of a fertilized egg.

A more reasonable approach is to continue to focus on regulating clinics that perform abortions, he said.

The anti-abortion organization Kansans for Life, which has offices in Overland Park, Wichita and Topeka, recommends taking more incremental action, such as education and working to elect lawmakers who oppose abortion.

“We want change to be lasting change, not try to throw the Hail Mary passes,” said Mary Kay Culp, executive director.

Her organization plans to push for introduction of a bill in the next legislative session that protects the rights of health care workers who want to refuse to participate in situations they find morally objectionable. Culp said President Barack Obama’s health care law weakens their rights to act on their consciences.

A more gradual approach may not be exciting, Culp said. “But it’s also not as apt to be turned on its head,” she said.

More restrictive measures require much thought, Culp said.

“Just because you have a governor that might sign it should it pass both bodies, there’s lots to be considered,” she said. “Is it right for the long run? It’s going to be sued, so where are you going? You end up in the U.S. Supreme Court, where you’re still short a vote.”

Gietzen said he would welcome a high-court test of heartbeat legislation because he thinks the justice who is perceived as the swing vote on abortion, Anthony Kennedy, has shown signs of returning to an anti-abortion stance he had when he was nominated to the court.

Issues are clouded

Problems over defining personhood and determining when, exactly, a heartbeat can be detected in a fetus are bound to complicate the issues.

Attempts to define personhood raise questions such as whether frozen embryos are persons, said Rep. Barbara Bollier, a Republican from Mission Hills.

She is a former physician who taught bioethics courses that wrestled with definitions of personhood. “You run into all these gray areas. It’s incredibly difficult,” she said.

In spite of the complexities, Bollier — who voted against the state’s new “fetal pain” bill because she believed that accepted medical literature doesn’t support the claim that fetuses feel pain at 22 weeks — said both measures were likely to pass in Topeka.

“I think that anything that has to do in some way with limiting people’s choices for abortion has a significant chance of going through,” she said.

Rep. Randy Garber, a Republican from Sabetha, is sponsoring the personhood legislation, but he isn’t sure how that vote will turn out.

“Some strong pro-life people think it’s the wrong way to go. I think it’ll be a very close vote,” he said.

But Garber, a pastor, is determined to get it passed. He said that he tells critics of the approach, “This is why God put me in the Legislature. I really prayed about it.”

And he isn’t concerned about legal ramifications. “If we believe God is in charge,” Garber said, “we should try to legislate the way God would want us to.”

Critics of heartbeat legislation say a fetal heartbeat can be detected within three to six weeks of conception, before women even know they’re pregnant. Factors such as the woman’s body fat, the fetus’s position in the womb and the type of detection method used vary, they say.

A woman could have a window of two weeks or less to find out she was pregnant, make a critical decision about whether to have an abortion, get any required approvals and schedule a procedure. Women who have irregular menstrual cycles may find out too late to do anything but continue the pregnancy.

Such bills don’t factor in the health of the mother, said Burkhart of Trust Women. “Let’s say you can detect a heartbeat in three to six weeks,” she said. “At that point, you don’t have viability of a fetus.”

Gietzen admits issues regarding heartbeat detection are problematic.

His bill hasn’t been written yet, he said, but it would be modeled on Ohio’s bill, which requires that a person who intends to perform an abortion must determine whether the fetus has a heartbeat, then inform the woman regarding the probability of bringing the unborn child to term.

The Ohio bill doesn’t provide exceptions for rape and incest. An abortion would be allowed only in a medical emergency.

Petition drives begun

Gietzen, of Wichita, has launched a petition drive to gather 15,000 signatures from around the state asking Brownback to call a special session. The petition has few signatures so far, but Gietzen announced it only two weeks ago and hasn’t geared up a major campaign yet.

Gietzen said he would ask lawmakers to convene the session at no cost to the state. He thinks they can deal with the bill in two days.

He doesn’t want to wait for the regular session in January because legislation usually gets pushed to the end of the session, he said.

“If we miss October, you’re looking at June, or a year from now, before a bill would go into effect,” Gietzen said.

John Willke, president of the Life Issues Institute in Cincinnati, has written letters to Brownback and legislators supporting the heartbeat effort, Gietzen said.

But Gietzen also has received negative feedback from other abortion foes who want him to support personhood instead. Gietzen said he would support personhood, but the country isn’t ready for it.

“We can pass heartbeat legislation now. We cannot get personhood legislation passed,” Gietzen said.

Skinvisible Licensee Launches First Prescription Product in the USA

Skinvisible Pharmaceuticals, Inc. (otcqb:SKVI) is pleased to announce that its licensee, Women’s Choice Pharmaceuticals LLC, a specialty pharmaceutical company based in Gilbert, Arizona, has launched ProCort(R), Skinvisible’s first prescription product in the United States. ProCort(R) is a topical treatment for hemorrhoids formulated with Skinvisible’s patented polymer delivery system Invisicare(R). Invisicare enhances the delivery of active ingredients by controlling the release and provides superior binding properties. ProCort(R) is made of a combination of hydrocortisone acetate and pramoxine hydrochloride. ProCort(R), launched this week, is a prescription product focused on the women’s health market.

Women’s Choice Pharmaceuticals has been granted the exclusive rights to commercialize Skinvisible’s product within the United States. Skinvisible has received a development fee and now will receive a license fee paid in milestones plus on-going royalties based on product sales. Women’s Choice Pharmaceuticals’ revenue forecast for ProCort is $20 million by its third year.

According to the U.S. Department of Health, hemorrhoids are most common among adults over 45 and in pregnant women. They state that approximately 75 percent of people will have hemorrhoids at some point in their lives. The U.S. hemorrhoid market, estimated at $85 million in 2006, is growing by approximately 1 million new cases diagnosed every year.

“ProCort(R) is Skinvisible’s first prescription product launched in the United States and we are very confident Women’s Choice Pharmaceuticals will gain market share quickly, as it has with its other product launches,” said Mr. Terry Howlett, President and CEO. “This is an example of how Skinvisible’s Invisicare technology can meet the growing need for patent-protected options for pharmaceutical companies in dermatology and other markets.”

Women’s Choice Pharmaceuticals is an innovative specialty pharmaceutical company whose primary focus is to provide high quality prescription products to healthcare providers in the United States. Their nationwide sales target more than 30,000 OB/GYNS and selected other medical specialties. Their managed markets division will target PBM’s, HMO, GPO, CMS and other managed care organizations ensuring their products are covered under drug benefit plans.

Women’s health czar needed to lead on radical overhaul

A women’s health czar shoud be appointed to take on a radical overhaul of women’s healthcare services, argues an expert advisory group in a new report from the Royal College of Obstetricians and Gynaecologists (RCOG), published today.

The group, which includes GPs, nurses, anaesthetists, paediatricians, and representatives from Association of Early Pregnancy Units, the British Association of Perinatal Medicine, and the British Fertility Society, among others, says the current configuration of services is unsustainable.

This is due to the combined forces of the NHS reforms and workforce pressures, including the Working Time Regulations, financial pressures, rising demand, increasing complexity, and demographic changes.

And it calls for the appointment of a national clinical director for women’s health to lead on the quality agenda and ensure that service configuration, workforce and commissioning issues are championed in women’s healthcare.

Among the raft of recommendations, the report says that services should be provided in managed clinical networks which link primary, community, secondary and tertiary services, with more midwifery led care, and that a life course approach to women’s healthcare should be adopted, with a focus on prevention of ill health.

The current wide variations in health service provision need to be ironed out by implementing universal clinical standards and guidelines and mandating the reporting of outcomes, it says.

And medical workforce planning will need to take account of the Working Time Regulations and the likely reduction in the number of specialist trainees. This will require greater flexibility in the settings in which healthcare is delivered as well as in the make- up of the professional team providing services.

Hospitals should be reconfigured so that safe and timely care can be provided by multiprofessional teams on fewer sites than at present. Currently, too much care is provided within secondary and tertiary settings, says the report.

With an ageing female population, more specialist attention is also needed for women in later life, including an invitation to attend a health and lifestyle consultation to discuss a personal health plan for navigating the menopause and beyond once a woman reaches 50, says the report .

And it calls for the appointment of a national clinical director for women’s health to lead on the quality agenda and ensure that service configuration, workforce and commissioning issues are championed in women’s healthcare.

Chair of the Expert Advisory Group, Dame Joan Higgins, said: “Women’s health services need to be planned in a way that enables integration across different levels of care, delivered in partnership between local health and social care services and the voluntary sector. This network of providers should ensure that women experience co-ordinated and appropriate care which meets their needs.

Dr Tony Falconer, President of the RCOG added: “The UK has declining infant, neonatal and maternal mortality rates. However, there is scope for significant improvement and an urgent need to elevate the standards of care in all parts of the UK.”

Commenting on the report, NHS Confederation chief executive Mike Farrar said:
“If the NHS is to maintain the recent improvements in quality and access to care, we will need to change the way we deliver healthcare and we’ve got to do it quickly over the next 18 months. This means looking at where services are provided and taking some tough decisions.

Maternity care is a classic example of where, in many parts of the country, there is a desperate need to reorganise our services into fewer specialist centres with more care in the community. This would be better for mums and their babies and in many cases we have the opportunity to save lives.”

He added: “Where the case for change is clear, politicians should stand shoulder to shoulder with managers and clinicians to provide confidence to their constituents that quality and care will improve as a consequence of this change.”

Health care disparities at issue in abortion rates among black Americans

OAKLAND, Calif. — The abortion rate in the African-American community is several times higher than any other group, but community members and health providers say a recent anti-abortion billboard campaign in Oakland is misguided and simplistic.

The billboards, financed and distributed by the anti-abortion organization Issues4Life have prompted outrage among abortion rights groups and women’s health care organizations who say the ads are inflammatory, racist and demeaning. But Walter Hoye, who directs the group, says the billboards are a way of bringing attention to what he has described as an abortion-created “genocide” in the African-American community.

Nationwide, African-American women receive approximately five times as many abortions as white women, according to U.S government statistics collected by the Centers for Disease Control and Prevention. Those numbers hold true across all income levels. In 2006, the CDC recorded 45.9 abortions per 100 births among African-American women, versus 16.2 for white women.

The Guttmacher Institute, an abortion rights research center that focuses on issues around women’s reproductive health, said African-American women are three times as likely as white women to have an unintended pregnancy.

“This is a topic we ought to talk about,” said Hoye, a Berkeley pastor and Union City resident. “It’s the number one killer in the African-American community.” Hoye’s efforts are part of a nationwide anti-abortion movement that has erected billboards in Atlanta, Chicago and New York, among other cities.

Women’s health experts, abortion rights groups and several prominent African-American activists have decried the billboards’ appearance as a simplistic and demeaning response to a complex concoction of social ills.

“It is reprehensible, and disrespectful to the African-American community,” said Lupe Rodriguez, spokeswoman for the Alameda County branch of Planned Parenthood. “They’re trying to single out one part of the overall health care of that community, and using a wedge issue to divide people.”

Rodriguez and others say the high number of African-American abortions is due to a widespread pattern of health disparities in low-income and minority communities that prevents women from obtaining effective contraception and then sustaining its use over long periods of time.

A 2008 report from the Guttmacher Institute showed that the vast majority of abortions in the U.S. were due to unintended pregnancies, regardless of race or economic status.

“Life events such as relationship changes, moving or personal crises can have a direct impact on (contraceptive) method continuation,” wrote Susan Cohen, the author of the report, “Abortion and Women of Color: The Bigger Picture.” ”Such events are more common for low-income and minority women than for others, and may contribute to unstable life situations where consistent use of contraceptives is lower-priority than simply getting by.”

Moreover, say critics of the billboards, the high abortion rates are just part of the picture. More broadly, the abortion figures fit into a pattern of poor health outcomes for African-Americans and Latinos in a number of areas. In 2008, the CDC reported that black teens were more than twice as likely to have some form of sexually transmitted disease. The incidence of AIDS rates nationwide is eight times higher for African-American men than for whites.

Meanwhile, across California, African-Americans represent 6 percent of the population, but 16 percent of the uninsured. In Alameda County, there are roughly four times as many uninsured African-Americans as whites, even though their population numbers are on par.

“This was a longer effort to shame and blame black women to make some tough reproductive health decisions,” said Toni Bond Leonard, a spokeswoman for Black Women for Reproductive Justice, a national group based in Chicago where billboards have also appeared. “At no point has anyone attempted to reach out to black women in the community to find out what we believe. They want to make this about abortion, but this is about health disparities.”

In Oakland, the billboards are prominently visible. One of the 60 or so scattered across the city sits above a liquor store in West Oakland. It shows a pastiche of an African-American infant below the words “Black is Beautiful.” At the bottom of the sign is a website address: toomanyaborted.com.

Across the street, a young woman named Nikki glances up and frowns. “We’re approaching it backward,” she said. “The message up there should say, ’Do you have enough support?’ or ’Do you have resources to help you during this pregnancy?’ ”

One young African-American man in the area said he supported the overall message, largely because of the two young daughters he works so hard to support.

“I don’t believe in abortion,” said Auntrell Brooks, 32, a carpenter. “I have two daughters, and once you see them grow up, you see what you have.”

Brooks had his first daughter when he was 16. But he says he knows many women who have aborted their pregnancies. “They said it hurt, they couldn’t afford it, the baby’s daddy was gone, they just had sex and got pregnant.”

Planned Parenthood and a number of other local health organizations have begun responding to the billboards by meeting with community leaders and doing outreach programs to counter Hoye’s message.

“It really boils down to people not having access to care, not being able to prevent those unintended pregnancies,” Rodriguez said.

Access is not the real issue, counters Hoye.

“One side is comfortable taking the life of a human being, and one side isn’t,” he said. “That baby should be protected by love and by law. If there’s any confusion about that, we can wait and find out.”

Ultimately, the billboards may be more of a distraction than a help, said Belle Taylor-McGhee, national communications director for Trust Black Women, an abortion rights advocacy group.

“Across the country, you’re going to find a majority of African-American women support a woman making a private decision about when and whether to be a parent,” she said. “But you have to engage people to assess that.”