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Shaheen, Menendez, Colleagues Reintroduce Bill to Restore Reporting on Reproductive Rights through the State Department

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May 26, 2021

** Legislation would permanently require the US State Department to include reproductive rights in its annual country reports on human rights practices **

(Washington, DC) – US Senator Jeanne Shaheen (D-NH), along with Senator Bob Menendez (D-NJ) and 21 Senators, reintroduced her legislation today. The law on reproductive rights are human rights. The bill would require the State Department to include reproductive rights in its annual country reports on human rights practices – including reports on the adoption of national guidelines promoting access to contraception, maternal health, and family planning services – to ensure accountability for abuses of those rights . The State Department removed this critical component of its 2017 report under the Trump administration for no reason.

“Women’s health and bodies shouldn’t be an issue. Reproductive care is a basic human right, ”Shaheen said. “The US plays an important role as an advocate for the fundamental rights of women around the world, but we cannot do this without extensive information and reporting on the status of reproductive care. The Department of State’s annual human rights report is an important tool for accountability for women’s access to basic health. The Trump administration’s decision to remove this from previous reports had dangerous consequences for the health, equality and freedom of women around the world. That is why I am working with Congress and the Biden Administration to stop the politicization of this reporting and restore transparency on the state of reproductive rights around the world. ”

Under the Foreign Assistance Act of 1961 and the Trade Act of 1974, the Secretary of State reports annually to Congress on the status of human rights in every country receiving US foreign aid and in every member state of the United Nations. Since 2011, these reports have provided detailed information on women’s deprivation of access to reproductive rights. The removal of women’s rights from the 2017 annual report marked a dramatic and dangerous shift in US efforts to protect international women’s rights, sending a message to abusive governments that the US would no longer hold them accountable for violations.

In response to efforts by Congress and civil society, the Biden government resumed reporting in March 2021. The reproductive and human rights law, reintroduced today, would ensure that this reporting continues.

For the 117th Congress, the bill has been updated to reflect current human rights standards and now requires reporting on:

  • Equal access to abortion, contraception, quality maternal health care, and the frequency and causes of maternal deaths.
  • Disaggregated maternal health data to better understand differences in pregnancy-related outcomes, especially for low-income and marginalized communities.
  • Data on other forms of reproductive coercion, in addition to forced abortion and involuntary sterilization.

Congress and the private sector rely on this report in their review of funding requests and advocacy, planning and policy making. In addition, the report is used by immigration judges and asylum officers to determine asylum status for women who declare human rights abuses at the U.S. border. Removing reproductive health and rights from the report left women without this basic evidence to support their asylum applications.

The full text of the invoice is available here.

As the only woman on the Senate Foreign Relations Committee, Senator Shaheen has been a fierce advocate for women and girls in the United States and around the world. Shaheen has prioritized issues to empower women and support women’s rights, such as: For example, opposing efforts to reduce women’s reproductive rights, fighting for the rights of sexual assault survivors, advocating family planning and global women’s health, and advancing efforts to end violence against women, ensuring women’s leadership Conflict resolution and peace negotiations, and legislation to remove barriers girls around the world face in accessing education. She led a bipartisan group of senators to propose a resolution recognizing March 8, 2021 as International Women’s Day, and she is the main sponsor of the Global, Health, Empowerment and Rights Act (HER). The Global HER Act would permanently repeal the Global Gag Rule. Shaheen had previously reinstated the International Law Against Violence Against Women (IVAWA). This bipartisan law would ensure that combating gender-based violence around the world remains a top diplomatic and development priority for the United States. She also helped reintroduce the bipartisan law “Protecting Women and Girls Before the Start Authorization Act of 2021” to combat gender-based violence during humanitarian crises that disproportionately endanger the well-being of vulnerable women and girls.

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Women’s Health

Why I Invested: Whitney Port on investing in prenatal vitamin brand Perelel

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Perelel, touting himself to be the first OBGYN-founded prenatal vitamin supplement brand to offer targeted nutrition at each stage of pregnancy, recently announced the completion of a $4.7 million seed fundraise with notable participation from celebrities in business, fashion, and wellness.

The company’s subscription-based business model spans a number of product offerings targeted for the particular life stage the customer is in, including a conception support pack; prenatal packs for first, second, and third trimesters; packs for postpartum and early motherhood; and daily vitamins for women of all reproductive ages. Perelel also has offerings for men, including a multi-support pack and additional supplemental products for iron, libido, and probiotic support.

The Hills star and Cozeco founder Whitney Port recently shared more with Fortune about her own prenatal experiences and subsequent interest to invest in the company.

  • Startup: Perelel
  • Location: Santa Monica, Calif.
  • Year founded: 2018
  • valuation: Declined to disclose
  • investment level: Seed
  • Number of employees: Nine
  • Other major investors: The seed round was led by Unilever Ventures with additional investors including Willow Growth Partners; Gaby Dalkin, CEO of What’s Gaby Cooking; Marissa Hermer, restaurateur and owner of the Draycott, Olivetta, and Issima; Rocky Barnes, founder of The Bright Side; Julia Hunter, dermatologist and founder of Wholistic Dermatology; Joan Nyugen, co-founder and CEO of Bumo; Aimee Song, founder of Song of Style and Two Songs; and Ali Weiss, chief marketing officer of Glossier

Why she invested, in her own words

Since striving for child number two, I’ve become much more conscious about the ingredients I put into my body. In my research on prenatal vitamins, I learned that most supplement brands on the market offer a one-size-fits-all approach to nutrition, which neglects essential dosages and nutrients during the different stages of pregnancy and postpartum. After multiple miscarriages, I learned there isn’t just one answer or one solution to fertility problems. Each miscarriage I’ve had occurred for a different reason.

So, as someone who can intimately relate to these multileveled issues that Perelel is tackling head-on in women’s healthcare, I was immediately drawn to the brand’s innovation and mission-driven business model. After the birth of my son, postpartum presented additional problem areas for me and I needed a boost; Perelel checked all the boxes I needed. Now I know countless women who are struggling similarly and would truly benefit from the product.

Perelel is much more than a business venture for me, and the value proposition goes further than a dollar sign. Its products are intentionally formulated for each stage of womanhood by a team of top women’s health doctors, including my reproductive endocrinologist, Dr. Andy Huang (who formulated their Conception Support vitamin packs).

Also, the intentionality behind building the brand community moved me. It’s much more than a customer base; it’s an intimately supportive network of women where we can lean on each other for emotional support and tap Perelel’s panel of doctors and experts for insight. Finally, for every subscription Perelel donates a supply of their own prenatal vitamins to underserved women in the US who lack access to high-quality prenatal care.

This is an installation of Why I Invested, a series featuring famous investors from all different backgrounds and industries, revealing what inspired them to invest their own money in a new business.

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​​While UI faculty are warned against even talking about emergency contraception, WSU will offer emergency contraceptives in vending machine

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Separated by just 8 miles, Washington State University and the University of Idaho remain vastly different places. Now in the post Roe v. Wade era, the differences are more apparent than ever.

This week, the University of Idaho warned faculty and staff that counseling students about abortion or contraception could lead to termination or result in a felony charge. The warning was delivered in a controversial memo that prompted a response from the White House. Meanwhile, across the state line, WSU’s student government announced funding for a contraceptive vending machine that will dispense pregnancy tests, condoms and Plan B, the so-called “morning-after” pill.

“WSU is part of a state system in (Washington) and Idaho is part of a state system in a state that is much more conservative,” said Mike Satz, former law professor and associate dean at the University of Idaho. “The workplace environment is very different for both schools and what it’s like to be a student is very different for both schools.”

The differences have led to confusion and frustration among students and faculty, according to multiple interviews and media coverage.

“It feels awful that my body is having to be used in a political fight,” said Alexandria Miller, a student at the University of Idaho.

Miller worries that the women’s health center on the UI campus will be restricted in the help they can offer students in need of contraceptives and counsel around pregnancy. The Idaho law mentioned in the memo also states that the university cannot dispense any emergency contraception except in the case of rape.

As of now, it is safe for Idahoans to travel to Washington to use resources, but that could change, Satz said.

“There are certain members of the legislature that have clearly shown their intent to want to control women’s choices, no matter where they are,” Satz said. “That is something that advocates for women’s health are looking at in Idaho because we’re very concerned about that.”

At WSU, a different political landscape

WSU’s Director of University Affairs Nikolai Sublett has been spearheading a way to bring an emergency contraceptive vending machine to WSU at a reasonable price. His inspiration came from an Instagram post.

Students were asking where to get Plan B and responses poured in saying that even though Plan B is accessible at places like Safeway, Walmart and Planned Parenthood, they are either sold out or are too far away from campus to be readily available, Sublett said.

Funding for the machine itself, which costs about $4,000, is coming from the budget of the Associated Students of WSU, while funding for the actual products will come from the student government’s Coug Health Fund, he said.

Sublett said emergency contraceptives will be priced at $15 a pill, $35 less than the usual name-brand price.

Excluding the $15 fee for the pill, bringing the vending machine to WSU will be no additional cost to students, he said. Sublett made a purchase request for the emergency contraceptives vending machine on Sept. 19 and hopes to get it ordered within the next two weeks, he said.

At least 22 universities around the country have vending machines for emergency contraceptives on their campuses, with at least 12 more in the works, according to an article from Bloomberg.

Safe sex supplies such as condoms, dental dams and lube are easily accessible on campus at WSU’s Women’s Center and the university’s Gender Identity/Expression and Sexual Orientation Resource Center, according to Amy Sharp, director of WSU Women’s Center.

Sharp said the only option for emergency contraception on campus costs $25 from the Cougar Health Services pharmacy, Sharp said.

“It just adds more accessibility for our students,” Sharp said.

Idaho employees unwilling to speak

Until recently, condoms have been made available on campus to prevent sexually transmitted diseases and pregnancy. Now, they are only advertised to prevent sexually transmitted diseases, Miller said.

“It’s almost considered offensive to talk about the facts of what a condom is used for,” she said.

In media reports, University of Idaho faculty and staff are requesting anonymity when they discuss the topic. The memo urged staff and faculty to refrain from speaking on these issues until they know more.

The fact that professors are asking for anonymity in interviews speaks to a toxic environment in which faculty and staff are afraid to speak, Satz said. He worries the memo could also damage faculty-student conversations for students seeking resources.

“I cannot tell you how many times as a faculty member I’ve had students come with really serious personal problems, and they came to me in my case, because I was one of the few faculty members of color on campus and they knew that they could trust me,” he said. “In this case, I think it’s going to be very damaging to those kinds of situations.”

Satz, who left the University of Idaho in 2020 and has co-founded the Idaho 97 Project, which advocates for sensitive public health measures and an end to hate, intimidation and disinformation, has been outspoken on the issue. This week, he posted a tweet noting the university memo and the Idaho law cite language that was originally written in 1887 – when Idaho was still a territory.

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ER Goddess: Low-Income Women and Women of Color Will Bear th… : Emergency Medicine News

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figures:

abortion, bias

FU2-7figures

Half of American women seeking abortions live on incomes below the federal poverty level. (N Engl J Med. 2022;386[22]:2061; https://bit.ly/3zYFcRy.) It will be these women—women who are least able to support a pregnancy and a child—who will disproportionately bear the brunt of post-Roe abortion bans.

In anti-abortion states, only women with the financial resources, ability to take time off work, and pay for child care will be able to seek abortions elsewhere. What was formerly a right for all women is now in too many states a privilege for those with money and connections.

My patients generally don’t have money or connections. I work in an urban inner-city ED where the surrounding neighborhood has a lower per capita income, more single-mother households, and a child poverty rate higher than 99.9 percent of the neighborhoods in America. (Neighborhood Scout. http://bit.ly/2Oc37XD.) I recently saw a 12-year-old who is sexually active. Her mother, who had just learned her preteen was having sex, brought her in concerned that she could be pregnant. What will happen to this 12-year-old and other girls and women who come to my ED when they can’t access abortion?

The Turnaway study offers some unsettling insights into what life will be like for women after they are denied an abortion. (Foster, Diana Greene. The Turnaway Study: Ten Years, a Thousand Women, and the Consequences of Having—or Being Denied—an Abortion. New York: Scribner, 2021; https://bit.ly/3JsHBHz.) The prospective longitudinal study compared the trajectories of women who were turned away by abortion clinics because they were too far along to the trajectories of women who received abortions at the same clinic.

Still stigmatized

The two groups were similar in demographics and socioeconomics; what separated them was who got to the clinic in time and who didn’t. Interviews with the women every six months during the five years following their pregnancies revealed that receiving an abortion did not harm women’s health and well-being. On the contrary, carrying an unwanted pregnancy to term harmed their finances, health, and families.

The Turnaway study showed that women who were denied an abortion were more likely to end up living in poverty, be unemployed, and go through bankruptcy or eviction and less likely to have money for food, gas, or other basic necessities. Women denied an abortion were more likely to be with a partner who abused them and to end up as a single parent. They were less likely to agree with the statement, “I feel happy when my child laughs or smiles” and more likely to say they felt trapped as a mother.

Even teens could be criminalized for pregnancy if we continue on our current path of stripping women of their reproductive health rights. It sounds like a dystopian novel, but women have already been jailed for miscarrying, something that happens naturally in 12 to 15 percent of pregnancies of women in their 20s, a number that rises to about 25 percent by age 40. (Cleveland Clinic. July 19, 2022; https://cle.clinic/3oUNfIV.)

Brittney Poolaw was 19 when she presented to an Oklahoma ED having a miscarriage at about 16 weeks gestational age. She was asked about illicit drug use, and she answered honestly that she had used methamphetamine. The fetus tested positive for methamphetamine at autopsy. No conclusive evidence proved that methamphetamine caused her miscarriage, but she was sentenced to four years in prison for first-degree manslaughter. She was all of 21 by then. The autopsy reported that the miscarriage could have been caused by congenital abnormality or placental abruption, but this was apparently ignored. (BBC. Nov. 12, 2021; https://bbc.in/3Q3lKJ2.)

Brittney, a Native American, faced the same type of prosecution that many low-income women, drug-using women, and women of color will face if the current legal climate surrounding pregnancy and abortion persists. The majority of women with unplanned pregnancies reported to the Turnaway researchers that they had used contraception, but these women are still stigmatized, as if forgoing abstinence is a moral shortcoming and birth control doesn’t have a significant failure rate.

Supporting Women in the ED

Contrary to what lawmakers may assume, decisions to have an abortion are not casual but serious and agonizing, often made in order to take care of family. The Turnaway interviews showed that most women seeking abortion were already mothers, and their children were more likely to hit developmental milestones and less likely to live in poverty in the years after they terminated a pregnancy. Many who had abortions went on to have more children; their subsequent pregnancies were more likely to be planned and those children had better outcomes too.

Women who seek abortion after their state’s gestational age cutoff often don’t even realize they are pregnant until it’s too late, due to factors like irregular menses and lack of morning sickness, the Turnaway study found. Nonetheless, strangers will impose their morality on these women’s private reproductive health decisions.

At best, our low-income, marginalized patients left with no option but to carry an unwanted pregnancy will face the loss of life they had envisioned for themselves. At worst, they will face their own death from complications of pregnancy. None of the women in the Turnaway study who received an abortion died from it, but two women who were turned away died from complications of pregnancy. The risk of dying from childbirth is 50 to 130 times greater than the risk of dying from abortion, according to the Centers for Disease Control and Prevention. (N Engl J Med. 2022;386[22]:2061; https://bit.ly/3zYFcRy.)

Are we willing to sacrifice the people who gestate fetuses on the altar of fetal rights?

No matter our political or religious beliefs, we EPs need to be empathetic to patients who feel frightened and trapped by the disturbing trend of forced birth and criminal sentences for pregnancy outcomes. Our patients may not seek health care during a miscarriage or after an illegal abortion because they are too scared. We need to be ready to support them with whatever resources we can when they end up in our EDs. Sadly, we also need to be ready for more of them to come experiencing the medical emergencies that will inevitably occur when a common health care procedure becomes illegal and inaccessible.

dr Simonsis a full-time night emergency physician in Richmond, VA, and a mother of two. Follow her on Twitter@ERGoddessMDand read her past columns athttp://bit.ly/EMN-ERGoddess.

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