The debate which has raged for the past two and a half weeks on the future of the National Maternity Hospital has (NMH), at times been frustrating but has more often been simply perverse.

The Government’s decision to pause the approval of the move from Holles Street to St Vincent’s Hospital was done to allow documents related to the deal to be published and for all the concerns held by people being fleshed out, amid some lingering concern among ministers.

Having watched every step of the debate, having read all that could be read on the matter, I was left baffled as to why and how the Government lost two TDs given the robustness of the guarantees of the deal.

As Kieran Mulvey the man who brokered the 2017 deal between the NMH and St Vincent’s made clear, all legal procedures will be performed in the new hospital.

As he said this week, the very clear statement made in the mediation agreement was that the laws of the state would apply in the new maternity hospital, and that all existing practices currently carried out in the NMH would be available in the new NMH.

“They were clear they were unequivocal in fact, there was little or no argument about that from either side once that paragraph was agreed,” he said.

Reaction of female politicians

After nine years of delaying this hospital project getting going, we were left in the curious position of some of the country’s leading female politicians claiming the process was being rushed and seeking to have it delayed even further.

It was bonkers.

It was if they have dug themselves into an ideological hole that they were unable to get out of.

Perhaps scarred by the legacy of the truly appalling treatment of women in our society over the last century, the levels of trust in the system are low

But the true scandal is not what is going to happen in the new NMH but what is actually happening in the existing maternity hospitals.

I speak from relatively recent experience of seeing my three kids born in the crumbling Rotunda Hospital where conditions can only be described as inhumane despite the best efforts of staff.

And we were lucky as all of ours were hail and hearty.

Many others are not so lucky and have had to face inordinate struggles to get the supports they need.

But to the hospital itself, even those who have proposed this deal will say it is complex and messier than they would have liked it to be.

Starting from scratch, as Taoiseach Micheal Martin said, you would not do it this way. You would ensure it was a publicly owned building on fully publicly owned land.

Both time and money wasted

But, the decision was made to co-locate to St Vincent’s Hospital and those behind St Vincent’s simply did not want to sell or gift the land to the State.

It was utterly frustrating to see so much time and energy wasted on this argument of why a 300-year lease at €10 a year was not sufficient.

Calls for the lands to be compulsorily purchased may sound snappy and good, but so slow is our planning system that such a move is not guaranteed of success and would further delay this project substantially.

And for what?

Even though there is a lease of 300 years, belt and braced alongside a constitution which makes it clear the church will have no influence, it is still not enough for some.

I am no fan of the Catholic Church. Like many of my generation, I have utterly renounced its teaching, dogma and despise the poisonous impact it has had on public policy in Irish life in the past century.

Also, as the Attorney General Paul Gallagher advised the Cabinet, the State’s interest is well protected here and there are layers of protection to ensure no religious ethos will be at play in the running of this hospital.

The constitution says so, not just once, but several times. As Dr Rhona Mahony explains, the greatest indication that all legally permissible services will be available in the new hospital is that they are already taking place in Holles Street, even with the Archbishop of Dublin as the chairman of the board.

The truth of the matter is; rather than continuing the direct influence of the church, again from reading the documents, it is clear such influence is ended. It will be a secular organization and institution

The six-month expulsion of two Government TDs for voting against the Government on a meaningless motion on the NMH in a way sums the utter lunacy of the past two and a half weeks.

The Green Party parliamentary party voted to suspend TDs Neasa Hourigan and Patrick Costello, who voted against the Government on a Sinn Fein motion concerning the new National Maternity Hospital

TDs Neasa Hourigan and Patrick Costello, no doubt convinced their stance is justified, felt compelled to go overboard because of the failure of the State to ensure the new hospital would be built on public land.

Expelled by their party automatically on Wednesday having voted for the Sinn Féin motion, Hourigan and Costello were always likely to fall foul of the rigid whip system as they have struggled to reconcile their ideology with the realities of compromise and coalition government.

Having voted against the Greens entering Government in 2020, it has always been a matter of “when” and not “if” they would break ranks once again.

But beyond their removal from the Government ranks technically (as they are likely to continue to support Government votes), it is fair to say many in the opposition who have been among the loudest voices of concern over the NMH have not covered themselves in glory.

Never-ending debate

The most alarming aspect of this whole saga has been that as soon as the Government and the backers of this deal satisfied the demand of a particular group or representatives on one issue, it moved on to another, becoming a never-ending cycle.

Like we had this rather incongruous situation that arts minister Catherine Martin was not OK with the deal until she got letters of comfort from the HSE, St Vincent’s and the NMH to state that certain procedures including abortions will take place in the new hospital.

Last week, for three hours at the Oireachtas Committee we had a debate going on between freehold and leasehold and which is better or worse.

Quite frankly, that’s not what the NMH is about.

It is and should be about the care of women who are giving birth so that they can be safe.

And if a difficulty occurs, they have available to them the specializations the discipline and the care they need quickly.

A large crowd of protesters carrying placards saying separate Church and State at a National Maternity Hospital protest rally outside the Dail (Leinster House).

From a relatively recent user of the system, I can tell you we were not interested in that kind of debate.

My only concern was that my wife and new babies would be safe and not at risk.

The Vatican has no more role in this now than any other foreign entity.

Albeit far too late, the Cabinet has now decided and approved the deal.

As opposed to selling out the women of Ireland, it was a good day for those who want to see the maternity services in this country advance beyond the cruel and intolerable state it is in

While of course we are shaped by our history, we should never allow ourselves to be imprisoned by our history and this saga has seen anger at what has gone before conflated into something else which in turn became a barrier to progress.

As cold as this may sound, this is not about what has gone before, but about ensuring better healthcare for the mums and babies of the future.

Let’s get on with it.

With a $4M seed round, Pique is creating a new category by offering sexual health solutions and prescriptions like vaginal estrogen and sex therapy – all dedicated to improving a woman’s sexual experience.

LOS ANGELES, May 19, 2022 /PRNewswire/ –Pique, the revolutionary new online sexual healthcare platform, launches today, founded on the belief that all women deserve great sex, as an intergal part of living a healthy, fulfilling life. The brand will take an integrated approach that offers medical expertise combined with a focus on mental, physical, hormonal, and social factors to offer patients holistic, personalized care.

In the United States, 43% of women struggled with sexual dysfunction, compared to 31% of men, and 62% of women have admitted to not being satisfied in their sex lives. However, only 29% of gynecologists ask their patients about their sexual satisfaction and the average medical student only receives 3-10 hours of sexual health education during their studies. While there are many solutions to treat erectile dysfunction and the market is projected to reach almost $5 billion by 2026, there are few medical equivalents for women and the women’s reproductive and sexual health market remains in its infancy. Oftentimes sexual health discourse is limited to toys, lubes, and lingere, causing women to feel alone in their struggles, insecure, and unsure of where they can obtain answers to their sexual health issues.

Pique is here to change that. This digital health clinic is on a mission to provide a suite of solutions for every chapter of a woman’s sexual journey, starting with menopause, and help address concerns from painful sex, vaginal dryness and low libido, to helping women build confidence, maintain strong intimate relationships, overcome sexual trauma, and beyond.

After seeing and experiencing the lack of resources for women dealing with sexual health issues, Leslie Busick, the founder and CEO of Pique, took matters into her own hands. She started by curating virtual events during the pandemic where women would come together and discuss sexual concerns and topics. The conversations continued to gain traction and after partnering with close friends and Stanford graduate, Max Savage, they decided to create a digital health platform for women to receive personalized, sexual health care plans with tangible solutions to support their concerns. New patients begin their Pique journey with a complimentary introductory session with a nurse practitioner who specializes in sexual health and creates a custom care plan that may include different types of vaginal estrogen, sex & relationship counseling services, suggested lifestyle changes, and recommended resources from Pique’s library. Patients are able to track their progress with the Female Sexual Function Index (FSFI), a standardized sexual health quiz to measure sexual function in women. Busick hopes the brand will help to destigmatize the sexual health category and give women the power to take control of their health, pleasure and well-being.

“At Pique we are empowering women to celebrate their desires and embrace them as a fundamental pillar for a happy, healthy life. By providing prescriptions, mental health support, resources and more, we can support women as they progress in their sexual health journey so they can build a deeper relationship not only with their partners, but with themselves,” shared Leslie BusickFounder and CEO of Pique.

With a recent $4M seed round led by Maveron, a leading venture capital firm, Pique will be utilizing the capital to further build out and continue scaling accessible, effective, sexual health care solutions for women.

“We are thrilled to back Leslie, Max, and the team as they take on a huge category of women’s sexual health. The need to support women throughout their reproductive and sexual journey, including during menopause, is more pressing than ever before. A full stack solution that combines clinical level care with mental health and the convenience of a direct to consumer brand is exactly what we were looking for in the space, and is precisely Pique’s approach.Every woman entering menopause should feel empowered and supported — we are excited to support Pique as they go after this audacious and important opportunity,” shared Anarghya Vardhana, Partner at Maveron.

Pique’s clinical care team is led by Chief Medical Officer, Dr. Ashley Winters, a Weill Cornell trained board-certified urologist who specializes in sexual medicine. dr Winter and the team look at sexual well-being from a multi-faceted lens that integrates every aspect of one’s mental, physical, hormonal, and social well-being. “Pique is reimagining women’s health care at scale, spearheading a future where women can get the personalized, approachable, and effective care they need. I am thrilled to partner with Leslie to bring light to this underserved subject matter and use Pique’s platform to shift the narrative around women’s sexual health to reach and serve more women,” shared Dr. Winter.

For more information on Pique, please visit https://www.piquehealth.co/ and @pique.health on Instagram.

About Pique: Pique is an online sexual health platform starting with a focus on women in the menopause stage of life. The company delivers personalized care to help address concerns from painful sex, vaginal dryness and low libido, to helping women build confidence, maintain strong intimate relationships, overcome sexual trauma, and beyond. Patients are led through the platform by a nurse practitioner who specializes in sexual health and creates custom care plans that may include prescribing vaginal estrogen, sex & relationship counseling services, suggested lifestyle changes, and recommended resources from Pique’s library.

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SOURCE Pique

The shock over the leak of Justice Samuel Alito’s draft opinion in Dobbs v. Jackson Women’s Health Organization has left many asking how the Supreme Court could so easily overturn a near 50 year precedent protecting women’s legal right to abortion.

Of course, anyone following the direction of the court in recent years is not entirely surprised by the draft opinion. The court has increasingly prioritized religious rights over other rights and public health, including in cases focused on LGBTQ+ rights, women’s health, and COVID-19 restrictions. The strength of the textualist and originalist approach employed by Alito in the draft opinion (and apparently sanctioned by the conservative majority of the Court), believed a dark future for women’s rights and health.

Indeed, the opinion paints the realities of women’s lives in 2022 through rose-colored glasses—when it mentions them at all. To reach its apparent goal of overturning the two major abortion precedents, Roe v. Wade and Planned Parenthood v. Casey, this new Supreme Court treats women’s lives and health as mere abstractions

Women’s Lives In 2022 Through Rose-Colored Glasses

Alito spends much of the opinion arguing that the word, “abortion” is not in the Constitution and that it is not “deeply rooted in the nation’s history.” But Alito’s textualist and originalist approach to abortion not only obscures the legal and social context of women’s lives in the past, it entirely decontextualizes their lives today.

Indeed, he makes almost no attempt to balance the interests of women–their health, mental health, economic security, and caretaking obligations–with the interests of the state in restricting or banning abortion. He devotes less than two pages of the 67 page draft opinion to the effect of banning abortion on women’s lives. In a few sentences, he dismisses the Roe and Casey courts’ consideration of women’s autonomy and equal opportunity and quickly concludes that in 2022, women are empowered enough that if they experience an unwanted pregnancy, they needn’t worry.

His claims are these: Women are no longer ostracized as single mothers, there are legal protections against pregnancy discrimination in the workplace, they have access to health insurance while pregnant, and they are eligible for parental leave “in many cases.” The reality of women’s lives in 2022 is vastly different than the one Alito depicts.

Alito’s cheery scenario completely erases the facts about pregnancy and motherhood in the US The US has the highest rate of maternal mortality among wealthy countries, double the rate of its closest peers. The rate for Black women is three times that of white women. It is far from certain that all women have access to insurance during pregnancy. Low-income women and women of color are most likely to be uninsured during pregnancy.

The US is also the only developed country and only one of 6 in the world that does not guarantee paid maternity leave. Childcare is prohibitively expensive for many families. The opinion is devoid of any social, racial and economic context.

The status of women’s reproductive health in the US and the gross racial and socioeconomic health disparities among women receive no attention at all. Alito’s only mention of race is to suggest, in a footnote, that the practice of abortion derives from the eugenics movement which sought to sterilize women of color as a means to reduce the population of Black people, a claim made by his colleague, Justice Clarence Thomas in his concurring opinion in Box v. Planned Parenthood.

The claim has been widely rebutted by historians and utterly confused autonomous decision-making by women with state sanctioned forced sterilization. What is more, this line of reasoning overlooks persistently high rates of Black maternal morbidity and mortality, a public health and human rights crisis that has been largely ignored by policymakers for decades.

Research shows that access to safe abortion reduces maternal mortality. A 2019 study in the American Journal of Preventive Medicine shows that states with the most restrictive abortion laws and policies have significantly higher maternal mortality. Other studies of the link between abortion access and maternal mortality have demonstrated a similar association. Because a majority of Black women live in the South and Southern states are most likely to further restrict or ban abortion if the Court overturns Roe and Casey, the Court’s decision is likely to exacerbate the Black maternal health crisis.

”To Participate Equally In The Economic And Social Life Of The Nation”

Alito excoriates the 1973 Roe court for its “fact-finding,” including its citation of the amicus briefs submitted by the American Medical Association and the American Public Health Association about the harms of illegal abortion on women’s health and well-being. To Alito, it is not the role of the court to engage in this kind of “fact-finding” because interpretation of the Constitution should not involve consideration of the effect of law on real people. Entertaining the complexities of women’s lives would make legal analysis and reasoning much too messy for the Court.

Indeed, Alito asserts that the Roe court’s consideration of two factors—“the relative weights of the respective interests involved” and the “demands of the profound problems of the present day”—represented legislating, not judicial interpretation. So, should no medical, public health or social science evidence about the effect of access to abortion on women’s health and well-being ever be considered by a court?

Similarly, Alito rejects, as completely unworkable, the Casey court’s “undue burden” standard, which it defined as policies that placed a “substantial obstacle in the path of a woman seeking an abortion before the fetus attains viability.” But it is clear from the Dobbs opinion that he cannot fathom any burden so great that it would reduce the state’s power to restrict or ban abortion. He derides the Roe and Casey courts for balancing women’s liberty interest in controlling their reproductive lives with the interest in “potential life.”

Abortion, he argues, is different from other interests the Court has deemed to be liberty interests because many people believe it constitutes taking the life of an “unborn human being”; the Court, therefore, should not weigh in. Following this line of thinking, one would have to conclude that women have no interest so substantial that it would outweigh state power to restrict or prohibit access to abortion.

He also wholeheartedly rejects the notion of reliance put forth by the Casey court when it asserted that “the ability of women to participate equally in the economic and social life of the nation has been facilitated by their ability to control their reproductive lives.” Rather than entertain such a reliance interest, Alito asserts that it “is hard for anyone—and in particular, for a court—to assess, namely, the effect of the abortion right on society and in particular on the lives of women.”

So, if courts shouldn’t be addressing complexities, who should? Women, Alito asserts, have great political power; if they want to have legal abortion, they should simply elect pro-choice candidates. He points to Mississippi (the state that is testing the constitutionality of pre-viability abortions) as an example of women’s enormous political power, citing the fact that in the 2020 election women cast more ballots than did men.

Obscured by this rosy picture of American democracy are some uncomfortable realities. Mississippi is one of six states in the US that does not allow no excuse in-person or mail-in voting. Women make up just 14% of the Mississippi state legislature, while they are 52% of the population.

Now, place those disparities in relief against the realities of Mississippi women’s reproductive health and experiences of motherhood. They are atrocious: In 2019, nearly a quarter of all births in Mississippi are to parents who live in maternal health care deserts; nearly half of Medicaid covered mothers reported no postpartum visit. Children fare no better. Mississippi has the country’s highest infant mortality rate and the highest poverty rate in the nation, with 28 percent of children living in poverty.

The Future Of Women’s Health And Equality

Alito’s opinion reveals not just the Court’s readiness to overturn nearly 50 years of the constitutional protection for legal abortion. It gives the Court permission to distance itself from any of the consequences its decisions have for the lives of real people, especially the most disenfranchised and marginalized.

At oral argument, Justice Brett Kavanaugh suggested that the Court must use “scrupulous neutrality” in the abortion debate to avoid having to “pick sides.” In essence, this court wishes to wash its hands of the issue and let the chips fall where they may. At the end of the opinion, Alito matter-of-factly states, “we do not pretend to know how our political system or society will respond to today’s decision overruling Roe and Casey. And even if we could foresee what will happen, we would have no authority to let that knowledge influence our decision. We can only do our job, which is to interpret the law…”

In other words, what this decision will mean for women’s health, safety, autonomy, and equal opportunity and for the well-being of their children is of no consequence to this court.

Alito’s texualist and originalist approach to constitutional interpretation presumes that there is one correct interpretation and that courts should play no role in considering the practical implications of their decisions.

But courts, including the Supreme Court, consider the practical and social impact of their decisions all the time. As constitutional scholar Melissa Murray has pointed out, in overruling the legal doctrine of “separate but equal,” the Court in Brown v. Board of Education considered a broad range of social science evidence regarding the effects of racial segregation on educational opportunity and on Black children’s psychological health. The draft opinion’s refusal to consider the practical effects of their decision on women underscores the conservative capture of the court and further deepens the loss of Justice Ruth Bader Ginsburg.

Ginsburg, mostly in dissent, consistently reminded the court’s majority of the realities of women’s daily lives and health, often citing medical and public health evidence. To Ginsburg, abstraction and exclusion of women’s lives in the name of neutrality has long been used to obscure injustice. She saw that the Court’s chipping away at Roe by sanctioning state restrictions on abortion was most harmful to low-income women.

In a 2019 interview with the BBC, she warned that women and their allies should care about abortion rights the way they did in 1973, lest those rights be completely eroded. With the leak of Alito’s draft opinion and the likelihood that the Court will overturn Roe and Casey in June, it is well past time for the majority of Americans who support legalized abortion to take her admonition seriously.