Maternal Mortality: A National Embarrassment

Americans spend more money on childbirth than any other country, but we’re not getting a good return on our investment.

Less than a century ago, approximately one mother died for every 100 live births — an occurrence so common that nearly everyone belonged to a family, or knew of one, that was devastated by such a loss. Fortunately, in most nations, those tragedies have declined over the years. In fact, in the decade between 2003 and 2013, only eight countries saw their maternal mortality rates rise.

Unfortunately, the United States was one of those eight countries, joining a club that also includes Afghanistan and South Sudan. Within the 31 industrialized countries of the Organization for Economic Cooperation and Development, an American woman is more likely to die as a result of pregnancy than a citizen of any other country besides Mexico. Among developed countries, the United States has one of the highest maternal mortality rates — and those rates are only getting worse.

Graph: CDC

U.S. maternal mortality has attracted the attention of organizations whose oversight you wouldn’t expect. Amnesty International, which most Americans associate with the fight against human rights abuses in far-flung authoritarian regimes, considers our high maternal mortality rates to be a violation of human rights. Additionally — and pathetically — one of the biggest sources of funding for maternal health in the United States comes not from taxpayers but from the pharmaceutical company Merck. The Economist quoted a Merck spokesperson as saying, “We expected to be doing all our work in developing countries.” Continue reading

Sound Science and Unsound Ideology: Sixty Years of Obstetric Ultrasound

Ultrasound image used in an anti-abortion billboard in Ireland, 2012. Photo: The Vagenda

For decades now, ultrasound technology has been a fixture in the journey from pregnancy to parenthood. It has also become a prized weapon among abortion opponents in the battle over reproductive rights.

Ultrasound, which uses high-frequency sound waves to render images of a developing fetus, had its beginning 60 years ago this week, with the publication of a seminal paper in the British medical journal The Lancet. The development of the technology has a colorful history, one involving flying mammals, German submarines, a desert-dwelling inventor, and countless medical professionals who saw a range of patient care possibilities.


Ultrasound is a powerful tool, which can benefit patients or be used as a cudgel by abortion opponents.


But that colorful history belies the drab and fuzzy appearance of most ultrasounds. That limitation, though, has never stopped it from taking on enormous significance. When the technology was first developed, it gave obstetricians an unprecedented ability to survey fetal development, making it one of the most important advances in their field during the latter half of the 20th century.

By the same token, ultrasound has not only been a valuable medical tool but also a powerful storytelling tool. Today, it is often put to use four or more times before a patient’s due date. While the FDA and other authorities advise against ultrasounds that aren’t medically necessary — recommending just two for a low-risk pregnancy — many patients opt for additional, elective ultrasounds for the sake of having keepsake images. Posting those images online has become a popular way to share their news with family and friends. Continue reading

Learning About Alcohol and Drug-Related Birth Defects

The week of May 14 is Alcohol and Drug-Related Birth Defects Awareness Week. According to the National Council on Alcoholism and Drug Dependence:

About 20% of pregnant women smoke cigarettes, 12% drink alcohol and 6% use an illicit drug at least once during pregnancy. These numbers are very alarming. If only people knew the dangers of their decisions, perhaps we would be looking at something more acceptable in those numbers.

So what are some of the dangers posed by these substances to a developing fetus?

Effects of Tobacco Use

According to the Centers for Disease Control and Prevention, the fetus gets less oxygen when the mother smokes. Smoking during pregnancy is a risk factor for low birth weight, preterm birth, placenta problems, miscarriage, and sudden infant death syndrome (SIDS).

Effects of Alcohol Use

I have written about the effects of alcohol use during pregnancy before — in fact, it was the subject for the first article I wrote for this blog.

Alcohol easily passes through the placenta, so when a pregnant woman drinks, so does her fetus. Continue reading

Brothers in Arms, Part 1: Racist Anti-Abortion Rhetoric from the Restell Years to Roe v. Wade

Newspaper illustration of Madame Restell in jail, February 23, 1878

This article is our first installment in a series that explores the historical and contemporary links between racial intolerance and opposition to abortion, from the fears of immigration that fueled abortion prohibition in the late 1800s to the gender-based hatred rooted in today’s white nationalist resurgence.

In the battle over abortion, Kentucky was this year’s ground zero. In Louisville, the EMW Women’s Surgical Center fought to keep its doors open, as a governor, a legislature, and a base of activists — all hostile to abortion — made it their mission to shut the clinic down. For reproductive justice advocates, the stakes were high, as EMW stands as the only abortion provider in Kentucky, the last one in a state that had more than a dozen such providers in the late 1970s.


In the 19th century, opposition to abortion was fueled by racist paranoia.


The situation in Louisville was emblematic of a national phenomenon. In 2011, state legislatures entered a fever pitch, passing new restrictions on abortion, including ultrasound requirements, waiting periods, state-mandated counseling, and prohibitions against telemedicine care and abortion medications. Within a few years, more than 200 restrictions were enacted, and by early 2016, The Washington Post was reporting that 162 abortion providers had closed in their wake.

Boom Years for Abortion

When Ann Lohman first opened her abortion practice, her experience could not have stood in starker contrast to the battle of attrition against regulations and harassment that shutters many of today’s providers. If there were any challenges to keeping her doors open, it was competing with the many other providers who clamored for attention, with advertisements in newspapers, popular magazines, and even religious publications. Lohman’s own advertising budget, to stand out from the crowd, eventually reached $60,000 a year.

Lohman’s experience, like the EMW Center’s, was a sign of the times — but they were very different times.  Continue reading

July 11 Is UN World Population Day

The following guest post comes to us via Esteban Camarena, a graduate student at the University of Arizona. He is currently in Brazil doing field research on politics and public health policy. He can be reached at estebanc@email.arizona.edu.

The world’s population is on the way to reaching 8.6 billion people by 2030 — that’s approximately 1.1 billion more inhabitants on the planet in less than 13 years. If we break it down further, that’s 84.6 million more people per year, 7.1 million per month, 1.8 million per week, or 252,0000 people added every day, roughly.

July 11 is UN World Population Day, which aims to create awareness of population growth issues and their relation to the environment and development. With the world’s population increasing every year, the limited amount of natural resources combined with the effect of climate change hinders any country’s ability to achieve sustainable economic growth and development. As the global population continues to grow, so too does the demand for food, water, energy, and land.


An investment in women’s health is an investment in families’ economic stability and a country’s development.


The inability to meet these demands will inevitably lead to malnutrition, poverty, and conflict between nations and people. This depletion of resources would particularly affect developing countries where the greatest amount of population growth is expected; in fact, more than half of the anticipated growth will occur in Africa, followed by Asia and Latin America. Among other factors, population growth is concentrated in these developing regions due to limited or lack of access to reproductive health care, family planning services, and sex education. Continue reading

What’s in a Name: Repealing the Affordable Care Act

Supporters drop off petitions and rally at Rep. Martha McSally’s Tucson office, March 15, 2017

As this post goes to press, word has come that Speaker Paul Ryan has pulled the American Health Care Act, being unable to muster enough votes to pass it. So we have escaped that disaster, and it appears no attempt to repeal the Affordable Care Act will proceed in the near future. But the fight is not over. Aspects of this bill will come up in other forms and we will have to be vigilant. But this is a victory for activism, so many thanks to all of you who made phone calls, demonstrated, told your stories, and reminded the Republicans that destroying something is not the same as governing.

So as you read this, realize what we have escaped, and what we need to watch out for as we proceed.


People were going to die. But the free market would have triumphed.


Republicans called it Obamacare, and used that name as a slur to run against President Obama in 2012. It didn’t win that race for them, but there are enough people in this country for whom the name Obama is enough to damn a program. One woman, whose son lost his job and had his monthly insurance premium fall from $567 to $88, attributes that decrease to the tax credits in Trump and Ryan’s new American Health Care Act. You know, the bill that never passed. In actuality, her son became eligible for a subsidy under Obamacare — the Affordable Care Act — which is still the law.

Paul Ryan and his cronies in the House of Representatives hated the Affordable Care Act before it was written. They hated it even more when it passed and more than that when it was implemented.

What did they hate about it? Continue reading

Pro-Choice Friday News Rundown

  • The wingnuts over at the Center for Arizona Policy are almost always behind every single awful anti-choice bill in on our state. This time’s no different. Senate Bill 1367, if passed, would require doctors to take measures to maintain the life of a fetus born “alive” during an abortion procedure. Arizona Republic writer E.J. Montini expounds upon why this legislation is harmful. (AZ Central)
  • The most important opinions on this subject, however? Those of the mothers whose last precious moments with their newborns would have been stolen due to this cruel, useless law. (AZ Central)
  • A bit of good news though — it’s highly unlikely we’d ever see a “bathroom bill” or other extreme/homophobic/transphobic anti-LGBTQ legislation hit Arizona. Let’s focus on the small victories, people. (AZ Central)
  • Speaking of homophobia, South Dakota has passed a bill allowing state adoption agencies to refuse to allow same-sex couples to adopt children. Now, seeing as many who are anti-LGBTQ cling fervently to the “pro-life” title, it’s interesting that they’d rather let orphan children suffer without families than allow them into loving homes, isn’t it? (Slate)
  • In case you missed it — an enormous, smelly wheelbarrow filled with excrement known as the American Health Care Act (aka Trumpcare) was rolled out last week and is a total sh*tshow that will really only benefit the rich and healthy. Everyone else will basically die. (NY Mag)
  • Pregnant women will definitely be among the hordes of “losers” under Trumpcare. Ironic considering the GOP does literally everything possible to force women to remain pregnant, whether they wish to be or not, and then they create atrocious legislation to make it financially impossible to be able to afford to have a child. (Salon)
  • Aside from pregnant women, other parents as well as millions of children would lose their vital health coverage. (Romper)
  • And I’m far from done, ’cause this plan is the gift that keeps on giving. Other losers under Trumpcare? Pumpkin-colored Pinocchio’s very supportive voter base. This is his thanks to you all, thanks for playing and helping “Make America Great Again,” folks! Better luck voting for a president and Legislature who give a damn about you next time! (WaPo)
  • Trumpcare’s provision to defund Planned Parenthood puts our patients in the loser category as well. (Planned Parenthood Action)
  • And defunding us means the number of births in the Medicaid program would increase, as well as direct spending for Medicaid — which would increase by $21 million in 2017 alone. (NPR)
  • Appallingly, some supporters of Trumpcare think the thousands of unintended pregnancies that will result from this asinine bill are a good thing. Forced birthers are elated at the possibility that more babies will be born under potentially horrendous conditions. They will ignore the fact that these babies weren’t wanted and their parents are economically disadvantaged in a country led by a party that has proven itself to be unsympathetic to the plight of the poor. More babies under those circumstances is not a win. It’s a tragedy with the potential to have long-term emotional, mental, and financial consequences for real people — especially children! (WaPo)
  • Illinois Republican John Shimkus idiotically complained about men having to pay for maternity care via their health insurance and it got a lot of women thinking. What if women didn’t have to pay for men’s health care? (Elle)
  • Florida bill HB19 would allow women to sue abortion doctors for “emotional distress” after undergoing the procedure, which is, by the way — elective and voluntary. Here’s why that’s a slippery slope — it is well known that MANY anti-choice activists have “secret” abortions (check out the riveting book, “This Common Secret: My Life As An Abortion Doctor” by Susan Wicklund, for stories about this). How horrendous would it be for them to have the power to ruin doctors’ lives under such a law? They benefit doubly — they terminated an unwanted pregnancy and then get to benefit financially. What.A.Sham. And what other elective, LEGAL medical procedures allow for lawsuits from patients over regrets or emotional distress? ZERO. (Orlando Sentinel)
  • For the billionth time, “community health centers” cannot “fill the gap” in care if Planned Parenthood is defunded. Don’t believe me? Look at Wisconsin and Texas. (Guardian)