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Economic Recession Prompting California Women To Seek Health Care In Clinics
The current economic recession has prompted more women in California to seek health care -- including routine gynecological exams, contraceptives and abortions -- at clinics and family planning agencies, the Los Angeles Times reports. Many of the services, such as contraception and abortion, are related to avoiding or ending pregnancies as women experience job losses and subsequent loss of insurance coverage amid the recession, according to the Times. For example, Planned Parenthood clinics report that they are performing a record number of abortions, while other women"s health agencies report higher call volumes, more visits and additional requests for abortion funding. Clinic officials also report that women increasingly are switching their contraceptive methods to longer-term options than can last five to 10 years.According to the Times, the increased demand for reproductive health services -- particularly abortions funded by Medi-Cal, the state"s Medicaid program -- are putting a strain on some clinics. In addition, paying for an abortion can be difficult for women who already are struggling financially. The Times reports that as women attempt to raise the money for abortions, thereby postponing the procedure, the cost increases from about $450 during the first trimester to $1,200 during the second trimester. Delays in abortion funding also can cause more difficult choices for some women. Destiny Lopez -- executive director of ACCESS, a group that helps low-income women seeking reproductive health care -- said that some women who decided to terminate an early pregnancy are forced to decide between a second-trimester abortion or continuing an unwanted pregnancy because of funding delays. "It"s not like women are making these decision at the drop of a hat," she said, adding, "They are considering their life situations."Stephanie Poggi, executive director of the National Network of Abortion Funds, said, "We are seeing poor women get poorer and we"re also seeing low-wage women become poor," adding, "The economy is definitely having an impact. ... We see a greater demand for assistance." According to clinic officials, pregnant women who call in for assistance increasingly are considering the costs of raising a child when deciding how to proceed with their pregnancies. Lopez said, "Women are really having to make thoughtful decisions whether now is the right time to get pregnant or not."According to a recent Gallup Organization survey conducted on behalf of the American College of Obstetricians and Gynecologists, nearly one in 10 married women reported that the recession is a contributing factor in a decision to postpone a planned pregnancy; one in five women reported being more concerned now than one year ago about an unintended pregnancy; and about one in five women reported being more conscientious about using contraceptives (Yoshino, Los Angeles Times, 5/20).
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Washington Post Examines Lack Of Information About Stillbirths, Bill To Expand Data Collection

Centers for Disease Control and Prevention data show that stillbirth occurs in about one in every 160 pregnancies in the U.S., but physicians rarely warn pregnant women or their partners about the possibility, Washington Post staff writer Alan Goldenbach writes in an article discussing his experience when his wife"s pregnancy ended in stillbirth. In the U.S., the clinical definition for stillbirth is the death of a fetus after 20 weeks" gestation or weighing 350 grams if the age is unknown.There are about 26,000 stillbirths annually in the U.S., according to CDC. Goldenbach writes that this is "10 times the number of deaths attributed to sudden infant death syndrome, which has been identified as a key public health issue, and four times the incidence rate of Down syndrome, for which prenatal testing has become almost ritual." He continues that many doctors told him and his wife "that they don"t see any point in discussing stillbirth, that it"s a catch-all term for an event, and one that is frequently unexplained." Doctors contend that if they knew the causes or signs of stillbirth, they would warn patients or take preventive action, he adds. Noting that awareness of SIDS spurred research into preventive measures, Goldenbach writes that "[w]e can"t know if improved technology or more stringent standards of monitoring can lower stillbirth rates unless we do the research."Ruth Fretts, an assistant professor of obstetrics and gynecology at Harvard Medical School and chair of the scientific committee for the International Stillbirth Alliance, said, "It"s a trade-off -- you are going to frighten a lot of people" by discussing stillbirths. According to Fretts" research, the leading cause of fetal death after 28 weeks" gestation is an unexplained . Goldenbach writes, "Several doctors told us privately that many ob-gyns fear charges of malpractice following a stillbirth, leading them to avoid citing a cause of death."Stillbirth Legislation in Development Sen. Frank Lautenberg (D-N.J.) is drafting legislation similar to a stillbirth prevention bill that then-Sen. Barack Obama (D-Ill.) introduced in June 2008. According to s familiar with the bill, it will be brought to the Senate floor before the August recess. The legislation will expand stillbirth registries already in operation in Iowa and metropolitan Atlanta. The bill"s supporters hope to have as many as 12 states participating in the registry and installing a standard protocol for data collection after each stillbirth. Another provision would create a campaign to increase public awareness and strengthen grief support services, Goldenbach writes (Goldenbach, Washington Post, 7/6). Reprinted with kind permission from http://www.nationalpartnership.org. You can view the entire Daily Women"s Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women"s Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company. © 2009 The Advisory Board Company. All rights reserved.


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