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  • The Health of All Women

    By Aliye Runyan
    AMSA Education and Research Fellow

    Do you know Roe v. Wade is currently under attack and the health of all women is at stake?

    Cleverly disguised as "state-based regulation", seven states have passed or will soon pass devastating legislation affecting access to family planning, especially in rural and underserved areas. This impacts not only the women and families in those states, but taken collectively, is a serious and deliberate blow to national family planning services.

    AMSA believes matters of reproductive health to be private and sensitive, and support the right of patients to make these decisions in confidence with their physician without the interference of any third party. In that spirit, we disagree with and discourage wholeheartedly the recent legislation affecting Ohio, Wisconsin, Texas, North Carolina, Virginia, Alabama, and Mississippi. These laws, sometimes "stuck in" along with other, completely unrelated legislation, do nothing more than prevent access to safe options for abortion. In cases of such legislation where clinics like Planned Parenthood are defunded, this not only prevents safe abortion options ( in those clinics which provide it) but also restrict and discourage access to family planning resources such as contraception and scientifically based sexual education, which in turn, reduce the need for abortion.

    The way most of these bills decrease access is through TRAP laws. TRAP stands for Targeted Regulation of Abortion Providers. Six states have made it illegal for abortion clinics to operate unless the physician has admitting privileges at a nearby hospital. In rural areas of Virginia and Wisconsin, two states that have recently passed TRAP laws, there is not a hospital close by.

    Dozens of rural clinics face closure because of TRAP laws. Those who support TRAP laws say they help ensure the safety of women by requiring their doctors to have admitting privileges. The vast majority of abortions are outpatient procedures that are less invasive than some dental work, colonoscopies, vasectomies, and plastic surgeries, yet only abortion providers are targeted for these unnecessarily restrictive measures.

    In an article in today's Chicago Tribune, professor emeritus of obstetrics and gynecology Dr. John Sciarra writes, "in those days [before Roe v Wade], 20 American women died for every 100,000 live births, many from unsafe abortions. We knew that legalizing abortion could save many of those lives, and we were right: today's maternal mortality rate is half of what is was then, because legal abortion is safe and back alley attempts are much rarer. We were optimistic that society would hail legalized abortion as a win for everyone. [...] Rather than increasing contraceptive availability as we recommended in 1972, ideologues attack family planning and are making all reproductive health care less available to the poor."

    Sciarra concludes with "no law that has ever been passed and no law that ever will be passed can prevent a determined woman from trying to end an unwanted pregnancy. Society and hospitals must accept their role in keeping women safe in that process."

    As a physician in training who believes in her patient's abilities to make their own choices and in the privacy and privileges of the doctor patient relationship, I absolutely agree with Sciarra's words.

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  • Tell Congress to Protect Women's Healthcare!

    Recognizing the benefit of removing barriers to access to contraception, the Department of Health and Human Services released a rule requiring insurance plans to provide no-cost birth control coverage. Some conservative groups have manufactured an uproar about this, claiming that it impinges on religious freedom to require insurance to offer contraception at no cost - despite the fact that churches and houses of worship may exempt themselves from the requirement. On top of that, many states have had similar requirements for several years without incident and the inclusion of contraceptive coverage in insurance plans has been widely required since the year 2000.

    This rule does not requires anyone to use contraceptives and it does not require employers to endorse them. What it does is allows students at religious universities or employees of religiously-affiliated hospitals to exercise their own individual beliefs without the barrier of cost.

    Some members of Congress are now attempting to overrule the administration by introducing bills that would take these decisions out of the hands of women and physicians, and instead let employers choose if women should have access to contraception. Write or call your elected officials today and tell them to protect access to preventive care for women, including no-cost contraception!

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  • Supporting Expanded Access to Plan B

    By Elizabeth Wiley, JD, MPH
    AMSA Vice President of Internal Affairs


    In an act motivated by politics rather than scientific evidence, Health & Human Services (HHS) Secretary Kathleen Sebelius has decided to keep Plan B emergency contraception from being sold over the counter, overruling the decision of Food and Drug Administration (FDA) Commissioner Margaret Hamburg, M.D.

    Currently, Plan B is sold behind pharmacy counters and is available without a prescription only for those 17 or older. At issue was whether the current age restrictions on the purchase of Plan B (levonorgestrel) should be lifted in light of new evidence that even the youngest girls of reproductive age were capable of using Plan B safely and effectively. After a ten-month review, Dr. Hamburg stated, “there is adequate and reasonable, well-supported, and science-based evidence that Plan B One-Step is safe and effective and should be approved for nonprescription use for all females of child-bearing potential.” Secretary Sebelius’s veto of this evidence-based decision is unprecedented.

    As a form of emergency contraception, Plan B is most effective when used within 72 hours of intercourse. Current over-the-counter age restrictions prevent retailers from stocking this form of contraception on the shelves and create barriers to access for women of all ages.

    AMSA believes emergency contraception should be fully accessible to all and condemns Secretary Sebelius’s decision to continue to limit access to Plan B. It is deeply disappointing that the Obama Administration has privileged politics over science when it comes to women’s health and reproductive freedom.

    Take action today and tell Secretary Sebelius and President Obama to put evidence before politics and reconsider expanding access to Plan B.

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  • No-cost birth control! New HHS guidelines on women's preventive health

    By Kathy Wollner
    Women's Policy Coordinator, AMSA Gender & Sexuality Committee


    This week, buried under chatter about raising the debt ceiling, was some pretty great news for women’s health care. The U.S. Department of Health and Human Services (HHS) announced new guidelines that all FDA-approved contraception options must be covered by all new health insurance plans*** without cost-sharing. These guidelines are based on the Institute of Medicine (IOM) recommendations issued this July and will go into effect August 1, 2012.

    This means women will be able to get whatever mode of birth control is right for them - oral contraceptive pills, patches, rings, injectables, IUDs - without having to pay co-pays or contribute into their deductibles.

    This is huge in assuring that women will no longer be burdened with additional costs when seeking family planning. We know that giving women access to contraception allows them to prevent unintended pregnancies and space their children in a way that’s healthy for both moms and babies. When women have access, they and their partners are able to plan their families in the way that’s best for them. Removing barriers based on cost is a big step in the right direction toward ameliorating health disparities based on income and access.

    But wait, there’s more!

    Other services to be covered by new health insurance plans without co-pay include well woman visits, HIV testing and counseling, STD counseling (testing is covered under existing guidelines for women under 24 and those at high risk), HPV testing for women over 30, domestic violence screening and counseling, and breastfeeding support, supplies, and counseling.

    The Obama Administration’s support of evidence-based medicine and commitment to investing in preventive health care will in the end have a major impact on women’s health. No woman should be unable to access these basic health services due to cost. I am beyond excited for myself, my sisters, my friends, and my future patients that we can stop making health care decisions based on what’s covered by insurance and start making them based on what’s best for our health and well-being. Hooray!


    *** What exactly does “new health insurance plans” mean? Good question. It essentially means that it won’t go into effect for everyone right away. While many employers stick with the same coverage year to year, there’s pretty much always a re-negotiation of the terms of the plan in some way, which will make it “new.” It’s unclear at this point (to the people who know more than me who I posed this question to and thus to me as well) what this means for individual plans, but in the case of group plans, these new guidelines should catch up to most plans sooner rather than later.

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  • HHS Requires Free Birth Control for Women

    This week the Department of Health and Human Services (HHS) announced new guidelines requiring health insurers to cover certain women’s preventative services, including birth control, HPV screenings, breastfeeding support and STD counseling.

    The guidelines are based on the recommendations issued by the Institute of Medicine in July. According to HHS Secretary Kathleen Sebelius, the decision is a part of the Affordable Care Act's move toward prevention. "These historic guidelines are based on science and existing literature and will help ensure women get the preventive health benefits they need."

    Many groups oppose the guidelines, citing that many people have moral and religious convictions against contraception. President Obama issued an amendment allowing religious groups who offer insurance coverage to employees the right to choose whether to cover contraception.

    "Covering birth control without co-pays is one of the most important steps we can take to prevent unintended pregnancy and keep women and children healthy," said Cecile Richards, president of Planned Parenthood Federation of America.

    Supporters believe that covering contraception will helps the government save money by decreasing the number of unintended pregnancies, which accounted for 51 percent of publicly funded births in 2006. By reducing the numbers of unintended pregnancies, the move could save more than $11 billion in medical costs.

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  • Take Action on "No Taxpayer Funding for Abortion Act"

    Kathy Wollner
    Women's Policy Coordinator, AMSA Gender & Sexuality Committee

    Your voice is needed to challenge the House of Representatives' attack on women's health. Tell your Representative to vote NO on the "No Taxpayer Funding for Abortion Act" (H.R. 3)!

    This bill creates new, harmful restrictions on reproductive health care that go far beyond current law by raising taxes on small businesses and the self-employed who wish to purchase a private insurance plan that includes abortion care. This extent of government overreach into the use of private funds is unprecedented. Medical decisions - including those to end a pregnancy - should be discussed between women and their health care providers, not among members of Congress or employees of the IRS.


    As medical and premedical students we must speak out in defense of our profession and the rights of our patients across the country. Reproductive health care is just that, health care. It is time for Congress to treat is as such.

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