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Archive for the ‘Inequality’ Category

Women’s health is a salient public health and medical concern in our nation. We live in a country that takes enormous pride in being different, but I find it hard to believe that such a prideful country is lettings its mothers fall by the wayside, when it comes to maternity leave.   This is especially surprising because it has been shown that paid maternity leave, especially one that extends to at least one month prenatally and lasts a full year, has shown to be beneficial in Britain[1]. Maternity leave in the US is simply too short to prove effective. Furthermore, our policy in all states, even those with some paid leave, is unhelpful, is limited to large companies, poorly protects women’s jobs, places undue stress on women to return to work early, and grossly ignores many of the documented benefits of paid maternity leave. Enforcing paid maternity leave would stop women from returning to work prematurely. Most importantly, it would reduce the number of cesarean sections, improve early infant health, and reduce the postpartum maternal mental health problems.

Currently, the U.S. policy for maternity leave as set by The Family and Medical Leave Act guarantees 12 weeks of unpaid leave after giving birth and protects mothers’ jobs [2]. The policy does not include any antenatal care, thus keeping women working until their due date. I believe it is likely that this prolonged work schedule is likely correlated to the high rate of cesarean sections and its associated health risks. Women working until their due date often deal with occupational stress which is associated with increased risk of preeclampsia[3] and increased rates of cesareans. Additionally, both occupational stress and poor sleep are associated with an increased rate of cesarean sections[4].  The rate of cesareans are currently two times recommended by the World Health Organization [5] and four times more likely among women not receiving antenatal care [6].

The current policy ignores the rise in cesareans and its serious implications associated with the high number cesarean sections performed in the U.S. Women who deliver by cesarean are likely to undergo surgical complications, are twice as likely to be re-hospitalized during the first thirty days after birth [7], and are associated with longer stays in hospitals, thereby placing the mother at a high risk of contracting a hospital-born infection that further separates the mother and infant. Furthermore, extended paid maternity leave is shown to bolster infant health by decreasing the number of low birth weight babies. Additionally, chronic work stressors during the antenatal period have been associated with a moderate relationship between stress hormone concentration and preterm deliveries [8]. Infants whose mothers return to work prematurely are less like to receive regular medical checkups, immunizations, and breastfeed [9].

Lastly, an extended aid maternity leave will help alleviate the incidence of maternal mental health problems. About 8-15% of women have postpartum depression and 50-80% have the postpartum blues [10]. Postpartum depression is serious and often makes women hate themselves, feel they lack maternal skills10, and decreases verbal and play time with infants, thereby weakening the crucial mother infant bonding in the early years of life[11].

Clearly, we should question our health policy agenda. Legislators and public health officials cannot ignore the red flags described above. Collaboration is necessary because our currently policy is undermining the health of our women and children.

Sources:

The two news articles are below with the hyperlinks, then all of the sources including the news articles are listed again below in APA format.

http://www.forbes.com/2009/05/04/maternity-leave-laws-forbes-woman-wellbeing-pregnancy.html

http://www.huffingtonpost.com/2011/02/23/paid-parental-leave_n_826996.html

[1] Ray, R, J Gornick, and J Schmitt. Parental Leave Policies in 21 Countries Assessing Generosity and Gender Equality Washington, D.C: Center for Economic and Policy Research, 2009. http://www.cepr.net/documents/publications/parental_2008_09.pdf.

[2] Baum II, C L. “The Effect of Government-Mandated Family Leave on Employer Family Leave Policies.” Contemporary Economic Policy 24, no. 3 (2006): 432-445. doi:10.1093/cep/byj025.

[3] Robles De Medina, P J., A C. Huizink, B R. Van den Bergh, J K. Buitelaar, and G H. Visser, and . “Prenatal Maternal Stress: Effects of Pregnancy and the (unborn) Child.” In Early Human Development, 3-14. 2002.

[4] Lee, L, and C Gay. “Sleep in late pregnancy predicts length of labor and type of delivery.” Journal of Obstetrics and Gynecology 191, no. 6 (2004): 2041-2046. doi:10.1016/j.ajog.2004.05.086.

[5] Weitz, R. “The Social Meanings of Illness.” In In Sociology of Health, Illness, and Health Care, 5th ed., 107-129. Boston, MA, USA: Wadsworth CENGAGE Learning, 2010.

[6] Guendelman, S, M Pearl, S Graham, A Hubbard, N Hosang, and M Kharrazi. “Maternity leave in the ninth month of pregnancy and birth outcomes among working women.” Womens Health Issues 19, no. 1 (2009)

[7] Declercq, E, M Berger, H J. Cabral, S R. Evans, M Kotelchuck, C Simon, J Weiss, and L J. Heffner. “Maternal Outcomes Associated With Planned Primary Cesarean Births Compared With Planned Vaginal Births.” In Obstetrics & Gynecology, 669-677. 2007.

[8] Guendelmen, S, J L. Kosa, M Pearl, S Graham, and M Kharrazi. “Exploring the relationship of second-trimester corticotropin releasing hormone, chronic stress and preterm delivery.” Journal of Maternal-Fetal and Neonatal Medecine 21, no. 11 (2008): 788-795. doi:10.1080/14767050802379031.

[9] Berger, L M., J Hill, and J Waldfogel. “Maternity leave, early maternal employment and child health and development in the US.” In The Economic Journal, F29–F47. 2005.

[10] Perfetti, J, R Clark, and C M. Fillmore. “Postpartum Depression: Identification,Screening,and Treatment.” Wisconsin Medical Journal 103, no. 6 (2004): 56-63.

 [11] Righetti-Veltema, M, A Bosquet, and J Manzano. “Impact of postpartum depressive symptoms on mother and her 18-month-old infant.” European Child and Adolescent Psychiatry 12, no. 2 (2003): 75-83. doi:10.1007/s00787-003-0311-9.

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When you and other family members take special care of my mothers food and care during pregnancy, it makes me happy and I feel secure and comfortable.

This is what a letter to Om Prakash, a soon to be father in India, read. The letter was written from the perspective of his unborn child as part of a program called Sure Start which aims to involve men in their wife’s pregnancy and help fathers to understand what is required of them to ensure their child and wife survive. The letter pleads to the father-to-be and asks him to ensure positive health behaviors in his wife during pregnancy and alerts him to warning signs that the woman may need medical attention. The letter had such a strong effect on Om Prakash that he immediately left the area where he was living and working and returned home to his pregnant wife. When she fainted days after his return, the knowledge Om Prakash had gained from the letter helped him to realize she needed medical attention and because of this, he was able to make the important decision to get her medical attention. Because he did, both his son and wife are healthy today. (more…)

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Here in the United States, fast food restaurants govern almost every street corner.  Between dollar menus and supersized portions, it is no surprise that overweight and obesity are major health concerns of our country; and with all of the inexpensive kid-portion meals and plastic toys available, the thought of a hungry child is often overlooked.  Reality is, however, that malnutrition afflicts one in four children around the world, and almost 16,000 children die from hunger-related causes every day.  Not only does it affect growth and development into young adults, but malnutrition can weaken the immune systems of young children as well, which can lead to lifelong damage and disease, such as malaria, diarrhea and pneumonia, all of which can result in death.  Also, for example, a disease like malaria further reduces the appetite among these children, weakening them even more, and creating a deadly spiral from which it is difficult to escape. (more…)

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Big news from Washington D.C last Friday, from President Obama about his nomination for president of the World Bank. He nominated Dr. Jim Young Kim, who is the president of Dartmouth College and a global health expert. This nomination comes after the current World Bank’s president, Robert B. Zoellick, announced the end of his presidency after a five-year term. Upon hearing this news, my first reaction was to wonder how Dr. Kim and his skills would be right for the World Bank? (more…)

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My interest in health and human rights on an international setting has led me to question a great deal about international public health, particularly with regard to the intervention by developed nations in underdeveloped ones and the application of concepts like “sustainability” and “cost-effectiveness” as well as the very nature of public health initiatives. Too often, it seems that western nations take a mindset similar to that of Americans in the 19th and 20th centuries and their ideas of Manifest Destiny. Essentially, they justified colonialism and political, economic, and territorial greed by claiming that, as a developed nation, it was our duty to improve the lives of underdeveloped societies. Certainly, it would be inappropriate to compare our public health campaigns to combat HIV/AIDS, maternal and child health concerns, and preventable disease in afflicted countries to these skewed ideals of our forefathers, but it is important to realize that many programs still contain undertones that bear a somewhat shocking resemblance to those days. Ultimately, it may be important for developed nations to decide how great of a factor sustainability or cost-effectiveness should be when weighed against the value of human lives across the globe. (more…)

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A nation’s status is directly related to the status of its women. Time and time again issues surrounding global health, human rights, and economics are tested and resolved via the empowerment of women. There are numerous examples around the globe of women, given access to adequate resources and education, changing the shape of their countries health, education system, and government. Yet, it surprised me and angered the small feminist within in me when MIT professor, Dr. Esther Duflo stated, “[we] cannot rely on women’s empowerment to make us all rich and healthy” in an interview in the Financial Times. (more…)

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Water is essential to everyday life and yet, in 1990, 24 percent of the world’s population did not have access to clean drinking water. This paved the way for stronger efforts to battle the world’s water woes and the lack of access to clean water was addressed in the United Nations’ Millennium Development Goals. One goal was to reduce by half the number of people who lived without access to adequate drinking water. Recently, it has been determined that this goal has finally been achieved. This achievement marks the first goal to be accomplished and means that the health and well-being of communities around the globe should greatly increase. (more…)

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