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Archive for the ‘Maternal health’ Category

By Madeleine Kelly

The hot topic at every girl’s sleepover in high school; how many kids their going to have, at what age their going to have them, and what their names are going to be. Unfortunately family planning turns out much better in your imagination than it does in real life.  The fight for access to sexual education and contraceptives makes it hard for women to control their bodies and lives. Living in a developed country we are lucky to have the minimal access that we have. Unfortunately those living in still developing countries are not as lucky.

In 2012, the United Nations declared access to contraception a “universal human right.” This was quite a step in allowing women to take control of their bodies. This declaration is by no means a law, it stands with no legal emphasis, but it opens doors to future legal movements towards much needed help. As of 2015 it was found that only 40% of married or in union women of childbearing age in developing countries were using some form of contraceptive (Department of Economic and Social Affairs, 1). Keep in mind this only pertains to the percent of society married or in union. Family Planning is so vital to this century, with our high abortion and unsafe abortion rates, infant mortality rates, skyrocketing fertility rates coinciding with the poverty levels in underdeveloped (and developed) countries, and economic turmoil for so many countries.

With abortion as controversial as ever, it should not even be considered as a type of contraceptive or family planning. However because of lack of accessibility here we are in 2016 still abusing abortions. An amazing example of how family planning, access and education on contraceptives can impact abortion rates is Europe, which holds both the highest and the lowest incidence rates of abortion. The lowest, 12 per 1,000 women, is in Western Europe, and the highest is in Eastern Europe, with a rate of 43 per 1,000. The difference between the two is that Eastern Europe has low contraceptive use and dependence on outdated methods like the withdrawal and rhythm method (Guttmacher Institute, 1). Countries outside of the US and Europe haven’t been as lucky with family planning.

In developing countries, abortion rates are high, but unsafe abortion rates are even higher. What the World Health Organization is calling, a “preventable pandemic,” unsafe abortions are the result of fear of childbirth but also fear of shame. Defined by the WHO as  “abortions done by individuals without the requisite skills, or in environments below minimum medical standards, or both,” they claim 19-20 million abortions annually (World Health Organization, 1). This is nearly half of the 43 million global abortions that took place in 2008, according to the Guttmacher Institute (1).  They also show that an estimated 68,000 women die annually world wide due to complications from unsafe abortions (1). These are complications that can easily be fixed, with more access to contraceptives and access to legal and available abortions when absolutely necessary.

Another issue with limited access to contraceptives is infant mortality. For those who decide to come to term with pregnancies, despite not being ready emotionally, physically, or financially for a child, put themselves and their newborn in a risky position. As of 2015, the top three countries with the highest infant mortality rates, Afghanistan, Mali, and Somalia, are all developing countries with roughly 10% of their infants dying. There are 36 countries losing more than 5% of their infants, all developing countries (Central Intelligence Agency, 1). These high death rates are correlated with high birth rates, correlated with a lack of control over birth.

The UNFPA goes as far as saying that family planning will boost the economy, stating that for every dollar invested in contraception leads to a reduction in the cost of pregnancy-related care by $1.47 (UNFPA, 1) They also comment on the annual GDP of growing countries, giving the example, “If adolescent girls in Brazil and India were able to wait until their early twenties to have children, the increased economic productivity would equal more than $3.5 billion and $7.7 billion, respectively” (UNFPA, 1).  As you can see, family planning is as important, if not more important in still developing countries than in already developed countries. It is a public health issue that is in desperate need for more attention, with the ability to decrease need for abortion, decrease infant mortality and population problems, and potentially increase economic productivity, family planning needs to be of higher concern to nations with these problem areas.

 

Beadle, Amanda Peterson. “United Nations Declares Access To Contraception A ‘Universal Human Right’.” Center for American Progress Action Fund, 14 Nov. 2012. Web. <http://thinkprogress.org/health/2012/11/14/1189161/un-contraception-human-right/&gt;.

 

“Facts on Induced Abortion Worldwide.” Facts on Induced Abortion Worldwide. Guttmacher Institute, Nov. 2015. Web. 23 Feb. 2016. http://www.guttmacher.org/pubs/fb_IAW.html

 

“Family Planning/Contraception.” World Health Organization, May 2015. Web. <http://www.who.int/mediacentre/factsheets/fs351/en/&gt;.

 

“Family Planning | UNFPA – United Nations Population Fund.” Family Planning | UNFPA – United Nations Population Fund. United Nations Population Fund, 20 Apr. 2015. Web. <http://www.unfpa.org/family-planning#&gt;.

 

“Increased Contraceptive Use Worldwide.” Reproductive Health Matters. Department of Economic and Social Affairs 11.21, Integration of Sexual and Reproductive Health Services: A Health Sector Priority (2003): 198. Web. <http://www.un.org/en/development/desa/population/publications/pdf/family/trendsContraceptiveUse2015Report.pdf&gt;.

 

“The World Fact-book: Country Comparisons: Infant Mortality.” Central Intelligence Agency, 2015. Web. https://www.cia.gov/library/publications/the-world-factbook/rankorder/2091rank.html

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By Michaela Gillis

Scientists are still puzzled by the Zika virus. Before 2007, only 14 people were documented to have Zika. No scientist was conducting research on the virus – it was not a subjective problem. People were experiencing flu like symptoms, nothing life threatening. Today, many mothers are wishing scientists took an interest nine years ago. Now, the race to find out what Zika is, is on. Scientists are currently invested in figuring out what Zika is. What causes Zika, how it is transmitted, how is causes birth defects.  This comes at a high price. The only reason, arguably, why Zika is being noticed by so many scientists now is because it causes an awful birth defect. The birth defect correlated with Zika is the shrinking heads of babies, and because of this, their brains are not able to fully develop. This is called microcephaly. As a public health advocate, I wish scientists would be engaged in viruses to prevent these problems, not research viruses because of these problems. I understand research funding comes into play when scientists apply for grants to conduct research, but that just means the entire system is flawed. My hope for the future is it will not be foolish to scientifically investigate people who only have flu-like symptoms, like the first people with the Zika virus.

Researchers are conducting case control studies, where they look at mothers with the virus and those who do not have the virus, to determine if Zika is definitely the cause of the birth defects being reported. Many doctors in Brazil were failing to report birth defects in babies, so who really knows how detrimental the problem really is.

The Zika virus has huge implications for women. While it is not proven Zika causes birth defects in any/all women, women are still going to be afraid to get pregnant. We need to think, not only about the present, but also of the implications for the future. After WWII in America, there was a rise in reproductive activity, and we now call that generation of children the baby boomers. What will we call this lack of generation in the future?

God forbid if Zika comes into the United States, it will bring a new light on the pro life pro choice argument. As if we needed another reason to not allow foreigners into our country, cough cough Trump.

Zika Virus Map

The Pope is not afraid of a fight. He suggested birth control could be used to prevent the spread of Zika, despite the Catholic Church’s ban on contraceptives. This highly affects places like Latin America, which is mostly consisted of people who are Catholic. Abortion in Latin America is illegal and it is very hard for women to obtain contraceptives. The Pope coming out and advocating for contraceptives because of Zika, may encourage areas like Latin America to make contraceptives more available to their women citizens. The government can warn women not to get pregnant all they want, but if they do not help provide resources to not get pregnant, their message will not be very successful. The virus is not women’s fault. The government should be trying to help the victims of this situation. The virus is the government’s responsibility, not women citizens.

 

Resource: vox.com

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By Meagan Miranda

There is no lack of information in public health boosting the health and nutritional advantages of breastfeeding. It is well documented that breast milk not only provides all the vitamins and nutrients for babies in its first few months of life but it touts additional health benefits such as decreased incidences of obesity, diarrhea, and lower respiratory infections in children (1). Yet with all of these favorable circumstances global rates of breastfeeding have remained below 40% for the past 20 years particularly in East Asia and the Pacific. But breastfeeding is more than a matter of health and nutrition. It is a behavior that affects everyone’s bottom line. One piece of information that struck me in a recent report by Save the Children titled “Superfood for Babies” was a study mentioned in Nicaragua determining that low-income families who use infant formula spend 27% of their household budget every month on milk substitutes. It is apparent that economic household factors also need to be taken into the consideration in the public health issue of breastfeeding. (more…)

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Over the past 50 years especially, women have undergone a series of stark changes in almost every aspect of both their personal and social lives. While all of these areas are of particular importance, one of the most striking of these is women’s pregnancy and birth. In a Boston Globe article titled, “Women have longer labors today than 50 years ago,” the changes that can be seen within this phase of a woman’s life are identified. While much of this is largely shaped by a transformed society, these changes can also be of great concern to the health of both women and their babies. (more…)

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Just recently the results of the first ever national study on abortion inRwandawere released with data from 2009. The study showed that although the abortion rate in Rwanda is lower than that of the rest of Sub-Saharan Africa, 25 per 1,000 women of reproductive age as opposed to 31 per 1,000, there are still high rates of complications with these procedures and that these women are not receiving the medical care that they so desperately need. (more…)

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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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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]. (more…)

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