Wisconsin Governor Vetoes Abortion Bill

On Friday, Wisconsin Governor Jim Doyle vetoed a Senate Bill (SB 138) that would have required abortion providers to inform women that a fetus older than 20 weeks can feel pain. In the Governor's press release, he stated, "This bill intrudes on the doctor patient relationship in a heavy handed manner and means doctors don’t have to provide objective and accurate information to their patients. In any case, I trust doctors, not the Legislature, to make medical judgments. We should keep the doctor-patient relationship between doctors and patients and keep the Legislature out of it." The Governor also issued a veto statement which provides more rationale for the veto, including the lack of consensus in the medical field over whether the information is actually true. The text of the bill and bill history are available online. If you're a Wisconsin resident and have thanks or complaints for the Governor, you can submit them online here.
Technorati Tags: abortion; legislation; Reproductive Rights; Wisconsin
MeSH Tags: Abortion, Induced/legislation and jurisprudence

All Things Considered Covers Abortion

NPR show All Things Considered aired two stories on abortion on Wednesday. The first provides a clear overview of historic abortion-related legal decisions, and also addresses abortion rates in the U.S. and the state of affairs Mississippi, which has only one abortion clinic. The second piece covers the case concerning New Hampshire parental notification law that is currently before the Supreme Court, as well as other cases that may end up before the Court. Each of these stories can be heard online at the links posted above.
Technorati Tags: abortion; NPR
MeSH Tags: Abortion, Induced

Review of Abstinence-Only Education

An article in the current issue of the Journal of Adolescent Health (found via Feministing) looks at abstinence-only education programs in the United States. This is a review article, meaning that the authors have not done any original clinical studies or experiments, but are providing an overview of what is known on a topic. The piece looks at how abstinence is defined under federal guidelines, physical/psychological health outcomes of adolescent sexual behaviors, current federal policy and local programs, reviews of abstinence-only education, the effectiveness of abstinence in preventing pregnancy and STIs, and other related topics. The authors review the evidence on each of these topics, but add the following commentary to the end of article:

Although abstinence from sexual intercourse represents a healthy behavioral choice for adolescents, policies or programs offering “abstinence only” or “abstinence until marriage” as a single option for adolescents are scientifically and ethically flawed. Although abstinence from vaginal and anal intercourse is theoretically fully protective against pregnancy and disease, in actual practice, abstinence-only programs often fail to prevent these outcomes. Although federal support of abstinence-only programs has grown rapidly since 1996, existing evaluations of such programs either do not meet standards for scientific evaluation or lack evidence of efficacy in delaying initiation of sexual intercourse.

Although health care is founded on ethical notions of informed consent and free choice, federal abstinence-only programs are inherently coercive, withholding information needed to make informed choices and promoting questionable and inaccurate opinions. Federal funding language promotes a specific moral viewpoint, not a public health approach. Abstinence-only programs are inconsistent with commonly accepted notions of human rights.

In many communities, AOE has been replacing comprehensive sexuality education. Federally funded AOE programs censor lifesaving information about prevention of pregnancy, HIV and other STIs, and provide incomplete or misleading misinformation about contraception. The federal government’s emphasis on abstinence-only approaches may also be harming other public health efforts such as family planning programs and HIV prevention efforts—domestically and globally. Federally funded abstinence-until-marriage programs discriminate against GLBTQ youth, as federal law limits the definition of marriage to heterosexual couples.

Schools and health care providers should encourage abstinence as an important option for adolescents. “Abstinence-only” as a basis for health policy and programs should be abandoned.

A concluding paragraph stating the authors' conclusions and thoughts about their implications is very common in the medical literature. What is unusual is reading a scholarly article in a reputable medical journal and feeling as though you are being slapped in the face with the authors' political agendas. It seems striking that this should be the reader's reaction - after all, sexual and reproductive health are medical issues, not political ones. There can be two readings of this particular article. As a scholarly piece, it can read as a summary of known fact that seems to support comprehensive sex education rather than abstience-only, making the authors' concluding points a perfectly reasonably "implications" section of a standard research article. As a political piece, it is a strong editorial statement in opposition to the abstience-only agenda being pushed by certain policy-makers. Because the audience for this journal may be limited, it will be interesting to see what reaction this article provokes, if any.

Technorati Tags: abstinence; Sex Education
MeSH Tags:Sexual Abstience; Sex Education

A Yahoo! Answers Challenge for Information Professionals

This one is especially for my librarian and pre-librarian readers:
For everybody else: we'll be back to women's health for the next post!

Librarian Gary Price expressed his own concerns about Yahoo! Answers here. Given the concerns I have about the quality of health-related answers over at Answers (previous posts here and here), I decided to set up an account and periodically contribute answers. I'm focusing on health questions due to my interests and aspirations in medical librarianship. I may periodically tackle questions in other subjects in order to keep my reference skills sharp. I recognize that most of you already are very busy with work, life, and/or school. However, if you have a few minutes each week to spare, I would encourage you to lend your skills to this site.

You may ask:
Why should I do this?: Because by choosing librarianship, you have chosen to commit yourself to bringing quality information to those who need it. Admit it, you're compelled to answer the unanswered and seemingly unanswerable. You are the kind of person who makes unplanned stops in a bookstore to look at a slang dictionary in order to prove a point about an odd word for "drunk." It's okay, you're not alone.

Where can I find the time?: The questions I've handled are pretty easy ready reference queries, taking no more than 5 minutes or so to dig up accurate sources. You can do a lot with a little here.

What's in it for me?: Okay, here's the part where we talk about devaluing librarian work by giving it away for free. I don't know the answer to that problem, but I'm not convinced that contributing your answers on the Yahoo site will make it much worse. What I do think is that working on assorted reference-type questions outside of your regular specialized library and community is a good tool for continuing education. Pick a question, search for an answer, keep your info skills up to date. Pretty simple. For the newbies on the job hunt, why not use your stellar question-answering as proof of your committment to information provision?

You can visit my profile and see what questions I've tackled here. I would encourage you to include some mention of "librarian" in your username as a way to promote the profession via a nontraditional route. If you take me up on the challenge, please post in the comments with a link to your profile - I'm looking forward to seeing your work. Next stop: librarian vs librarian Yahoo! Answers point challenge! :)

Technorati Tags: librarians; Librarianship; Yahoo
MeSH Tags: Internet/utilization; Librarians

Coached Pushing May Not Be Necessary During Labor

We've all seen television programs and movies in which a woman giving birth is coached to push during contractions. As reported in a recent New York Times article (Childbrith: Rethinking the Big Push During Contractions, 1/3/06), it may not be necessary. The article discusses a study published in the current issue of American Journal of Obstetrics and Gynecology [194(1):10-13]. Women who met certain criteria (first birth, uncomplicated labor, at term, not receiving an epidural, etc.) were randomized to either be coached on pushing and breathing by a certified nurse-midwife during the second stage of labor, or to be attended by the CNM and not coached to push, but told to do what felt natural. No real differences were found in the outcomes for the mother or the child, except that women coached to push spent an average of 13 fewer minutes in labor.

Technorati Tags: childbirth
MeSH Tags: Labor Stage, Second

"Cruel Times for Vaginas"

"Our Vaginas, Ourselves" is an essay in New York Times Magazine (1/1/06) on designer vaginas (found via Feministing). Author Daphne Merkin comments on vaginal plastic surgery, hymen reattachment, and the slow creep of beauty standards to cover the usually hidden parts of women's bodies. An excerpt:

Which leaves the one part of the female body formerly not available to harsh scrutiny now glaringly on display, held up to culturally defined aesthetic standards undreamed of by the smut-obsessed author of "My Secret Life," borrowed as they are from centerfolds and online pornography. Sagging groin skin and limp labia are going the way of crooked noses and post-nursing breasts, courtesy of new cosmetic surgeries focused on this once-neglected hinterland of female beauty. As recently noted in an article in The Wall Street Journal, vaginal plastic surgery is one of the field's fastest growing sectors, and its high priest, one Dr. David Matlock of - where else? - Los Angeles, claims that he has a five-month waiting list for women eager to get that Playboy look.

This is a rather fluffy essay, concluding as it does that, "From where I sit, life looks to be one long Madonna-esque self-invention tour, and there's nothing to be done but to grin, tighten your Kegel muscles and bear it." Despite the thread of objection that seems to run through the piece, this nonchalant conclusion suggests that women just go along, accepting that now their genitalia need to be "improved" because plastic surgeons offer procedures that purport to make the labia and vagina "better." In additional to labiaplasty, it discusses hymen reattachement, a procedure designed to make a woman "appear" to be a virgin, despite the fact that hymens often stretch or tear prior to first sexual intercourse. A recent article from the Wall Street Journal also discusses this trend, and is reprinted here. It begins:

For her 17th wedding anniversary, Jeanette Yarborough wanted to do something special for her husband. In addition to planning a hotel getaway for the weekend, Ms. Yarborough paid a surgeon $5,000 to reattach her hymen, making her appear to be a virgin again.

"It's the ultimate gift for the man who has everything," says Ms. Yarborough, 40 years old, a medical assistant from San Antonio.

You really have to read the article for the full effect. The procedure apparently stems in part from cultures that highly value virginity in a woman at the time of marriage, and in some cases require inspection of the hymen. The surgery is not without risks and recovery time, which the article says can take about six weeks. The American College of Obstetricians and Gynecologists "which hasn't taken a formal position on the matter, said it worried that doctors may not be able to fully inform their patients about the procedure because it doesn't appear in the medical literature." Says one patient:

A 26-year-old Latin American woman who lives in New York's Queens had a hymen repair in 2001 and says it took almost two months for her to feel comfortable again. It took even longer for her to enjoy sex.

The married mother of two says she's glad she had the surgery nonetheless. She says her husband wanted to experience intercourse with a virgin. "If a woman isn't a virgin when she gets married, a man can always put her down for that," says the woman...

This is a difficult topic, because it involves a whole range of cultural factors that make women believe this is a necessary or worthwhile procedure. I really cannot comprehend the aspect of "doing something special for [the] husband," however, opposed as I am to mutilating the body for the sake of another (crazy, I know). If I was married to a man who wanted me to spend $5,000 to have my body cut up so he could "have sex with a virgin," I think I'd spend the $ on a divorce attorney instead. I'm betting Aunt B will have something to say on this as well...

Technorati Tags: cosmetic surgery; hymen; labioplasty; plastic surgery
MeSH Tags: Hymen/surgery; Vulva/surgery; labioplasty

New Year's Resolution - More Women's Health News Posts

Okay, it's not exactly a resolution. This spring will be my final semester in the University of Pittsburgh's Masters of Library and Information Science program, where I'm a distance student while working full-time at a Nashville medical library. Having exhausted most of the distance courses I'm interested in, I'm taking medical informatics, and a self-designed independent study. That independent study consists of working on this blog. That's right, fair readers, I'll be working on this blog for Masters credit.

Lest you think that this is just formal slacking in my last semester, I submitted a fairly detailed proposal to my advisor on what this activity would consist of. The goals/objectives are as follows:

Build subject knowledge base in women’s health, which can include obstetrics, gynecology, midwifery, infectious disease, oncology, cardiology, and other subjects

Develop communication and writing skills through creation of brief yet informative blog entries

Enhance critical research appraisal skills through review of topical journal articles

Develop skills for ongoing continuing education through monitoring of research, policy, news, and other outlets for medical information

Enhance cataloging/subject selection training through assignment tags to blog posts including MeSH subject terms linking to PubMed searches as well as “folksonomy” tags through del.icio.us and Technorati online services

Expand knowledge of relevant web resources through identification and summarization of sites tied to the topic of blog postings

Monitor and develop understanding of popular interest in medical subjects through observance of search strings and clicked tags leading to the blog, as well as mass media items that appear during the course of the project

I'm excited about this project, the main side effect of which will be increased postings to this blog, as I have to complete a certain number of hours of work on the postings in order to fulfill the credit requirement. The time spent on reading and appraising resources, searching for information, writing for posts, and working with subject assignments will be valuable in improving my nexgen medical librarian skills, but I hope it will also make the experience better for my readers as more frequent posts appear. I look forward to your comments!

Technorati Tags: Blogs; librarians; Librarianship
MeSH Tags: Internet; Librarians