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Archive for the ‘reproductive health’ Category

CRS — Title X (Public Health Service Act) Family Planning Program (September 3, 2014)

September 15, 2014 Comments off

Title X (Public Health Service Act) Family Planning Program (PDF)
Source: Congressional Research Service (via Federation of American Scientists)

The federal government provides grants for voluntary family planning services through the Family Planning Program, Title X of the Public Health Service Act (42 U.S.C. §§300 to 300a-6). Enacted in 1970, it is the only domestic federal program devoted solely to family planning and related preventive health services. In 2012, Title X-funded clinics served 4.8 million clients.

Title X is administered through the Office of Population Affairs (OPA) in the Department of Health and Human Services (HHS). Although the authorization of appropriations for Title X ended with FY1985, funding for the program has continued through appropriations bills for the Departments of Labor, Health and Human Services, and Education, and Related Agencies (Labor- HHS-Education).

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Racial and Sexual Minority Women’s Receipt of Medical Assistance to Become Pregnant

September 5, 2014 Comments off

Racial and Sexual Minority Women’s Receipt of Medical Assistance to Become Pregnant (PDF)
Source: Health Psychology

Objective:
This study aimed to determine rates at which racial minority (i.e., non-White) and sexual minority (i.e., lesbian and bisexual-identified) women in the United States receive medical help to become pregnant. Income and insurance coverage discrepancies were hypothesized to mediate differences in receipt of medical help as a function of race and sexual orientation.

Method:
Two studies compared rates at which adult women ages 21–44 reported receiving medical help to become pregnant as a function of race and sexual orientation, using data from 2 cycles of the National Survey of Family Growth (the 2002 wave in Study 1, and the 2006–2010 wave in Study 2). Mediation analyses controlling for age and education level evaluated whether race and sexual orientation were positively associated with receipt of medical pregnancy help, as mediated by insurance coverage and income.

Results:
Heterosexual White women reported receiving medical fertility assistance at nearly double the rates of women who identified as non-White, sexual minority, or both. Differences in rates of help received by White and non-White groups were only partially mediated by insurance coverage and income in both studies. Insurance and income discrepancies accounted for all differences between sexual minority and heterosexual women’s receipt of pregnancy help in Study 1; insurance coverage alone explained differences in Study 2.

Conclusions:
Researchers often indicate that economic differences are responsible for health disparities between minority and majority groups, but this may not be the case for all women pursuing medical fertility assistance. Possible origins of these disparities are discussed.

Contraceptive Needs and Services, 2012 Update (August 2014)

September 4, 2014 Comments off

Contraceptive Needs and Services, 2012 Update (PDF)
Source: Guttmacher Institute
From press release:

Between 2000 and 2012, the number of U.S. women in need of publicly funded family planning services increased by 22%, or 3.5 million women; in 2012, 20 million women were in need of publicly funded services. Women were considered to be “in need” if they were adults with a family income below 250% of the federal poverty level, or teens regardless of family income, and were sexually experienced and did not want to become pregnant. The increased need for publicly funded family planning services was driven primarily by a rise in the number of poor and low-income adult women (<250% of poverty) in need of contraceptive services and supplies.

Ancestral exposure to stress epigenetically programs preterm birth risk and adverse maternal and newborn outcomes

September 2, 2014 Comments off

Ancestral exposure to stress epigenetically programs preterm birth risk and adverse maternal and newborn outcomes
Source: BMC Medicine

Background
Chronic stress is considered to be one of many causes of human preterm birth (PTB), but no direct evidence has yet been provided. Here we show in rats that stress across generations has downstream effects on endocrine, metabolic and behavioural manifestations of PTB possibly via microRNA (miRNA) regulation.

Methods
Pregnant dams of the parental generation were exposed to stress from gestational days 12 to 18. Their pregnant daughters (F1) and grand-daughters (F2) either were stressed or remained as non-stressed controls. Gestational length, maternal gestational weight gain, blood glucose and plasma corticosterone levels, litter size and offspring weight gain from postnatal days 1 to 30 were recorded in each generation, including F3. Maternal behaviours were analysed for the first hour after completed parturition, and offspring sensorimotor development was recorded on postnatal day (P) 7. F0 through F2 maternal brain frontal cortex, uterus and placenta miRNA and gene expression patterns were used to identify stress-induced epigenetic regulatory pathways of maternal behaviour and pregnancy maintenance.

Results
Progressively up to the F2 generation, stress gradually reduced gestational length, maternal weight gain and behavioural activity, and increased blood glucose levels. Reduced offspring growth and delayed behavioural development in the stress cohort was recognizable as early as P7, with the greatest effect in the F3 offspring of transgenerationally stressed mothers. Furthermore, stress altered miRNA expression patterns in the brain and uterus of F2 mothers, including the miR-200 family, which regulates pathways related to brain plasticity and parturition, respectively. Main miR-200 family target genes in the uterus, Stat5b, Zeb1 and Zeb2, were downregulated by multigenerational stress in the F1 generation. Zeb2 was also reduced in the stressed F2 generation, suggesting a causal mechanism for disturbed pregnancy maintenance. Additionally, stress increased placental miR-181a, a marker of human PTB.

Conclusions
The findings indicate that a family history of stress may program central and peripheral pathways regulating gestational length and maternal and newborn health outcomes in the maternal lineage. This new paradigm may model the origin of many human PTB causes.

See: Stress during pregnancy can be passed down through generations (EurekAlert!)

Recent Declines in Nonmarital Childbearing in the United States

August 28, 2014 Comments off

Recent Declines in Nonmarital Childbearing in the United States
Source: National Center for Health Statistics

Key findings
Data from the National Vital Statistics System and the National Survey of Family Growth

  • Nonmarital births and birth rates have declined 7% and 14%, respectively, since peaking in the late 2000s.
  • Births to unmarried women totaled 1,605,643 in 2013. About 4 in 10 U.S. births were to unmarried women in each year from 2007 through 2013.
  • Nonmarital birth rates fell in all age groups under 35 since 2007; rates increased for women aged 35 and over.
  • Birth rates were down more for unmarried black and Hispanic women than for unmarried non-Hispanic white women.
  • Nonmarital births are increasingly likely to occur within cohabiting unions—rising from 41% of recent births in 2002 to 58% in 2006–2010.

See also: National and State Patterns of Teen Births in the United States, 1940–2013 (_DF)

Administration takes steps to ensure women’s continued access to contraception coverage, while respecting religious-based objections

August 25, 2014 Comments off

Administration takes steps to ensure women’s continued access to contraception coverage, while respecting religious-based objections
Source: U.S. Department of Health and Human Services

Today, the Administration took several steps to help ensure women, whose coverage is threatened, receive coverage for recommended contraceptive services at no additional cost, as they should be entitled to under the Affordable Care Act. The rules, which are in response to recent court decisions, balance our commitment to helping ensure women have continued access to coverage for preventive services important to their health, with the Administration’s goal of respecting religious beliefs. The first administration action announced today maintains the existing accommodation for certain religious non-profits, but also creates an additional pathway for eligible organizations to provide notice of their objection to covering contraceptive services. In addition, the Administration is soliciting comment on how it might extend to certain closely held for-profit companies the same accommodation that is available to non-profit religious organizations, while continuing to urge Congress to take action to ensure women’s access to contraception services.

Racial Disparities in Access to Maternity Care Practices That Support Breastfeeding — United States, 2011

August 25, 2014 Comments off

Racial Disparities in Access to Maternity Care Practices That Support Breastfeeding — United States, 2011
Source: Morbidity and Mortality Weekly Report (CDC)

Despite the well documented health benefits of breastfeeding (1), initiation of breastfeeding and breastfeeding duration rates among black infants in the United States are approximately 16% lower than among whites (2). Although many factors play a role in a woman’s ability to breastfeed, experiences during the childbirth hospitalization are critical for establishing breastfeeding (3). To analyze whether the implementation by maternity facilities of practices that support breastfeeding varied depending on the racial composition of the area surrounding the facility, CDC linked data from its 2011 Maternity Practices in Infant Nutrition and Care (mPINC) survey to U.S. Census data on the percentage of blacks living within the zip code area of each facility. The results of that analysis indicated that facilities in zip code areas where the percentage of black residents was >12.2% (the national average during 2007–2011) were less likely than facilities in zip code areas where the percentage was ≤12.2% to meet five of 10 mPINC indicators for recommended practices supportive of breastfeeding and more likely to implement one practice; differences for the other four practices were not statistically significant. Comparing facilities in areas with >12.2% black residents with facilities in areas with ≤12.2% black residents, the largest differences were in the percentage of facilities that implemented recommended practices related to early initiation of breastfeeding (46.0% compared with 59.9%), limited use of breastfeeding supplements (13.1% compared with 25.8%), and rooming-in (27.7% compared with 39.4%). These findings suggest there are racial disparities in access to maternity care practices known to support breastfeeding.

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