Challenges to Maternal Mental Health During the COVID-19 Crisis

Challenges to Maternal Mental Health During the COVID-19 Crisis

The current SARS-CoV-2 pandemic has devastated communities across the United States since early this spring and continues to do so on a global scale. The impact on maternal health and welfare, and by extension child health has not been lost on mothers across the world. Hospitals have closed their doors to visitors and accompanying loved ones for those seeking healthcare – victims of COVID-19 fight alone and too often succumb to the illness without their primary emotional support systems, but rather in isolated rooms with little human contact. In the case of pregnant and expectant mothers, this means potentially giving birth alone. These women are now also kept in isolation rooms, away from their families and loved ones, and surrounded by healthcare workers masked in personal protective equipment – a far cry from the societal norms previously established and long withstanding (Hermann, Fitelson, & Bergink, 2020). This newfound isolation and the impact of the pandemic extends to reaching antenatal care and...
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What President-Elect Biden’s win means for COVID relief in Kenya and other low- and middle-income countries

What President-Elect Biden’s win means for COVID relief in Kenya and other low- and middle-income countries

Recent attention has been focused on what the Biden-Harris administration can accomplish with executive orders starting from day one. From student debt relief to fully implementing the Defense Production Act, these actions can have a direct impact on domestic economic relief and health care. History tells us that, like every recent Democratic presidential administration, within the first few days of office Biden will also repeal the Global Gag Rule. This executive order will permit non-governmental organizations (NGOs) receiving U.S. foreign aid to provide comprehensive sexual and reproductive health care, including abortion advocacy and abortion services. But the impact this action could have goes well beyond abortion and into other areas of public health as well. From July-October 2020, my two undergraduate research assistants (Ema Kuczura and Sarah Hubner) and I interviewed 35 sexual and reproductive health NGOs in Kenya who universally reported that the Global Gag Rule (implemented by the Trump administration in January 2017 and expanded by Secretary of State...
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Director’s Blog December 2020

Director’s Blog December 2020

The past eight months have been a time of unexpected and often stressful changes as we navigate life with Covid-19 amidst a period of social and political unrest in this country. As the year comes to a close, we’ve chosen to focus this newsletter on the changes we’ve experienced over the past semester—what we’ll keep, what we’ve learned and how this has been a powerful catalyst for our work.  At this stage in the pandemic, the changes that felt temporary have become engrained into our daily lives—it’s natural to grab a mask before leaving the house, standing six feet away is the norm and it’s assumed that when we set up a meeting, it will be by Zoom.  While most of us can’t wait to resume more normalcy in our social and personal lives, some of these necessary changes have turned out to have unexpected benefits. Personally, I get to see my kids a lot more than I did before...
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Washington Sex-Ed Curriculum

Washington Sex-Ed Curriculum

This November 3rd, voters in Washington will be voting on a law to ensure a comprehensive sexual education curriculum in schools. The new law, called Referendum 90, would require schools districts to adopt a sexual education curriculum consistent with state standards. This new law encourages schools to follow a curriculum approved by the state, although they are allowed to develop their own provided that they are inclusive, age-appropriate, and teach medically accurate information about contraceptives and disease prevention. Parents are allowed to review material and request to excuse their children. The curriculum mandates at least 6 lessons throughout grades K-12, with a minimum of one lesson between kindergarten and third grade, one in grade four or five, two in middle school, and two in high school. In the earlier lessons, content would focus on social-emotional learning such as how to cope with feelings or how to set goals. Proponents of the bills cite rising sexually transmitted infections, unintended pregnancies, and...
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Supreme Court’s Recent Ruling on Abortion Drug

Supreme Court’s Recent Ruling on Abortion Drug

The latest victory for abortion rights: the supreme court declined to reinstate restriction for patients seeking to obtain a drug used for early pregnancy abortions. With COVID-19 continuing to ravage through the country, the Supreme Court allowed a blocking of FDA rules requiring an in-person visit with a medical professional to pick up mifepristone, the drug in question which is the first of two drugs taken to terminate pregnancies less than 10 weeks. The ACLU argues on behalf of the American College of Obstetricians and Gynecologists that the FDA rules served no purpose and forced women to face unnecessary risks with added trips to the doctor during the pandemic. Mifepristone is the only medication that the FDA forced patients to pick up in clinic, despite the fact that women can take the pill without supervision. This comes as a blow to the Trump administration, as he asked the supreme court to reinstate this rule earlier in the year despite the...
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State Policies and Reproductive Rights

Reproductive rights remain a contested and highly debated topic, largely left up to the discretion of states to decide on more or less restrictive policies. However, recent research has provided evidence that states with less restrictive policies see better birth outcomes. In a new study released just a week ago on October 13th, Sudhinaraset and her team compared several reproductive policies across states including, mandatory parent consent for minors seeking abortion, mandatory waiting periods, restrictions on public funding for abortion, percentage of women living in counties with abortion providers, expanded eligibility for Medicaid family planning services, and mandatory sexual education in schools. The results show that women in most restrictive states showed a 7% higher low birth weight risk when compared to women in the least restrictive states. They also showed the less restrictive policies are particularly protective against adverse birth outcomes for Black women. As more restrictive policies are being put in place and status of certain reproductive rights...
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Restrictions on US Global Health Assistance Reduce Key Health Services in Supported Countries

The 2017 Mexico City Policy, or Global Gag Rule, prohibits non-US-based NGOs from receiving US global health assistance if they either perform or refer for abortion services. Sherwood et al. (2020) studied the effects of the expanded policy on implementing partners of US-funded HIV programming by the President's Emergency Plan for AIDS Relief (PEPFAR) via a survey in all recipient countries. Survey results showed that 28% of organizations reported stopping or reducing at least one service in response to the policy. The delivery of information about sexual and reproductive health, pregnancy counseling, contraceptive provision, and HIV testing were services reduced. These disproportionately harmed pregnant women, youth and vulnerable populations such as sex workers and men who have sex with men. Thus, the intended beneficiaries of PEPFAR funding may be the most negatively impacted, especially in areas with high HIV prevalence. This study calls attention to policy makers to respond to disruptions in service delivery from the expanded Mexico City Policy...
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Proposed Changes to US Global Gag Rule Threaten Wider Harm

The Global Gag Rule, which already forces health providers to choose between providing information to patients or receiving US funding, is now set to be expanded even further by the Trump Administration. This policy cuts US government funds to overseas programs that use non-US funds to provide or discuss safe abortion care, family planning services, HIV care, and all other US-funded global health assistance. The proposed expansion of this rule would cover all contracts and subcontracts funded partially or wholly with US global health assistance. This includes organizations subcontracted by organizations that receive US funding, which are often small, local organizations. Ultimately, this expansion would increase restrictions limiting health care and information to people in need. It would not reduce the number of abortions; according to The Lancet, it instead would lead to more and riskier abortions in poor countries. This would be further exacerbated by the COVID-19 pandemic, which has disrupted sexual and reproductive health services....
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How the Pandemic Has Affected Abortion Rules Around the World

Globally, the COVID-19 pandemic has made it more challenging for women and girls to access reproductive health services, with an estimated 47 million women potentially cut off from modern contraception, according to the UN. In addition to clinic closures and barriers to medical care, the pandemic has halted progress in abortion decriminalization in many countries. For instance, in Argentina, the lower house passed a bill in 2018 to legalize abortion during the first 14 weeks of pregnancy, but once Congress went virtual in March, the bill was delayed, indefinitely. Colombia was also on the cusp of change, but in early March, the court ruled not to change the existing law that only permits abortion in cases of rape, risk to mother's life, or involves a fetus with serious medical problems. The pandemic further made it challenging for citizens to access reproductive services. In addition, Poland has one of Europe's most restrictive abortion laws, which Parliament discussed tightening in April. On...
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An Interview with Dr. Joy Noel Baumgartner

What originally sparked your passion in global sexual and reproductive health? I was originally interested in child welfare issues and realized how closely related that is with women’s ability to realize their reproductive intentions.   Have you had any mentorship opportunities that brought you to where you are today? I didn’t get into SRH work until after my PhD, while working at FHI 360. I can’t say there was one particular mentor—more like a committed environment of like-minded individuals dedicated to social and reproductive justice issues.   Do you have any guiding principles that keep you on track? I’m an applied researcher. At the end of day, I have to see how any project I’m working on will impact practice or policy—not “someday” but within a tangible time period.  That usually means very close collaborations with my research partners endure past the end of the funding.   Do you have any advice for students intending to follow the same professional pathway? If you’re interested in global SRH, know the countries/regions...
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