Welcome to the New Newsletter

The Women's Health Activist is now fully digital.

But don't worry - you're in the right place. All the articles for the latest quarter two, 2023 issue can be accessed by scrolling down this page, or by jumping to the articles that interest you specifically by clicking on the headings in our handy table of contents below. Have questions? Something not working right? Send us an email at [email protected]. 

A NOTE FROM DENISE HYATER-LINDENMUTH, 

EXECUTIVE DIRECTOR OF THE NATIONAL WOMEN’S HEALTH NETWORK

NWHN Values

We believe that...

  • Health is a human right.
  • Our gender identity, race, ethnicity, sexual orientation, disability, geographical location, socioeconomic status, insurance status, and/or immigration status should not dictate the quality of healthcare we receive.
  • This work is intersectional and must be conducted through a lens of diversity, equity, inclusion, and justice.
  • Lived experience and scientific evidence must drive health policy and shape healthcare.
  • Maintaining the integrity of our work is essential.
To All Our Members, Donors and Supporters, 

Now that congress has reached a deal on the debt ceiling and avoided a disastrous recession and government shutdown, let’s collectively turn our attentions back to the most pressing women’s health issue of the day: protecting access to abortion care in a post-Roe nation. The Network has been laser-focused on keeping Mifepristone, one of the two drugs typically used in medication abortion, accessible to pregnant people. The drug’s legality as well as the authority of the FDA are currently under unprecedented attack, and I wanted to write to you all personally about the state of things. 

Where Are We on Mifepristone?: A Quick Recap 

The issues around Mifepristone and its safety are part of our daily conversations and advocacy. First, some background.

Mifepristone was legalized thanks in large part to the Network’s advocacy in the year 2000. However, with legalization, the FDA imposed restrictions on the use of Mifepristone for medical abortion. These restrictions are known as the Risk Evaluation and Mitigation Strategy (REMS) and they included, in their original form, several requirements, such as:

  • Mifepristone can only be dispensed by a certified health care provider who has completed REMS certification. 
  • The drug can only be dispensed in clinics, medical offices and hospitals with the ability to provide emergency medical care in cases of complications.  
  • Patients must sign an agreement form acknowledging they have been informed of the risks and benefits of the drug before taking it. 
  • Mifepristone must be taken under the direct supervision of a health care professional, and the patient must return to that office one to two weeks after for a follow-up visit.  
  • Mifepristone cannot be prescribed or dispensed through mail order or retail pharmacies.  

In the ensuing years, multiple studies revealed that Mifepristone was safer than many over-the-counter drugs, and did not call for many of the restrictions above. The National Women’s Health Network, along with the EMAA project and others, used this data to advocate for the removal of medically unnecessary restrictions to Mifepristone – and succeeded. In December 2021, the FDA permanently removed all medically unnecessary access restrictions to the abortion pill. Most significantly, they removed the requirement that the pills be dispensed in-person, opening up telehealth and mail options to consumers.   

But this all changed on April 7 2023.

 

Mifepristone Case Header (1)
The New Court Case  

On April 7, a federal judge ruled to invalidate the FDA’s approval of  Mifepristone. Judge Kacsmaryk issued a partial stay to pull Mifepristone from the market and reinstated the outdated and medically unnecessary REMS restrictions. This case has potentially damning consequences for access to abortion care and larger implications for the FDA’s authority.  

What Are the Facts of the Case? (Excerpted from our recent policy blog)  

The Alliance for Hippocratic Medicine sued the FDA on behalf of anti-abortion advocates to achieve a nationwide ban on medication abortion. This is the latest effort to chip away access to abortion after the Dobbs decision overturned Roe v. Wade and stripped away nearly 40 years of legal precedent that protected the right to bortion. The Alliance for Hippocratic Medicine made meritless accusations that the FDA did not follow its own protocol in the approval of Mifepristone and urged the FDA to reinstate restrictions on medication abortion that were previously loosened after experts determined them to be medically unnecessary. Worst of all, they asked the court to invoke the Comstock Act, a criminal law that prohibits the mailing of “obscene materials” to prevent the FDA and medical providers from mailing the abortion pill.  

The Comstock Act is not only wildly out of step with the public’s desires, but it has not been enforced since 1965 when the landmark Supreme Court case Griswold v. Connecticut found it unconstitutional to restrict access to birth control.  

Despite the suit’s meritless arguments, Judge Kacsmaryk sided with the anti-abortion advocates. How did this happen? Step by step; the makeup of the federal courts shifted steadily during the Trump Administration to be more anti-choice. The former president strategically appointed political activist judges to promote an anti-abortion agenda and achieve a nationwide abortion ban. So far, this effort has been successful.  

Judge Kacsmaryk in particular has a reputation for championing anti-abortion groups and has received widespread criticism for making judicial decisions based on ideology rather than the law. When abortion supporters heard that this case was going to his desk, they knew that this would be the likely outcome. However, on the same day Judge Kacsmaryk issued his decision in Texas, another medication abortion case was decided in Washington. A different federal judge ordered the FDA to maintain the availability of mifepristone in the 17 states and the District of Columbia that brought a case against the FDA. In other words, this federal judge ruled the exact opposite as Judge Kacsmaryk on the same issue.  

The conflicting decisions reflect the current polarized reality of abortion access politics in the United States. Abortion access is alive in states that have decided to listen to the science and the beliefs of their constituents and protect abortion care. And in other states, abortion is practically nonexistent. If anti-abortion advocates have it their way, safe abortions will be banned across the United States. Banning abortion does not end abortion; it only makes it more dangerous. Women will continue to have abortions in the United States, but they will put their health and lives at risk to do so.  

What Comes Next? 

The Supreme Court extended its stay to block the lower court’s decision as the case continues to play out in the appeals court. This means that, while the proceedings go on, Mifepristone will still be available across the United States. This case is now being decided by the 5th Circuit Court of Appeals, and depending on the outcome, it is likely that this case will be appealed to the Supreme Court.   

 

Photo by Ian Hutchinson on Unsplash
Photo by Ian Hutchinson on Unsplash
The Network’s Position 

The Network is in full support of the continued availability of Mifepristone, and will work hard with our coalition partners to retain access to this life-saving medication. Mifepristone provides a non-invasive alternative to surgical abortion. Furthermore Mifepristone is less expensive than surgical abortion, particularly for women who must travel long distances to access any health care – let alone abortion services.     

Mifepristone is also used to treat medical conditions such as uterine fibroids and Cushing’s Syndrome. Taking it off the market or making it hard to access will have implications beyond providing for safe abortions. As long as people are pregnant by choice, change, or force, the National Women’s Health Network will continue to support pregnant people’s bodily autonomy, reproductive choice,s and safe abortion health care. 

-Denise Hyater-Lindenmuth, Executive Director

Executive Director Denise

I Lived It

Real health stories from members to inspire, educate, and activate you.

Called by the Water: Mary’s First Birth and What Happened Next 

Interview Granted by Mary Badame, NWHN Supporter  
Edited by Adele Costa, NWHN Director of Communications  

 

The U.S. continues to rank far behind almost all other developed countries in birth outcomes for both mothers and babies, including unacceptably high rates of maternal and infant mortality and preterm births. Here at the Network, we’ve made improving these outcomes one of our top policy priorities this congress (see our Policy Pages for details on that).
 

But as we all live and work in this “big P” political context, it can be easy to lose sight of how maternal health policies and existing institutional structures affect real women and families on the ground. That’s why we sat down with Mary Badame, a trained doula and a mom, to hear what it was like birthing and caring for her first child. Keep reading for some deeply personal examples that illustrate why things like better access to reproductive autonomy, out-of-hospital labor and delivery spaces, and adequate paid maternity leave are so crucial.

***This interview has been edited for length and clarity***

Okay, well, why don't you tell us about yourself?  

I'm Mary, I just turned 33. I live on the west side of Buffalo, New York. I've been working in reproductive health for twelve years. Primarily, I help people access abortions and have also worked to expand out-of-hospital birth options. I have a husband and two daughters – one and four years old. I've also had four pregnancy losses, which have really informed my parenthood and my work. I was already working in this space when I was experiencing the losses, and it's made me a better advocate and a better counselor.

 

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Tell us about your first pregnancy? 

Most of my pregnancies have been unplanned, but all of them have been wanted. I got pregnant the first time with an IUD in place. (Not fair!) That pregnancy was ectopic, though, and I was treated with methotrexate, which is a shot, so I avoided surgery. I still have both fallopian tubes, which I'm grateful for, and I got that care at a secular hospital, which I'm also grateful for. It was a very emotional experience for me and my partner, though, and we ended up deciding that we would be life partners shortly after that. And we got engaged a few weeks later. For me, it didn't feel like I had lost a baby, but it did feel like I lost my first pregnancy experience, which was important to me.

A year after this experience, on my honeymoon, I accidentally got pregnant with my first daughter. (I took plan B, but it didn't work.) This was hard, because my husband was really not ready to be a dad yet. We wanted a few months of being married before we started our family, but ultimately we continued the pregnancy.

So this was your first termed pregnancy. What was it like for you?  

Well, to start, something that was really present for me then is that of our set of friends, we were the first to become parents. I felt very isolated particularly in my first trimester because most of my friends were still at a point in their lives where they were going out and doing things that really aren't accessible to pregnant people. Like, I'm not somebody that loves going to a bar if I'm not drinking myself. And my partner also bucked a little bit at the idea of becoming a dad early in that pregnancy, and that was really hard because I felt pretty alone.

Did you deal with any physical symptoms or challenges getting prenatal or perinatal care? 

Because I work in this field, I have high health literacy, and am in close proximity to excellent perinatal care via my midwifery center, so that's never been a problem for me. I also see a local midwifery practice, but I did deal with normal first trimester challenges. I remember thinking in my first trimester with Beatrix, she's going to be an only child. I felt that I just couldn’t be this nauseous again. I cannot imagine doing this again. And it was like a veil. Just the world was nauseous. I couldn't imagine what it would be like not to feel that way. And then at ten weeks, it just lifted, and the second trimester was fine.

The third trimester was pretty awesome; it’s actually my favorite time of pregnancy. I just love being really big, and I love my pregnant body. I love feeling the big baby rolls. I love my swollen belly and my swollen breasts. I've never felt more confident about myself than when I'm pregnant. I love getting dressed in the morning. I wish I had spring babies, because spring and summer maternity dresses are nice dresses. I will also say I have been fortunate enough to live in New York State and we have decent time off. I'm not going to say it's good or great because I think parents deserve so much more. But I was able to leave work at 39 weeks, and I had her at 41. So I got two full weeks where I was really just by myself and able to take naps and go for walks and take care of my pregnant body in a way that I never take care of my non pregnant body. I also went past my due date and was pregnant for 41 weeks. Which is a very special and challenging thing emotionally and physically, but I wouldn't change it for anything. It really helped me get to the mental space I needed to meet my baby and helped me bond with her more as I was coaxing her to please enter the world.  

 

Photo By Jen Lombardo of Buffalo Doula Services
Photo By Jen Lombardo of Buffalo Doula Services
What thinking went into your birthing plan?

So I actually wanted to have a home birth with her. We ultimately decided to have her at a birth center because the birth center was the happy medium that my partner and I decided on​if he was going to have a baby, it would be at a hospital. 

Is that because there was that feeling that it was safer? Can you talk about that? Because I think a lot of parents struggle with this decision, and I think hearing the thought process will help. 

I think so much of it is that we just don't see birth outside of the hospital. We don't have representations of it, we don't talk about it, we don't hear stories about it. When somebody says, ‘I'm pregnant’ and they ask your birth plan, it's assumed, like, what hospital will you be delivering at? So I think that was a lot of it for my husband at least. He was worried about the mess of a home birth, and I think safety was also a big concern for him. But also because I have such a background in this, he really trusted my judgment.  

I wanted to be outside of the hospital because it's where I feel the safest. Almost all of my losses happened in the hospital. And that's the only hospital care I've actually ever accessed. Like, I've been a pretty healthy, low risk person my whole life. So to me, that's what the hospital feels like; like fear, and complications.   

But also, I've had so much exposure to out of hospital birth and was fighting for midwives and birth centers far before I ever had a baby. To me, everything I do is rooted in the belief that bodily autonomy is our most fundamental right. As a feminist, I fight tooth and nail for bodily autonomy. And giving birth outside of the hospital was where I felt like I had the most control over my body and my experience.  

What about a birth center made you feel like you had more autonomy?

At a birth center, labor and delivery is a much more patient and family centered experience. The hospital is caring for many people with all different clinical scenarios. They may have different providers from different practices who are coming in. There are many learners, residents and medical students taking part in care, and that's all wonderful, but I was a healthy person with a low risk pregnancy, and I didn't necessarily need the level of care the hospital provides.

Also, in a hospital setting, you are bound by hospital protocols, by your providers, and by what is physically available at the time of your labor. For instance, whether any of the cordless fetal monitors are available for your freedom of movement, if you can have a waterproof one to go into the tub, stuff like that. Our hospitals here also do not allow water birth, and that was something that was important to me. 

Photo By Jen Lombardo of Buffalo Doula Services
Photo By Jen Lombardo of Buffalo Doula Services
Can you talk about why having a water birth was essential for you, and what it was like?  

Water is just a really calming element for me. Throughout my pregnancy, I took baths all the time. As a doula, I often tell people, use the comfort techniques in labor that have worked for you, particularly in the last days of your pregnancy, because you already have those tools that you can draw on really easily. So for me, water was a no-brainer. I had seen other water births, and it is such a gentle way for babies to enter the world. They're often just such calm births, and that's exactly what my water birth was like.

I was in labor for a few days, but that's pretty normal for somebody who's birthing for the first time without any intervention. It was very humbling. I've worked as a doula and in this field for so long, I felt really prepared. But labor is humbling no matter how prepared you are. As it turned out, the midwives weren't even in the room when I could feel that she was coming. So I said to my husband, go get the midwives. He went into the hallway and got them. They came in, and a few more pushes later, she was out. And my whole birth was very calm and quiet. And then I remember the midwife saying, okay, Mary, now it's time to lift up your baby. And I scooped my baby up out of the water and then put her on my chest, and she's just looking up at me and she wasn't even crying. It was just the gentlest experience. Water is known to have incredible pain relieving qualities. It’s often called “nature's epidural.”

Ok, I have a dumb question, but I’m going to ask it anyway because I’m sure I’m not the only one who has it: How does the baby not breathe in water and drown during a water birth?

The baby is in amniotic fluid in utero, sothey're going from not breathing air in utero to also not breathing air until they're lifted out of the water. Their umbilical cord is still providing the oxygen they need. I understand the confusion because some people think that when your water breaks, that’s when the baby starts to need air – not so. Amniotic fluid at the end of pregnancy is actually baby pee, and they continue to pee – meaning they’re surrounded by amniotic fluid even after the water breaks.  

 That is fascinating. It's funny because I think everybody is so unique. I hear from parents who were like, “I needed somebody to tell me how to do this. I wanted to stay in the hospital as long as I could. I didn't know what to do. There's no rulebook.” But it sounds like you wanted that exact opposite. You felt confident in your ability. Is that fair to say that you knew what to do and you just wanted that time? 

Yeah. And I think that the goal of prenatal care within a midwifery model and a birth center is to prepare parents to feel really confident taking their baby home right away or giving birth at home and just having their baby home right away. There is so much more education that's built into this model. In the traditional medical model with OBGYNs, appointment​s are brief, typically 15 minute visits. They're really just measuring the baby, making sure baby sounds okay, making sure you're doing okay. And that's it. Midwifery care is slow. Prenatal visits last at least a half hour, really focus on education, on how your family is doing, wraparound support. 

 

Photo By Jen Lombardo of Buffalo Doula Services
Photo By Jen Lombardo of Buffalo Doula Services
So, now you've had Beatrix. You're at home in your bed. Parenthood begins. Did anything surprise you about the postpartum phase? And when we talk about postpartum in this sphere, we're really interested in that full year postpartum, because that's actually when a lot of complications can happen.  

For me, breastfeeding was so hard for the first two weeks. It hurt so much, and I wasn't expecting that. And I think we kind of set people up for it being this wonderful bonding experience, and we tell them that if there's pain, it means there's a problem. But that's not always the case. Sometimes it's just really painful when it's your first baby becauseyour nipples aren't used to it.  

So yes, initial breastfeeding was really hard, but we made it through, and I'm glad that we did. But honestly, other than that, I think what's surprising when I talk to other people about it is that my postpartum experiences have been the happiest times of my life. I'll talk about the immediate six weeks after first. I love just physically being this little baby's safe space and only focusing on that. My husband and I are both fortunate enough that we’ve been able to take pretty good time off after all my births, and these are some of the only times in our lives that we've had that sustained time off together. With Beatrix, I think I took off 15 weeks, two before she was born, and then 13 after. My husband took off five months after. A lot of it was unpaid, but we were really fortunate to be able to do that; he worked at a company at the time that really supported new parents.  

Not that it isn't also super hard. But for me, as a highly organized, busy, motivated person moving in the world, taking that time off to hibernate with my family after giving birth has been really awesome. I'm also very practiced in setting boundaries, so I think that that's something that helps.

Many new mothers I talk to describe it being a little overwhelming healing from what was essentially a major health event while having to take care of somebody. Can you speak to that?

Yeah, I did have tears. My labia tore symmetrically; one side needed stitches. I remember taking a lot of really shallow baths. I think for the first month, every time I pooped I would put my butt in a bath afterwards. I also use a lot of witch hazel postpartum. That is my secret weapon. Overall, I have felt really fortunate that my body has healed the way it has after my births. That hasn't been the case for all of my friends. 

 

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Was there anything that you wish somebody had told you about the postpartum period?  

Well, one thing is, you should have sex (and do what you want with your body) whenever you feel like you're ready. We use this six week marker like it's the Holy Grail. But I had sex three weeks after Beatrix was born, and that felt right for us, and it was fine. And I had sex like three months after my second daughter was born, and that was right at that time, and it surprised me, and that was fine, too.  

I like that you're thinking about the full year postpartum, because mostly we just think about those like six or eight weeks. I know that those newborn days are the hardest for many people, but for me, the postpartum challenges really began about three months in, when I had to return to work. There's just not enough support for working parents. Child care has always been really hard for me to find. I've also had issues carving out flexibility for myself when I return to work after a maternity leave and needed that especially as a new parent. And because of that, I've left the workplace at different times throughout my motherhood journey because I couldn't find childcare, or because after coming back from a maternity leave aspects of my job were just so unrecognizable.  

What adds to the challenge is that I have mostly worked for very small businesses, so it's really hard for them to accommodate an employee's maternity leave when they're not getting institutional or state support. The way our paid family leave is structured in New York State, it's through your employer. So you have to have worked somewhere for, I think, six months before you can take it. And then that means that if you're not the happiest in your current employment, you really can't find a new job before you have your baby. There's just a lot of things that aren't great about it. And then, for me, pumping breast milk sucks in general, but pumping at work is the worst.  

After Beatrix was born, I had a lot of transitions to do. I wasn’t pregnant anymore and I wanted to be who I was before I had her and to feel some aspects of that life again. And birth just transforms you and transforms what your life is going to be. And I had a lot of growing pains to do after she was born in relation to that. I remember one time going out with friends and then getting a little drunk and then feeling like the worst mom in the world. I was just really hard on myself in the same way society is hard on moms, especially first-time moms. Because not only does society have all these unrealistic expectations, but you don't have anything to go by. You don't have a benchmark and that confidence of having kept a child alive yet.  

What advice do you have for other pregnant and birthing people out there or people who might want to become pregnant?  

I think the best advice is to find the people who will support you no matter what. I think it's really helpful to do your own research to find the people who can give you information that's trustworthy. Everybody has different information for pregnant people and parents. So just because you get one answer doesn't mean there's not another answer out there. And I just saw someone say something on their social media that I think is perfect: There's no way to be a perfect mother, but there's a million ways to be a really good one.  

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The Policy Pages

Updates on how we're making change at the highest levels of government.

A Summary of Action

By: Kristen Batstone, NWHN Policy Consultant 

The National Women’s Health Network works with members of Congress to improve the health and well-being of women across the life continuum. This article provides the highlights of our women’s health policy work. Please contact policy consultant Kristen Batstone ([email protected]) with any questions or comments regarding the content.  

Women’s Health and the 118th Congress – Our Priorities  

In the 118th Congress, the Network’s top priorities include expanding access to family planning services, improving and diversifying perinatal and postpartum care, and increasing access to preventative screenings.  

Key Women’s Health Legislation:  

The Network is happy to see introductions and reintroductions of key women’s health legislation. You can learn more about key legislation the Network supports and why on our virtual bill tracker here. Other recently introduced women’s health bills include:  

Sexual and Reproductive Health:  
  • H.R.561 - EACH Act: This bill ensures that every person who receives care or insurance through the federal government will have coverage for abortion services. This bill would remove the Hyde Amendment, which prohibits the use of federal funds to finance abortion. 
  • H.R.2907 - Let Doctors Provide Reproductive Health Care Act: This bill establishes protections for doctors who provide abortion services to patients traveling between states. Additionally, this bill establishes funds to assist doctors who face legal issues relating to their provision of reproductive health care services. 
  • H.R.782 - Ensuring Women’s Right to Reproductive Freedom Act: This bill prohibits state laws that restrict women from traveling across states to access reproductive health care.  
  • H.R. XX (Not yet introduced this congress) - Real Education and Access for Healthy Youth Act: Under this bill, the Department of Health and Human Services must establish grants to support sex education and sexual health services for young people. This bill prohibits the use of federal dollars to promote discrimination or misinformation, and it repeals the Abstinence Only Until Marriage program.   
Maternal Health:  
  • S.948 - Healthy Moms, Healthy Babies Act: This bill seeks to improve maternal health outcomes by coordinating “whole-person” care and telehealth services to pregnant and birthing people. It also aims to implement new reporting requirements and reduce higher-risk cesarean births.  
Aging Women and Health Equity:  
  • H.R. XX (Not yet introduced this congress) - SCREENS for Cancer Act: This bill reauthorizes the National Breast and Cervical Cancer Early Detection Program (NBCCEDP). 
  • S.1317/ H.R.2904 - Anti-Racism in Public Health Act: This bill would take a public health approach to combatting police brutality and violence by creating a dedicated law enforcement violence prevention program at the CDC.  

 

A perspecive shot of the US capitol building with a blue sky and sun flare behind it
Photo by Bernd 📷 Dittrich on Unsplash

Activity on the hill... 

First Generation of the HEALTH Program Knocks Hill Day Out of the Park 

On Tuesday, May 23, the Network hosted a virtual hill day for our HEALTH Program grantees to share their legislative priorities with members of the Black Maternal Health Caucus. The Network created the HEALTH Program to build the capacity of grassroots organizations via monetary and technical assistance. During the hill day, we facilitated their engagement in high-impact legislative advocacy and helped them influence policy makers. This expansive conversation covered everything from sex education to conditions for incarcerated pregnant women to indigenous birth practices. The event was a success as many of our HEALTH Program grantees were asked by hill staff to collaborate with their offices in the drafting of Momnibus 2.0. 

Our grantees do phenomenal work in their communities, and we are thrilled that they had this opportunity to be heard by policymakers. If you would like to learn more about our grantees, we have included their profiles and relevant links below:  

  • Changing Woman Initiative (Albuquerque, New Mexico): Seeks to renew cultural birth knowledge to empower and reclaim indigenous sovereignty of women’s medicine through women’s stories and life ways. Visit their website. ~ Hear from their founder. 

  • Baobab Birth Collective (Birmingham, Alabama): DONA Trained Doulas and Certified Lactation Counselors serving Huntsville, Central Alabama. Visit their website. ~ Hear from Chauntel the Doula. 

  • Oshun Family Center (Philadelphia, Pennsylvania): The core mission of Oshun Family Center is to provide racially concordant care to members of the Black community that are struggling to cope with life transitions. Visit their website.

  • Teen Health Mississippi (Jackson, Mississippi): To ensure that all young people in Mississippi have access to high-quality sex education and youth-friendly healthcare services. Visit their website.  

  • New Voices for Reproductive Justice (Ohio | Pennsylvania): NVRJ is dedicated to transforming society for the holistic health and wellbeing of Black women, girls and gender expansive people. Visit their website. ~ Learn about their Black Women Green Future program. 

 

The Network's Virtual Hill Meeting
NWHN Joins Advocates on the Hill for a Congressional Briefing on Black Maternal Health 

On Monday, April 27, the Network attended a congressional briefing on Black maternal health hosted by The Century Foundation and joined by members of the Black Maternal Health Collective and the Black Maternal Health Caucus. At this event, staffers and stakeholders heard from esteemed panelists as they discussed their work on the local, state and federal levels to affect change and improve Black maternal health outcomes. This event was part of a series of events hosted to honor Black Maternal Health Week and prepare for the reintroduction of the Black Maternal Health Momnibus Act. The Black Maternal Health Momnibus Act was reintroduced by Rep. Underwood (D-IL), Sen. Booker (D-NJ) and the Black Maternal Health Caucus on May 15, 2023, and you can track its progress through congress here.    

 

Updates on the Money - Fiscal Year 2024 Appropriations 

The debt crisis put millions of people at risk of losing their health insurance and tightened restrictions on food assistance. An early iteration of a congressional budget proposal called for a return to Fiscal Year (FY) 2022 spending levels. Such extreme spending cuts would have slashed discretionary funding (much of which goes to vital health care initiatives such as Title X), by 22%. Proponents of these cuts attempted to hold up negotiations with the President by using the debt ceiling resolution as a leverage point. In the end, the President and Speaker McCarthy came to a compromise that would freeze non-defense discretionary spending at FY 2023 levels and include a 1% bump for 2025. By keeping spending levels stagnant, non-defense discretionary programs will receive a 5% cut across the board. Meaning, programs such as Title X and other essential women’s health programs are still at risk of losing critical funding, but this cut will be more modest than the initially proposed cuts.  The new spending plan also allows appropriators to reappropriate unused money from COVID-19 to discretionary programs. The Network urges Congress to use any remaining funds to maintain level funding for Title X, Title V, and other public health programs.  

Throughout negotiations, some lawmakers tried to impose work requirements on Medicaid which would have put 21 million people at risk of losing their health insurance. This policy would have disproportionately affected women because women are more likely to be enrolled in Medicaid and, due to caretaking responsibilities, women are more likely to be unemployed or underemployed. Fortunately, Medicaid work requirements did not make it into the final proposal; the Network sprang into action just as we did in 2019 when similar requirements were proposed, and joined its colleagues in a letter that urged the President to reject any policy proposals that increased poverty or endangered access to health care. Although we are pleased that the President managed to protect access to Medicaid, we are disheartened by the restrictions imposed on SNAP and TANF. Access to nutritious foods is a key determinant of health, and limiting access will only exacerbate existing disparities among marginalized communities. The new SNAP restrictions increase the age of eligibility for adults without dependents from 50 years old to 55 years old. However, the President managed to expand SNAP eligibility to homeless people, veterans, and people who lived in foster care until the age of 24. Although this plan is a far cry from the robust spending plan we had hoped for, it is better than the extreme cuts that were likely to go through.

 

Photo by Florian Pintar on Unsplash

Activity in the Courts...  

The Network will continue to track court cases that affect women’s health, and we have joined our colleagues in advocating against court decisions that ignore legal precedent and medical expertise in favor of ideology. Here are a few cases we are watching closely right now:  

  • Alliance for Hippocratic Oath v. FDA: In April, the U.S. 5th Circuit Court of Appeals temporarily issued a stay, blocking a lower court’s decision to remove Mifepristone - one of two medication abortion drugs - from the commercial market. The court voted to extend its stay, but that does not mean that a majority of judges will vote to maintain access to medication abortion. During oral arguments, judges asked questions that were decidedly critical of the FDA’s approval process and cast doubt on Mifepristone’s safety. Read the NWHN’s statement on Mifepristone here, and check out our Executive Director's summary of the issue above.
  • Braidwood v. Becerra: In May, the 5th circuit court issued a stay to block the lower court’s decision to undermine access to important preventative services. The court's decision comes two months after the lower court’s initial ruling. Fortunately, the lower court’s delayed decision did not significantly affect people’s ability to receive preventative care, because there are protections in place that prevent people from abruptly losing care. 
  • Deanda v. Becerra: In February, the Department of Justice appealed the ruling to the 5th Circuit Court of Appeals and allied organizations submitted amicus briefs. This court case will determine whether adolescents are able to obtain birth control through the Title X program without parental consent. However, the court has not issued an injunction to pause the lower court’s decision, nor has there been any indication as to when oral arguments will be held. Therefore, the lower court’s decision to restrict adolescents’ access to Title X services will remain in effect until other actions are taken.  

 

Activity in the Executive... 

In response to activity in the Executive Branch, the Network has submitted comments to rule changes and guidelines that affect women’s health.  

  • On Tuesday, April 29, the Network commented on the Food and Drug Administration’s decision to host an advisory committee meeting to review HRA Pharma’s request to switch their drug, Opill, a birth control pill, from behind the counter to over-the-counter. If approved later this summer, Opill would become the first-ever birth control pill in the United States made available over the counter.  
  • On Tuesday, June 6, the Network commented on the United States Task Force on Preventative Services proposed guidelines for breast cancer screenings. The proposed guidelines reduce the recommended age for women to seek breast cancer screenings from 50 years old to 40 years old. Learn more about why this is essential in our Executive Director’s recent op-ed.   

 

NWHN In The News 

  • The Network’s federal policy lead, Kristen Batstone, spoke to National Geographic Science about the rise of STIs post-COVID. Read more about it here
  • Executive Director Denise Hyater-Lindenmuth wrote a widely publicized op-ed on the importance of early cancer detection and participation in clinical trials. Read it here.  
  • The Network’s federal policy lead, Kristen Batstone, responded to inaccurate comments made by Rep. Lauren Boebart  (R-CO) about the cost of childbirth and birth control in an article for Newsweek. Check out the full article here 
  • The NWHN's research on birth control cost was cited in an Axios article about the OTC birth control debate. Read the full article here.  

 

Women’s Health Champion of the Month 

Rep. Lauren Underwood  

 

Lauren Underwood Official Portrait (1)

 

The Network would like to recognize Rep. Lauren Underwood (D-IL) as our Women’s Health Champion of the quarter. On May 15, Representative Underwood reintroduced the Black Maternal Health Momnibus Act. This important legislation makes historic investments to improve the health and well-being of mothers across the United States with an intersectional focus on how systemic barriers and the social determinants of health affect maternal health outcomes. Passing the Momnibus package continues to be a top priority for the Network, and we look forward to working with Rep. Underwood, Sen. Booker and the Black Maternal Health Caucus to get this bill across the finish line.  

Network News

Can't-miss updates from Headquarters.

 In Case You Missed It...

By: Adele Costa, Director of Communications 
  • The NWHN Shed Light on the Health Issues Faced by Older Women – On May 23 2023, Executive Director Denise Hyater-Lindenmuth participated in a panel facilitated by the Center for American Progress in honor of Older Americans Month. During the panel, a multitude of issues faced by older women, including health care, caregiving responsibilities, age discrimination, and poverty, were discussed by subject matter experts.
     
  • The NWHN Presented on What to Consider When Researching Chronic Conditions in Women – On May 31 2023, Executive Director Denise Hyater-Lindenmuth presented at the National Academies of Sciences, Engineering, and Medicine (NASEM)’s round table on Chronic Debilitating Conditions in Women.  This presentation included an overview of our long history advocating for more research into osteoporosis, breast cancer, menopause, and HIV/AIDS, as well as our organizational position and recommendations regarding future research. 
     
  • Our Policy Expert Has Been Closely Monitoring the Nationwide Ban of Medication Abortion Currently Working Its Way Through the Courts – NWHN Policy Consultant Kristen Batstone penned an article in April on everything the public needs to know about Mifepristone, medication abortion access, and the case working its way through the courts right now. The NWHN also released statements on the federal court’s initial ban of Mifeprestone and the Supreme Court’s stay of that ban until the end of legal proceedings. 
  • The NWHN Released an Advocacy Toolkit Urging Support of the Women's Health Protection Act – The Women’s Health Protection Act is federal legislation that codifies the right to abortion and prohibits any restrictions that seek to limit or impede access to abortion care. Visit the full toolkit, which includes template social media posts, graphics, and congressional contact information.
      
  • The NWHN Gave Testimony to the FDA in Support of Making an Oral Contraceptive Available Over-The-Counter – NWHN Policy Consultant Kristen Batstone and Executive Director Denise Hyater-Lindenmuth submitted written testimony to the FDA’s Nonprescription Drugs Advisory Committee and the Obstetrics, Reproductive and Urologic Drugs Advisory Committee on May 9 – 10, 2023. In that testimony, they recommended making Opill, a thoroughly vetted oral contraceptive pill, available over-the-counter to consumers. Read the full testimony here.
     
  • The NWHN Examined the Underlying Causes of the Maternal Health Crisis in the U.S. – On May 15 2023, the NWHN released an article penned by Director of Communications Adele Cost anad Policy Consultant Kristen Batstone shedding light on six underlying causes of maternal mortality and morbidity in the U.S. in 2023. Read the full article here.
     
  • Seven Podcast Episodes Were Released in Q2 2023 – We interviewed medical experts and people with lived experience on topics like Indigenous health, living with disability and chronic illness, sexual education, and more. Click the images below to listen to full episodes, read the blogs, and view exclusive visual content:
  • New Health Pro Tips Now Available for April, May, and JuneEach month, the Network brings you the latest science, stories, and strategies related to National Health Themes. In April, we celebrated Stress Awareness, Black Maternal Health Month, Sexual Assault and Prevention Awareness, and Infertility Awareness. In May, we celebrated Older Americans Month, National Women’s Health Week, Preeclampsia Awareness, and Sex Ed For All Month. In June, we’re celebrating Alzheimer’s Awareness Month, LGBTQAI+ Pride Month, PTSD Awareness Month, Juneteenth, and National Migraine and Headache Awareness Month. For all the pro tips published to date, visit the pro tips archive here. 

Young Feminist

Articles by the future, for our future.

A Mother’s Burden, a Daughter’s Legacy: Navigating Sacrifice and Personal Wellness  

By: Molly Yeager, Young Feminist Essay Contest Winner

My mom always put everyone else first.  

When she was a young woman in the 1960s living in Indonesia working as a secretary for the US Foreign Service, her brother reached out. He had four children and was going through a divorce. He asked her to come home and watch them so he could keep working, and she did. 

When she was living in Washington, DC in the 1980s, her mother became ill. She gave up her job with the State Department, went back home to Camden, NJ, and cared for her mother until she passed away in a small house on Alveena Avenue.  

When my birthmother Rachel became pregnant with me at 17 in 1990 and ran away from her own mother’s home in California, it was that little house and her Aunt Pauline that she ran to. My birthmother ran away again, following the lead of her addictions, and that was how my mom adopted me and became my mom. 

We lived there until I was five years old, when my mom’s baby sister’s chronic illness worsened and she wanted to move somewhere rural to recover. She was in her early 30s and had never left home due to her health. We moved to the mountains in New Hampshire, and my mom cared for her sister until I was eight and she died in a hospital bed in our living room.  

 

By this time, my mother didn’t have anything left in her to care for me.  

 

 After decades of trauma and being subsumed into the needs of others, her love was not enough to care for and raise a child. Especially after her sister’s death, her drinking and her sadness consumed her. I was forgotten at softball games and had to be driven home by teachers. I ran feral as a teenager with nobody to protect me from abusive older boyfriends and other bad influences. I was dragged away from my own college graduation to drive from Philadelphia into New Jersey to watch my relatives get drunk at an Italian buffet while my friends celebrated and said goodbye on the other side of the Delaware. I remember cleaning the house constantly and living on frozen veggie burgers, boxed mac n cheese, and peanut butter sandwiches. 

Our society celebrates women who set aside everything to care for others. We all know a person, or realistically probably more than one, who just “doesn’t want to be a bother” or “will do whatever needs to be done - I don’t mind.” But caring for others comes at the cost of caring for yourself – and when the cup’s empty, it’s empty, no matter how much you care for the little girl waiting for you at the end of the road.  

The sacrifices my mom made were significant, and the cost is one she’s paying now. She currently lives in a long-term care home because she has advanced dementia caused by a lifetime of malnutrition from alcoholism and chronic dieting. Everything was out of control, so she attempted to control her body, and when that failed, she drank. 

When I was packing up her house for her move into assisted living in the spring of 2021, I found correspondence between her and her mother from when she was working in Indonesia. She would apologize for being too fat, ask her mother to send her girdles, and reassure her that she was taking her “little green pills.” These were methamphetamines, commonly prescribed to dissatisfied housewives who struggled under the weight of the gendered expectations of the era.  

I don’t know exactly when drinking started to control her life, but in photos after her return to the US her weight fluctuations were visible, and there were occasional mentions of treatment centers in letters I found at the bottom of boxes in the back of the closet. I found scraps of her dreams, too - paperwork for college courses not completed, yellowed rental applications, typeset resumes, and notes from one man in particular kept close with photos of them together, young and smiling. 

And so much of what I found underscored how much she loved me. There were my drawings and report cards from elementary school, photos of me at my first communion, an op-ed I had published in the local paper, my acceptance letter to Penn, and the postcards I had sent her from my own travels around the world and across the country.  

Now, she’s 83, I’m 32, and when I go into her long-term care facility to drop off checks and handle paperwork as her durable power of attorney, people say how nice it is that her granddaughter visits so often, that she talks about me in her lucid moments, that I’m her rock.

 

I gently correct them and say that I’m her daughter, but what I don’t say is that the pressure of being responsible for someone else is crushing. And yet there is nobody else who can carry this weight.  

 

I still feel overwhelmed by this responsibility sometimes, and I still don’t always respond in the healthiest possible way. But my mom, for all of her flaws, wanted me to have a different life than she had. She told me that she wanted me to live my life, to not worry about her, to travel and work and adventure in all of the ways that she had given up. On days that she recognizes me, she still tells me this.  

My mom always put everyone else first, and it cost her so much. It’s the last thing she would want for me. So I try to keep my cup from running empty. I do yoga. I hike. I cook healthy meals and make time for long calls with my friends. I do the best I can, because I need to keep myself healthy in order to care for her now.  

An Image of Molly Yeager, a white woman with red hair smiling against a background of fallen leaves. She is wearing a blue jacket and is smiling.

Molly Yeager is currently pursuing her MPA at UAlbany's Rockefeller College of Public Affairs and Policy. Her policy interests in labor and higher education as tools for increasing social and economic mobility are grounded in lived experience as a first-generation college student from a working-class background. She loves camping with her dog and husband, fermenting various vegetables in her basement, and powerlifting.

Since You Asked

Answers to your burning health questions.

Since You Asked – What Is The Role Of Statins In Maintaining Heart Health?  

By: Leah Juhle, Family Nurse Practitioner and NWHN Volunteer Health Officer

 

NWHN member June B. asked us –  

“My doctor wants me to start taking statins. What are they and how do they affect heart health?”  

 

The Role of Statins in Maintaining Heart Health 

To reduce overall risk for cardiovascular disease, more than 200 million people around the world take statins. These prescription medications help lower low-density lipoprotein (LDL) cholesterol and stabilize plaque along the blood vessel walls to protect against heart attack and stroke. Medical providers prescribe statins most often to people who: 

  • Have high cholesterol (LDL above 190 mg/dL) that they weren’t able to reduce through exercise and diet changes alone. 
  • Had a stroke, heart attack, or peripheral artery disease. 
  • Have diabetes and an LDL of at least 70 mg/dL and are 40 to 75 years old. 

Over the years, researchers have observed many health benefits associated with statin use in reducing the risk of heart disease and stroke, even for patients with normal cholesterol whose health history puts them at high risk for heart disease. 

 

An anatomical heart model on a small wooden base. Pictured against a white background
Photo by Ali Hajiluyi on Unsplash

 

Limited Research in Adults Over 75 

Although there have been many positive research studies on statins, very few have included participants over age 75. This leaves care providers to make educated guesses about the value of statin use in older adults. Nationwide treatment guidelines stop short of endorsing statin use in this population. Instead, these groups recommend care providers and patients have a careful discussion of risks and benefits to come up with an individualized plan. Factors to consider include overall health, use of other prescription medications and supplements, and the cost of treatment. 

Potential Side Effects 

While 20 years of research supports the role of statins in reducing heart attack and stroke risk, the medications are associated with some side effects like muscle pain, liver damage, and increased risk for diabetes. The risk for side effects increases with age, comorbid disease, and use of multiple prescription medications, further complicating decision-making for statin use in aging populations.  

Looking Ahead 

Two large scale trials aim to clarify the value of statins in older adults. Taken together, the PREVENTABLE (Pragmatic Evaluation of Events and Benefits of Lipid-Lowering in Older Adults) trial and STAREE (A Clinical Trial of Statin Therapy for Reducing Events in the Elderly) trial—both of which are ongoing—will evaluate the use of statins in nearly 40,000 older adults.  

 

 

We hope you found this information helpful. If so, please consider joining the NWHN family by becoming a member here. Have a question of your own? Email us at [email protected] 

The information on this site is not intended or implied to be a substitute for professional medical advice, diagnosis, or treatment. All content, including text, graphics, images, and information, contained on or available through this website is for general information purposes only. 

The continued availability of external resources is outside of the NWHN’s control. If the link you are looking for is broken, contact us at [email protected] to request more current citation information. 

Study Snapshots

Readable summaries of the latest medical research.

All Snapshots Researched & Summarized By: Grace Lee (MPH) NWHN Volunteer Health Officer 

The Effects of Maternal Stress on Babies’ Brains

A study done by the University of Cincinnati College of Medicine analyzed the effects of prenatal maternal stress on adverse neurodevelopment of babies. Five categories of stress were examined in about 5,500 people who participated in this study: financial stress, conflict with a partner, conflict with a friend or family member, abuse (physical, mental, emotional), and death of a friend or relative. Within this study cohort, researchers examined umbilical cord blood for a chemical reaction known as DNA methylation, in which a small molecule is added onto DNA. Prior research has shown that DNA methylation may be associated with neurodevelopmental outcomes of babies. It was shown that specific locations of DNA methylation were associated with three of the five categories of stress: conflict with family or friends, abuse, and death of a close friend or relativeWhile more research needs to be conducted on the biological pathways of DNA methylation on fetal development, this study shows that these stressors experienced by people who are pregnant may influence the neurodevelopment of the baby. 

How Birthing People of Color Are Fairing Post-Roe

On June 24th, the U.S. Supreme Court refused to strike down a Mississippi state law banning abortion after the fifteenth week of pregnancy in Dobbs vs. Jackson Women’s Health, which ultimately led to the overturning of Roe v. Wade. In this post-Roe era, anti-abortion laws have serious impacts on birthing people, especially for those of color, who make up about 60% of those who seek abortionsOf this 60%, about half live under the federal poverty line. Restricted access to abortion means that more birthing people may seek out abortions in unsafe conditions, which is furthered by the fact that Black birthing people are three times as likely to die in childbirth and face higher rates of other maternal complications compared to their white counterparts. Deep health disparities mean birthing people of color are more likely to need life saving abortions and other medications, of which may now be illegal where they live. Additionally, birthing people of color are expected to face a disproportionate risk of experiencing postpartum depression and other threats to psychological well-being 

A Roundtable on Endometriosis

The Society for Women’s Health Research recently held a roundtable of patients, clinicians, and researchers to identify unmet needs and knowledge gaps in endometriosis, a disease in which uterine-like tissue grows outside the uterus. While endometriosis affects nearly 10% of reproductive-aged people, the disease is both under-researched and underfunded. The roundtable discussion pushed for continued research into the underlying biology of endometriosis, as well as strategies to eliminate access barriers and stigma associated with the condition. The roundtable also called for new research to develop more innovative and less invasive diagnostic methods, higher quality therapies, and more comprehensive care for those living with endometriosis. 

Tribute gifts

The National Women's Health Network thanks our members for their generous donations.

Jennifer Allen In not-so-fond Memory Of Rush Limbaugh

Marcy Antiuk In Honor Of Roben S.

Sheila Attaie In Memory Of Shawn Attaie

Christine Boyd In Memory Of Vivian Boyd

Duke George Brady In Memory Of Sesame

Ryan Campagna In Honor Of Shelby-Gray Seshley

Gillian Canty In Memory Of Evelyn Canty

Jennifer Cunningham In Honor Of Dr. Whitney Behr, PhD

Sharon Davis In Honor Of Name Not Given

Diana Everett In Memory Of Eleanor Risser Davey, my mother

Frank Field In Memory Of Helen C. Field

Mark Foggin In Honor Of Julie Subrin

Robert Friedman In Honor Of Sherry Leibowitz

Hadley Fry In Honor Of GirlOnInternet

Adam T Goldman In Honor Of Ronna Tapper-Goldman

Matthew Goolsby In Memory Of Elvis A Presley

 

 

John Haskins In Honor Of Dan Savage

Elizabeth Haynes In Honor Of Katia Cook (Happy Birthday!)

Gowri Begade In Honor Of Suprabha Heggade

Betsy Hockstein In Honor Of Claudia Taskier's Birthday

Suzanne Hollingsworth In Honor Of Sarah-Gray Lesley & Shelby Sessions (Congratulations!)

Debbi Huntoon In Memory Of Richard Camacho

Elizabeth Hynes In Honor Of Ariel Dumas

Kimberly In Honor Of Mary Rusk

Daphne Rebecca Knudsen In Honor Of Sarah Lesley and Shelby Sessions' Wedding!

Susan Langan In Memory Of Lady Justice

Kit Lillia In Honor Of Kit Lillia

Allison Lim In Honor Of SG & Shelby

Tamara Kellogg, M.D. In Honor Of Patricia D. Kellogg, M.D.

 

Elizabeth Mosley In Honor Of My mother, my abortion doula

George Raphael In Memory Of PLAN C Community

Hannah Redfield In Honor Of Abby Maddigan

Bailey Remke In Memory Of Ruth Bader-Ginsburg

Adam Reynolds In Honor Of Madeleine Gyory

Jessica Ridge In Honor Of Ginia Littlepage

Meghann Riepenhoff In Honor Of victims of the war on womens bodies

Laura W. Sacks In Honor Of Sarah Schmidt

Marcy Schwartz In Memory Of Samantha Shain and Amit Schwalb

Harriet Shiffman In Honor Of Sarah Schmidt

Jodi Short In Memory Of Marlene Short

April Sutton In Honor Of Vicky (Mom)

Catherine Wilkinson In Memory Of Aunt Mimi

Elisheva Yuan In Honor Of Alyssa McGrath (Happy Birthday!)

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