Woman power

Straight Talk Express hits a bump when talk turns to Viagra
Today's topic has perplexed men and women (especially the women) for years: Why do almost all health insurance plans cover prescriptions for erectile dysfunction while many do not cover contraceptives?...

Because men run the world.

It is the male of the species that suffers erectile dysfunction, which, of course, means that it is a problem of earth-shattering importance...

Meanwhile, it is women - who pay 68% more for health care out-of-pocket than men - who are left to handle most of the chores when it comes to Katie barring the door...

Most men are more familiar with Baluchistan than the mechanics of contraception. One of the biggest miracles is how women pay for it...

For years, there has been an "EPICC" effort in Congress to help redress that imbalance with a proposal called the Equity in Prescription Insurance and Contraceptive Coverage Act...The intent of the legislation is to ensure affordable contraceptives to women...

And the bill makes sense: Thirty million sexually active women run the risk of unintended pregnancies each year. Without affordable contraception, they can incur expensive healthcare needs, from routine pregnancies to C-sections, abortions and medical emergencies. Still, drugs to treat erectile dysfunction and male pattern baldness are often covered while contraceptives are not. One absurdity: Half of large insurance plans don't cover routine contraceptive costs, but two-thirds of the medical plans pay for abortions.

"It's an outrageous inequity," says Sarah Stoesz, head of Planned Parenthood MN/ND/SD, who points out that men run most insurance plans. "Birth control is a basic health care need for almost all women. The only reason it isn't covered is insurance companies might have to reduce benefits for men, and increase them for women. They don't want to do either."

Boys, boys, boys.

Didn't our mothers teach us anything? It takes two to tango, and two to make babies. And two not to.

Men, we aren't holding up our end.

And Viagra won't help. (Nick Coleman, Star Tribune, B1, 7/13/08)
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A turf war over the maternity market
Doctors are up in arms over a documentary film that they see as promoting an unsafe alternative: home childbirth.

...Last year, I flew to Britain to be with a good friend for the birth of her first child. She's American but married into Britain's National Health Service, lucky duck. The differences in the prenatal care she got there were striking. First and foremost, she never saw a doctor. As a healthy woman with a normal pregnancy, she saw midwives. And one of their first questions to her was, "So, would you like to give birth in the hospital maternity ward or at home?"

Planning a home birth with a midwife may sound old-fashioned...but a solid body of research shows that for healthy women who seek a normal, nonsurgical birth, there are several benefits. At home, a woman can get one-on-one care and monitoring from a midwife trained to support the normal labor process. The mother-to-be is free to move about, eat and drink, sit in a birth tub - Britain's national health guidlines call water the safest, most effective form of pain relief. A woman will be helped to give birth in positions that are effective and protective: sitting, squatting, on hands and knees, even standing.

The physiological birth process is automatic: hormones fire, the cervix gradually opens, the uterus contracts, the baby descends, muscles engage. An optimal birth, one in which mother and child emerge as healthy as can be, is one that begins spontaneously, progresses on its own and concludes with the least amount of intervention necessary.

But hospital maternity care in the US is typically not supportive of this process. More than half of women are induced into labor, or it is sped up with artificial hormones; the vast majority of women labor and push in the desultory flat-on-the-back or leaning-back position; and (perhaps not surprisingly) nearly one-third of women end up giving birth through major surgery, the caesarean section.

This has led to an epidemic of pre-term births in the US. A 2006 survey showed that the majority of babies are now born before the spontaneous onset of labor, which leaves them more prone to breathing and feeding difficulties. Caesareans are also contributing to a rising maternal death rate, announced by the CDC last year.

Which is why some women...choose to give birth somewhere other than a hospital. Their choice is backed by sound science. Studies of "low-risk" women in North America planning out-of-hospital births with midwives have found that 95% give birth vaginally with hardly any medical intervention. The largest and most rigorous study to date published in the British Medical Journal found that in North America, babies were born at home just as safely as in the hospital.

Organized medicine can't believe this. Dismissing the research evidence, the AMA resolution states that "the safest setting for labor, delivery and the immediate postpartum period is in the hospital" or an accredited birth center. In its own statement earlier this year, the American College of Ob/Gyns went even further, implying that women who choose home birth are selfish and irresponsible: "Choosing to deliver a baby at home...is to place the process of giving birth over the goal of having a healthy baby."

Compare that to this information in Britain's NHS-issued handout my friend was given at her first prenatal appointment: "There is no evidence to support the common assertion that home birth is a less safe option for women experiencing uncomplicated pregnancies." In a joint statement last year, the Royal College of Obstetricians and Gynecologists and the Royal College of Midwives said, "There is no reason why home birth should not be offered to women at low risk of complications, and it may confer considerable benefits for them and their families."

The AMA's statement calls for legistlation that could be used against women who choose home birth, possibly resulting in child-abuse or neglect charges. The group says this is about safety. But with no credible research to back up its claim, this argument falls flat. Women are simply caught in a turf war over the maternity market, and it would appear that the physicians' groups are perfectly willing to trample the modern medical ethic of patient automony - grounded in our legal rights to self-determination to liberty and to privacy - in their grab for control.

If these groups were truly making maternal and child health a priority, they'd be reforming standard maternity care, not strong-arming women into it. (Jennifer Block, author of "Pushed: The Painful Truth About Childbirth and Modern Maternity Care," wrote this article for the Los Angeles Times. Star Tribune, OP1, 7/13/08)
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God bless the Star Tribune that weekend! (And the MAN who wrote the first article.)

In other words, men want all the sex that they can get, along with the profits on the outcome. But none of the responsibility.

I am so sad for myself and for women across the world, having lost the empowerment we ought to have in our miraculous female bodies. I have always been frustrated by what I've seen in clinics and delivery rooms, and have already studied non-traditional birth options for myself someday. I know my body can do amazing things. And my body knows how it needs to handle pain. Lucky I'm too tired to say much more tonight, other than: Women, you're a miracle.