Policy & Practice


Women, Minorities Bear STD Burden

Women continue to be disproportionately affected by sexually transmitted diseases, according to 2007 surveillance figures from the Centers for Disease Control and Prevention. The chlamydia rate among women was nearly three times that of men in 2007 with 543.6 cases per 100,000 women, compared with 190 cases per 100,000 men. More women also suffer from gonorrhea, the CDC reported, with 123.5 cases per 100,000 women, versus 113.7 cases per 100,000 men. The consequences of untreated chlamydia and gonorrhea infections are high for women, the report reminded: infertility, ectopic pregnancy, and chronic pelvic pain. The CDC report, Sexually Transmitted Disease Surveillance, 2007, also highlighted racial disparities in chlamydia, gonorrhea, and syphilis. Young African American women (aged 15–19 years) had the highest rates of chlamydia and gonorrhea. The full report is available online at

ACOG Supports Same-Sex Couples

The American College of Obstetricians and Gynecologists supports the right of same-sex couples to the same federal and state legal protections afforded heterosexual married couples. In a new position statement written by ACOG's Committee on Health Care for Underserved Women, committee members pointed out that lesbian women and their families face obstacles in accessing health care. These obstacles range from discriminatory attitudes and treatment to limited access to health insurance. For example, a lesbian woman might have a medical power of attorney but might still be prevented from seeing her partner in the hospital. Many women in same-sex relationships are unable to take leave under the Family Medical Leave Act to care for a sick partner. ACOG published its policy statement in the February issue of Obstetrics & Gynecology.

Misoprostol Urged After Abortion

The availability and use of misoprostol should be increased as a first-line method of immediate postabortion care in outpatient settings, according to another new opinion from ACOG. “Women need an option within their communities that will allow for immediate medical attention,” Dr. Laura Castleman, a member of ACOG's Committee on International Affairs. “A woman who is sick and in pain, poor, or otherwise unable to travel may not receive care she needs in time to preserve her health or save her life.” Misoprostol is a safe, low-cost alternative to vacuum aspiration, according to ACOG. The college also advised that nurses and midwives can safely provide postabortion care in outpatient settings, provided they received appropriate training and support. The ACOG policy statement was also published in the February issue of Obstetrics & Gynecology.

Reproductive Rights Report Card

Reproductive rights made some advances and had some setbacks in 2008, according to a report from the NARAL Pro-Choice American Foundation. Twenty-three states enacted 39 “prochoice” measures, such as policies to prevent unintended pregnancy. Colorado, Indiana, Minnesota, and Wisconsin each enacted measures to improve access to contraceptives and provide comprehensive sex education to teens. Wisconsin also enacted legislation that ensures that sexual assault victims receive information about and access to emergency contraception in hospital emergency departments. On the other hand, 16 states enacted 24 “antichoice” measures. For example, Oklahoma passed omnibus legislation that allows certain individuals and organizations to refuse to provide abortion services and requires women seeking abortions to view ultrasound images. The report provides grades for each state as well as an assessment of federal actions in this area.

Seeking Low-Cost Contraceptives

Legislation in the House of Representatives would restore discounts for contraceptives purchased by college health centers and safety-net clinics for low-income people. The “Prevention Through Affordable Access Act” (H.R. 398) would reinstate the health centers' access to the Medicaid discount drug prices, which they lost with the enactment of the Deficit Reduction Act of 2005. Since January 2008, women getting contraceptives at these clinics have seen the average price of a prescription increase from about $5 to almost $50, according to Rep. Joseph Crowley (D-N.Y.), who reintroduced the legislation last month after it failed to pass in the last session of Congress. The bill is supported by the Planned Parenthood Federation of America and Physicians for Reproductive Choice and Health.

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