Truthmonk

The oracle of on politics

[truthmonk]

Taking the High Road

 Our gorgeous design giving a visual meaning to Michelle Obama’S words, “When someone is cruel or acts like a bully, you don’t stoop to their level. No, our motto is, when they go low, we go high.”

This was tested in the third 2016 presidential debate between Donald Trump and Hillary Clinton. Our design celebrates Hillary taking the high road though the debate as Trump was stumbling his way through the low road mud.

Now available at www.zazzle.com/hillaryrclinton for a limited time!

[truthmonk]

Why Trump is Not Qualified for President

1) Committing Treason by encouraging Russian foreign intelligence service to commit an act of war (cyberespionage) against the United States.

18 U.S. Code § 2381 – Whoever...is guilty of treason...shall be incapable of holding any office under the United States.

2) By breaking US law by doing business with Cuba during the Cuba embargo.

3) Using third world dictatorship tactics by threatening to jail Hillary should he be the winner.

4) Locking room talk makes him susceptible to blackmail by foreign intelligence services.

5) For the first time the American intelligence has come out against Trump. The American intelligence community is queasy about him. Michael Hayden, the former head of the CIA and NSA and Michael Morell, the former deputy director of the CIA have both questioned Trump’s fitness for president.

Complete lack of knowledge of global issues.

His antisemitism would make him unreliable supporter of Israel.

Breaking our democratic tradition of not revealing the secret intelligence information that is given during the special secret intelligence briefings for presidential nominees. This is worst than any inadvertent disclosures made by Hillary clinton.

6) Breaking our democratic tradition of presidential nominees releasing their tax returns for public scrutiny which dates back to Richard Nixon.

7) Breaking our democratic tradition of presidential nominees releasing their  medical records.

8) Trump is racist.

Trump implied that Gonzalo Curiel, because of his Mexican heritage, could not fairly hear the class action case against his for-profit Trump University,

Trump was the leading proponent of “birtherism,” the racist conspiracy theory that President Barack Obama was not born in the United States and is thus an illegitimate president.

9) Trump is anti-Muslim.

Retaliated against Muslim Gold Star parents of the late Army Captain Humayun Khan.

Calling for a “total and complete shutdown of Muslims entering the United States.”

10) Trump is an anti-Semitic

He that claims Clinton “meets in secret with international banks to plot the destruction of U.S. sovereignty in order to enrich these global financial powers.”

[truthmonk]

The logo Hillary Clinton should have had

Now available at www.zazzle.com/hillaryrclinton for a limited time!

This is my proposed logo for the Hillary Clinton for President campaign. Using five strengths of Hillary - smart, sane stable, safe, and super. Clear, concise, and easily understood this gets the message across to the viewer why they should be in favor of Hillary. The circle shows Hillary expressing these qualities which in-turn reinforce who she is.

[truthmonk]

Is Trump a Manchurian candidate?

Frank Sinatra as Manchurian Candidate Captain Bennett Marco (Getty Images)

Vladimir Lenin (Isaac McBride)

Donald Trump (U.S. Marine Corps photo by Sgt. Gabriela Garcia)

Vladimir Putin (www.kremlin.ru)

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Republican presidential nominee Donald Trump may be a modern day Manchurian candidate or as the Russians would called him a "useful fool." Consider these actions by Trump.

1) Trump has praised Russian President Vladimir Putin at least as far back as October 2007 when “Trump told Larry King that Putin was doing a “great job in rebuilding the image of Russia and also rebuilding Russia period.”” Over the years, Tramp has called Putin a strong leader, "unlike what we have in this country", and "a man so highly respected within his own country and beyond." CNN has characterized this as a “long-established track record of...fondness for the autocratic Russian leader.”

2) In July 2016 Trump stated about Hillary Clinton's hacked email, “'Russia, if you're listening, I hope you’re able to find the 30,000 emails that are missing.' The New York Times reported that Trump was "essentially urging a foreign adversary to conduct cyberespionage against a former secretary of state.'”

The encouraging of an enemy's foreign intelligence service to commit an act of war against the United States is treasonous.

3) Tramp has most likely deep and long lasting financial relationships with the Russian oligarchs. Thus no tax return release.

   In 2008 Tramp made nearly $60 million when he sold a mansion in Palm Beach to Russian billionaire Dmitry Rybolovlev.

   Tramp brought the Miss Universe pageant to Moscow in 2013, with the help of Russian billionaire and close Putin ally Aras Agalarov.

   Again in 2013 Tramp signed a preliminary deal to build a tower in Moscow with Agalarov. According to The Washington Post, Agalarov told them “the project is on hold while Trump runs for president.”

   In March 2016 Tramp hired Paul Manafort, an American lobbyist with strong ties to pro-Russian Ukrainian exiled leader Viktor Yanukovych to run his presidential campaign.

4) Tramp questioned the United States continuing involvement in NATO in summer 2016.

5) Trump has said, “he might not provide military assistance to the Baltic countries—Estonia, Latvia, and Lithuania—if they were invaded by Russia, even though they are part of NATO and the alliance’s treaty declares that an attack on one member is an attack on all members.”

6) He has taken Russian's side with regards to Crimea stating, “he would consider recognizing Crimea as Russian territory.”

7) Before taking Russian's side in the Crimea he told ABC's George Stephanopoulos August 2016, “He's not going into Ukraine, OK, just so you understand. He's not going to go into Ukraine, all right? You can mark it down. You can put it down. You can take it anywhere you want.”

8) Obviously, Tramp wants closer ties to Russia saying, “that Russia could help the United States in fighting ISIS terror organization.”

[truthmonk]

I Love Hillary Design

Available at www.zazzle.com/hillaryrclinton for a limited time!

Show the world whom you will be voting for with our "I love Hillary" 2016 election posters, mouse pads, t-shirts, postcards, magnets, stickers, and other fine products. Now available at www.zazzle.com/hillaryrclinton for a limited time!

[truthmonk]

Available at www.zazzle.com/hillaryrclinton for a limited time!

The Yes We Can! series consist of eight versions of Hillary Clinton image imposed on the iconic "We Can Do It!" American wartime poster. Westinghouse Electric enlisted artist J. Howard Miller during World War II for an inspirational poster to boost worker morale. The eight titles are Yes We Can!. Powerful!, Determined!, Awesome!, Hillary!, I'm With Her!, For America, and Stronger Together.

Available at www.zazzle.com/hillaryrclinton for a limited time!

[truthmonk]

Military Action or Act of War?

 Editorial

Military Action or Act of War?

As reported in the August 27, 2013 New York Times, the military action that President Obama is considering is characterized as “limited” and meant to “deter and degrade” Syria’s military capabilities. The strike is “not aimed at ousting Mr. Assad from power or forcing him to the negotiating table” nor crippling Syria’s sizable military forces and infrastructure.

Does this remind anyone of another military action that was also “limited” and meant to “deter and degrade” another military. The “military action” I’m thinking about was carried out on December 7, 1941.

The attack on Pearl Harbor was a surprise military strike conducted by the Imperial Japanese Navy against the United States Pacific Fleet to prevent the fleet from interfering with the planned military actions in Southeast Asia of the Japanese Empire.

The Japanese were not trying to oust President Roosevelt or force our surrender or to cripple the entire military.

Why is the “limited” military action that is meant to “deter and degrade” Syria’s military capabilities not an act of war?

[truthmonk]

The War on Women's Health, Part 6: Religious Beliefs

The War on Women's Health

Part 6: Religious Beliefs

Where the rubber hits the road

By Truthmonk November 12, 2012

[youtube=http://www.youtube.com/watch?v= SV91AHRTKFM&hl=en&fs=0&rel=0&w=480&h=295&autoplay=1]

The Stoning Death of Du'a_Khalil_Aswad, a Kurdish teenager

Du'a Khalil Aswad, a 17-years-old teenager, was stoned to death on April 7, 2007 allegedly by members of her Yazidi family during an honor killing. Her crime? She hung out with a boy from the wrong ethic group. She was dragged half naked into the street in front of an excited crowd that had congregated to watch the stoning. A number of people filmed her death on their mobile phones.

Virtually all women have used contraceptives, even Catholic women

Among never-married young adult Catholic women 89% have had sex.1 Interestingly, among nonspecific never-married young adult women only 79% have had sex, 10% less than young adult Catholic women. Seems Catholic women are more promiscuous than most.

Among sexually experienced never-married Catholic women 98% have used a contraceptive method. This is similar to the 99% of sexually experienced never-married non-Catholic young adult women who have used a contraceptive method. A statistical dead-heat. Methods used includes: condom, IUD, female or male sterilization, and hormonal methods such as the pill.

Virtually all of the approximately 62 million reproductive age women in the United States will use a contraceptive method at some time during their lives. If the research tells us anything, it tells us the notion that strongly held religious beliefs and contraceptive use are incompatible is just plain wrong. Contraceptive use by Catholics and Evangelicals with strongly held religious beliefs is the widespread norm, not the exception.

Honestly how deep can a belief be when 98% of the Catholic women have used a contraception method?

How firm are Catholics beliefs

While a majority of Americans (55%) believe “employers should be required to provide their employees with health care plans that cover contraception and birth control at no cost,” an even larger number of Catholics (58%) do.2

For employers that are “religiously affiliated colleges and hospitals” the number drop to slightly under half for Americans (49%) and 52 percent for Catholics.

It is interesting that for both regular employers and religiously affiliated colleges and hospitals employers, a larger percent of Catholics believe they should be required to provide contraception and birth control at no cost than generic Americans.

Who are the Catholics bishops representing battling against women's contraception use? It can't be the 98% who have used or will use contraception. It can't be the majority of Catholics who believe that employers, even the “religiously affiliated colleges and hospitals” ones should provide contraception coverage in their health plans.

To a celibate man these may be "most deeply held religious convictions." But they aren't the ones who must live by them. So perhaps the bishops aren't representing Catholics at all. Their flock has moved on. The bishops have been left standing guard over crumbling relics of a bygone time.

Carving out religious exceptions

If Catholics are granted an exception for not covering contraception, what about exceptions for other religions?

Jehovah Witnesses3 would want an exception for not covering blood transfusions, Islam4 would need one for pig derived insulin, Scientology5 wouldn't want to cover psychiatric drugs, and Christian Scientists6 would want a big exception for not covering medical treatments and vaccinations. And the list goes on ad nauseam.

The Talmud has commanded Jewish women for over 1500 years to use a mokh for birth control.7 The mokh is a soft cotton pessary that presents a physical barrier to the sperm. Women would soak the mokh in lemon juice to give it anti-spermicidal properties before insertion into the vagina against the cervix.

Composite inage by Truthmonk

Component images: Cotton - redOrbit.com, Lemon tree - Allen Timothy Chang, Cut Lemons - André Karwath

The Judaism's Talmud (500 CE) is the passage named “the Bariata of the Three Women.” In this textual argument, rabbis deliberate when women must or may use a birth control device to avoid unintended pregnancies.

“R. Bebai recited before R. Nahman: Three (categories of) women use a mokh in marital intercourse: a minor, a pregnant women, and a nursing mother. The minor, because she might become pregnant and die. A pregnant woman, because she might cause her fetus to become a sandal (flattened or crushed by a second pregnancy). A nursing woman because she might have to wean her child prematurely and the child would die.”

The text's intent is concerned about the additional risks caused by coitus for a pregnant women.

“The reasons to prevent pregnancy are both to protect the woman and, importantly, to protect her child from danger. In the first, the rabbinic understanding that married minors (girls under the age of 12 years and a day) are at higher risk should they become pregnant is straightforward . In the second case, the rabbis, who at this point debate whether superfetation (second pregnancy) is biologically possible, are concerned primarily that the fetus might be compromised by a[n] intercourse.”

The third and final case is the nursing mother where a pregnancy might impair the quantity or nutritional quality of her milk. During the 2 – 3 year nursing period pregnancy was forbidden. This point is made crystal clear by several tractates of the Talmud.

Zoloth writes, “The idea of avoiding a second pregnancy until the child was fully weaned was so strongly held by some, including R. Y'hudah Ayyes in early 18th century Italy, that R. Ayyes writes a responsa allowing an abortion for a nursing mother, to protect her nursing child.”

Settled constitutional law

They also have the legal problem that it's settled constitutional law.

United States Conference of Catholic Bishops assert it would violate their religious beliefs to provide women with full health coverage8. They want to be excused from complying with the law, but religious beliefs do not relieve them of the obligation to obey the law.

Photograph from ThinkProgress.

From left, Roman Catholic Bishop Reverend William E. Lori, Lutheran Reverend Dr. Matthew C. Harrison, Baptist C. Ben Mitchell, Orthodox Rabbi Meir Soloveichik, and Baptist Craig Mitchell.

The Panel of Five testified before Rep. Darrell Issa's (R-CA) House Oversight and Government Reform Committee hearing Feb. 16, 2012.

The free-exercise clause of the First Amendment, "Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof...," pertains to the right to freely exercise one’s religion beliefs.9 However, the Supreme Court has placed limits on the expression of religious practices.

In the case of Employment Division, Department of Human Resources of Oregon v. Smith, 494 U.S. 872 (1990), the United States Supreme Court held that neutral laws of general applicability do not violate the Free Exercise Clause of the First Amendment.

In Smith, far-right conservative Justice Antonin Scalia writing the majority opinion said, "We have never held that an individual's religious beliefs excuse him from compliance with an otherwise valid law prohibiting conduct that the State is free to regulate. On the contrary, the record of more than a century of our free exercise jurisprudence contradicts that proposition."

SCOTUS/Steve Petteway

Antonin Gregory Scalia (R - Senior Associate Justice of the Supreme Court of the United States) was appointed by President Ronald Reagan in 1986. He is considered by conservative as the intellectual anchor of the Court.

Justice Scalia continued by quoting Justice Frankfurter from Gobitis10, "Conscientious scruples have not, in the course of the long struggle for religious toleration, relieved the individual from obedience to a general law not aimed at the promotion or restriction of religious beliefs. The mere possession of religious convictions which contradict the relevant concerns of a political society does not relieve the citizen from the discharge of political responsibilities." Later in the opinion Justice Scalia wrote, “Subsequent decisions have consistently held that the right of free exercise does not relieve an individual of the obligation to comply with a valid and neutral law of general applicability on the ground that the law proscribes (or prescribes) conduct that his religion prescribes (or proscribes).”

Justice Scalia argues the government's ability to make and enforce public policy cannot depend on the spiritual development of a religious objector to a law. To do otherwise permits the objector, by virtue of his beliefs, “to become a law unto himself.”11 at 167

This “contradicts both constitutional tradition and common sense.”

Next: The War on Women's Health, Part 7 - At the End

Previous: The War on Women's Health, Part 5: Women’s Economics

Sacred Rights: The Case for Contraception and Abortion in World Religions

In many of the world's religions there is a restrictive and pro-natalist view on family planning, and this is one legitimate reading of those religious traditions. Arguing for the existence of equally valid traditions that allow contraception and abortion, the authors, all scholar-practitioners of the religions about which they write, seek to escape the confines of oversimplified either/or, pro-choice/pro-life arguments. Instead, they point the way toward a more open discussion of family planning. Dispelling the notion that the world's religions are uniformly conservative on issues of family planning, the authors show that the parameters of orthodoxy are wider and gentler than that, and that the great religious traditions are wiser and more variegated than a simple repetition of the most conservative views would suggest.

Sources

1 Jones, Rachel K.; Dreweke, Joerg | Countering Conventional Wisdom: New Evidence on Religion and Contraceptive Use | Guttmacher Institute, New York, NY, USA | April 2011.   2 Ø | Survey: Majority of Catholics Think Employers Should Be Required to Provide Health Care Plans that Cover Birth Control at No Cost (Webpage) | February PRRI Religion and Politics Tracking Poll | Public Religion Research Institute | February 7, 2012 | Accessed February 29, 2012 @ http://publicreligion.org/research/2012/02/january-tracking-poll-2012.   3 Ø | Our View of Medical Care: Blood Transfusions | Jehovah's Witnesses Official Media Web Site | 2009 | Available @ http://www.jw-media.org/aboutjw/article01.htm.   4 Al-Munajjid, Muhammad Saleh | Fatwas, Can Muslims use animal organs/products for medicine, such as insulin made from pig tissue/medicine containing liver from cows or other organs from cows? () | ∞ halalmontreal.com | Available @ http://halalmontreal.tripod.com/id39.html.   5 Ø | Is it okay to take any sort of drugs when you are in scientology? « Scientology and Dianetics Auditing (Website) | Church of Scientology International | ∞ | Available @ http://www.scientology.org/faq/scientology-and-dianetics-auditing/is-it-okay-to-take-any-sort-of-drugs-when-you-are-in-scientology.html.   6 Ø | What is Christian Science? | The Christian Science Board of Directors | ∞ | Available @ http://christianscience.com/what-is-christian-science.   7 Zoloth, Laurie | “The bariata of the Three Women” (Pages 33 – 36) « Chapter 1: “Each One an Entire World”: A Jewish Perspective on Family Planning (Pages 21 – 54) « Sacred Rights: The Case for Contraception and Abortion in World Religions (Maguire, Daniel C. (Editor)) | Oxford University Press (New York, NY, USA) | 2003.   8 Lori, William E. | Testimony of Most Reverend William E. Lori Bishop of Bridgeport | Before the Judiciary Committee of the United States House of Representatives, Subcommittee on the Constitution | October 26, 2011.   9 Mullally, Claire | Free-exercise clause overview (Online) | First Amendment Center | 20110916 | Accessed 20120501 @ http://www.firstamendmentcenter.org/free-exercise-clause.   10 Minersville School Dist. Bd. of Educ. v. Gobitis, 310 U.S. 586, 594-595 (1940).   11 Reynolds v. United States, 98 U.S. 145 (1878), was a Supreme Court of the United States case that held that religious duty was not a suitable defense to a criminal indictment.  

[truthmonk]

The War on Women's Health, Part 5: Women's Economics

The War on Women's Health

Part 5: Women's Economics

Power that can't be ignored

By Truthmonk November 4, 2012

[youtube=http://www.youtube.com/watch?v=6Hy3-ny0q4M &hl=en&fs=0&rel=0&w=480&h=295&autoplay=1]

“Until things slowly changed during the last century, women's participation in the labor force was limited by traditional cultural, educational, and legal practices. Women's work outside of home and marriage was restricted to a handful of occupations such as domestic service, factory work, farm work, and teaching. Over the past several decades, the women's labor force in the United States and throughout the world has experienced many changes. Women's labor force participation rates are significantly higher today than they were in the 1970s. Throughout that period, women have increasingly attained higher levels of education and experienced an increase in their earnings as a proportion of men's earnings.”1

Winning the War

One rivet at a time

We Can Do It! (Rosie the Riveter), circa 1942 – 1943 Office for Emergency Management, War Production Board The U.S. National Archives

Women's economic power has grown over time. Women began entry into traditionally male jobs during World War II as rampant male war enlistment caused immense needs in the industrial labor force.2

Between 1940 and 1945, American women entered the workforce in unprecedented numbers increasing women workers from 27 percent to nearly 37 percent. By the end of the War, nearly one quarter of married women worked outside the home. Perhaps the most iconic image of working women during this time was the Westinghouse Electric & Manufacturing Company's poster of a woman riveter, “Rosie the Riveter."

When the war ended, the many industries that had once encouraged and celebrated the working War women, forced them to leave their high paying skilled jobs to returning veterans.

The American Working Women

Pillars of strengths

Today the percentage of American working women has increased to 47%3,4 of employed workers and 59% of the entire labor force5. Even 65% of mothers work6. The wages of the 66 million working women4 make up 23% of the National Gross Domestic Product.7,8,9

Employment by Industry

Building over the old

“In 1964, about 19 million of the nation's nonfarm employees were women; the three industries that employed the most women—manufacturing; trade, transportation, and utilities; and local government—accounted for 54 percent of these women.”1

Of the 66 million women who worked in wage and salary jobs in 2010, 70 percent worked in just four industries: 16 million were employed in education and health services; 12 million were employed in government; 10 million were employed in trade, transportation, and utilities; and 8 million were employed in professional and business services.

“During this period, the growth of the education and health industry, and the number of women employed in it, has been notable.”

“In the 1960s, more women were employed in manufacturing than in any other industry. During the 1970s, and 80s, more women were employed in trade, transportation, and utilities than any other industry. Until 1975, there were more women employed in local government than in education and health services. In 1976, employment of women in education and health exceeded that in local government. From 1993 to 2010, education and health services has ranked first in employment of women, followed by trade, transportation and utilities, and local government.”

During the 1964 – 2010 period, women went from 34 percent of the workforce to about 47 percent.3,4

Women in the Workforce

Cogs in the machines

The number of women employed, and the wages they earn, vary by occupation. Women who worked full time in wage and salary jobs had median weekly earnings of $669 in 201010. This represented 81 percent of men's median weekly earnings ($824).

In 2010, the 363,000 women employed as counselors earned, at the median, $818 per week, nearly 2 million women employed as elementary and middle school teachers earned, at the median, $931 per week, and the 88,000 women employed as pharmacists earned, at the median, $1605 per week.11 An additional 200,000 women employed as computer software engineers earned, at the median, $1445 per week, over 2 million women employed as secretaries and administrative assistants earned, at the median, $657 per week, another almost 2 million women employed as registered nurses earned, at the median, $1039 per week, and the 88,000 women employed as pharmacists earned, at the median, $1605 per week.

  Women CEOs

Running Empires: These women run companies could be members of the UN

The first woman CEO of a Fortune 500 company was Katherine Graham whom took over the Washington Post Co. in 1972.12 Now women hold 19 CEO positions at Fortune 500 rank companies13 for 4 percent.

Some women run public traded companies whose revenues exceed the Gross Domestic Product of entire countries.

Meg Whitman, the CEO of Hewlett-Packard, heads up a corporation that if it were a country would be rank the 65th largest country. This is larger than Cuba's GDP.

The corporations' revenue rankings was done by Fortune CNNMoney14 and the countries' GDP rankings come from the CIA's 2011 World Fact Book.15

Women Owned Businesses

Vēnērunt, vīdērunt, vīcērunt

There are an estimated 8 million U.S. businesses (2008) that are majority women-owned, i.e. privately-held firms where women own at lease 51 percent16. The businesses account for 28.2 percent of all businesses in the United States. The economic impact of these firms is nearly $3 trillion annually.

They have created almost 24 million jobs or 16 percent of all U.S. Jobs.

  The various service sectors had the greatest number of firms created. Women owned 21% of the firms in the professional, scientific, and technical services sector.

In 2008 the GDP was $14.2646 trillion.17 The $2.8 trillion impact of these firms gives them 19.6% of the National GDP.

If U.S.-based women-owned businesses were their own country, they would have trailed 5th rank Germany in GDP but ahead of countries like United Kingdom, Russia, France. Only the much larger countries United States, China, Japan, and India would have a larger GDP.15 ((repeat))

The Pill

Estrogen powered

What has allowed women to continue making progress after the appearance of Rosie the Riveter in the gut of the American industrial sphere?

It was contraception — more specifically the birth control pill. By 2010, 66 million women worked in wage and salary jobs earning about $3,347 billion18 because of pill. The pill also allowed women to establish 8 million businesses by 2008.

Now there are 19 women CEO of Fortune 500 companies. Is it only coincidence that the very first woman CEO, Katherine Graham took control of the Washington Post Co. in 1972 well after distribution of the pill started in the sixties?

Goldin and Katz18conclude:

“But a virtually foolproof, easy-to-use, and female-controlled contraceptive having low health risks, little pain, and few annoyances does appear to have been important in promoting real change in the economic status of women (Birdsall and Chester 1987). Moreover, women in the United States were well positioned to take advantage of the pill’s side benefit. By the time the pill was available to unmarried women, about 28 percent were graduating from four-year institutions of higher education.

“The most persuasive evidence for a role of the pill is that its initial diffusion among single women coincided with, and is analytically related to, the increase in the age at first marriage and the increase in women in professional degree programs. Other factors were involved in these changes, to be sure. No great social movement is caused by a single factor.”

  Year of entry of first-year female professional students as a fraction of first-year students overlaid contraceptive pill usage and total fertility rate.    

Next: The War on Women's Health, Part 6 - Religious Beliefs

Previous: The War on Women's Health, Part 4: Contraceptive Coverage Economics

Ayn Rand - A Sense of Life (Director's Vision Edition)

Perhaps the most widely read philosopher of the 20th century, Ayn Rand has delighted and infuriated people of all ideologies and, like it or not, has helped to create the political realities we deal with every day. With Ayn Rand: A Sense of Life you can follow her life story, from her childhood in the turbulent years of revolution in her native Russia to her great success as a popular writer and political philosopher in the United States.

Ayn Rand

At age nine, Ayn Rand (1905-1982) decided she would be a writer and published her first novel, We the Living, at the age of 28. This biography is a quick, general primer with short, manageable chapters that cover an average of 10 years each. Born in Russia in 1905, she immigrated to America as a young woman and worked in Hollywood film studios and theaters while trying to get her writing published. Like many authors, Rand experienced her share of initial rejection, but she soon became well known for controversial novels (i.e., The Fountainhead and Atlas Shrugged) that advanced her intensely individualistic philosophy. It features an impressive array of photos, many of which are published here for the first time, as well as reproductions of book jackets, letters, notes and artwork, which add richness to the narrative.

Capitalism: The Unknown Ideal

The view of Ayn Rand is that the foundations of capitalism are being battered by a flood of altruism, which is the cause of the modern world's collapse. She defends her philosophic views in this series of essays — she presents her stand on the persecution of big business, the causes of war, the default of conservatism, and the evils of altruism.

Sources

1 Ø | Women at Work: Spotlight on Statistics | U.S. Bureau of Labor Statistics | March 2011 | Accessed 20120922 @ http://www.bls.gov/spotlight/2011/women/.   2 Ø | Rosie the Riveter (Webpage) | History.com | ∞ | Accessed: 20121013 @ http://www.history.com/topics/rosie-the-riveter.   3 Ø | Series ID: LNU02000000 (Employment Level – All) from Labor Force Statistics from the Current Population Survey: Demographics: Women: Retrieve historical data series (Database) | U.S. Bureau of Labor Statistics << U.S. Department of Labor | Last Modified Date: August 28, 2012 | Data extracted on: September 22, 2012 @ http://www.bls.gov/cps/demographics.htm#women.   4 Ø | Series ID: LNU02000002 (Employment Level – Women) from Labor Force Statistics from the Current Population Survey: Demographics: Women: Retrieve historical data series (Database) | U.S. Bureau of Labor Statistics << U.S. Department of Labor | Last Modified Date: August 28, 2012 | Data extracted on: September 22, 2012 @ http://www.bls.gov/cps/demographics.htm#women.   5 Ø | Series ID: LNU01300002 (Labor Force Participation Rate - Women) from Labor Force Statistics from the Current Population Survey: Demographics: Women: Retrieve historical data series (Database) | U.S. Bureau of Labor Statistics << U.S. Department of Labor | Last Modified Date: August 28, 2012 | Data extracted on: September 22, 2012 @ http://www.bls.gov/cps/demographics.htm#women.   6 Ø | Table 6. Employment status of women by presence and age of youngest child, marital status, race, and Hispanic or Latino ethnicity, March 2010 << Women in the Labor Force: A Databook | U.S. Bureau of Labor Statistics << U.S. Department of Labor | Report 1034BLS | December 2011.   7 Ø | Women in the Labor Force in 2010 | Women's Bureau << U.S. Department of Labor | No date | Accessed: August 29, 2012 @ http://www.dol.gov/wb/factsheets/Qf-laborforce-10.htm.   8 Mataloni, Lisa and Key, Greg | Table 9. Relation of Gross Domestic Product, Gross National Product, and National Income << News Release: Gross Domestic Product: Second Quarter 2012 (Secend Estimate)/Corporate Profits: Second Quarter 2012 (Preliminary) | Bureau of Economic Analysis | BEA 12-35 | August 29, 2012 | Available @ http://www.bea.gov/newsreleases/national/gdp/2012/pdf/gdp2q12_2nd.pdf.   9 Ø | Table 11. Employed persons by detailed occupation and sex, 2010 annual averages (Corrected on February 9, 2012), Pages 28 – 38 << Women in the Labor Force: A Databook (2011 Edition) | U.S. Bureau of Labor Statistics << U.S. Department of Labor | Report 1034 | December 2011 | Website: http://www.bls.gov/cps/wlf-databook2011.htm, Available @ http://www.bls.gov/cps/wlf-databook-2011.pdf.   10 Ø | Quick Stats on Women Workers, 2010 | U.S. Department of Labor | ∞ | Accessed 20121015 @ http://www.dol.gov/wb/factsheets/QS-womenwork2010.htm#.UHyv7d0eiAl.   11 Ø | Table 2. Median usual weekly earnings of full-time wage and salary workers, by detailed occupation and sex, 2010 annual averages « Highlights of Women’s Earnings in 2010 | U.S. Bureau of Labor Statistics « U.S. Department of Labor | Report 1031 | July 2011 | Accessed: 20120923 @ http://www.bls.gov/cps/cpswom2010.pdf.   12 Ø | Quick Takes: Firsts for U.S. Women | Catalyst Inc. | Updated: June 7, 2012 | http://www.catalyst.org/publication/211/firsts-for-us-women.   13 Ø | Pyramids: Women CEOs of the Fortune 1000 | Catalyst Inc. | August 2012 | Accessed 201210 http://www.catalyst.org/publication/271/women-ceos-of-the-fortune-1000.   14 Ø | FORTUNE 500: Our annual ranking of America's largest corporations, 2010 | CNNMoney | May 3, 2010 | Accessed: 20121008 @ http://money.cnn.com/magazines/fortune/fortune500/2010/full_list/index.html.   15 Ø | Country Comparison :: GDP (purchasing power parity); The World Factbook, 2011 Edition | Central Intelligence Agency | 2011.   16 Pordeli, Hassan and Wynkoop, Peter | The Economic Impact of Women-Owned Businesses In the United States | The Center for Women’s Business Research | October 2009 | Available @ http://www.nwbc.gov/sites/default/files/economicimpactstu.pdf.   17 Mataloni, Lisa and Hodge, Andrew | Table 3. Gross Domestic Product and Related Measures: Level and Change From Preceding Period << News Release: Gross Domestic Product: Forth Quarter 2008 (Final)/Corporate Profits: Forth Quarter 2008 (Final) | Bureau of Economic Analysis | BEA 09-11 | March 26, 2009 | Available @ http://www.bea.gov/newsreleases/national/gdp/2009/pdf/gdp408f.pdf.   18 Goldin, Claudia and Katz, Lawrence F. | The Power of the Pill: Oral Contraceptives and Women’s Career and Marriage Decisions | Journal of Political Economy | Volume 110, Number 4, Pages 730–770 | August 2002 | Accessed: September 25, 2012 @ http://scholar.harvard.edu/cgoldin/files/the_power_of_the_pill_oral_contraceptives_and_ womens_career_and_marriage_decisions.pdf.  

[truthmonk]

The War on Women's Health , Part 4: Contraceptive Coverage Economics

<table width="100%" border="0" cellpadding="0" cellspacing="0" bgcolor="#ECECFF"><tr><td> <!-- Titles --> <h1>The War on Women's Health</h1> <h2>Part 4: Contraceptive Coverage Economics</h2> <h3>Penny wise and pound foolish</h3> <p>By Truthmonk<br /> November 2, 2012</p> <!-- 004 Preterm_Baby --> <div align="center">[youtube=http://www.youtube.com/watch?v=EIvFOnaK GsE&hl=en&fs=0&rel=0&w=480&h=295&autoplay=1]</div> <hr width="80%"> <!-- 12a The Economics of Premature Babies --> <h2>The Economics of Premature Babies</h2> <h3>Born too soon</h3> <p>The costs for a premature baby are very much greater than are the costs for a full term healthy newborn. A healthy full term newborn's cost is $3,325 while a late term is $13,621 (32-36 weeks) and an extreme preterm $190,467 (<28 weeks).^{[1, page 411]}</p> <!-- Graph --> <div align="center"><a href="http://truthmonkwowh.wordpress.com/average-annual-medical-care-costs/" target="_blank"><img src="http://truthmonk.files.wordpress.com/2012/10/table-4-1.png" alt="Average Annual Total Medical Care Costs" width="470" height="250" /></a><br /> <strong>Average Annual Total Medical Care Costs by Gestational Age and Year of Life, United States, 2005</strong></div> <p>Medical care costs are $16.9 billion (or about $33,000 per baby) and maternal delivery costs are another $1.9 billion (or about $3,800 per baby). Continuing costs include early intervention services costs at an estimated $611 million (or about $1,200 per baby), special education services costs at $1.1 billion (or roughly $2,200 per baby), and lost productivity costs of $5.7 billion (or about $11,000 per baby).^{[1, page 400]}</p> <div align="center"><a href="http://truthmonkwowh.wordpress.com/table-4-2-estimated-cost-of-preterm-birth-united-states/" target="_blank"><img src="http://truthmonk.files.wordpress.com/2012/10/table-4-2.png" alt="Table 4-2. Estimated Cost of Preterm Birth, United States" width="470" height="158" /></a><br /> <strong>Table 4-2. Estimated Cost of Preterm Birth, United States, Aggregate and Cost per Case</strong></div> <p>The medical, special education services, lost productivity costs are from only four developmental disabilities (DDs) — cerebral palsy, mental retardation, vision impairment, and hearing loss.</p> <p>“The annual societal economic burden associated with preterm birth in the United States was at least $26.2 billion in 2005, or $51,600 per infant born preterm.”^{[1, page 398]}</p> <p>The estimate doesn't includes costs for lost productivity, medical, or special educational services outside of the four DDs. Nor does it include any caretaker costs. Further only maternal medical costs associated with delivery are included. Therefore the costs should be considered a floor, or <em>minimum</em>.</p> <hr width="80%"> <!-- 12b Contraceptive Coverage Economics --> <h2>Contraceptive Coverage Economics</h2> <h3>Win Win — Save money and prevent unplanned pregnancy</h3> <p>“Debates over improving insurance coverage of contraceptives invariably touch on the issue of cost. Research and experience now suggest that contraceptive coverage does not raise insurance premiums and that employers providing such coverage can, in fact, save money by avoiding costs associated with unintended pregnancy.”²</p> <p>Multiple studies from 1987 to 2010 have found contraceptive coverage does not cost more but saves money both for public Medicaid and private insurers.</p> <div align="center"><a href="http://truthmonkwowh.wordpress.com/cost-savings-of-contraception/" target="_blank"><img src="http://truthmonk.files.wordpress.com/2012/06/06_cost_savings.png" alt="Cost Savings of Contraception Graph" width="470" height="484" /></a><br /> <strong>Cost Savings of Contraception</strong></div> <p>Results varied from a National Business Group on Health study that had results of $0.16 for the private insurers to a Business and Health study finding of $28.57 also for private insurers. Public Medicaid savings were about $3 to $4.2.</p> <p>Business and Health in a 1993 special report for employers, found the average costs associated with the birth of a healthy baby was $10,000 (prenatal care, delivery and newborn care for one year following birth). It also reported that the cost for oral contraceptives was $300–350 per year. Avoiding the cost for unintended pregnancies was a major factor in the savings for an insurer.</p> <p>The cost looked at in the studies are only the easily determined direct cost “associated with normal live births (vaginal and cesarean), abortions, miscarriages and ectopic pregnancies.”² There is also the saving of indirect costs which “include wages and benefits associated with employee absences, maternity leave, and pregnancy-related sick leave, as well as costs associated with reduced productivity during an employee's pregnancy and with replacing employees who do not return to work after a pregnancy.”</p> <p>Business employers not covering contraceptives in their employee health plans pay at least an additional 15 – 17% more than if they had coverage.</p> <p>Providing contraceptive coverage does not increase the bill an employer is required to pay. And may in fact reduce the bill.</p> <hr width="80%"> <!-- 12c High Costs of Birth Control --> <h2>High Costs of Birth Control</h2> <h3>This isn't any place for sticker shock</h3> <p>Center for American Progress stated in a February 15, 2012  briefing³ that:</p> <table width="100%" border="0" cellspacing="0" cellpadding="0">     <tr>         <td width="75"> </td>         <td><p>“Many people seem to think birth control is affordable, but high costs are one of the primary barriers to contraceptive access. It is for this reason that the Obama administration recently followed the recommendation of the Institute of Medicine to ensure that birth control will be covered as a preventive service with no cost-sharing beginning August 1, 2012.</p> <p>“Although three-quarters of American women of childbearing age have private insurance, they still have had to pay a significant portion of contraceptive costs on their own.</p> <p>“High costs have forced many women to stop or delay using their preferred method, while others have chosen to depend on less effective methods that are the most affordable.</p> <p>“Women are struggling to pay for birth control at a time when they need it most.”</p> </td>         <td width="75"> </td>     </tr> </table>  <br /> <div align="center"><a href="http://truthmonkwowh.wordpress.com/high-cost-of-birth-control/" target="_blank"><img src="http://truthmonk.files.wordpress.com/2012/11/table-4-3.png" alt="Table 4-3. The High Cost of Birth Control" width="470" height="274" /></a><br /> <strong>Table 4-3. The High Cost of Birth Control</strong></div> <p>While many people seem to think birth control is affordable, high costs have forced many women to stop or delay using their preferred method.</p> <p>Ø | The High Costs of Birth Control, It’s Not As Affordable As You Think | Center for American Progress | February 15, 2012 | http://www.americanprogress.org/wp-content/uploads/issues/2012/02/pdf/BC_costs.pdf</p> <hr width="80%"> <!-- 12d    The missing health insurance industry outrage --> <h2>The missing health insurance industry outrage</h2> <h3>Really. It's no biggie</h3> <table width="100%" border="0" cellspacing="0" cellpadding="0">     <tr>         <td valign="top"><div align="left"><a href="http://truthmonkwowh.wordpress.com/robert-zirkelbach/" target="_blank"><img src="http://truthmonk.files.wordpress.com/2012/10/robert-zirkelbach.png" alt="Robert Zirkelbach" width="201" height="230" /></a><br /> <strong>Press Secretary Robert Zirkelbach</strong></div> </td>         <td valign="top"><p>Press Secretary Robert Zirkelbach for America's Health Insurance Plans, the trade association for health insurers, while expressing apprehension about the precedent the contraceptive coverage rule may set, acknowledged “Health plans have long offered contraceptive coverage to employers as part of comprehensive, preventive benefits that aim to improve patient health and reduce health care cost growth (emphasis added).”⁴</p> </td>     </tr> </table> <hr width="80%"> <!-- 12e    Child raising costs --> <h2>Child rearing costs</h2> <h3>Penny wise and dollar foolish</h3> <p>The USDA stated in their annual report on Expenditures on Children by Families found that a middle-income family with a child born in 2011 will spend about $295,560 for food, shelter, and other necessities to raise that child.⁵</p> <div align="center"><a href="http://truthmonkwowh.wordpress.com/expenditure-shares-on-a-child/" target="_blank"><img src="http://truthmonk.files.wordpress.com/2012/10/12-expenditure-shares-on-a-child.png" alt="Expenditures on children" width="470" height="475" /></a><br /> <strong>Expenditures on children</strong></div> <p>The conservative Republicans in their fantasy realm believe low income families will miraculously be able to have the money for these children. </p> <p>How can conservative Republicans make any type of argument for bringing in more children into the world when there are already over 16 million children in poverty (21.9 percent)⁶ and 7.6 million (9.7 percent) without health insurance.⁷</p> <p>They aren't willing to take care of existing children. They certainly would not take care of any additional children. Only delusional, incoherent, drivel will come out of their mouths on this issue.</p> <p>In addition this doesn’t even count the costs associated with the use of the natural and societal resources, use of governmental services, overtaxing the existing public and private infrastructure, stressing the social cohesion, and increasing intangible demands on society such as traffic congestion and additional pollution.</p> <hr width="80%"> <!-- 12f Preventing abortions by funding contraceptive services --> <h2>Preventing abortions by funding contraceptive services</h2> <h3>Win Win — Save money and prevent abortions</h3> <p>The IOM report⁸ on page 105 asserts “as the rate of contraceptive use by unmarried women increased in the United States between 1982 and 2002, rates of unintended pregnancy and abortion for unmarried women also declined.”</p> <p>The report notes that “increased rates of contraceptive use by adolescents from the early 1990s to the early 2000s was associated with a decline in teen pregnancies” in several studies and any “periodic increases in the teen pregnancy rate are associated with lower rates of contraceptive use” as published by Santelli and Melnikas in 2010.</p> <p>National publicly funded family planning services are responsible for preventing almost two million unintended pregnancies in 2006.⁹ Nearly a million abortions, including natural and induced, are prevented each year by giving women the contraceptive services that they need. </p> <p>Two-thirds of U.S. women who practice contraception consistently and correctly account for only 5% of unintended pregnancies.⁹</p> <p>A positive side effect is the almost $7.5 billion is saved each year with family planning and contraceptive services by not needing to fund the $10,000² average cost associated with the birth of a healthy baby.</p> <div align="center"><a href="http://truthmonkwowh.wordpress.com/unintended-pregnancies/" target="_blank"><img src="http://truthmonk.files.wordpress.com/2012/10/12-unintended-pregnancies.png" alt="Unintended Pregnancies" width="470" height="481" /></a><br /> <strong>Unintended Pregnancies</strong></div> <p>ObamaCare would prevent 320,000 abortions from taking place. Many liberals believe that preventing 800,000 unintended pregnancies is good but not those on the right.¹⁰</p> <p>The IOM said in their report,⁸ “In a study of the cost-effectiveness of specific contraceptive methods, all contraceptive methods were found to be more cost-effective than no method, and the most cost-effective methods were long-acting contraceptives that do not rely on user compliance. …  Cost barriers to use of the most effective contraceptive methods are important because long-acting, reversible contraceptive methods and sterilization have high up-front costs.”</p> <p>They concluded, “that contraception is highly cost-effective” in preventing pregnancies.”</p>  <br /> <p><strong>Next: The War on Women's Health, Part 5 - Women's Economics</strong></p> <p><strong>Previous: </strong><a href="http://truthmonk.wordpress.com/2012/10/30/the-war-on-womens-health-part-3-maternal-fetal-medicine/" target="_self"><strong>The War on Women's Health, Part 3: Maternal Fetal Medicine</strong></a></p> <hr width="80%"><!-- Books -->     <table width="470" border="0" align="center" cellpadding="0" cellspacing="5"><!-- Book table -->         <tr>             <td valign="top"> <table width="230" border="1" cellspacing="0" cellpadding="0">     <tr>         <td width="230" align="center" valign="top">             <table width="220" border="0" cellspacing="0" cellpadding="1">                 <tr>                     <td align="center" valign="top">                         <font size="-1"><a href="http://www.amazon.com/gp/product/0553386301/ref=as_li_ss_il?ie=UTF8&camp=1789&creative=390957&creativeASIN=0553386301&linkCode=as2&tag=glas-20"><img border="0" src="http://ws.assoc-amazon.com/widgets/q?_encoding=UTF8&ASIN=0553386301&Format=_SL160_&ID=AsinImage&MarketPlace=US&ServiceVersion=20070822&WS=1&tag=glas-20"><br /> Caring for Your Baby and Young Child, 5th Edition: Birth to Age 5 (American Academy Of Pediatrics)<br /> <img src="https://images-na.ssl-images-amazon.com/images/G/01/buttons/buy-from-tan.gif" width="90" height="28" border="0"></a><img src="http://www.assoc-amazon.com/e/ir?t=glas-20&l=as2&o=1&a=0553386301" width="1" height="1" border="0" alt="" style="border:none!important;margin:0!important;" /></font>                     </td>                 </tr>                 <tr>                     <td valign="top">                         <font size="-1">                             <!-- Description --> <p>From the most respected organization on child health comes this essential resource for all parents who want to provide the very best care for their children. Here is the one guide pediatricians routinely recommend and parents can safely trust, covering everything from preparing for childbirth to toilet training to nurturing your child’s self-esteem. Whether it’s resolving common childhood health problems or detailed instructions for coping with emergency medical situations, Caring for Your Baby and Young Child has everything you need.</p>                         </font>                     </td>                 </tr>             </table>         </td>     </tr> </table>             </td>             <td width="230">                              </td>         </tr>     </table><!-- End Book table --> </td></tr></table><!-- End main post background color table --> <!-- Sources --> <hr width="80%"> <h2>Sources</h2> <table width="470" border="2" cellspacing="0" cellpadding="0" bgcolor="#FFFFFF"><tr><td><!-- Sources border --> <table width="100%" border="0" cellspacing="0" cellpadding="1"><!-- Sources data -->     <tr>         <td width="35" align="right" valign="top" nowrap="nowrap">¹</td>         <td align="left" valign="top">Behrman, Richard E. and Butler, Adrienne Stith (Editors) | Chapter 12: Societal Costs of Preterm Birth ⊂ Preterm Birth Causes, Consequences, and Prevention | The National Academies Press (Washington, DC, USA) | 2007.<br>  </td>     </tr>     <tr>         <td width="35" align="right" valign="top" nowrap="nowrap">²</td>         <td align="left" valign="top">Dailard, Cynthia | Special Analysis: The Cost of Contraceptive Insurance Coverage | The Guttmacher Report on Public Policy | Guttmacher Institute, New York, NY, USA | Volume 6, Number 1 | March 2003.<br>  </td>     </tr>     <tr>         <td width="35" align="right" valign="top" nowrap="nowrap">³</td>         <td align="left" valign="top">Ø | The High Costs of Birth Control, It’s Not As Affordable As You Think | Center for American Progress | February 15, 2012 | http://www.americanprogress.org/wp-content/uploads/issues/2012/02/pdf/BC_costs.pdf<br>  </td>     </tr>     <tr>         <td width="35" align="right" valign="top" nowrap="nowrap">⁴</td>         <td align="left" valign="top">Zirkelbach, Robert | Statement on contraceptive coverage | America's Health Insurance Plans | February 10, 2012 | eptember 18, 2012@ http://www.cbsnews.com/8301-505143_162-57374921/insurers-respond-cautiously-to-contraceptive-plan/<br>  </td>     </tr>     <tr>         <td width="35" align="right" valign="top" nowrap="nowrap">⁵</td>         <td align="left" valign="top">USDA Office of Communications | A Child Born in 2011 Will Cost $234,900 to Raise According to USDA Report, Release No. 0197.12 | U.S. Department of Agriculture | June 14, 2012 | Accessed September 18, 2012@ http://www.cnpp.usda.gov/Publications/CRC/2011CRCPressRelease.pdf.<br>  </td>     </tr>     <tr>         <td width="35" align="right" valign="top" nowrap="nowrap">⁶</td>         <td align="left" valign="top">Ø | Poverty: Income, Poverty and Health Insurance in the United States: 2011 - Highlights | Social, Economic, and Housing Statistics Division ⊂ U.S. Census Bureau | Last Revised: September 12, 2012 | Accessed September 18, 2012@ http://www.census.gov/hhes/www/poverty/data/incpovhlth/2011/highlights.html.<br>  </td>     </tr>     <tr>         <td width="35" align="right" valign="top" nowrap="nowrap">⁷</td>         <td align="left" valign="top">Ø | Newsroom: Income, Poverty and Health Insurance Coverage in the United States: 2011 | Public Information Office ⊂ U.S. Census Bureau | Last Revised: September 13, 2012 | Accessed September 18, 2012@ http://www.census.gov/newsroom/releases/archives/income_wealth/cb12-172.html.<br>  </td>     </tr>     <tr>         <td width="35" align="right" valign="top" nowrap="nowrap">⁸</td>         <td align="left" valign="top">Committee on Preventive Services for Women | Clinical Preventive Services for Women: Closing the Gaps | IOM (Institute of Medicine), The National Academies Press; Washington, DC | 2011.<br>  </td>     </tr>     <tr>         <td width="35" align="right" valign="top" nowrap="nowrap">⁹</td>         <td align="left" valign="top">Ø | In Brief: Facts on Unintended Pregnancy in the United States | Guttmacher Institute, New York, NY USA | January 2012 | Available @ http://www.guttmacher.org/pubs/FB-Unintended-Pregnancy-US.pdf.<br>  </td>     </tr>     <tr>         <td width="35" align="right" valign="top" nowrap="nowrap">¹⁰</td>         <td align="left" valign="top">Gold, Rachel Benson; Sonfield, Adam; Richards, Cory L.; Frost, Jennifer J. | Next Steps for America’s Family Planning Program: Leveraging the Potential of Medicaid and Title X in an Evolving Health Care System | Guttmacher Institute, New York, NY, USA | 2009.<br>  </td>     </tr> </table><!-- End sources data --> </td></tr></table><!-- End sources border -->

[truthmonk]

The War on Women’s Health Part 3: Maternal Fetal Medicine

The War on Women's Health

Part 3: Maternal Fetal Medicine

Planning for knowns while anticipating the unknowns.

By Truthmonk October 30, 2012

Contraindications for pregnancy

Why unplanned pregnancies are bad

Introduction

Women who are aware that a pregnancy would be high-risk may decide to delay getting pregnant. A high-risk pregnancy is one where there are potential complications that could affect the mother, baby, or both. Good medical practice requires high-risk pregnancies to be managed by a specialist to help ensure the best outcome for the mother and baby.

Risk come from a multitude of sources. Some conditions that can make a pregnancy high-risk include: the age of the mother,1 chronic diseases like cancer,2 – 13 infections and STDs,14 – 17, 21, 30 mental health medication,18, 31, 32 and recreational drug use including alcohol and tobacco,19, 20, 33environmentally imposed risks,22 – 24 inheritable genetic disorders.25 – 29

Contraindications for Pregnancy Click to open larger version with complications.

Contraindicated medical conditions that primarily affect (by medical dysfunction class):Age related risks 1 Older mothers   Chronic disease risks 2 Asthma 3 Thyroid Disease - hyperthyroidism (GravesÕ disease) 4 Thyroid Disease - hypothyroidism 5 Cancer 6 Epilepsy 7 Hypertension (High blood pressure) 8 Diabetes 9 Heart disease 10 Obesity 11 Anemia 12 Lupus 13 Kidney Disease21 HIV/AIDS

Infection risks 14 Congenital Rubella Syndrome 15 Varicella (chickenpox) 16 Sexually Transmitted Diseases 17 General infections 30 Viral hepatitis Mental health risks 18 Schizophrenia 31 Severe depression 32 Bipolar Disorder Recreational drug risks 19 Illicit drug use 20 Smoking 33 Alcohol (Fetal alcohol syndrome (FAS)) Environmental risks - Chemical Exposure   22 Agrichemicals 23 Pesticides Environmental risks - Radiation Exposure   24 Radiation Exposure Genetic disorder risks   25 Down syndrome 26 Cystic fibrosis 27 TayÐSachs 28 Sickle-cell anaemia 29 ThalassemiaFor the contraindicated medical conditions's citations in the inforgraph, see the matching number in the sources.

Teratogenic Effects34

Many developing fetal systems are vulnerable to outside influences called teratogens, especially during the first 4 to 10 weeks after conception. The fetal neurological system can develop neural tube defects, spina bifida, and mental retardation. The cardiovascular system is susceptible to birth defects such as truncus arteriosus, atrial septal defects, and ventricular septal defects. The skeleton can develop with musculoskeletal anomalies and clubfoot. Myasthenia gravis and severe combined immune deficiency affect the immune system. Female fetuses can suffer from the masculinization of their external genitalia. Other fetus components that are susceptible to birth defects include: ears, eyes, teeth, upper lip, palate, upper & lower limbs, kidneys, and lungs.

Teratogens also produce effects on the fetus indirectly through the mother. Maternal teratogens effects include creating susceptibility to premature birth, intrauterine growth retardation (small for gestational age infants), and placental development interruptions.

Pregnancy35, 36

A woman may not be aware that she is pregnant.

The early signs of pregnancy are variable between women and even from pregnancy to pregnancy in the same woman. Adding to the confusion is that the early symptoms of pregnancy also resemble symptoms before and during menstruation. Even more confusing is some women have periodic bleeding during pregnancy mimicking their menstrual period.

While some women are so aware of their bodies, they seem to know from the start when they become pregnant, most don't realize they are pregnant until they miss their menstrual period.

A woman's menstrual period isn't a sure fire way to determine if she is pregnant. For some women, an irregular period will make it difficult to recognized if an atypical event such as a pregnancy has occurred.

Irregular periods often occur during the first few years after menarche just when women start to explore their sexuality. Irregular periods usually occur just before memopause. Menstrual irregularities can be caused by diseases such as irritable bowel syndrome, tuberculosis, liver disease, and diabetes.

Even a missed menstrual period doesn't necessary mean a pregnancy. Other causes for a missed period include: excessive weight loss or gain, eating disorders such as anorexia or bulimia, increased exercise, emotional stress, illness, travel, pelvic organ problems such as impeforate hymen, and polycrystic ovary syndrome, or Asherman's syndrome. This is by no means an complete list.

A pregnancy test in the only reliably way to know for certain if a woman is pregnant.

This pregnancy test on the left shows a negative result because the results window has no pink line. The pink line in the control window shows that the test is working. The right pregnancy test shows a positive result because there is a pink line in the results window.

Photo from Photo from US Department of Health and Human Services

The only way a woman can avoid the birth defect dangers caused by teratogens is to know when she is pregnant. And the only way for a sexually active, fecund, non-pregnant or postpartum abstinence woman to be certain of not becoming pregnant is through the use of adequate family planning and modern contraceptives.

Only then can a woman take into account their personal and family situation and make appropriate medical decisions that are best for her and her baby's health.

Other overlooked benefits of oral contraceptive pills37

According to the American College of Obstetrics and Gynecology (ACOG), oral contraceptive pills (OCPs) help relieve or reduce the symptoms of dysmenorrhea (menstrual pain), normalization of irregular periods, acne treatment, treatment of endometriosis caused pelvic pain, prevention of menstrual-related migraines, menorrhagia (excessive menstrual bleeding), bleeding due to uterine fibroids, hirsutism (excess hair growth), suppression of menstruation.

National data from the 2006–2008 National Survey of Family Growth shows 58% of women on the pill use it for some type of noncontraceptive reason. Noncontraceptive reasons are the only reason for 14% of the women on the pill. In addition more than one-third of the women, which use the pill for noncontraceptive reasons, have multiple non-birth control health benefit reasons.

Life Changes

Or pregnancy is for life

During a woman's pregnancy, some cells from the fetus traverse through the placenta into the maternal circulation (fetal microchimerism (FMc)) and some cells from the mother travel to the fetus (maternal microchimerism(MMc)).38

  A fraction of these immigrant cells will survive in their new host. This intermingling of foreign DNA or cells is called microchimerism (Mc).39 

“Fetal cells have been detected in the human maternal circulation as early as 4 weeks and 5 days post-conception” to “as long as 27 years after the birth of a male.”40

This exchange of cells is expected since the placenta rather than being an impassable gate, must act like a selective porous filter to allow the developing fetus to obtain nourishment etc. These immigrant cells “persist in their new host, circulating in the blood and even taking up residence in various tissues.”41

[youtube=http://www.youtube.com/watch?v=g4A_mG1ABtA&hl=en&fs=0&rel=0&w=480&h=295&autoplay=1]

 During pregnancy, some cells from the fetus traverse through the placenta into the maternal circulation (FMc) and some cells from the mother travel to the fetus (MMc). A fraction of these immigrant cells will survive in their new host. This is called microchimerism. 

The immigrant maternal cells in the fetus can persist well into adult life.42 Another probable source of Mc in the fetus is from an older sibling or previous pregnancy of the mother.43

This means that every woman harbors foreign DNA derived from the fetuses of all her pregnancies and all fetuses harbor foreign DNA derived from their mothers and the fetuses of all her previous pregnancies. They may harbor this DNA for the remainder of their lives.

Various studies have implicated microchimerism in diseases such as systemic sclerosis (SSc), primary biliary cirrhosis (PBC), Sjögren's syndrome, polymorphic eruption of pregnancy, myositis, and thyroid disease.39

Eighty percent of people with autoimmune diseases are women.44 Several autoimmune diseases affect women in their postpartum years. Fetus-maternal microchimerism is one hypotheses proposed to explain the gender difference.

Hashimoto’s thyroiditis is an autoimmune disease believed to be the most common cause of primary hypothyroidism. It is characterized by a range of symptoms including weight gain, depression, fatigue, mania, memory loss, panic attacks, and hair loss. Sjogren’s syndrome is an autoimmune disease. It has symptoms such as dry mouth and dry eyes. Other autoimmune diseases where fetal DNA was detected, sometimes decades after pregnancy, include progressive systemic sclerosis (PSS) and systemic lupus erythematosus.

Other diseases fetus-maternal microchimerism has been implicated in include steatosis, hepatitis C, primary biliary cirrhosis, and cardiovascular disease.43 Its role in several cancers has been the subject of investigation including thyroid cancer, cervical cancer, lung cancer and melanoma.

Its role in degenerative diseases such as Alzheimer’s disease is intriguing. It has been suggested that an abnormal accumulation of fetal origin microchimerism is responsible for the increase risk with increase number of pregnancies for Alzheimer’s disease and the five fold increased risk in mothers who gave birth to a child with down syndrome.

Fetus-maternal microchimerism derived cells have been found in bone marrow, thyroid, lungs, lymph node, skin, kidney, liver, heart, intestine, gallbladder, cervix, brain, blood, spleen, pancreas, and other tissues.

Yet there is some evidence that fetal-derived cells may provide some protection against breast cancer.45

Mc caused disease isn't a one-way street. Chronic inflammatory disease in offspring has been linked to MMc.46 In neonatal lupus syndrome-congenital heart block (NLS-CHB), an acquired autoimmune disease, the hearts of patients have been found containing maternal myocardial cells.47 In juvenile dermatomyositis (JDM), a multisystem autoimmune disease, the presence of maternally derived chimeric cells was found and data indicates they have a direct role in the JDM disease process.48

 Various types of microchimerisms affect humans. The common mother-Mc and fetus-Mc and the organs/presumed cell types affected by them are shown. 

The foreign DNA derived from siblings from previous pregnancies that a child harbors could be to its benefit or detriment.43

The research into FMc and MMc, is still in its infancy. The jury is still out as to the relationship that FMc and MMc may play in disease. What can be said is pregnancies make permanent changes to a women's body. Some of these changes are on a large scale. Some, like FMc and MMc, are small scale.

Next: The War on Women's Health, Part 4 - Contraceptive Coverage Economics

Previous: The War on Women's Health, Part 2 - Family Planning

Mayo Clinic Guide to a Healthy Pregnancy

Women looking for authoritative, accurate information from a reputable source will appreciate this pregnancy book from the world-class Mayo Clinic. Features include week-by-week updates on baby’s growth and month-by-month changes for mom, a 40-week pregnancy calendar, a symptoms guide, and a review of important pregnancy decisions. In this illustrated book you’ll also receive advice on how to get pregnant, meal planning, exercise, medication use and parenthood. Plus, you’ll find answers to difficult or embarrassing questions. Mayo Clinic Guide to a Healthy Pregnancy is an essential pregnancy resource for parents-to-be.

Pregnancy, Childbirth, and the Newborn (4th Edition): The Complete Guide

This comprehensive, authoritative “bible” provides expectant couples with abundant, valuable, research-based information about pregnancy, labor, birth, the postpartum period, and newborn care. The book has been redesigned so it’s more accessible and reader-friendly, with more photos, illustrations, and boxed features that allow for important information to be highlighted. Also included in the new design are fun and informative sidebars, such as “Fact or Fiction?” in which the authors present common misinformation and the facts. New to this edition is a website with additional maternity care information as well as helpful forms and worksheets.

Sources

Numbers 1 – 33 are also for the contraindicated medical conditions’s cited in the inforgraph.   1 ø | Trying to get pregnant: Pregnancy after 35 (Webpage) | March of Dimes Foundation | May 2009 | Accessed February 27, 2012 @ http://www.marchofdimes.com/pregnancy/trying_after35.html.   2 ø | NAEPP Working Group Report on Managing Asthma During Pregnancy: Recommendations for Pharmacologic Treatment, Update 2004 | U.S. Department of Health and Human Services; National Institutes of Health; National Heart, Lung, and Blood Institute: Bethesda, MD | NIH Publication No. 05-5236 | March 2005 | Available @ http://www.nhlbi.nih.gov/health/prof/lung/asthma/astpreg/astpreg_full.pdf | Accessed February 27, 2012.   3,4 ø | Thyroid Disease and Pregnancy | American Thyroid Association | 2005 | Available @ http://www.thyroid.org/patients/brochures/Thyroid_Dis_Pregnancy_broch.pdf | Accessed February 27, 2012.   5 ø | Pregnancy and Cancer (Webpage) | American Society of Clinical Oncology | May 2011 | Accessed February 27, 2012 @ http://www.cancer.net/patient/Coping/Emotional+and+Physical+Matters/ Sexual+and+Reproductive+Health/Pregnancy+and+Cancer.   6 Staff | Epilepsy and pregnancy: What you need to know (Webpage) | Mayo Clinic | July 30, 2011 | Accessed February 27, 2012 @ http://www.mayoclinic.com/health/pregnancy/PR00123.   7 ø | High Blood Pressure in Pregnancy (Webpage) | U.S. Department of Health & Human Services; National Institutes of Health; National Heart Lung and Blood Institute | Not dated | Accessed February 27, 2012 @ http://www.nhlbi.nih.gov/health/public/heart/hbp/hbp_preg.htm.   8 ø | Type 1 or Type 2 Diabetes and Pregnancy, Problems of Diabetes in Pregnancy (Webpage) | Centers for Disease Control and Prevention | Updated: June 7, 2010 | Accessed February 27, 2012 @ http://www.cdc.gov/NCBDDD/pregnancy_gateway/diabetes-types.html.   9 ø | Impact on Females | American Heart Association (Webpage) | Updated: Mon, 24 Jan 2011 | Accessed February 27, 2012 @ http://www.heart.org/HEARTORG/Conditions/CongenitalHeartDefects/ TheImpactofCongenitalHeartDefects/Impact-on-Females_UCM_ 307113_Article.jsp#.T1gBjt0SCAk.   10 Rasmussen, Sonja A | Human Teratogens | Centers for Disease Control and Prevention | June 26, 2011 | Available @ http://www.teratology.org/pubs/2011_human_teratogens_update.pdf | Accessed February 27, 2012.   11 Keller, Scott | Anemia in Pregnancy (Webpage) | WebMD | Reviewed: January 08, 2012 | Accessed February 27, 2012 @ http://www.webmd.com/baby/anemia-in-pregnancy?page=2.   12 ø | Pregnancy and Lupus (Webpage) | Lupus Foundation of America | No date | Accessed March 9, 2012 @ http://www.lupus.org/webmodules/webarticlesnet/templates/new_donate.aspx?articleid=314&zoneid=6.   13 Krane, N Kevin; Feinfeld, Donald A; Talavera, Francisco; Legro, Richard S; Batuman, Vecihi | Renal Disease and Pregnancy, Pregnancy and Underlying Renal Disease (Webpage) | Medscape Reference | Updated: Mar 29, 2011 | Accessed February 27, 2012 @ http://emedicine.medscape.com/article/246123-overview#aw2aab6c15.   14 ø | Chapter 19 Rubella; Epidemiology and Prevention of Vaccine-Preventable Diseases (The Pink Book), 12th Edition | Centers for Disease Control and Prevention, Atlanta, GA | Updated: April 15, 2011 | Accessed February 27, 2012 @ http://www.cdc.gov/vaccines/pubs/pinkbook/rubella.html.   15 ø | Vaccines and Immunizations, Vaccines and Preventable Diseases: Varicella Vaccine - Q & As about Pregnancy | Centers for Disease Control and Prevention | Reviewed on June 1, 2009 | Accessed February 27, 2012 @ http://www.cdc.gov/vaccines/vpd-vac/varicella/vac-faqs-clinic-preg.htm.   16 ø | Sexually Transmitted Diseases (STDs), STDs & Pregnancy - CDC Fact Sheet | Centers for Disease Control and Prevention | Updated: February 27, 2012 | Accessed February 27, 2012 @ http://www.cdc.gov/std/pregnancy/STDFact-Pregnancy.htm.   17 ø | Pregnant Women Need a Flu Shot! (Webpage) | Centers for Disease Control and Prevention | Updated: February 27, 2012 | Accessed March 10, 2012 @ http://www.cdc.gov/Features/PregnancyAndFlu/.   18 Nilsson, E; Lichtenstein, P; Cnattingius, S; Murray, RM; Hultman, CM | Women with schizophrenia: pregnancy outcome and infant death among their offspring | Schizophrenia Research | Volume 58, Number 2-3, Pages 221 – 229 | December 1, 2002.   18 Jaffe, D.J., | Pregnancy pointers for women with Schizophrenia | Schizophrenia.com | No date | Accessed February 27, 2012 @ http://www.schizophrenia.com/schizoph/NBDpreg.html.   19 Nihira, Mikio A. | Health & Pregnancy: Drug Use and Pregnancy (Webpage) | WebMD | Reviewed: December 20, 2009 | Accessed February 27, 2012 @ http://www.webmd.com/baby/drug-use-and-pregnancy?page=2.   20 ø | Smoking during pregnancy (Webpage) | March of Dimes Foundation | April 2010 | Accessed February 27, 2012 @ http://www.marchofdimes.com/pregnancy/alcohol_smoking.html   21 ø | Pregnancy and Childbirth (Webpage) | Centers for Disease Control and Prevention | Reviewed: October 10, 2007 | Accessed February 27, 2012 @ http://www.cdc.gov/hiv/topics/perinatal/index.htm   22 Winchester, Paul D; Huskins, Jordan; Ying, Jun | Agrichemicals in surface water and birth defects in the United States | Acta Paediatrica | Volume 98, Number 4, Pages 664–669 | April 2009.   23 Sanborn, M.; Kerr, K.J.; Sanin, L.H.; Cole, D.C.; Bassil, K.L.; Vakil, C. | Non-cancer health effects of pesticides, Systematic review and implications for family doctors | Canadian Family Physician | Volume 53, Number 10, Pages 1712 – 1720 | October 2007.   24 ø | Emergency Preparedness and Response, Radiation and Pregnancy: A Fact Sheet for the Public | Centers for Disease Control and Prevention | Reviewed March 29, 2011 Accessed February 27, 2012 @ http://www.bt.cdc.gov/radiation/prenatal.asp.   25-29 ø | Frequently Asked Questions About Genetic Disorders (Webpage) | U. S. Department of Health and Human Services; National Institutes of Health; The National Human Genome Research Institute | Updated: February 27, 2012 | Accessed February 27, 2012 @ http://www.genome.gov/19016930.   30 ø | Protect Your Baby for Life, When a Pregnant Woman Has Hepatitis B | Centers for Disease Control and Prevention | Publication No. 22-0432 | October 2010 | Accessed February 27, 2012 @ http://www.cdc.gov/hepatitis/HBV/PDFs/HepBPerinatal-ProtectWhenPregnant.pdf.   31 Staff | Antidepressants: Safe during pregnancy? (Webpage) | Mayo Clinic | January 10, 2012 | Accessed February 27, 2012 @ http://www.mayoclinic.com/health/antidepressants/DN00007.   32 Chang, Louise | Bipolar Disorder in Pregnancy | WebMD | Reviewed: July 13, 2010 | Accessed February 27, 2012 @ http://www.webmd.com/bipolar-disorder/guide/bipolar-disorder-in-pregnancy.   33 ø | Alcohol Use in Pregnancy (Webpage) | Centers for Disease Control and Prevention | Updated: October 6, 2010 | Accessed February 27, 2012 @ http://www.cdc.gov/ncbddd/fasd/alcohol-use.html.   34 Professordoktor | Chart of critical periods of humandevelopment (Weblog) | SciTechLab |20120612 | Accessed 20120618 @ http://scitechlab.wordpress.com/2012/06/12/chart-of-critical-periods-of-human-development/.   35 Chang, Louise (Reviewer) | Health & Pregnancy, Pregnancy Symptoms (Online) | WebMD | Reviewed on August 09, 2010 | Accessed April 29, 2012 @ http://www.webmd.com/baby/guide/pregnancy-am-i-pregnant.   36 ø | Women's Health, Missed or Irregular Periods - Topic Overview (Online) | WebMD | Updated on /2, 09 1 | Accessed April 29, 2012 @ http://women.webmd.com/tc/missed-or-irregular-periods-topic-overview.   37 Jones, Rachel K. | Beyond Birth Control: The Overlooked Benefits Of Oral Contraceptive Pills | Guttmacher Institute, New York, NY, USA | November 2011.   38 Pritchard, Stephanie; Wick, Heather C.; Slonim, Donna K.; Johnson, Kirby L.; and Bianchi, Diana W | Comprehensive Analysis of Genes Expressed by Rare Microchimeric Fetal Cells in the Maternal Mouse Lung (Online) | Biology of Reproduction Papers in Press | 20120606 | Accessed 20120618 @ http://www.biolreprod.org/content/early/2012/06/01/biolreprod.112.101147. full.pdf+html.   39 Nelson, J Lee | Microchimerism in human health and disease | Autoimmunity | Volume 36, Number 1, Page 5-9 | February 2003. http://informahealthcare.com/doi/abs/10.1080/0891693031000067304   40 Bianchi, D W; Zickwolf, G K; Weil, G J; Sylvester, S; and DeMaria, M A | Male fetal progenitor cells persist in maternal blood for as long as 27 years postpartum | Proceedings of the National Academy of Sciences of the United States America | Volume 93, Number 2, Page 705 – 708 | 19960123.   41 Nelson, J. Lee | Your Cells Are My Cells | Scientific American | February 2008 | 20080117 | http://www.scientificamerican.com/article.cfm?id=your-cells-are-my-cells.   42 Nelson, J. Lee | Microchimerism (webpage) | No date | Accessed 20120619 @ http://www.microchimerism.org/.   43 Nelson, J. Lee | The otherness of self: microchimerism in health and disease | Trends in Immunology | TREIMM-939, Pages 7 (Not in print) | 20120523 | Accessed 20120622 @ http://www.ncbi.nlm.nih.gov/pubmed/22609148.   44 Knippen, Maureen A. | Microchimerism: Sharing Genes in Illness and in Health | ISRN Nursing | Volume 2011, ID 893819, Pages 4 | 20110523 | Accessed 20120622 @ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3169192/.   45 Gadi, Vijayakrishna K.; Malone, Kathleen E.; Guthrie, Katherine A.; Porter, Peggy L. | Nelson, J. Lee | Case-Control Study of Fetal Microchimerism and Breast Cancer | PLoS ONE | Volume 3, Number 3, e1706 | 20080305 | Accessed 20120619 @ http://www.plosone.org/article/info:doi%2F10.1371%2Fjournal.pone.0001706.   46 Stevens, Anne M | Do maternal cells trigger or perpetuate autoimmune diseases in children? | Pediatric Rheumatology (Online journal) | Volume 5, Article ID 9 | 20070516 | Accessed 20120623 @ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1892552/   47 Stevens, A. M.; Hermes, H. M.; Lambert, N. C.; Nelson, J. L.; Meroni, P. L.; and Cimaz, R. | Maternal and sibling microchimerism in twins and triplets discordant for neonatal lupus syndrome-congenital heart block | Rheumatology | Volume 44, Issue 2, Pages 187-191 | February 2005 | Accessed 20120623 @ http://rheumatology.oxfordjournals.org/content/44/2/187.short.   48 Reed, Ann M.; McNallan, Kelly; Wettstein, Peter; Vehe, Richard; and Ober, Carole | Does HLA-Dependent Chimerism Underlie the Pathogenesis of Juvenile Dermatomyositis? | The Journal of Immunology | Volume 172, Number 8, Pages 5041-5046 | 20040415 | Accessed 20120623 @ http://www.jimmunol.org/content/172/8/5041.abstract?ijkey=fbe3e730b4a2d4cd19087a084b8efef6c0cce2d0&keytype2=tf_ipsecsha  

[truthmonk]

The War on Women’s Health, Part 2 – Family Planning

The War on Women's Health

Part 2: Family Planning

It's all about keeping mothers well and making healthly babies.

By Truthmonk October 29, 2012

The CDC called family planning one of the ten greatest achievements in public health in the 20th century.1 Family planning is about deciding how many children couples want to have and when they want to have them.

Family planning has allowed the United States to achieve desired birth spacing and smaller family size. The success of family planning has been instrumental in the decline of infant, child, and maternal deaths as well as improving the overall health of infants, children, and women.2

Reproductive events in a woman's life

The typically American woman spends about five years pregnant, recovering from being pregnant, or trying to get pregnant. However, she'll spend most of her reproductive life, almost 40-years or 87%, trying to avoid getting pregnant. In the end she'll have two children.3

Without family planning and modern contraceptives, the average woman would have 12 to 15 pregnancies in her lifetime.4

American Family Size

The colonial family from the founding of the Plymouth colony in 1620 to the Revolutionary War in 1775 had on average at least seven children and sometimes as many as nine or 10.5

But with the start of the Industrial Revolution, the American family size started to drop.6 The interrelationships between the social, economic, and political arenas caused fundamental changes to occur. One change was the increased opportunities for upward social and economic mobility brought about by the construction of industrial mills, primarily iron and textiles.

Peale family Portrait by Charles Willson Peale in 1771-1773. Some of Charles Peale 17 children. All this economic growth "led to increases in the quality and quantity of available consumer products and services, expected consumption standards rose, and individuals were required to spend more money simply to maintain the new normal standard of living."

Adults sought to take advantage of these opportunities for themselves and their families. However, the urban locations of the mills, required them to move from the farms to the cities. Moving to the cities meant they had to give up self-sufficiency in exchange for the necessity of paying cash for housing, food, clothing, and other essentials.

Another change was the downward adjustment in the parental benefits of having children. This came from two directions. First the benefits of having a large number of children while economical on the farm had little purpose in the cities, especially after “the passage of laws restricting child labor and mandating compulsory education.” Second children in the cities cost money. The cost of supporting each additional child at a new normal level became increasingly apparent.

  Larger Graph

Herdandez tidily summed up the situation said, “In addition, the newly available goods and services competed with children for parental time and money. Since each additional child in a family requires additional financial support and makes greater demands on parental time and attention, the birth of each child reduces the time and money parents can devote to their own work or career as well as to recreation and to older children.”

Parents met this challenge "at least in part by limiting their fertility," i.e. family planning.

Short birth intervals has medical risks for mother and fetus

Short birth intervals not only plays a significant role in determining the weight and health of the newborn baby, but has ramifications for the mother and fetus as well.

A short list of maternal risk include infection, premature rupture of the amnion and chorion membranes, third-trimester bleeding, and postpartum hemorrhage;7 placental abruption, placenta previa, and uterine rupture;8 and even maternal morbidity, and death.9

Some maternal medical conditions that can emerge during the pregnancy are anemia7 and macro- and micro-nutrient nutrient depletion.9

These conditions can affect the developing fetus causing low birthweight and small size for gestational age;8 retarded fetal growth;9 preterm births, miscarriages and stillbirths.10

Short birth interval leads to low birthweight infants

In the last three decades, advances in medical technology and neonatal intensive care have significantly improved the survival rates of infants born preterm. Yet, these very small premature babies, those under three pounds, are at high risk for delayed growth and lasting developmental problems.

A neonatal intensive care nurse holds a very small premature baby weighing less than 3 pounds.

Photo from CarmenWiki, The Ohio State University

The spacing between births, called the birth interval, plays a significant role in determining the weight of the newborn baby, thus the health of the baby.11Normal, healthy babies weigh at least 2,500 grams or 5 pounds 8 ounces. Babies weighing less at birth are classified as follows: low birthweight (LBW) infants (less than 2,500 grams or 5 pounds 8 ounces), moderately low birthweight (MLBW) infants (1,500-2,499 grams, or 3 pounds 4 ounces to 5 pounds 8 ounces), and very low birthweight (VLBW) infants (less than 1,500 grams, or 3 pounds 4 ounces).

The correlation between subnormal birthweight risk and birth interval is direct as shown in the graph. There is a substantial increase risk of low birth weight when babies are born less than 18 months after a previous live birth. The risk for low birth weight increases after 48 months. The best birth interval is between 24 to 47 months, i.e. the birth interval associated with the lowest risk for having a low birth weight baby.

Low birthweight has medical risks for infant and children

    “ The smaller an infant is at birth, the greater the risk of health and developmental complications.”12

As advances in medical technology have for low birthweight (LBW) infants greatly increased their survival odds, there remains troubling medical outcomes for them.

Surviving LBW infants are three times more likely to have neurodevelopmental handicaps and twice as likely to have a serious congenital anomaly.11

Studies have shown LBW children have "significantly greater risk for developing respiratory symptoms, including wheezing, coughing and pulmonary infections"13 and "that these respiratory problems may persist well beyond their infancy and childhood and into adulthood."14

LBW children are "at higher risk for psychiatric disturbances from childhood through high school" including delinquent & aggressive behavior in boys15 and anxiety & depression in girls.16 The incidence of ADHD is higher for LBW children.15

The additional familial stress puts them at higher risk for abuse and neglect.17

They have an increased risk of developing serious or prolonged illnesses throughout their lives. A host of medical complications developing in later life such as cardiovascular diseases, high blood pressure, type II diabetes (adult onset diabetes)18, and asthma19 are associated with low birthweight.

Low birthweight leads to higher risk of infant death

Obviously the worse medical risk for an infant is death. The risk of dying at less than 1 year of age sharply increases with declining birth weight.12 In the first year of life the risk of dying for very low birth-weight babies is 105 times higher than for normal birth weight babies. Even for moderately low birth-weight babies there is a 6 times higher risk of death during the first year.

Dr. Maureen Hack, the Director of the High Risk Follow-Up Program in the Department of Pediatrics and Department of Obstetrics and Gynecology at Case Western Reserve University, tidily summed up:   NEUROLOGICAL ABNORMALITIES: •  Cerebral palsy, blindness, deafness and other neuromotor dysfunction are potential risks of low birth weight. •  Though the mean IQ score of low birth weight children falls within the average range, there are higher rates of deficient and subnormal intelligence.   HEALTH PROBLEMS: •  Higher rates of health problems result in more medical and surgical procedures, frequent rehospitalizations after surgery, and limitations to the activities of daily life. •  The rates of conduct disorder, hyperactivity and attentional weakness increase with decreasing birth weight and are associated with brain injury due to low birth weight.   FAMILY ISSUES: •  Low birth weight has significant negative effects on families, including financial impact, increased caretaker burden, and general family burden. •  Parents of low birth weight children exhibit higher levels of parental protection at school age than normal birth weight children.   SOCIAL EFFECTS: •  Mental or emotional delay can limit a child’s ability to participate in physical activities and to play or socialize with others. •  Health problems contribute to an increased number of days spent in bed, restricting children’s activity, decreasing their school attendance, and limiting their social interactions. •  Learning problems at school place LBW children at greater risk for grade repetition or placement in special education programs. •  LBW teens are involved in fewer risky behaviors in adolescence, including lower rates of alcohol and marijuana use, less contact with police, and lower rates of pregnancy than normal birth weight teens.   GROWTH AND DEVELOPMENT: •  Growth attainment is generally lower than normal birth weight peers. •  Compared to their peers, children born with low birth weight are more likely to experience functional limitations.   Hack, Maureen | Focus on Research at Case Western Reserve University | Policy Brief | Schubert Center for Child Studies (Case Western Reserve University) | Policy Brief 6 | October 2007.

Next: The War on Women's Health, Part 3 - Maternal Fetal Medicine

Family Life in 17th- and 18th-Century America (Family Life through History) Colonial America comes alive in this depiction of the daily lives of families—mothers, fathers, children, and grandparents. The Volo's examine the role of the family in society and typical family life in 17th- and 18th-century America. Through narrative chapters, aspects of family life are discussed in depth such as maintaining the household, work, entertainment, death and dying, ceremonies and holidays, customs and rites of passage, parenting, education, and widowhood. Readers will gain an in-depth understanding of the world in which these families lived and how that world affected their lives. Also included are sources for further information and a timeline of historic events.

The book focuses on the day-to-day lives and roles of families throughout history. The roles of all family members are defined and information on daily family life, the role of the family in society, and the ever-changing definition of family are discussed.

America's Children: Resources from Family, Government, and the Economy (Population of the United States in the 1980s: A Census Monograph) Chapter 2 (The family-size revolution: From many to few siblings) reports the dramatic decline in the number of children in families, the change in sibling relationships, and the corresponding competition for limited family resources between the siblings.

A Population History of North America The book discusses the fine details of many broad trends of North America's population history from pre-Columbian times to the present.

Sources

1 Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, CDC | Ten Great Public Health Achievements — United States, 1900–1999 | MMWR | Volume 48, Number 12, Pages 241 – 243 | 19990402.   2 Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, CDC | Achievements in Public Health, 1900–1999: Family Planning | MMWR | Voloume 48, Number 47, Pages 1071 –1081 | 19991203.   3 Gold, Rachel Benson; Sonfield, Adam; Richards, Cory L.; Frost, Jennifer J. | Next Steps for America’s Family Planning Program: Leveraging the Potential of Medicaid and Title X in an Evolving Health Care System | Guttmacher Institute, New York, NY, USA | 2009.   4 Ø | Fact Sheet On Benefits of Family Planning | Bixby Center for Reproductive Health Research & Policy (University of California, San Francisco) | Version 3 | June 2006.   5 Volo, James M.; Volo, Dorothy Denneen | Family Life in 17th- and 18th-Century America (Family Life through History) | Greenwood (2005) | Page 45.   6 Herdandez, Donald J. | America's Children: Resources from Family, Government and the Economy | Russell Sage Foundation (New York, New York, USA) | 1993 | Pages 36 – 38.   7 CATALYST Consortium | Systematic Literature Review and Meta-Analyses on Birth Spacing: How Birth Spacing Relates to Infant and Child Mortality, Maternal and Perinatal Health, and Maternal and Child Nutrition Outcomes | U.S. Agency for International Development | April 29, 2005.   8 Mayo Clinic staff | Family planning: Get the facts about pregnancy spacing | Mayo Clinic | May 27, 2011 | Accessed 20060226 @ http://www.mayoclinic.com/health/family-planning/MY01691.   9 King, Janet C. | The Risk of Maternal Nutritional Depletion and Poor Outcomes Increases in Early or Closely Spaced Pregnancies| Journal of Nutrition | Volume 133, Number 5, Pages :1732S-1736S | May 2003.   10 USAID | Family Planning, Birth Spacing (Webpage) | U.S. Agency for International Development | Updated June 02, 2009 | Accessed 20060226 @ http://www.usaid.gov/our_work/global_health/pop/techareas/birthspacing/index.html.   11 Taffel, SM | Trends in low birth weight: United States, 1975-85; Vital Health Statistics | National Center for Health Statistics | Series 21, Number 48 | October 1989.   12 Mathews, T.J.; MacDorman, Marian F. | Infant Mortality Statistics From the 2007 Period Linked Birth/Infant Death Data Set | National Vital Statistics Reports (National Center for Health Statistics; Hyattsville, MD) | Volume 59, Number 6 | 20110629.   13 Ø | Full-Term, Low-Birth-Weight Babies At Significantly Greater Risk For Early Respiratory Symptoms (Webpage) | ScienceDaily's Science News | May 15, 2007 | Reviewed Feb 25, 2012 @ http://www.sciencedaily.com.   14 Ø | Low Birth Weight Linked To Long-Term Respiratory Problems (Webpage) | ScienceDaily's Science News | July 7, 2009 | Reviewed Feb 25, 2012 @ http://www.sciencedaily.com.   15 Ø | Low Birth Weight Children Appear At Higher Risk Of Psychiatric Disturbances (Webpage) | ScienceDaily's Science News | Sep. 1, 2008 | Reviewed Feb 25, 2012 @ http://www.sciencedaily.com.   16 Ø | Low Birth Weight May Predict Depression In Teen Girls (Webpage) | ScienceDaily's Science News |Mar. 5, 2007 | Reviewed Feb 25, 2012 @ http://www.sciencedaily.com.   17 Ø | Small Birthweight And Premature Births Associated With Higher Risk Of Child Abuse (Webpage) | ScienceDaily's Science News | Mar. 14, 2006 | Reviewed Feb 25, 2012 @ http://www.sciencedaily.com.   18 Ø | Low Birth Weight Of A Baby Entails Risks For The Baby's Father (Webpage) | ScienceDaily's Science News | June 30, 2005 | Reviewed Feb 25, 2012 @ http://www.sciencedaily.com.   19 Ø | Impaired Fetal Growth Increases Risk Of Asthma (Webpage) | ScienceDaily's Science News (Oct. 12, 2009 | Reviewed Feb 25, 2012 @ http://www.sciencedaily.com.  

[truthmonk]

The War on Women’s Health

The War on Women's Health

Part 1: In the Beginning

What all the fuss is about.

By Truthmonk October 26, 2012

In a repeat of history, the conservative Republicans are once again attacking what they perceive as a soft target – women. As is typical for their species, conservative Republicans look backward to the past, for their vision of the future.

Margaret Sanger. Photograph by Underwood & Underwood in 1922.

Photo from Famous People Collection of the Library of Congress

Stepping through a crack of time, we see a woman, dressed in gray, in a bleak concrete jail cell. The time is 1917. The middle-aged women, Margaret Sanger, is pacing with an urgency born out of real-life experience. Earlier Sanger had been found guilty of distributing information for the prevention of conception. For in this age of darkness, it was considered an evil to tell of “any recipe, drug, or medicine for the prevention of conception.”1 She had tried to argue "exposing women, against their will, to the danger of dying in childbirth violated a woman’s right to life." Therefore any law prohibiting distribution of contraception or information about contraception, must be unconstitutional. The trail judge bellowed from his high throne of justice, that no woman had “the right to copulate with a feeling of security that there will be no resulting conception.” With that he brought down his gavel, its sound echoing the impeding doom through the chamber.

Sanger had to get out and continue the fight.

Artist's conception of Margaret Sanger's trail.

Introduction

Just Another Right-wing-conservative Fake Controversy

The brouhaha over the U.S. Department of Health and Human Services (HHS) ruling is too little, too late. The new guidelines are designed to ensure women will receive preventive health services* at no additional cost.

US Department of Health and Human Services Secretary Kathleen Sebelius.

Photo from US Department of Health and Human Services

“ 'The Affordable Care Act helps stop health problems before they start,' said HHS Secretary Kathleen Sebelius. 'These historic guidelines are based on science and existing literature and will help ensure women get the preventive health benefits they need.' ”2

As stated in a January 20 HHS press release3, the rules would:

require most health insurance plans to cover women's preventive services without charging a co-pay, co-insurance or a deductible

exemption allowing certain non-profit religious organizations not to provide contraception coverage similar to the regulations in 28 states

other nonprofit religious employers will be provided an additional year to comply with the new rules.

The guidelines also mandated coverage in many other women healthcare areas from breast feeding support to well-women visits.

To accommodate non-profits employers such as charities, hospitals, schools, universities, or other religious organizations that may have "a religious objection to providing contraceptive services as part of its health plan," President Obama modified the guidelines4 so they no longer have to include contraceptive services. Instead, the health insurance company will cover the women's contraceptive services needs. Thus the new guidelines "accommodates religious liberty while protecting the health of women."

Catholic Health Association, Catholic Charities, and Catholics United have praised the new guidelines -- White House (Feb 12)4.

Even with this olive branch offered to the right-wing religious community, the critics keep babbling about the infringement of their religious liberty.

Some Facts about the new law -- White House (Jan 20)5:

Churches are exempt from the new rules.

No doctor will be forced to prescribe contraception when it violates their religious or moral beliefs.

No individual will be forced to buy or use contraception.

Abortifacient drugs like RU486 are excluded from the list of contraceptive drugs that must be covered, period. No Federal tax dollars are used for elective abortions.

  The eight new additional women’s preventive services that will be covered without cost-sharing requirements include:

Well-woman visits: This would include an annual well-woman preventive care visit for adult women to obtain the recommended preventive services, and additional visits if women and their health care providers determine they are necessary. These visits will help women and their health care providers determine what preventive services are appropriate, and set up a plan to help women get the care they need to be healthy.

Gestational diabetes screening: This screening is for women 24 to 28 weeks pregnant, and those at high risk of developing gestational diabetes. It will help improve the health of mothers and babies because women who have gestational diabetes have an increased risk of developing type 2 diabetes in the future. In addition, the children of women with gestational diabetes are at significantly increased risk of being overweight and insulin-resistant throughout childhood.

HPV DNA testing: Women who are 30 or older will have access to high-risk human papillomavirus (HPV) DNA testing every three years, regardless of Pap smear results. Early screening, detection, and treatment have been shown to help reduce the prevalence of cervical cancer.

STI counseling: Sexually-active women will have access to annual counseling on sexually transmitted infections (STIs). These sessions have been shown to reduce risky behavior in patients, yet only 28 percent of women aged 18-44 years reported that they had discussed STIs with a doctor or nurse.

HIV screening and counseling: Sexually-active women will have access to annual counseling on HIV. Women are at increased risk of contracting HIV/AIDS. From 1999 to 2003, the Centers for Disease Control and Prevention reported a 15% increase in AIDS cases among women, and a 1% increase among men.

Contraception and contraceptive counseling: Women will have access to all Food and Drug Administration-approved contraceptive methods, sterilization procedures, and patient education and counseling. These recommendations do not include abortifacient drugs. Most workers in employer-sponsored plans are currently covered for contraceptives. Contraception has additional health benefits like reduced risk of cancer and protection against osteoporosis.

Breastfeeding support, supplies, and counseling: Pregnant and postpartum women will have access to comprehensive lactation support and counseling from trained providers, as well as breastfeeding equipment. Breastfeeding is one of the most effective preventive measures mothers can take to protect their health and that of their children. One of the barriers for breastfeeding is the cost of purchasing or renting breast pumps and nursing related supplies.

Interpersonal and domestic violence screening and counseling: Screening and counseling for interpersonal and domestic violence should be provided for all adolescent and adult women. An estimated 25% of women in the United States report being targets of intimate partner violence during their lifetimes. Screening is effective in the early detection and effectiveness of interventions to increase the safety of abused women.

Members of Congress are already have coverage for these preventive services. The National Business Group on Health recommends these services and many private employers already cover them.

Source: Ø | Affordable Care Act Rules on Expanding Access to Preventive Services for Women | U.S. Department of Health & Human Services | Posted on: August 1, 2011; Last updated: July 31, 2012; Accessed September 7, 2012 @ http://www.healthcare.gov/news/factsheets/2011/08/womensprevention08012011a.html  

National Academy of Sciences Report

Advise from The Supreme Council of Nerds

Where could more unbiased, dispassionate, honest, factual advice be found than with our very own National Academy of Sciences' Institute of Medicine?

The Institute of Medicine6 (IOM) has an international reputation for scholarly independence and the highest quality reports. Their reports are regularly used internationally. The IOM7 found that “evidence exists that greater use of contraceptionwithin the population produces lower unintended pregnancy and abortion rates nationally” and the removal of co-pays, co-insurance, and deductibles will greatly increase the use of contraception.

IOM states that preventive contraceptive services is the healthcare industry standard for both federal and private insurance programs. All federal employees, including members of congress have no-cost contraceptive services benefits.

The IOM concluded that “ the full range of Food and Drug Administration-approved contraceptive methods, sterilization procedures, and patient education and counseling for women with reproductive capacity” should be provided as a preventive service for women. (Page 165)

By accepting the IOM expert advisory panel recommendations for contraceptives, supplies, and counseling services, the HHS wants to eliminate financial disincentives to using effective preventive care and improving the subsequent health outcomes.

National Business Community

The Gold Star Standard in Healthcare

The National Business Group on Health represents large employers on national health policy issues.8 In their report Investing in Maternal and Child Health they reported that all

contraceptive methods produced a significant cost-savings.[2-83]They came from both financial savings and health gains. Compared to no contraception, oral contraceptives resulted in cost-savings of $8,827 and the monthly injectable resulted in cost-savings of $8,770.

Among NBGH's unintended pregnancy prevention services recommendations is to include, even in their most basic benefit set:

“all FDA-approved prescription contraceptive methods (e.g., pills, patches, IUDs, diaphragms, vaginal rings);”

“voluntary sterilization” procedures (e.g., tubal ligation, vasectomy);

“medically appropriate laboratory examinations and tests, counseling services, and patient education;” and

with no coverage limits or cost-sharing on counseling services, medication, procedures, or prescribed devices.

The report concluded, "In order to reduce unintended pregnancy, employers should provide comprehensive contraception coverage for employees and dependents. Employers should also consider removing cost barriers by eliminating cost-sharing requirements on contraceptive medications, devices, procedures, and office visits. Expanding coverage and removing cost barriers is particularly important for adolescents because many can not afford to pay for contraceptives out-of-pocket."[4-27]

Doing this will the raise preventive contraceptive services coverage in ObamaCare to near the national business community standard.

28 States Have Similar Requirements

Or the Horses Have Already Left the Barn

Most of our citizens already live in state with similar contraceptive health requirements as the proposed federal requirements.

Twenty eight states9 require insurers to provide full coverage of all FDA approved contraceptive drugs and devices if they cover prescription drugs.

Eight states have no exemptions — Colorado, Georgia, Iowa, Montana, New Hampshire, Vermont, Washington, and Wisconsin.

Another four states allow only churches and their associations an exemption: Arizona, California, New York, and Oregon. The remaining 16 states require coverage very similar to the federal plan.

Right now 178 million people have full coverage under their state plans and the federal plan would have little, if any effect on them. The federal plan would be bringing the other 133 million people up to par.

The religious right's outrage seems to have gone awol concerning the 28 states that have full coverage requirements where over half the population lives.

The Economics of Providing Contraceptive Coverage

Saving money by preventing unplanned pregnancies

“Debates over improving insurance coverage of contraceptives invariably touch on the issue of cost. Research and experience now suggest that contraceptive coverage does not raise insurance premiums and that employers providing such coverage can, in fact, save money by avoiding costs associated with unintended pregnancy.”10

Multiple studies from 1987 to 2010 have found contraceptive coverage does not cost more but saves money both for public Medicaid and private insurers.

Results varied from a National Business Group on Health study that had results of $0.16 for the private insurers to a Business and Health study finding of $28.57 also for private insurers. Public Medicaid savings were about $3 to $4.

Business and Health in a 1993 special report for employers, found the average costs associated with the birth of a healthy baby was $10,000 (prenatal care, delivery and newborn care for one year following birth). It also reported that the cost for oral contraceptives was $300–350 per year. Avoiding the cost for unintended pregnancies was a major factor in the savings for an insurer.

The cost looked at in the studies are only the easily determined direct cost "associated with normal live births (vaginal and cesarean), abortions, miscarriages and ectopic pregnancies." 10 There is also the saving of indirect costs which "include wages and benefits associated with employee absences, maternity leave, and pregnancy-related sick leave, as well as costs associated with reduced productivity during an employee's pregnancy and with replacing employees who do not return to work after a pregnancy."

Business employers not covering contraceptives in their employee health plans pay at least an additional 15 – 17% more than if they had coverage.

Providing contraceptive coverage does not increase the bill an employer is required to pay. And may in fact reduce the bill.

Next: The War on Women's Health, Part 2 - Family Planning

Choices of the Heart: the Margaret Sanger Story (True Stories Collection) Starring Dana Delany and Henry Czerny, Directed by Paul Shapiro Rated: NR IMDb: **********

The movie tells the story of Margaret Sanger (Dana Delany, China Beach) fight for women’s health through family planning and sex education in the early 1900s. The story takes place in New York City where despairing, often poor, women are forced by their situation to end unwanted pregnancies themselves.

Sanger, a registered nurse, crosses paths with some of these women and sees the resulting mayhem and death. Outraged and saddened by what she sees, Sanger takes on her life work to fight against the moral zealots that have created chaos in women’s lives.

Margaret Sanger: A Life of Passion Trained as a nurse and midwife in New York’s Lower East Side gritty slums, Margaret Sanger grew aware of the dangers of unplanned pregnancy—both physical and psychological. A botched abortion resulting in the death of a poor young mother catalyzed Sanger, and she quickly became one of the loudest voices in favor of sex education and contraception.

Sanger ignited a movement that has shaped our society to this day. The movement she started spread across the country, eventually becoming a vast international organization with her as its spokeswoman.

Her views on reproductive rights have made her a frequent target of conservatives and moral zealots. Yet lately even progressives have shied away from her, citing socialist leanings and a purported belief in eugenics as a blight on her accomplishments. In this captivating new biography, the renowned feminist historian Jean H. Baker rescues Sanger from such critiques and restores her to the vaunted place in history she once held.

Sources 1 Lepore, Jill | Birthright, What’s next for Planned Parenthood? (Webpage) | The New Yorker Digital Edition | 20111114 | Accessed 20120301 @ http://www.newyorker.com/reporting/2011/11/14/111114fa_fact_lepore.   2 HHS Press Office | Affordable Care Act Ensures Women Receive Preventive Services at No Additional Cost | U.S. Department of Health & Human Services | 20110801 | Accessed 20120213 @ http://www.hhs.gov/news/press/2011pres/08/20110801b.html.   3 HHS Press Office | A statement by U.S. Department of Health and Human Services Secretary Kathleen Sebelius | U.S. Department of Health & Human Services | 20120120, Last revised: 20120202 | Accessed 20120213 @ http://www.hhs.gov/news/press/2012pres/01/20120120a.html.   4 Palmieri, Jennifer | What They Are Saying: Preventive Health Care and Religious Institutions | The White House Blog | 20120212, Last revised 20120213 | Accessed 20120218 @ http://www.whitehouse.gov/blog/2012/02/12/what-they-are-saying-preventive-health-care-and-religious-institutions.   5 Muñoz, Cecilia | Health Reform, Preventive Services, and Religious Institutions | The White House Blog | 20120201, Last revised 20120201 | Accessed 20120213 @ http://www.whitehouse.gov/blog/2012/02/01/health-reform-preventive-services-and-religious-institutions.   6 Wilkinson, Emma | The science behind the policy | European Heart Journal | Volume 30, Number 24, Pages 2955 – 2956 | December 2009.   7 Committee on Preventive Services for Women | Clinical Preventive Services for Women: Closing the Gaps | IOM (Institute of Medicine), The National Academies Press; Washington, DC | 2011.   8 Campbell, Kathryn Phillips: editor | Chapter 2, Maternal and Child Health Plan Benefit Model: Evidence-Informed Coverage; Investing in Maternal and Child Health: An Employer’s Toolkit | Center for Prevention and Health Services, National Business Group on Health, Washington, DC | 2007 | 89 Pages.   9 State Policies in Brief: Insurance Coverage of Contraceptives | Guttmacher Institute | February 2, 2012.   10 Dailard, Cynthia | Special Analysis: The Cost of Contraceptive Insurance Coverage | The Guttmacher Report on Public Policy | Guttmacher Institute, New York, NY, USA | Volume 6, Number 1 | March 2003.