by Kathleen Gilbert

BISMARCK, North Dakota, February 11, 2011 (LifeSiteNews.com) – A strong majority of lawmakers in the North Dakota House of Representatives on Friday afternoon passed a law that would make it illegal to murder any human being from the moment of their conception.

The Defense of Human Life Act, HB 1450, recognizes every human being at any stage of development as a person under state law with a right to protection.

“The overwhelming community and legislative support for HB 1450 proves that North Dakota could be the first state to recognize the value and dignity of every living human being,” stated Representative Dan Ruby. “The Defense of Human Life Act is just common sense. Of course every human being is a person, and every innocent person should receive legal protection. I am motivated to see women and children protected by HB 1450, and I look forward to its passage in the Senate in the near future.”

While the bill prohibits chemical abortifiacients such as RU-486, it does not apply to emergency contraception, or other “contraception administered before a clinically diagnosable pregnancy.” The bill also exempts legitimate medical procedures that may lead to the death of children in the womb when a woman’s life is in danger. The bill also exempts pregnant women seeking abortions from criminal prosecution.

The bill, supported by ND Right to Life, ND Life League, ND Family Alliance, ND CWFA, and the ND Catholic Conference, passed 68-25 in Friday’s vote.

Daniel Woodard, a legal consultant for North Dakota Right to Life and the North Dakota Life League, told LifeSiteNews.com that the bill would put the one remaining abortion clinic in the state out of business. “This bill should shut down that clinic,” said Woodard.

While the bill also bans the killing of frozen embryos produced by in-vitro fertilization, Woodard said, it would leave the implementation of new regulations to the medical community. “In North Dakota, the legislature has confidence in its medical professional groups to regulate itself,” he said.

While pro-lifers are optimistic about the bill’s survival in the Senate, Woodard said that supporters would “be taking no chances” and continue to lobby for its passage. A vote in the Senate is expected around March 10.

North Dakota Gov. Jack Dalrymple has not stated whether or not he plans to sign the bill.

for the article at its source, go here

The House GOP’s Plan to Redefine Rape

Vanderbilt Adjusts Nursing Program Application After Complaint From Christian Legal Group

January 13, 2011 — Vanderbilt University Medical Center has modified the application for its nurse residency program after a Christian legal group complained that a statement in the packet could make applicants believe they would be required to participate in abortion services,The Tennessean reports (Gee, The Tennessean, 1/13).

In a complaint filed on Tuesday with the HHS Office of Civil Rights, the Alliance Defense Fund took issue with an acknowledgment statement that VUMC required applicants to sign to request enrollment in its summer 2011 nurse residency program. The statement read, “I am aware I may be providing nursing care for women who are having” procedures such as abortions. The Christian legal group alleged that the statement violated a federal law stipulating that entities receiving federal funds cannot require someone to participate in abortion care against his or her religious or moral objections (Gee, The Tennessean, 1/12).

Although legal experts said that the statement did not violate the law, VUMC spokesperson John Howser on Wednesday announced that medical center officials “decided it would be helpful to clarify the language.” The new version includes modified language, has no signature requirement and informs applicants about how to request an exemption from participating in abortion care. VUMC also e-mailed applicants to assure them that employees are not required to provide care against their moral or religious objections (The Tennessean, 1/13).

Statement Meant To Inform Applicants, VUMC Says

The original statement did not suggest or require that residents participate in abortion procedures, Howser said. Rather, it was meant to inform applicants that they might be asked to provide care to women who have had or are seeking abortions, he said.

The original statement said, “It is important that you are aware of this aspect of care and give careful consideration to your ability to provide compassionate care to women in these situations.” It continues, “If you feel you cannot provide care to women during this type of event, we encourage you to apply to a different track of the Nurse Residency Program to explore opportunities that may best fit your skills and career goals.”

The Alliance Defense Fund filed the complaint on behalf of an unnamed Mississippi resident who applied to the residency program (The Tennessean, 1/12).

for the article at its source, go here

by Roxann MtJoyJanuary 06, 2011

Last summer, I told you about an innovative technology that helps provide abortion access to women in rural areas of Iowa. Planned Parenthood there had developed a unique telemedicine system where doctors video conference with patients and are able to dispense medication via remote control. But now, Iowa state legislators have vowed to work to ban the practice, effectively cutting off thousands of women from access to safe, affordable abortion care.

Iowa, while currently the only state to offer abortions via telemedicine, is not the only state where conservatives are fighting the practice. Nebraska, already known for its restrictive abortion laws, is planning a preemptive strike. “I’m not trying to inhibit telemedicine, but we’re talking about chemical abortions here. It’s not appropriate,” said Nebraska State Senator Tony Fulton, who plans to introduce a bill this year that would require doctors to be in the same room as the patient when the pills are handed over.

What exactly is inappropriate here? Abortion is legal and the telemedicine practice is safe. Women receive in-person counseling and education on the procedure and potential side effects. Mind you, this is all taking place at her local clinic, not at home on her couch. Doctors who are willing to perform abortions can be nearly impossible for rural women to find — 86% of counties in the United States do not have an abortion provider — yet Senator Fulton thinks this is inappropriate and something in the “realm of science fiction.” Really?

Doctors do amazing, skilled things that take years of training to do, things I would only would only trust them to do. Physically putting a pill packet in my hand is not one of those things. Those who oppose reproductive telemedicine have nothing to back up their fear-mongering. The dangers they claim are the real science fiction. Whether you are pro-choice or not, the fact is that abortion is safe and legal and it is not the government’s place to override doctors’ judgement or put obstacles in the way of women exercising their right to choose. Tell Iowa not to abandon its rural women in need of abortion care.

For the article at it’s source, go here.

New women’s clinic in Chicago, Illinois to be city’s first free-standing health facility staffed solely by nurse-midwives.

By Ann Keeton, Special to the Tribune

December 1, 2010

Part of the Aviva Women’s Health and Midwifery Care program at the University of Illinois at Chicago, a new women’s clinic will be the first freestanding clinic in the city to be solely staffed by nurse-midwives.

Evelyn Rodriguez has avoided getting regular medical checkups for several years. The Logan Square resident uses a wheelchair and says she knows many women who won’t make appointments for a variety of reasons.

“A lot of us are afraid to go to the doctor,” she said. “There are women with physical disabilities who are embarrassed about being different, women who don’t speak English or who have trouble paying for medical care.”

A new women’s clinic, set to open early next year, aims to address these issues. Part of the Aviva Women’s Health and Midwifery Care program at the University of Illinois atChicago, this will be the first free-standing clinic in the city to be solely staffed by nurse-midwives and serve both disabled and able-bodied women.

While the medical establishment has been critical of lay midwives in the past, holding that it’s dangerous for women to give birth without the support of a doctor and hospital, those staffing the new clinic will be certified by the American Midwifery Certification Board, which is recognized by the American College of Obstetricians and Gynecologists. The midwives in the Aviva program, registered nurses with postgraduate degrees, already assist with births at Sts. Mary and Elizabeth Medical Center. At the new facility they will also provide prenatal care, gynecological exams, menopausal counseling and other services in a clinical setting, where female patients can also join groups for networking and follow-up care.

A $1.9 million federal grant is providing startup costs for the clinic, said Judith Storfjell, professor of health systems science and head of academic practice at the UIC College of Nursing. But she is still negotiating a lease for a space close to transportation and convenient for underserved women in Logan Square, West Town and Humboldt Park — areas that have high rates of infant mortality and premature birth rates.

In the Aviva program, specially trained nurses already provide primary health care. In partnership with Sts. Mary and Elizabeth, UIC provides service at two clinics: one run by the Infant Welfare Society of Chicago in Logan Square and the Chicago Public Health Department’s West Town Neighborhood Health Center Humboldt Park.

Patients who see midwives at the clinics can deliver their babies at Sts. Mary and Elizabeth, where a backup doctor can be called in if needed. Pregnant women who need more care are referred to specialists at UIC Medical Center. The new clinic will follow the same model.

More than 100 graduate students are enrolled this year in the UIC program for nurse-midwives, Storfjell said. Students can start the program after they have earned a bachelor’s degree and have become registered nurses, or they can get those credentials while they are training as midwives.

“We have many graduates working as midwives, but this will be the first clinic of our own. This will fill a huge need out there,” she said.

The new clinic will be accessible for people with disabilities, said Carol Gill, a professor in disability studies at the university. Plans for the Aviva clinic have been ‘”energized by a collaboration between the College of Nursing and the department of disability studies,” she said.

Students are learning that physical disability is a cultural and economic phenomenon, not just a medical issue. While patients with disabilities may not require different treatment, they may need more time.

“On average, we allow about 45 minutes for each patient visit, compared with the standard 15 minutes to 20 minutes,” Gill said.

Evelyn Rodriguez, the Logan Square resident, said she likes the inclusive plan to serve both disabled and able-bodied women. “My last doctor’s office made me feel like a thing, not a person; no one wants to be treated like that.”

Mary Bauer, the director of the Aviva program, will head the new clinic, which will have four full-time nurse-midwives and three part-time midwives. Bauer, who has been a midwife for two years, went through the UIC graduate program for nurse-midwives. She’s now delivered more than 125 babies. She recently helped Fani Castro, a teenage mom who doesn’t speak English, bring a healthy baby into the world.

“I didn’t speak Spanish before I got my midwife training. Now I can communicate just fine. You sort of pick things up.”

Castro had a very natural birth experience, Bauer said. “She had the freedom to move around a lot, even standing and squatting on the bed. That helped the baby get in the right position to be born.”

Bauer said midwives, along with trained volunteers called doulas, can help women experience childbirth without pain medicine.

“You have to understand that pain in childbirth is OK, but suffering isn’t,” said Bauer. But there is still a misconception that midwives frown on painkillers. “We offer a full range of pain medicine. About half of our patients use epidurals” — injections that numb the body below the waist.

Lindsay Prior was a patient of Bauer’s at the West Town clinic. “I have medical insurance, so I could have gone anywhere, but I stayed with Mary. I would follow her anywhere,” Prior said, ”She answered every question about my pregnancy, no matter how dumb it was. I had some trouble with my blood pressure, and they monitored it very carefully.”

Prior had planned for natural childbirth, but, 36 hours into her labor, “Mary made the call that we needed the doctor,” said Prior. She ended up having a cesarean section at Sts. Mary and Elizabeth to deliver her son Logan, who weighed 8 pounds, 8 ounces. He’s 6 months old now, and doing fine.

A few years ago, Bauer was a dental hygienist with five kids at home. “I wanted another child, but my husband said why not go back to school instead?” Bauer, 53, loves her new career.

“Most of our patients are prenatal,” she said of the Aviva program’s clients. “But if it comes up, we are trained to treat a cold or flu. If they have a broken arm, they need to go to the ER.”

for the article at it’s source, go here

Check out Talk of the Nation about the expanding the role of nurses to serve the patients left out by the primary care physician shortage.

As Dr. Trybulski points out, this idea is not new. With nurse anesthetists around since 1877 and nurse midwives since 1925.

Read the transcript or listen to the program. 36 min 52 sec.

Nurse visitation programs for low-income, first-time mothers can help them hold off on having a second child too soon, researchers found.

After one such program got under way in Pennsylvania, participating high-risk mothers were 13% less likely to have a second pregnancy within two years of the first than were controls (hazard ratio 0.87, 95% confidence interval 0.80 to 0.96).

Teen mothers and particularly those in rural areas appeared to get the greatest benefit, David M. Rubin, MD, MSCE, of Children’s Hospital of Philadelphia, and colleagues reported online in the Archives of Pediatrics & Adolescent Medicine.

These results add to the evidence supporting home-visitation programs, noted Kay Johnson, MPH, EdM, of Dartmouth Medical School in Hinesburg, Vt., in an accompanying editorial.

This point is key now that the Affordable Care Act of 2010 has promised to fund such state-based programs across the country by 2011 but specifying that at least 75% of funds must go for “evidence-based” programs, she wrote.

One such program is the Nurse-Family Partnership, which has spread to serve more than 20,000 families per year in 31 states, Rubin noted.

Prior trials have shown it effective in improving outcomes for mother and child, but to demonstrate real-world impacts in large scale implementation and in broader populations Rubin’s group studied the program’s implementation across Pennsylvania between 2000 and 2007.

The retrospective cohort study included 3,844 first-time mothers on welfare who were partnered with nurses in the program compared with 10,938 local area controls matched by propensity scores.

One aspect of the program was helping parents plan the timing of subsequent pregnancies.

The program showed no advantage for preventing a second pregnancy within two years of the first in the first three years after program launch (19.3% versus 18.9% for controls).

But after the early implementation period, by 2004 to 2005, the mothers partnered with nurses in the program did show a reduction in such rapid-succession pregnancies compared with controls not in the program (16.8% versus 19.0%,P=0.05).

The delay in success wasn’t unexpected since implementation experience “forecasts a start-up period in which program effectiveness is delayed as interventions move from the controlled laboratory to community settings,” the researchers wrote in the paper.

Nevertheless, the importance of knowing that this start-up period may take three years “cannot be understated,” Johnson added in the editorial.

“Congress set an expectation for states to report results on selected benchmarks in three years and to show measurable change in outcomes in five years,” she wrote, noting that “states launching new home visiting programs with Patient Protection and Affordable Care Act funding are not likely to report improved outcomes in less than three years and that the five-year time frame is more realistic.”

The benefit for mothers in the program, after the early implementation period, principally accrued to those 18 years old or younger (17.9% versus 23.3% among controls, HR 0.73, P=0.003).

Those in rural areas also appeared to gain more. The reduction in second pregnancies within two years was twice as great among teen mothers from rural locations (HR 0.40, 95% CI 0.22 to 0.73) than among those from urban areas (HR 0.79, 95% CI 0.65 to 0.95).

This added benefit in rural areas surprised the researchers, but may have been related to less overwhelming caseloads and greater community penetration than in urban areas or because rural at-risk mothers may have stood to benefit more because of fewer available family planning or other home visitation programs.

Whatever the reason, “this finding suggests that urban sites may need more intensive programs, staff capacity, community linkages, and/or technical assistance to achieve the same results as rural sites,” Johnson suggested in the editorial.

The researchers cautioned that their study looked at only one possible outcome for mothers and children; used birth certificates, which would identify only live births; and may have been limited by unmeasured selection factors.

The project was supported by a grant from the Pennsylvania Department of Public Welfare.

The researchers reported having no conflicts of interest to declare.

Johnson reported having no conflicts of interest to declare.

By Crystal Phend, Senior Staff Writer, MedPage Today
Published: November 01, 2010
Reviewed by Dori F. Zaleznik, MD; Associate Clinical Professor of Medicine, Harvard Medical School, Boston and
Dorothy Caputo, MA, RN, BC-ADM, CDE, Nurse Planner

for the article at its source, go here

Ariz. ruling rejects challenge to new limits on abortion.

PHOENIX – A judge refused to block the state from enforcing new regulations next week that an attorney for the state’s largest abortion provider said will impair the ability of women to terminate their pregnancies.

Judge Donald Daughton of Maricopa County Superior Court said Planned Parenthood Arizona waited too long before asking him to bar the Department of Health Services from enforcing a new rule prohibiting anyone other than a doctor from performing various medical procedures before or after an abortion. He pointed out the state approved the new rules at the end of April. But Daughton noted that Planned Parenthood did not file its legal papers until Oct. 14 – and the rules are set to take effect Monday.

Planned Parenthood President Bryan Howard said he did not know whether his organization would seek another way to block those rules. But he said the regulations, if implemented, will result in delays for women because there are not enough qualified doctors willing to perform abortions.

And Planned Parenthood attorney Eve Gartner said the longer the wait to terminate a pregnancy, the greater the risk to the patient.

The legal fight is an extension of a lawsuit that Planned Parenthood filed last year after the Legislature voted to prohibit anyone other than a doctor from performing abortions.

Daughton enjoined the state from enforcing that law, ruling that challengers were likely to prevail once the case goes to trial. That trial, though, remains on hold while his injunction is being argued to the Court of Appeals.

The new rules at issue say doctors must be the ones to do everything from determining the gestational age of the fetus to remaining on the premises until all patients undergoing any kind of surgical abortion are stable and ready to leave.

At a hearing Wednesday, Gartner told Daughton those rules amount to an end run by the state around his 2009 order.

She said the shortage of qualified doctors remains. Gartner said requiring a doctor to perform the pre- and post-abortion procedures would have the same net effect as requiring a doctor to do the abortion itself: a delay in care for women.

Assistant Attorney General Carrie Brennan did not argue the merits of that claim. Instead, she told Daughton that Planned Parenthood waited too long to seek the relief.

“Planned Parenthood could have filed in May,” when the final rules were published, she said. “And they didn’t.”

Cathy Herrod, president of the Center for Arizona Policy, which encouraged lawmakers to enact the restrictions in the first place, said the real underlying issue is her organization’s belief that anything involving abortion should be performed by a doctor.

“This is about women being given appropriate medical care when seeking an abortion,” Herrod said. “Legally, the best medical care for a woman seeking an abortion is given by a licensed physician, not by anyone else.”

Herrod, however, did not deny that her organization has been at the forefront of pushing for greater restrictions on abortion. And its official position is that the procedure should be outlawed entirely.

She also said Daughton got it wrong when he issued last year’s injunction against the ban on nurse-performed abortions, which is why that ruling is being appealed.

State law allows nurse practitioners to perform “medical abortions” involving a patient being given the abortion-inducing drug known as RU-486.

But a 1999 law regulating abortions left unclear the question of who could perform a surgical abortion. That led to Planned Parenthood allowing certified nurse practitioners to perform early-term abortions in which a fetus is vacuumed out of the womb.

Last year the Legislature enacted a series of new abortion restrictions, one requiring that all surgical abortions be performed by a physician. Daughton’s injunction blocks that from taking effect.

The state Board of Nursing ruled two years ago that vacuum abortions can be performed by properly trained certified nurse practitioners.

(for the article from it’s source, go here)

With the rise of advance practice clinicians such as nurse practitioners and physician assistants increasingly providing primary care, isn’t it important for them to receive full training in women’s reproductive health care?

Check out this article from NPR; Midlevel Providers Fill Primary Care Doctors’ Shoes

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