Roundup: Mothers in New York Twice As Likely to Die During Childbirth Or First Year Post-Partum

Robin Marty

Mothers in New York are dying at twice the rate of the rest of the country, and Susan B. Anthony List gives up and that whole pesky "woman candidate" thing.

New York City is known for many things: the Statue of Liberty, Times Square, Central Park.  Now it can add something new to the list – the Dead Mother Capital of the United States. 

According to a recent report from the New York City Department of Health and Mental Hygiene, the maternal mortality rate in the city is double that of the rest of the nation.  The Epoch Times reports:

For every 100,000 live births, 23.1 expecting mothers died in New York City, compared to 11.8 deaths per 100,000 births across the United States, according to the Health Department data gathered between 2001 and 2005.

Of the 266 pregnancy-related deaths that were evaluated, 60 percent—or 161 deaths—were directly due to the complications with the childbirth process. Of the 161 mothers who died, 49 percent were found to be obese and 56 percent had chronic problems, such as hypertension or asthma—factors that may have possibly contributed to the complications.

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Embolism, hemorrhage, infection, and pregnancy-induced hypertension constituted 63 percent of the childbirth-related deaths.

In an even more startling statistic, the rate of death for African American mothers was significantly higher than that of Caucasians.  Seven times higher,  according to NBC New York.  And although a majority of the deaths related directly to the birthing process, there was a large amount of post-birth violence that was seen, as well.

In the rest of the cases, where death occurred within a year of pregnancy but was not directly attributed to the pregnancy, half of these were due to injury.  “Homicide accounted for 44% of these injury deaths.  More than half of the homicide deaths were linked to intimate-partner violence.”

Nearly 50 percent of all pregnancies are unplanned.  That statistic, coupled with these terrifying numbers from New York, may help better explain the timing on yesterday’s OP-Ed in the New York Times, “Let the Pill Go Free.”

The pill remains part of the solution, but its usefulness has been limited because it’s available only by prescription. As every woman who has run out of pills on a Sunday or forgotten to take them along on vacation knows, refills are not always easy to come by.

What’s more, the difficulties involved in obtaining a pill prescription, especially for women without access to a doctor, can cause gaps in contraceptive use. And the birth control methods that are available without prescription — condoms, spermicide and the sponge — have higher failure rates than the pill.

But there is something we could do to help the pill live up to its potential: let women purchase it over the counter. A half-century of evidence shows us that it’s safe to dispense the pill without a prescription.

Preventing unintended pregnancies with easier access to birthcontrol has always been a no-brainer for those of us who advocate for women’s reproductive health.  But now it’s no longer just a matter of convenience, it can often be a matter of life and death.

Mini-Roundup: EMILY’s List is accused of relaxing their standards to allow in any female candidates who are for upholding Roe V Wade (which their president says is not true), meanwhile, Susan B. Anthony List really changes its criteria, and endorses a man.  So much for “Elect[ing] more women to Congress through our connected Candidate Fund.”

June 21, 2010

Understanding Ella, the Latest Controversy in ‘Morning After Pills’ – Huffington Post

Ready to Go 12 Rounds With Boxer – National Catholic Register

In politics, being a woman doesn’t mean much – Los Angeles Times

Bork to publicly oppose Kagan for Supreme Court – The Associated Press

CA-Sen: In the mold of Sarah Palin – Daily Kos

How Mitch Daniels Can Be The Most Pro-Life, and Fiscally Conservative Too –

“Choose Life” Plate Hits the Road in Mass. – FOXNews

Republican Voters More Enthusiastic Than Democrats for 2010 Election Season –

Should Church control access to health care? – Washington Post

Minority Leader, Nana Oye Lithur clash on abortion –

Kagan, Clinton, and Partial-Birth Abortion – National Review Online

Recommended Approval of After-Sex Pill to Prevent Pregnancy – Salient News

Robert Bork to Oppose Pro-Abortion Supreme Court Nominee Elena Kagan –

Abortion Rights Supporters Squabble Over Bill – New York Times

Conservatives, liberal wary of Kagan on abortion – The Associated Press

Lawmakers Should Be at Least as Thoughtful About Abortion as Women Are – Huffington Post

Missouri Could Be 5th State to Opt Out of Abortion Funding Under Health Care  –

But maternal foreign aid not a top priority for respondents –

The New York Times: Abortion Advocates Discover Adoption – Opposing Views

U of I Professor Writes Book on Parental Abortion Notification – WGIL Radio News

New family planning drive targets 1.3% growth rate –

Bulgarian Teenagers to Receive Sexual Education –

Let the Pill Go Free – New York Times

AIDS Drug Combinations Given to Pregnant Women Block 99 Percent of HIV … – Kansas City infoZine

HIV/AIDS Pose Risks For Small Businesses in South Africa – Voice of America

Newly Approved HIV Test Can Spot Infection Earlier – BusinessWeek

Mothers Urged To Use Breast-Feeding Rights –

Report Says G8 Countries Short $10B On $50B Commitment, Reveals Mixed Progress … – Kaiser Family Foundation

Tom Fiebiger, Fargo, ND schools need comprehensive sex ed – Grand Forks Herald

NYC Maternal Pregnancy Deaths Twice the National Average – NBC New York

Kourtney Pumps Breast Milk on TV After Kim Slams Public Nursing – Us Magazine

June 22, 2010

Defendant in rape-abortion waives hearing – Pocono Record

Kagan’s record on abortion stirs bipartisan unease – Boston Globe

What would make one columnist drive around Wellesley – The Swellesley Report

EMILY’s List President: Our Stand on Abortion Rights Is Unwavering – Politics Daily

IUDs: the Better Contraceptive? – Ivanhoe

Anti-family planning group sues govt to stop sex education – Manila Standard Today

Opinion: Canada can help to intensify war against killer diseases – Toronto Star

Pregnancy-Related Deaths More Likely in New York City – The Epoch Times

Gay Workers Will Get Time to Care for Partner’s Sick Child – New York Times

Analysis Law and Policy

Justice Kennedy’s Silence Speaks Volumes About His Apparent Feelings on Women’s Autonomy

Imani Gandy

Justice Anthony Kennedy’s obsession with human dignity has become a hallmark of his jurisprudence—except where reproductive rights are concerned.

Last week’s decision in Whole Woman’s Health v. Hellerstedt was remarkable not just for what it did say—that two provisions in Texas’s omnibus anti-abortion law were unconstitutional—but for what it didn’t say, and who didn’t say it.

In the lead-up to the decision, many court watchers were deeply concerned that Justice Anthony Kennedy would side with the conservative wing of the court, and that his word about targeted restrictions of abortion providers would signal the death knell of reproductive rights. Although Kennedy came down on the winning side, his notable silence on the “dignity” of those affected by the law still speaks volumes about his apparent feelings on women’s autonomy. That’s because Kennedy’s obsession with human dignity, and where along the fault line of that human dignity various rights fall, has become a hallmark of his jurisprudence—except where reproductive rights are concerned.

His opinion on marriage equality in Obergefell v. Hodges, along with his prior opinions striking down sodomy laws in Lawrence v. Texas and the Defense of Marriage Act in United States v. Windsor, assured us that he recognizes the fundamental human rights and dignity of LGBTQ persons.

On the other hand, as my colleague Jessica Mason Pieklo noted, his concern in Schuette v. Coalition to Defend Affirmative Action about the dignity of the state, specifically the ballot initiative process, assured us that he is willing to sweep aside the dignity of those affected by Michigan’s affirmative action ban in favor of the “‘dignity’ of a ballot process steeped in racism.”

Meanwhile, in his majority opinion in June’s Fisher v. University of Texas, Kennedy upheld the constitutionality of the University of Texas’ affirmative action program, noting that it remained a challenge to this country’s education system “to reconcile the pursuit of diversity with the constitutional promise of equal treatment and dignity.”

It is apparent that where Kennedy is concerned, dignity is the alpha and the omega. But when it came to one of the most important reproductive rights cases in decades, he was silent.

This is not entirely surprising: For Kennedy, the dignity granted to pregnant women, as evidenced by his opinions in Planned Parenthood v. Casey and Gonzales v. Carhart, has been steeped in gender-normative claptrap about abortion being a unique choice that has grave consequences for women, abortion providers’ souls, and the dignity of the fetus. And in Whole Woman’s Health, when Kennedy was given another chance to demonstrate to us that he does recognize the dignity of women as women, he froze.

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He didn’t write the majority opinion. He didn’t write a concurring opinion. He permitted Justice Stephen Breyer to base the most important articulation of abortion rights in decades on data. There was not so much as a callback to Kennedy’s flowery articulation of dignity in Casey, where he wrote that “personal decisions relating to marriage, procreation, contraception, family relationships, child rearing, and education” are matters “involving the most intimate and personal choices a person may make in a lifetime, choices central to personal dignity and autonomy.” (While Casey was a plurality opinion, various Court historians have pointed out that Kennedy himself wrote the above-quoted language.)

Of course, that dignity outlined in Casey is grounded in gender paternalism: Abortion, Kennedy continued, “is an act fraught with consequences for others: for the woman who must live with the implications of her decision; for the persons who perform and assist in the procedures for the spouse, family, and society which must confront the knowledge that these procedures exist, procedures some deem nothing short of an act of violence against innocent human life; and, depending on one’s beliefs, for the life or potential life that is aborted.” Later, in Gonzales, Kennedy said that the Partial-Birth Abortion Ban “expresses respect for the dignity of human life,” with nothing about the dignity of the women affected by the ban.

And this time around, Kennedy’s silence in Whole Woman’s Health may have had to do with the facts of the case: Texas claimed that the provisions advanced public health and safety, and Whole Woman’s Health’s attorneys set about proving that claim to be false. Whole Woman’s Health was the sort of data-driven decision that did not strictly need excessive language about personal dignity and autonomy. As Breyer wrote, it was a simple matter of Texas advancing a reason for passing the restrictions without offering any proof: “We have found nothing in Texas’ record evidence that shows that, compared to prior law, the new law advanced Texas’ legitimate interest in protecting women’s health.”

In Justice Ruth Bader Ginsburg’s two-page concurrence, she succinctly put it, “Many medical procedures, including childbirth, are far more dangerous to patients, yet are not subject to ambulatory-surgical-center or hospital admitting-privileges requirements.”

“Targeted Regulation of Abortion Providers laws like H.B. 2 that ‘do little or nothing for health, but rather strew impediments to abortion,’ cannot survive judicial inspection,” she continued, hammering the point home.

So by silently signing on to the majority opinion, Kennedy may simply have been expressing that he wasn’t going to fall for the State of Texas’ efforts to undermine Casey’s undue burden standard through a mixture of half-truths about advancing public health and weak evidence supporting that claim.

Still, Kennedy had a perfect opportunity to complete the circle on his dignity jurisprudence and take it to its logical conclusion: that women, like everyone else, are individuals worthy of their own autonomy and rights. But he didn’t—whether due to his Catholic faith, a deep aversion to abortion in general, or because, as David S. Cohen aptly put it, “[i]n Justice Kennedy’s gendered world, a woman needs … state protection because a true mother—an ideal mother—would not kill her child.”

As I wrote last year in the wake of Kennedy’s majority opinion in Obergefell, “according to [Kennedy’s] perverse simulacrum of dignity, abortion rights usurp the dignity of motherhood (which is the only dignity that matters when it comes to women) insofar as it prevents women from fulfilling their rightful roles as mothers and caregivers. Women have an innate need to nurture, so the argument goes, and abortion undermines that right.”

This version of dignity fits neatly into Kennedy’s “gendered world.” But falls short when compared to jurists internationally,  who have pointed out that dignity plays a central role in reproductive rights jurisprudence.

In Casey itself, for example, retired Justice John Paul Stevens—who, perhaps not coincidentally, attended the announcement of the Whole Woman’s Health decision at the Supreme Court—wrote that whether or not to terminate a pregnancy is a “matter of conscience,” and that “[t]he authority to make such traumatic and yet empowering decisions is an element of basic human dignity.”

And in a 1988 landmark decision from the Supreme Court of Canada, Justice Bertha Wilson indicated in her concurring opinion that “respect for human dignity” was key to the discussion of access to abortion because “the right to make fundamental personal decision without interference from the state” was central to human dignity and any reading of the Canadian Charter of Rights and Freedoms 1982, which is essentially Canada’s Bill of Rights.

The case was R. v. Morgentaler, in which the Supreme Court of Canada found that a provision in the criminal code that required abortions to be performed only at an accredited hospital with the proper certification of approval from the hospital’s therapeutic abortion committee violated the Canadian Constitution. (Therapeutic abortion committees were almost always comprised of men who would decide whether an abortion fit within the exception to the criminal offense of performing an abortion.)

In other countries, too, “human dignity” has been a key component in discussion about abortion rights. The German Federal Constitutional Court explicitly recognized that access to abortion was required by “the human dignity of the pregnant woman, her… right to life and physical integrity, and her right of personality.” The Supreme Court of Brazil relied on the notion of human dignity to explain that requiring a person to carry an anencephalic fetus to term caused “violence to human dignity.” The Colombian Constitutional Court relied upon concerns about human dignity to strike down abortion prohibition in instances where the pregnancy is the result of rape, involves a nonviable fetus, or a threat to the woman’s life or health.

Certainly, abortion rights are still severely restricted in some of the above-mentioned countries, and elsewhere throughout the world. Nevertheless, there is strong national and international precedent for locating abortion rights in the square of human dignity.

And where else would they be located? If dignity is all about permitting people to make decisions of fundamental personal importance, and it turns out, as it did with Texas, that politicians have thrown “women’s health and safety” smoke pellets to obscure the true purpose of laws like HB 2—to ban abortion entirely—where’s the dignity in that?

Perhaps I’m being too grumpy. Perhaps I should just take the win—and it is an important win that will shape abortion rights for a generation—and shut my trap. But I want more from Kennedy. I want him to demonstrate that he’s not a hopelessly patriarchal figure who has icky feelings when it comes to abortion. I want him to recognize that some women have abortions and it’s not the worst decision they’ve ever made or the worst thing that ever happened to him. I want him to recognize that women are people who deserve dignity irrespective of their choices regarding whether and when to become a mother. And, ultimately, I want him to write about a woman’s right to choose using the same flowery language that he uses to discuss LGBTQ rights and the dignity of LGBTQ people.  He could have done so here.

Forcing the closure of clinics based on empty promises of advancing public health is an affront to the basic dignity of women. Not only do such lies—and they are lies, as evidenced by the myriad anti-choice Texan politicians who have come right out and said that passing HB 2 was about closing clinics and making abortion inaccessible—operate to deprive women of the dignity to choose whether to carry a pregnancy to term, they also presume that the American public is too stupid to truly grasp what’s going on.

And that is quintessentially undignified.

Roundups Law and Policy

Gavel Drop: Conservatives Try New Tactic to Discredit Fetal Tissue Research

Imani Gandy & Jessica Mason Pieklo

But what they need to do is give up their fight against it.

Welcome to Gavel Drop, our roundup of legal news, headlines, and head-shaking moments in the courts.
Republicans absolutely refuse to give up on their campaign to discredit fetal tissue research.
Attorneys in Florida are challenging portions of a new anti-abortion law that tries to block Medicaid funding to Planned Parenthood, mandate additional inspections of abortion clinics, and change the definitions of pregnancy trimesters.
So Bill Cosby’s sexual assault trial is moving forward. At least for now.
Meanwhile, some states are reconsidering statutes of limitations in rape cases.
This look at the costs to children and states when a parent is incarcerated is just devastating.
A federal judge ruled Portland, Maine can’t use its noise ordinance to restrict clinic protesters’ access to a local Planned Parenthood.
In other news about clinic protests, a federal appeals court revived a challenge to a Pittsburgh buffer zone ordinance.
Broadly explores how Texas clinic closures are affecting women who are undocumented.
Colorado State University was not illegally using tax dollars to subsidize abortions, ruled a Colorado judge.
Turns out that even the women on the Supreme Court get interrupted more than their male colleagues during oral arguments.
The U.S. women’s soccer team continues to fight for equal playing conditions, this time arguing they have the right to strike if concerns about poor playing conditions and equal pay are not addressed.
Speaking of pushing equality forward, this transgender veteran sued the barber who refused to do their hair.
Justice Stephen Breyer may be driving the Supreme Court’s compromise efforts in Zubik v. Burwell, not Justice Anthony Kennedy as Linda Greenhouse of the New York Times previously thought.