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© Ellen Shub

Advocacy & Activism

Pregnancy & Birth
Egg Donation: Associated Risks & Transparency
Commercial Global Surrogacy
Breast Implants: Safety & Health
Educate Congress – and All Public Officials

PREGNANCY & BIRTH: EVIDENCE-BASED CARE

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U.S. maternity care is not based on the best available evidence, nor is it distributed equally. The question is: What can be done about it?

OBOS has long supported a midwifery model of care as a way of encouraging adherence to evidence-based care that improves the health outcomes of both mothers and babies. The midwifery model is based on the assumption that most pregnancies, labors and births are normal biological processes. The focus, therefore, is on maximizing the health and wellness of a woman and her baby, identifying and managing medical problems early on, and attending to the emotional, social, and spiritual aspects of pregnancy and birth.

This differs from a strict medical model of care that views pregnancy, labor and birth as a risky act that must be managed with high-tech procedures and interventions, even when a pregnancy is low-risk. Read more about both models.

OBOS played an instrumental role in the development of Choices in Childbirth, a statement produced in collaboration with physicians, midwives and women’s health advocates.

Choices in Childbirth shows the growing support for evidence-based birth models. The statement supports: preserving the option for vaginal birth after cesarean (VBACs); hospital-based midwifery care; licensing and regulation of Certified Professional Midwives (CPMs); and adherence to evidence-based practices to reduce pre-term and low-weight births.

OBOS also built medical and political support for the licensing and regulation of Certified Professional Midwives (CPMs), especially in Massachusetts, where both House and Senate bills have been proposed. OBOS has encouraged support for MA S.1206/H.1189, “An Act Relative to Out-of-Hospital Birth Access and Safety,” which would require all midwives practicing in out-of-hospital settings to be accredited as Certified Professional Midwives (CPMs) according to newly-established educational standards.

The bill establishes a special Committee on Midwifery under the Department of Public Health (with a majority of midwives) to determine practice guidelines and includes a Bridge Certificate for current direct entry midwives who need to upgrade their present status. Learn more about the bill and learn why OBOS co-founder Judy Norsigian and longtime midwife and educator Jo-Anna Rorie believe it is a key means of securing economic and racial justice for women who now cannot afford to pay for home birth midwives out of pocket.

EGG DONATION: ASSOCIATED RISKS & TRANSPARENCY

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As couples and individuals rely more on assisted reproductive technology to overcome infertility and other health issues and to make parenthood possible for same-sex couples, the demand for donor eggs is on the rise. Our Bodies Ourselves has raised concerns about the lack of safety data — especially long-term safety data — regarding the health risks egg donors may face.

In 2018, OBOS commissioned a video developed by Raquel Cool, co-founder of We Are Egg Donors. Cool and others share their experiences and concerns related to paid egg donation, from the risks associated with unethically high numbers of harvested eggs to the absence of data on the health of those that provide these eggs.

Beginning in the early 2000s, infertility clinics increased recruitment of young women, encouraging them to donate their eggs for infertility and research purposes. These ads became especially common on college campuses and in public spaces where they were likely to be seen by college-age women.

In response, OBOS launched a petition to demonstrate to state and national policy makers the importance of implementing a national health registry to oversee donor health tracking. Other participating groups include the Alliance for Humane Biotechnology, Pro Choice Alliance for Responsible Research, and the Center for Genetics and Society.

The petition encourages long-term studies to better understand the health risks, particularly with respect to the impact of drugs used for both suppression and stimulation of the ovaries, and urges that advertisements and notices seeking egg donors be required to state that long-term risks of egg-harvesting procedures are unknown.

OBOS also partnered with the Infertility Family Research Registry, a volunteer registry based at Dartmouth-Hitchcock Medical Center, to increase awareness of its data collection and encourage participation.

Some women who take drugs to stimulate egg production report mild or moderate reactions such as bloating, abdominal pain, or mood swings. The more potentially serious medical issues include ovarian hyperstimulation syndrome (OHSS), which causes the ovaries to become swollen and painful. Severe OHSS can cause a dangerous build-up of fluid in the the abdomen and chest.

What does it mean for a young woman’s future fertility or her longer term risk of cancer and other health problems if she provides eggs repeatedly, especially within a short period of time? We simply don’t know enough — and this means that young women still do not have the information they need to make evidence-based choices or give truly informed consent.

INTERNATIONAL COMMERCIAL SURROGACY

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International commercial surrogacy is largely regarded as a business; some even call it an industry. While there are well-meaning go-betweens who genuinely want to protect the interests of their clients — the intended parents — and help them form families, others mainly prioritize their own interests, subjecting the parents to fraud and overcharging or denying them basic information. Either way, the vast majority of gestational mothers (surrogates) are left to fend for themselves, with no one looking out for their needs.

In 2016, OBOS created Surrogacy360.org, an educational website that serves as a clearinghouse for information on commercial international surrogacy and the effects on all parties: intended parents, donors, gestational mothers and children.  The site promotes transparency and best medical practices by documenting the health, legal, and ethical aspects of surrogacy arrangements. The Center for Genetics & Society is now overseeing the website.

BREAST IMPLANTS: SAFETY & HEALTH

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While breast augmentation procedures are popular, many women remain unaware of the potential health risks and the debate over implant safety. OBOS worked for years to ensure women are fully informed about the safety risks of breast implants and are able to remove implants when their health is at risk.

After the passage of the Affordable Care Act, OBOS worked with the National Center for Health Research in several key states to ensure that health insurance policies under the Affordable Care Act cover treatment and breast implant removal when it is medically necessary — such as for removal of leaking breast implants, painful capsular contracture, or ALCL, a rare type of lymphoma that can be caused by breast implants.

OBOS has also worked collaboratively with Carol Ciancutti, director of the acclaimed documentary “Absolutely Safe.” Carol and Judy Norsigian, OBOS’s current board chair, have toured the country to screen the film and meet with college students and community groups to discuss the health risks of implants. The movie’s goal is to “bring the controversy into focus, leaving viewers more informed and inspired to ask questions about implant safety, implant regulation, the rising popularity of implants, and the reasons why so many women make this choice.”

In 2017 – 2018, OBOS and Carol created new resources to update the information in the film and to help facilitate rich discussions at public screenings. These resources include a discussion guide for college and university professors and community educators, to use in conjunction with screenings, as well as an update on breast implant safety and a list of resources for teachers. 

If you, or anyone you know, have breast implants that are making you sick and need to be removed, please contact the National Center for Health Research: info[AT]breastimplantinfo.org. They can help you try to get health insurance to cover your medically necessary breast implant removal surgery.

For more information, see Facts About Breast Implants.

EDUCATE CONGRESS – AND ALL PUBLIC OFFICIALS

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Legislators frequently vote on bills that affect reproductive health, taking on difficult issues that have a very real impact on women and families, yet those bills are not always based on the best available scientific evidence. That’s why OBOS launched the successful Educate Congress campaign, during which we delivered copies of “Our Bodies, Ourselves” to every member of the House and Senate. The initiative was completed in 2013.

There’s still more work to be done. Many states have enacted laws that are harmful to women’s health, and schools around the country are promoting sex-education programs that don’t teach the facts.

From what I understand from doctors, [pregnancy from rape is] really rare. If it’s a legitimate rape, the female body has ways to try to shut that whole thing down.

-Former Rep. Todd Akin (Aug. 19, 2012)

That wildly inaccurate statement sparked OBOS’s sex-ed road trip with The Ladydrawers to deliver “Our Bodies, Ourselves” to then-Rep. Todd Akin and, in the spirit of non-partisanship, Sen. Claire McCaskill in Missouri.

Akin wasn’t the only politician who had his facts wrong; a string of inaccurate comments about women’s bodies followed in the fall of 2012, prompting numerous debates on the politics of women’s healthcare.

Readers suggested sending “Our Bodies, Ourselves” — a valued resource used in healthcare clinics and academic courses across the country — to every member of Congress.

The Educate Congress campaign kicked off at the National Press Club. Funds were raised via Indiegogo with this simple premise: Everyone deserves access to accurate information concerning women’s reproductive and sexual health — especially those who write the laws.

In early 2013, OBOS delivered books to all members of the U.S. House and Senate. Judy Norsigian, OBOS co-founder, made a number of deliveries in person. Read about Judy’s visit to Capitol Hill, accompanied by Christy Turlington Burns, founder of Every Mother Counts, and Erin Thornton, EMC executive director.

MEDIA COVERAGE