India To Create National Registry Of Pregnancies, Abortion To Reduce Sex-Selective Abortion, Infant Mortality

The Indian government is planning to create a national registry of all pregnancies and abortions performed in the country in an effort to curb sex-selective abortion and infant mortality, Minister for Women and Child Development Renuka Chowdhury said on Thursday, the Hindustan Times reports (Chauhan, Hindustan Times, 7/13).

According to a UNICEF report released in December 2006, about 7,000 fewer girls than expected are born daily in India, and about 10 million fewer girls than expected were born in the past 20 years. The most recent Indian census figures found that the gender ratio decreased from 947 girls per 1,000 boys to 927 girls per 1,000 boys from 1991 to 2001.

The country in 1994 approved the Prenatal Determination Act, which bans the use of technologies, such as ultrasounds and sonograms, for the purpose of sex-selective abortion. The law also bans advertisements for prenatal sex determination, as well as the practice of preconception sex selection (Kaiser Daily Women's Health Policy Report, 4/18). India currently encourages pregnant women to voluntarily register with community health workers to receive health and nutrition services, an official said (Agence France-Presse, 7/13).

Government's Plan
The government would like to have public and private health centers, hospitals and maternity homes in the country to record pregnancies and abortions, Reuters reports. The government also aims to increase the number of health workers who will locate and provide care to pregnant women in rural areas (Zaheer, Reuters, 7/13). Chowdhury said that abortions will be permitted only when there is "valid and acceptable reason." According to the Hindustan Times, officials would not say what criteria would be used to determine if an abortion is "acceptable and valid."

Chowdhury said the registry also will help locate facilities that provide sex-selective abortions. An unnamed government official said that the "confidential information" recorded at the facilities "will then be passed on to local health officials who will maintain a data bank" and that the data would help officials to focus on locations that show huge gaps between the numbers of pregnancies and births (Hindustan Times, 7/13).

Reaction
Marzio Babille, UNICEF's head of health in India, said, "Registering pregnancies is good," adding, "If we act upon mothers by registering pregnancies, offering quality antenatal care, good counseling to deal with complications and an efficient transportation network, ... this would enormously help promote institutional deliveries and strengthen and expand the safe maternity scheme." Some family planning advocates said it is unrealistic to create registry in the country, in which 1.1 billion people live and more than 50% of pregnant women deliver children without medical assistance, Reuters reports.














"We cannot give elementary health services in a satisfactory way to most of our citizens, and to talk about registering pregnancies is ridiculous," Alok Mukhopadhyay, head of the Voluntary Health Association of India, said, adding, "Public awareness, empowerment of women and extension of health services are key in fighting infant mortality and feticide, as well as implementing the existing laws that forbid sex determination" (Reuters, 7/13). Ranjana Kumari, president of a consortium of women's groups called WomenPowerConnect, said that the plan could "lead to too much intrusion in somebody's private life," adding that the data will be difficult to obtain (Hindustan Times, 7/13).


PRI's "The World" on Friday included a discussion with Urvashi Bhuttalia, a writer and publisher on gender issues in India, about the proposal (Werman, "The World," PRI, 7/13). Audio of the segment is available online.

"Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

Maternal Placental Syndrome Increases Risk of Cardiovascular Disease, Study Says

Pregnant women who experience maternal placental syndrome -- which includes high blood pressure and preeclampsia -- are three times as likely as other women to later experience cardiovascular disease, according to a study published in the Nov. 19 edition of the journal Lancet, the Toronto Star reports (Harvey, Toronto Star, 11/18). Joel Ray and colleagues at the University of Toronto studied the records of more than one million women living in Canada's Ontario province who had not had cardiovascular disease before delivering their first infant. Researchers examined the women's medical records for evidence of cardiovascular disease for an average of nine years after giving birth (BBC News, 11/18). Out of the approximately 75,000 women who were diagnosed with maternal placental syndrome, 305 experienced a heart attack, angina, stroke, or peripheral artery disease or needed surgery to open blocked arteries within nine years of giving birth. The average age of a "serious cardiovascular event" among the women was 38 years old, and the average age of first birth among study participants was 28 years old, the CP/Canada reports (Ubelacker, CP/Canada, 11/19). "We believe the maternal placental syndrome should be considered as an additional risk factor for cardiovascular disease," Ray said (Reuters, 11/17). Ray said that a woman's "metabolic state prior to pregnancy, during pregnancy and after pregnancy that predisposes her to both maternal placental syndrome and cardiovascular disease" (CP/Canada, 11/18).


"Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

New Ovarian Transplant Technique Could Expand Use Of Procedure To Preserve Fertility

Two recent advancements in ovarian transplant techniques could potentially expand the availability of the procedure for women seeking to avoid fertility problems as they age, researchers reported Monday at a meeting of the European Society of Human Reproduction and Embryology, the AP/Yahoo! News reports. According to the AP/Yahoo! News, ovary transplants traditionally have been performed on women with cancer as a method of preserving fertility after chemotherapy or other treatments that can affect the reproductive system. The procedure involves removing the ovaries before treatment and re-implanting them after treatment is complete. Because only a handful of these procedures have been successful, ovarian transplants have been an option only for women with serious diseases. However, as more women delay having children until their 30s or 40s, researchers say the new techniques, in theory, could make it simpler for healthy younger women to have an ovary removed, frozen and then re-implanted later in life when they are ready to have children.

The first study examined how many eggs were lost or preserved in fresh and frozen ovarian tissue of 15 young women prior to the start of cancer treatment. According to the study, there was no difference in the quantity of eggs in the fresh tissue and in the ovaries frozen using a new ultra-fast technique. The study found that about 50% of a woman's eggs were lost using the traditional, slow-freezing methods of preserving the ovaries.

The second study reported on a new surgical technique to restore an ovary's function after transplantation. For the study, Pascal Piver of Limoges University Hospital and colleagues divided the transplant process into two separate procedures in an attempt to more quickly re-establish blood and hormone supplies to the ovary. In the first procedure, the researchers performed a graft of small pieces of ovarian tissue to prompt blood vessels to grow. They performed the ovary transplant three days later. The technique was successful in a woman who lost fertility because of treatment for sickle cell anemia.

Sherman Silber, director of the St. Louis Infertility Center in Missouri and a researcher for the first study, said the new techniques "could dramatically expand our reproductive life span." He added, "This is not an experimental procedure for cancer patients anymore. The question is whether more women should be able to have this option" (Cheng, AP/Yahoo! News, 6/29).


Reprinted with kind permission from nationalpartnership. You can view the entire Daily Women's Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women's Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.


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Amnesty International Report Calls For Efforts To Address U.S. Maternal Mortality Rate

Maternal deaths in the U.S. have doubled over the last 20 years, according to a new report from Amnesty International that frames the issue "as part of a systematic violation of women's rights," Time reports. The report, titled "Deadly Delivery," found that more than two women die of pregnancy-related causes each day in the U.S. About half of pregnancy-related deaths in the U.S. are preventable, according to the report (Block, Time, 3/12). About 1.7 million women a year, one-third of pregnant women in the United States, suffer from pregnancy-related complications, with the lifetime risk of maternal death in this country greater than for women in 40 other countries, the report said (Smith, CNN, 3/12).

Nan Strauss, the report's co-author, said, "In the U.S., we spend more than any other country on health care, yet American women are at greater risk of dying from pregnancy-related causes than in 40 other countries." She also said, "Women are not dying from complex, mysterious causes that we don't know how to treat," adding, "Women are dying because it's a fragmented system, and they are not getting the comprehensive services that they need" (Time, 3/12).

Larry Cox, executive director of Amnesty International USA, said, "This country's extraordinary record of medical advancement makes its haphazard approach to maternal care all the more scandalous and disgraceful" (CNN, 3/12).

The U.S. maternal mortality rate was 13.3 deaths per 100,000 births in 2006, compared with 6.6 maternal deaths per 100,000 births in 1987, the report found. Amnesty said the actual number of maternal deaths could be much higher because there are no federal requirements to report such outcomes and because data collection at state and local levels is often inadequate (Time, 3/12). In addition, pregnancy-related complications that almost caused death rose by 25% since 1998.

U.S. black women have a much higher maternal mortality rate than white women. The rate for white women is 9.5 deaths per 100,000 pregnancies, compared with 32.7 deaths among black women (CNN, 3/12). At the same time, black women are less likely than white women to experience certain complications, such as hemorrhages.

According to Amnesty's report, many pregnancy-related deaths in the U.S. are the result of systemic failures, such as barriers to accessing care; inadequate, neglectful or discriminatory care; or overuse of interventions -- such as labor induction or caesarean sections. Poverty is a major factor in women's access to proper care, Amnesty said. However, overuse of obstetrical interventions and barriers to accessing midwives and family-practice doctors can decrease the quality of care for all women.

In the report, Amnesty requests that President Obama create an Office of Maternal Health within HHS to improve outcomes for pregnant women and reduce disparities in care, among other initiatives. It also asks the federal government to address the shortage of maternity-care providers (Time, 3/12).


Reprinted with kind permission from nationalpartnership. You can view the entire Daily Women's Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women's Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.


© 2010 The Advisory Board Company. All rights reserved.