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You are here: Home / Archives for Civil Rights / Women's Rights / Contraception Clusterfuck

Contraception Clusterfuck

Notes on needing/supporting Abortions in the US, now and Post-Roe (Open Thread)

by MisterDancer|  May 3, 20227:11 pm| 78 Comments

This post is in: Activist Judges!, Civil Rights, Contraception Clusterfuck, Fuck The Poor, GOP Death Cult, Healthcare, Open Threads, Organizing & Resistance, Politics, Vote Like Your Country Depends On It, Women's Rights, Women's Rights Are Human Rights, World's Best Healthcare (If You Can Afford It), Your Place Is In The Resistance

Everything below is from my prior awareness and information collected recently. Corrections welcome:

If you need assistance, or want to help the fight via donations and/or volunteering? This document focuses on local/state level support groups.
(Thanks to UncleEbeneezer for the hookup on this!)

A broader, if slightly older (just a couple years), set of guidance is the Handbook for a Post-Roe America by Robin Marty. I can recommend the author as someone I paid into the Patreon of, before she closed it. And that was due to the quality, and importance, of her work in this area.

I hear from some sources, including a Doula I know, that acquiring Plan B now is wise — if you can w/o impacting overall supply. For those unaware, Plan B is a “morning after” drug. However, you should be clear on it’s usage and esp. it’s weight restrictions. It’s not dangerous, just has key limitations.

In addition to http://reprocare.com, mentioned in 1st link above, someone here noted https://aidaccess.org/ as another site for Abortion via mail.

I’m providing a variety of approaches — different people will have different needs. Even today, Roe is a dead letter for poorer people, especially of Color, due to lack of Internet access and ability to take time off for the procedure, if needed — including for bullshit “waiting periods”.

Many of the agencies and advocates mentioned above have experience, and guidance, in these areas. It’s worth at least getting familiar with modern options now, even if you’re in a “safe” State.

We have a lot of threads on the Roe leak. This one’s Open.

Notes on needing/supporting Abortions in the US, now and Post-Roe (Open Thread)Post + Comments (78)

Keeping Women Barefoot And Pregnant

by Cheryl Rofer|  May 9, 201910:32 pm| 81 Comments

This post is in: Contraception Clusterfuck, Women's Rights Are Human Rights, "Lock Her Up!!", All we want is life beyond the thunderdome, Assholes, Blatant Liars and the Lies They Tell

The Georgia legislature passed a law making abortion after six weeks of pregnancy illegal. I won’t go into all the details of the law. The theory is that a fetal heartbeat can be detected at that time. This is nonsense, because the embryo (it isn’t a fetus until nine weeks after conception) doesn’t have a heart at that point, although it does have a group of cells that, with luck, will become a heart and pulse together.

Pregnancies are defined from the last period, so six weeks is about when a period is late enough (for most women) that the woman starts thinking that maybe she’s pregnant. So the law bans all abortions. It also, and I haven’t dug into these details, makes it likely that women who have miscarriages can be convicted and imprisoned. Some asshole also said that it applies to ectopic pregnancies too, because the embryo/fetus should be removed from its unfortunate implantation outside the uterus and gently placed into that uterus. This is also nonsense – no such procedure has been developed.

Ohio wants to ban insurance coverage for abortion and most types of contraception. (Thanks, debbie!)

Alabama has also indulged in some sort of fuckery around a forced pregnancy law, but they haven’t gotten to voting on it yet.

The ACLU and others are challenging the Georgia law. At least two movie production companies are withdrawing from making movies in Georgia.

The responses on Twitter have been great. Here are some.

It is hard to imagine how much men hate and fear women to write those abortion laws.

— Cheryl Rofer (@CherylRofer) May 10, 2019

Great thread here – women will identify, and men should think about this.

If you didn't bleed through every pair of pants you had in 7th grade, you can't write laws about reproductive rights.

— Megan Gailey (@megangailey) May 8, 2019

My mother was big in the abortion rights movement. In the early 1960s, when abortion was still illegal, she had a miscarriage at around six months. So she's covered in blood, with a dead fetus between her legs, and the doctor told her she couldn't be cleaned up yet. GUESS WHY? 1/ https://t.co/AyUjp4sNeS

— David Avallone (@DAvallone) May 9, 2019

Hi @BeckerGOP, I’m a practicing ob-gyn and researcher on abortion and contraception, and thought you might want some help understanding ectopic pregnancy since your bill (HB182) gets some things wrong. I’ll clear up a few things in this thread. https://t.co/BdXYHnCAtI

— Dr. Daniel Grossman (@DrDGrossman) May 8, 2019

Something that I don't think most people really get is that we've never really seen abortion laws this draconian in the history of the United States, even pre-"Roe v. Wade." https://t.co/oIzaYzKxZT

— David Walsh (@DavidAstinWalsh) May 8, 2019

At six weeks, the embryo is microscopic. A late and difficult period may well be an early miscarriage. Will the legislators want to examine menstrual fluid for those microscopic people?

liz chances are you’ve flushed one of these down the toilet without noticing https://t.co/fPedwV1kw5

— Brandy Jensen (@BrandyLJensen) May 8, 2019

https://twitter.com/noboa/status/1126192158481035264

You can donate to Planned Parenthood here. (thanks joel haines)

I think it’s cool that so many women are talking so candidly about menstruation and related matters.

Over to you all.

 

 

Keeping Women Barefoot And PregnantPost + Comments (81)

Aetna, CVS and data thoughts

by David Anderson|  December 4, 20176:49 am| 30 Comments

This post is in: Anderson On Health Insurance, Contraception Clusterfuck

CVS has agreed to buy Aetna for a lot of money. This raises a lot of questions including, what is the value proposition?

Aetna already uses CVS as its PBM, so would a merger yield much more effiencies? Maybe, but not obvious. https://t.co/cLmMRugBJC

— (((Martin Gaynor))) (@MartinSGaynor) December 3, 2017

There is the obvious value proposition that CVS has 10,000 physical locations on the same information platform. I am spitballing and harkening back to my days as an insurance data geek and there are three inter-related items that could generate an incredible amount of revenue for the Aetna/insurance side of the deal. This is a risk adjustment data gold mine.

show full post on front page

Every risk adjustment system which drives money that I know needs a claim based event to trigger an action. Previous history of chronic conditions is the easiest to access predictor of current chronic conditions. When I worked at UPMC, I spent three years figuring out how to optimize the risk adjustment revenue for the Medicaid line of business. UPMC Health Plan is a multi-line insurer with products in Medicaid, CHIP, Exchange, Medicare and Employer Groups. It is not at all unusual for people to bounce between Medicaid, CHIP, Exchange and Employer coverage over time. One of my major projects that I was very happy to have completed was building an integrated data model that mined the entire UPMC claims universe instead of just the Medicaid claims universe. That increased the total revenue haul and decreased the number of false positives.

I had it easy. Data geeks working for insurers with either low market share or shallow data had a much harder time optimizing their risk adjustment revenue.

Aetna has a kick-ass data team. They have huge and deep data sets that they control. It is quite likely that a significant chunk of their risk adjusted covered lives in 2018 have shown up in some point in their data bases in the past decade. An individual who is now insured by Aetna Medicare Advantage in Texas may have had an amputation claim from Aetna Medicaid in Pennsylvania that is dated in 2009. That is valuable information to build and curate a risk adjustment optimization list.

However there are always serious holes in the Aetna list. Either someone has never been on Aetna before or there was a major change in health status when that person was covered by someone else. This is where CVS comes in. There is a good chance that CVS has filled some prescriptions for people who do not show up in Aetna’s data banks. Newly covered lives by Aetna can have a risk profile built off of CVS prescription data to minimize the number of surprises and optimize risk adjustment strategies.

This is the most obvious play from my days as a risk adjustment data geek. The other side of the far more complete pre-enrollment data universe for Aetna via the CVS pharmacy data is that Aetna will have far more granular level information on their markets. This will influence plan design, it will influence marketing materials, it will influence whether or not Aetna enters or leaves a market or bids for certain contracts.

Finally, the biggest data bonanza from my point of view is the CVS non-prescription data that is tied to the loyalty card that almost everyone carries on their keychain. This should give a massive predictive edge to the Aetna data geeks. Let me share way too much personal information to illustrate.

Our two children were extremely planned children. My wife used oral contraception until we started trying for our first child. After our daughter’s birth, we switched to condoms as our birth control method as she felt better off the pill and for the most part, we could handle a happy accident or a baby one year premature. I felt that I was tempting fate if I bought condoms from Costco. I walked past a CVS at least twice a day to and from the bus-stop I used for work. If we were running low, I would pick up condoms and a gallon of milk.

If an insurer could see the non-prescription purchases tied to the customer loyalty card, they had an excellent idea of when my wife and I started trying for Kid #2. If this was an insurer that sought to be socially productive and useful, we could expect to get mailings and outreach calls on pre-natal and perhaps pre-conception health enhancers. If the insurer was run by cynical bastards and the time of the year was right, they might try to be enough of a pain in the ass to get us to switch insurers so that someone else could pay for labor and delivery.

That is the most obvious data play that I can think of based on personal experience. I can think of using the CVS retail data as population health monitoring service, I can think of using the over the counter sales data tied to individuals to fuel predictive models for future opioid issues, or arthritis flares, or pulmonary hospital admissions or one hundred other things.

So from my former point of view as an insurance data geek, this merger offers an incredibly rich vein of data that can be mined and minted. This makes a lot of sense to me without even thinking about how the entire pharmacy benefit management function is a messed up situation.

Aetna, CVS and data thoughtsPost + Comments (30)

Actions Have Consequences: Lysistrata Edition

by Adam L Silverman|  April 5, 20173:22 pm| 74 Comments

This post is in: America, Contraception Clusterfuck, Domestic Politics, Local Races 2018 and earlier, Open Threads, Politics, Religious Nuts 2, The War On Women, Vagina Outrage, Women's Rights Are Human Rights, Rare Sincerity, Teabagger Stupidity

I’ll just leave this here for your schadenfreude and viewing pleasure. Albo is quitting the Virginia House of Delegates.

Video: Memories…Dave Albo says his wife rejected sex with him following his transvaginal ultrasound bill https://t.co/59YUawa7s5 pic.twitter.com/jdLQcESya8

— lowkell (@lowkell) April 5, 2017

Actions Have Consequences: Lysistrata EditionPost + Comments (74)

Evidence based care in Medicaid

by David Anderson|  January 6, 201711:51 am| 37 Comments

This post is in: Anderson On Health Insurance, Contraception Clusterfuck, Free Markets Solve Everything, Fuck The Poor, The War On Women, Vagina Outrage, Women's Rights Are Human Rights, Zombie-Eyed Granny Starver, Bring On The Meteor, Nobody could have predicted

We want to do evidence based care.  We want to do things that work and avoid things that don’t work.  This sounds simple.  Let’s look at two very good natural experiments on unintended pregnancy rates:

Colorado:

    Since 2008, Colorado has successfully increased access to family planning services throughout the state, particularly for the most effective contraceptive methods, such as intrauterine devices (IUDs) and implants.

  • The Colorado Family Planning Initiative has increased health care provider education and training and reduced costs for more expensive contraceptive options, enabling more than 30,000 women in the state to choose long-acting reversible contraception….
  • When contraception, particularly the long-acting methods, became more readily available in Colorado between 2009 and 2013, the abortion rate fell 42 percent among all women ages 15 to 19 and 18 percent among women ages 20 to 24.
  • Colorado is a national leader in the use of long-acting reversible contraception, and reducing teen pregnancy and repeat pregnancies.

    • Teen birth rates in our state have declined more rapidly than in any other state or the nation as a whole.
  • The birth rate for Medicaid-eligible women ages 15 to 24 dropped sharply from 2010 to 2012, resulting in an estimated $49 million to $111 million avoided expenses in Medicaid birth-related costs alone.

More reliable and effective contraception was made available to Colorado women who had the choice to elect Long Acting Reverisble Contraception (LARC) or do something else.  A significant number of women elected to use LARC and the increased autonomy and reliability produced amazingly good results.

Texas

8c) When Texas defunded Planned Parenthood, births paid for by Medicaid rose 27%. Births are a lot more expensive than birth control. pic.twitter.com/VJgGvHVHro

— Caroline O. (@RVAwonk) January 5, 2017

 

Reducing contraceptive availability led to higher abortion rates and higher unplanned pregnancies. Earlier live births have massively negative multi-generational repercussions for both the parents and kids.

The evidence strong suggests that significant improvements in quality of life can be made and significant expenditures reduced if contraception is made readily available.

And guess what Congress will consider to be a high priority:

House Speaker Paul Ryan announced Thursday that Republicans will move to strip all federal funding for Planned Parenthood as part of the process they are using early this year to dismantle Obamacare.

Wahoo… the evidence will strongly support the hypothesis that this policy will lead to more unintended pregnancies, more abortions and far worse outcomes for far more Americans.

Evidence based policy making — Hoo Yaa

Evidence based care in MedicaidPost + Comments (37)

Why we can’t have success

by David Anderson|  November 16, 20167:47 am| 154 Comments

This post is in: Anderson On Health Insurance, Contraception Clusterfuck, The War On Women, Women's Rights Are Human Rights, All we want is life beyond the thunderdome

The kids these days…

They’re more than alright… they, as a cohort, engage in far less dumb, risk seeking behavior than my cohort did at the same point in my life.

Some good news: The teen birth rate continues to hit record lows. https://t.co/XDnrbJ5doR pic.twitter.com/AnJzLsgPfx

— Dan Diamond (@ddiamond) November 16, 2016

There are two major components of the decline. The first is that kids these days are far less stupid and idiotic and risk taking thrill seekers compared to twenty years ago. This would be Kevin Drum’s Lead hypothesis. As teenagers grow up with far lower exposures to known neurotoxins that impede judgement and encourage short term gratification, they use more judgement and think about the future a little more. They’re still teenagers but they are not stupid. Compared to my teen years, teens are having less sex. However over the past nine years, the amount of sex teens are having is fairly constant.

The other major component of the decline is far more frequent and effective contraception use. Guttmacher found that the entire decline in pregnancy rates among teens was the uptake in effective birth control utilization:

Sexual activity in the last 3 months did not change significantly from 2007 to 2012. Pregnancy risk declined among sexually active adolescent women (p = .046), with significant increases in the use of any method (78%–86%, p = .046) and multiple methods (26%–37%, p = .046). Use of highly effective methods increased significantly from 2007 to 2009 (38%–51%, p = .010). Overall, the PRI declined at an annual rate of 5.6% (p = .071) from 2007 to 2012 and correlated with birth and pregnancy rate declines. Decomposition estimated that this decline was entirely attributable to improvements in contraceptive use.

So the question going forward is whether or not we’ll see those trend lines break?

I think we will. The Federal government will go all in again on ineffective abstinence based misinformation. Essential health benefits will be redefined to exclude most highly effective birth control methods (oral hormones, IUDs, implants etc). Awareness of what works will decrease while access will decline. If we hold the amount of sex being had constant, that means more pregnancies.

I also predict that the older teens will see a lower bounce in their age adjusted pregnancy risk than younger teens. Older teens have some money, they have some knowledge of how to work the system and most importantly, the women who know that they are at high risk of unplanned pregnancy have had the ability to get long acting and reversible contraception (IUDs) to control their risk and maintain their autonomy. Younger teens in the Trump administration won’t have those advantages. I expect births to mothers under the age of 15 to increase at a higher rate than births to mothers at age 18.

Why we can’t have successPost + Comments (154)

Zika and abortions

by David Anderson|  August 23, 20166:33 am| 64 Comments

This post is in: Contraception Clusterfuck, Women's Rights Are Human Rights

Scientific America has some bad news about Zika in Puerto Rico:

“Based on the limited available information on the risk of microcephaly, we estimate between 100 to 270 cases of microcephaly might occur” between mid-2016 and mid-2017, said Dr. Margaret Honein, chief of the birth defects branch at the CDC, who was one of several authors of the study published August 19 in JAMA Pediatrics.

Politico’s Jennifer Haberkorn looks at how Zika could change the discssion on abortion:

Pregnant women with the Zika virus are at risk of giving birth to babies with devastating brain damage, which can be detected only around 18 to 20 weeks — and often much later than that. …

An Aug. 5 Harvard University-STAT poll found only 23 percent of American adults believe a woman should have access to abortion after 24 weeks of pregnancy. But that opposition softened notably when the question was framed in terms of Zika.

“Maybe the Zika epidemic and its implications for pregnant women will help us shine a light on the exactly tragic situation in which you have these abortions,” said Rep. Diana DeGette (D-Colo.), co-chairman of the House Pro-Choice Caucus.

Life and decision making gets a lot simpler when we assume that women are capable moral agents making their own decisions about their own health and autonomy.  But our political process does not allow for that.  The Politico article brings up the rubella epidemic that led to abortion being discussed in public as “respectable” discussion as it was seen as a health procedure instead of an non-punishment for the sluts (you know those girls) for having sex.

Dr. Jen Grunter writes about how she came to perform abortions during later stages of pregnancies.  Her patients needed help and she helped them.

show full post on front page

I didn’t set out to do post 20 week abortions, I just kind of ended up doing them because with each turn in medical school and residency it seemed no one else was….

However, as the doctor it was left to me to explain why we thought it best they not look. All the things no one knows how to do or wants to do are left to the doctor. Do you show a woman that her baby really is a cyclops? I know she knows because she told you between sobs when she called, or rather her husband did because she was crying so hard she couldn’t speak anymore. But is that the image I should lock in her brain for the rest of her life or the five toes? You just do the best you can. I like to think that my patients knew that….

.A law was passed to prevent abortions at KU medical center unless the life of the woman was in jeopardy… Want state funding, stop abortions. …

Guess who gets to decide if a woman passes the Kansas state government’s test for being sick enough to die from her pregnancy? Not the cardiologist who calls at 3 a.m. in a panic or the nephrologist who breathlessly corners you in the hallway or the intensivist who tracks you down on your vacation. Not any of the people who manage the illness trying to kill the pregnant woman. Not me either, but the politician who crafted the mayhem via a three-way phone call set up by the hospital attorney. And yes he was shocked beyond belief that such a scenario existed….

What is it like doing late abortions? It’s mostly very sad because no one is there because they are happy. A wanted pregnancy causing serious physical harm, well, no one is happy they are sick or that they have to terminate their wanted pregnancy to live. I know these women were happy they met me and some even returned to be my patient. That always meant a lot. “You saved my life, how could I go to someone else?” What about a wanted pregnancy with severe malformations? No joy there either.

Zika and abortionsPost + Comments (64)

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