Christina Asima seems tired for a 13-year-old. I meet the shy-mannered girl in the remote farming village of Chitera, in the southern African nation of Malawi. She wears a bright pink zip-up shirt and a blue print cloth wrapped up to her chest. Snuggled in that, hugging her side, is a chubby-cheeked baby boy.
My gut assumption is that the infant must be Christina’s little brother. I know 8-month-old Praise is actually her son. Still, it’s startling when, as we speak, she shifts him around front to nurse.
"I was 12 years old when I got married to my husband," she explains softly. "My mom had run away, so I was forced to get married to help my other siblings."
Despite decades of international and local efforts to curb child marriage, it’s estimated that 1 in 3 girls still marries before age 18 in developing countries; 1 in 9 marries before age 15. And the numbers are even worse in Malawi.
In fact, pregnancy and childbirth are the leading causes of death worldwide for girls ages 15 to 19.
Malawi law permits marriage at 15 with parental consent and merely “discourages” it at younger ages. But last summer Chitera passed its own legal age of marriage — 21 — with the ambitious goal that every girl attend college.
Parents in the village now face a steep penalty if parents marry off a daughter before age 21.
"They have to give five goats to the chief," says another local official, Roben Ndrama, "and eight chickens to the village headmen."
In a more humiliating measure, some parents have been made to scrub clean the local health center. Ndrama laughs when I ask if parents get mad about that.
"It’s worked!" he says. "This year there’ve been no early marriages."
Photograph: Christina Asima says she had no choice but to marry last year at age 12 to help care for younger siblings after her mother abandoned the family. But she says her husband was abusive, so she left him, and now must look after her 8-month-old son, Praise, alone. (Jennifer Ludden/NPR)
What will it take to make intrauterine devices sexy?
IUDs are highly effective forms of contraception, but fear of side effects, lack of training for doctors and costs can keep women away. Health organizations and private companies are trying to change that by breaking down misconceptions and broadening access.
The contraceptives are inserted into the uterus and can prevent pregnancy for years. And they’re reversible. Shortly after they’re taken out, a woman can become pregnant.
IUDs are more than 99 percent effective. The World Health Organization reports they are “the most widely used reversible contraceptive method globally.” But few women in the U.S. use them; the percentage is only in the single digits, in part because IUDs have a checkered past. The Dalkon Shield IUD, marketed nationwide beginning in 1971, was found to raise the risk of pelvic inflammatory disease. Medical complications and deaths sparked lawsuits with thousands of claimants.
"So we had a whole generation in the ’70s and ’80s … where doctors and clinicians weren’t trained and women didn’t have that option," says Dr. Jeffrey Peipert, a professor of obstetrics and gynecology at Washington University in St. Louis.
The two common intrauterine devices in the U.S. are ParaGard, which releases copper to interfere with sperm, and Mirena, which prevents pregnancy with the hormone progesterone. There is still a slight risk of pelvic inflammatory disease. But Bayer Healthcare Pharmaceuticals, the maker of Mirena, says fewer than 1 percent of users of its device get the infection. More common side effects for women using IUDs are irregular bleeding or cramping.
Upfront costs also limit access; the price of the device and getting it inserted can cost hundreds of dollars.
But Mirena works for up to five years, and the copper IUD up to 10. So over time, they can actually be cheaper than monthly payments for, say, the pill. And IUDs, like other contraceptives approved by the Food and Drug Administration, are expected to be covered for most users under the Affordable Care Act.
The true extent of female genital mutilation or cutting is huge and revealed on Monday in a report from Unicef (pdf). It says a total of 125 million women and girls are now living with the consequences of FGM – and yet the report suggests that the practice continues only because of social convention, while most women and men wish it would end. There are 29 countries in Africa where FGM is now practiced but over half the girls who are cut live in just three – Egypt, Ethiopia and Nigeria.
In terms of the percentage of girl who are cut, Egypt is in fourth place, below Somalia on 98%, Guinea on 96% and Djibouti on 93%. At the bottom end of the scale, in Uganda and Cameroon, just 1% of girls are cut. In more than half the 29 countries studied, Unicef says FGM is becoming slightly less common – in Kenya and Tanzania, the older generation of 45- to 49-year-old women are three times more likely to have undergone FGM than today’s 15- and 16-year-olds.
(From MWB News)
(From the Office of Women’s Health, OWH.)
The anti-abortion laws of Texas may be daunting, but Amber Tamblyn and David Cross channel their frustration over reproductive health-care regulation into comedy in a new video.
"The personal is political," goes the mantra of second-wave feminism. In a new video starring real-life power couple Amber Tamblyn and David Cross, the personal is both political and hilarious, albeit in a kind of depressing way.
Gynoticians finds Tamblyn playing a patient looking for birth control from her gynecologist, and Cross plays the white-coated doctor who offers twisted advice like, “Find a gentleman that’ll intercourse the cramps out of you.” Many people—including the politically active Tamblyn and Cross—are more than a little upset after a wave of new laws passed recently in states from Texas to Wisconsin that increase government regulation of reproductive health services. Those laws have brought protesters out to the capitols and the streets in all of the states facing the new laws and have garnered a ton of media attention (a CNN report yesterday declared this "The Summer of Abortion"). But the laws probably haven’t been satirized effectively until now.
In the four-minute clip, Cross plays the sort of bumbling beardo that he’s built his career around: In this case, a self-described “gynotician,” which Planned Parenthood’s website defines as “a politician who feels more qualified than women and their doctors to make women’s health-care decisions.” As such, he lectures Tamblyn’s patient about the evils of ObamaCare and about why she doesn’t need birth control; panics at the mention of the word “abortion”; talks about his B.A. from “Todd Akin Non-Technical College of Biologicalish Studies and Rhetoric”; and boasts that his clinic is the last one left in 200 miles. Tamblyn, meanwhile, is left to play the shocked straight woman, making increasingly horrified faces as Cross lays on the grim tidings ever thicker.
As funny as the video is, presumably Cross and Tamblyn would prefer not to be in a position where they felt as though they had to make it.
Angelique Kidjo speaks out about female genital mutilation/cutting
UNICEF Goodwill Ambassador Angelique Kidjo speaks out about female genital mutilation/cutting. The singer and activist gave a concert at the United Nations to raise awareness on the issue and spoke with UNICEF to share her thoughts and concerns about this practice.
On 22 July, we launch a new report about female genital mutilation/cutting that looks at data from 29 countries over the past 20 years. Our main finding? Overall, support for the practice is declining - even in countries where FGM/C is widespread, such as Egypt and Sudan.
But there is still work to be done! In a few countries, the proportion of girls and women who want FGM/C to continue has remained constant.
Bottom line: birth control works really well when you use it correctly all the time.
BY ITS fifth month, Beatriz’s pregnancy had become dangerously complicated. Scans showed that the fetus was developing without parts of its brain and skull and would not survive more than a few hours outside the womb. Beatriz (not her real name) was suffering from kidney problems and lupus, an autoimmune disease, which had become so acute that her doctors said she risked death too. With the backing of El Salvador’s health ministry, she decided to terminate the pregnancy.
Not so fast, said the Supreme Court, ruling on May 29th that the constitution’s protection of all citizens “from the moment of conception” meant that abortion could not be permitted in any circumstances. Hours later, the Inter-American Court of Human Rights ordered that the government should give Beatriz’s doctors access “without interference” to whatever measures were necessary to save her life.
A compromise was reached: rather than have an abortion, Beatriz could undergo a premature caesarean section. Since she was already past 20 weeks of pregnancy, the operation could be considered an “induced birth”, not an abortion, the health ministry said. This seemed to satisfy the courts. On June 3rd the baby was delivered, and died a few hours later. Beatriz was in intensive care as The Economist went to press.
This sorry story and its face-saving solution is typical of the ineffective abortion regime present in most of Latin America. At the urging of the Catholic church, abortion is banned under all circumstances—including rape, and where the mother faces death—in Chile, the Dominican Republic, Haiti, Honduras, Nicaragua and Suriname, as well as in El Salvador. In most other countries it is highly restricted. Only Cuba, Guyana, Puerto Rico and Uruguay offer abortion on demand (so does Mexico City, unlike the rest of Mexico).
(From The Economist)
“It is my fundamental philosophy that patients are emotionally, mentally, morally, spiritually and physically competent to struggle with complex health issues and come to decisions that are appropriate for them.” - Dr. George Tiller
Four years ago Dr. Tiller, an abortion provider in Wichita, Kansas, was murdered. Today we remember his courageous and compassionate work as both a health care provider and a women’s health advocate.
As illustrated by this infographic, the road to obstetric fistula is fraught with delays: delays in the progression of labour, delays in getting to an appropriate facility, delays in getting the proper health treatment.
For those women unfortunate enough to sustain a fistula as a result, some are able to get the advice, care and support that leads to a brighter future. Meanwhile, an estimated 2 million women and girls remain left in the isolation of living with a condition that causes incontinence and intense suffering. The goal of the Campaign to End Fistula is to prevent the condition from occurring in the first place, and to ensure that more women have an opportunity to recover from it and regain their lives.
The infographic was produced for the Campaign to End Fistula in partnership with Johnson & Johnson, a long standing supporter of fistula programmes and efforts to reduce fistula and maternal mortality by scaling-up access to maternal health services and skilled birth attendants.
(From Campaign to End Fistula)