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Tag: women's health

  • FDA advisers vote unanimously in support of over-the-counter birth-control pill | CNN

    FDA advisers vote unanimously in support of over-the-counter birth-control pill | CNN

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    CNN
     — 

    Advisers for the US Food and Drug Administration voted unanimously on Wednesday in support of making the birth-control pill Opill available over-the-counter, saying the benefits outweigh the risks.

    Two FDA advisory panels agreed that people would use Opill safely and effectively and said groups such as adolescents and those with limited literacy would be able to take the pill at the same time every day without help from a health care worker.

    The advisers were asked to vote on whether people were likely to use the tablet properly so that the benefits would exceed the risks. Seventeen voted yes. Zero voted no or abstained.

    Opill manufacturer Perrigo hailed the vote as a “groundbreaking” move for women’s health.

    “Perrigo is proud to lead the way in making contraception more accessible to women in the U.S.,” Murray Kessler, Perrigo’s president and CEO, said in a statement. “We are motivated by the millions of people who need easy access to safe and effective contraception.”

    The FDA doesn’t have to follow its advisers’ advice, but it often does. It is expected to decide whether to approve the over-the-counter pill this summer.

    If it’s approved, this will be the first birth-control pill available over the counter in the United States. Opill is a “mini-pill” that uses only the hormone progestin.

    At Wednesday’s meeting, Dr. Margery Gass of the University of Cincinnati College of Medicine thanked the FDA for its consideration of switching Opill to an over-the-counter product.

    “I think this represents a landmark in our history of women’s health. Unwanted pregnancies can really derail a woman’s life, and especially an adolescent’s life,” she said.

    The FDA has faced pressure to allow Opill to go over-the-counter from lawmakers as well as health care providers.

    Unwanted pregnancies are a public health issue in the US, where almost half of all pregnancies are unintended, and rates are especially high among lower-income women, Black women and those who haven’t completed high school.

    In March 2022, 59 members of Congress wrote a letter to FDA Commissioner Dr. Robert Califf about OTC contraception.

    “This is a critical issue for reproductive health, rights, and justice. Despite decades of proven safety and effectiveness, people still face immense barriers to getting birth control due to systemic inequities in our healthcare system,” the lawmakers wrote.

    A recent study showed that it’s become harder for women to access reproductive health care services more broadly – such as routine screenings and birth control – in recent years.

    About 45% of women experienced at least one barrier to reproductive health care services in 2021, up 10% from 2017. Nearly 19% reported at least three barriers in 2021, up from 16% in 2017.

    Increasing reproductive access for women and adolescents was a resounding theme among the FDA advisers.

    “We can take this opportunity to increase access, reduce disparities and, most importantly, increase the reproductive autonomy of the women of our nation,” said Dr. Jolie Haun of the James A. Haley Veterans’ Hospital and the University of Utah.

    Dr. Karen Murray, deputy director of the FDA’s Office of Nonprescription Drugs, said the agency understands the importance of “increased access to effective contraception” but hinted that the FDA would need more data from the manufacturer.

    Some of the advisers and FDA scientists expressed concern that some of Perrigo’s data was unreliable due to overreporting of “improbable dosing.”

    Murray said the lack of sufficient information from the study poses challenges for approval.

    “It would have been a much easier time for the agency if the applicant had submitted a development program and an actual use study that was very easy to interpret and did not have so many challenges. But that was not what happened for us. And so the FDA has been put in a very difficult position of trying to determine whether it is likely that women will use this product safely and effectively in the nonprescription setting,” she said. “But I wanted to again emphasize that FDA does realize how very important women’s health is and how important it is to try to increase access to effective contraception for US women.”

    Ultimately, the advisers said, they don’t want further studies of Opill to delay the availability of the product in an over-the-counter setting.

    “I just wanted to say that the improbable dosing issue is important, and I don’t think it’s been adequately addressed and certainly leads to some uncertainty in the findings. But despite this, I would not recommend another actual use study this time, and I think we can make a decision on the totality of the evidence,” said Kate Curtis of the US Centers for Disease Control and Prevention.

    Curtis said she voted yes because “Opill has the potential to have a huge positive public health impact.”

    Earlier in the discussion, Dr. Leslie Walker-Harding of the University of Washington and Seattle Children’s Hospital said the pill is just as safe as many other medications available on store shelves.

    “The safety profile is so good that we would need to take every other medicine off the market like Benadryl, ibuprofen, Tylenol, which causes deaths and people can get any amount of that without any oversight. And this is extremely safe, much safer than all three of those medications, and incorrect use still doesn’t appear to have problematic issues,” she said.

    Dr. Katalin Roth of the George Washington University School of Medicine and Health Sciences also emphasized the safety of the pill over the 50 years it has been approved as a prescription drug in the US.

    “The risks to women of an unintended pregnancy are much greater than any of the things we were discussing as risks of putting this pill out out over-the-counter,” she said. “The history of women’s contraception is a struggle for women’s control over their reproduction, and we need to trust women.”

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  • FDA panel backs over-the-counter sales of birth control pill

    FDA panel backs over-the-counter sales of birth control pill

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    WASHINGTON — Federal health advisers said Wednesday that a decades-old birth control pill should be sold without a prescription, paving the way for a likely U.S. approval of the first over-the-counter contraceptive medication.

    The panel of FDA advisers voted unanimously in favor of drugmaker Perrigo’s request to sell its once-a-day medication over the counter. The recommendation came at the close of a two-day meeting focused on whether women could safely and effectively take the pill without professional supervision. A final FDA decision is expected this summer.

    If the agency follows the nonbinding recommendation, Perrigo’s drug, Opill, would become the first contraceptive pill to be moved out from behind the pharmacy counter onto store shelves. The company said sales could begin late this year if OK’d.

    The outside experts said they were mostly confident that women of all ages could use the drug appropriately without seeing a health provider first.

    “In the balance between benefit and risk, we’d have a hard time justifying not taking this action,” said Maria Coyle, an Ohio State University pharmacist, who chaired the panel. “The drug is incredibly effective, and I think it will be effective in the over-the-counter realm just as it is in the prescription realm.”

    The positive vote came despite numerous criticisms from FDA scientists about how Perrigo studied the drug, including questions about whether study participants were able to understand and follow labeling instructions.

    “We have an application with many complicated issues and uncertainties, including questionable reliability,” FDA’s Dr. Pamela Horn told panelists on Tuesday.

    But the panel largely set those concerns aside, emphasizing the benefits of providing more effective birth control, particularly to young people and lower-income groups, than what’s available over the counter now, like condoms and diaphragms.

    Most birth control pills used in the U.S. today contain a combination of progestin and estrogen. Opill is part of an older class of contraceptives that only contain progestin. They generally have fewer side effects and health risks but can be less effective if they’re not taken around the same time daily.

    FDA’s decision won’t apply to other birth control pills, only Opill, although advocates hope that an approval decision might push other drugmakers to seek over-the-counter sales. Birth control pills are available without a prescription across much of South America, Asia and Africa.

    Nonprescription medicines are usually cheaper, but generally not covered by insurance. Requiring insurers to cover over-the-counter birth control would require a regulatory change by the federal government.

    Opill was first approved in the U.S. five decades ago based on data showing it was more than 90% effective in preventing pregnancy when taken daily. But some women should not take it, particularly those with breast cancer, because of the risk that it could accelerate tumor growth. Women who have unusual vaginal bleeding are instructed to speak with a doctor before using it, because bleeding could indicate a serious health issue.

    But in reading comprehension studies conducted by Perrigo, 68% of women with unexplained bleeding incorrectly answered they could take the drug. And a few women with breast cancer also told researchers they could use Opill.

    Panel members said almost all women with a history of breast cancer would be under the care of a cancer specialist, who would advise them not to take hormonal drugs that could make their condition worse.

    “I would think any woman who had a breast cancer diagnosis in the past would be highly aware of that, so I don’t think that’s going to be a concern,” said Dr. Deborah Armstrong of Johns Hopkins University.

    Perrigo said its 880-patient study of the drug showed that women will consistently take the pill daily if it’s made available over-the-counter. But the FDA found several problems in the study, including more than 30% of participants who erroneously reported taking more pills than they were actually supplied. FDA reviewers said the problem called into question the company’s overall conclusions about the drug’s use and effectiveness.

    FDA regulators also suggested changes in U.S. demographics since the pill was first tested — including increased obesity and other chronic conditions— could reduce the drug’s effectiveness.

    Despite those concerns, Opill has the support of dozens of reproductive rights and medical groups that have long pushed for expanded access to birth control.

    “Opill over the counter would give us one more option for access and the more options that are available the better,” said Clare Coleman, president of the National Family Planning and Reproductive Health Association

    Coleman was one of more than 25 speakers who supported Perrigo’s application during a public comment session Tuesday.

    Catholic groups, including the United States Conference of Catholic Bishops, oppose the move, saying women should be evaluated by a doctor before getting it.

    Even if the pill is approved, it’s unclear how popular it might be. Opill has not been marketed in the U.S. since 2005 and was previously owned by Pfizer. Perrigo acquired the drug with its buyout of French drugmaker HRA Pharma last year.

    ___

    The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

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  • Over-the-counter birth control pill faces FDA questions

    Over-the-counter birth control pill faces FDA questions

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    WASHINGTON — U.S. health regulators are weighing the first-ever request to make a birth control pill available without a prescription.

    But in an initial review posted Friday, the Food and Drug Administration raised numerous concerns about drugmaker Perrigo’s application to sell its decades-old pill over the counter.

    The FDA cited problems with the reliability of some of the company’s data on the drug, Opill, and questioned whether women with certain other medical conditions would correctly opt out of taking it. The agency also noted signs that study participants had trouble understanding the labeling instructions.

    Advisers to the FDA meet next week to review drugmaker Perrigo’s application. The two-day public meeting is one of the last steps before a final FDA decision.

    If the agency grants the company’s request, Opill would become the first contraceptive pill to be moved out from behind the pharmacy counter onto store shelves or online.

    Friday’s FDA review suggests regulators have serious reservations about broad access to the drug, including whether younger teenagers will be able to correctly follow the labeling directions.

    At the end of the meeting, the FDA panel will vote on whether the benefits of making the pill more widely available outweigh the potential risks. The panel vote is not binding and the FDA is expected to make its final decision this summer.

    Perrigo executives say Opill could be an important new option for the estimated 15 million U.S. women — or one-fifth of those who are child-bearing age — who currently use no birth control or less effective methods, such as condoms.

    “We have no doubt that our data clearly shows that women of all ages can safely use Opill in the over-the-counter setting,” Frederique Welgryn, the company’s global vice president for women’s health, said this week.

    The company’s application has no relation to the ongoing lawsuits over the abortion pill mifepristone, which is not a contraceptive. Research for over-the-counter sales of the pill began nearly a decade ago.

    Hormone-based pills, like Opill, have long been the most common form of birth control in the U.S., used by tens of millions of women since the 1960s.

    Opill was first approved in the U.S. 50 years ago. Perrigo acquired rights to the drug last year with its buyout of Paris-based HRA Pharma, which bought the pill from Pfizer in 2014. It’s not currently marketed in the U.S. but is sold without a prescription in the U.K.

    FDA’s decision won’t apply to other birth control pills, only Opill, although advocates hope that an approval decision might push other pill makers to seek over-the-counter sales. Birth control pills are available without a prescription across much of South America, Asia and Africa.

    Many common medications have made the over-the-counter switch, including drugs for pain relief, heartburn and allergies. Generally, drugmakers must show that consumers can accurately understand and follow the labeling instructions to safely and effectively use the drug. Non-prescription medicines are usually cheaper, but generally not covered by insurance. Forcing insurers to cover over-the-counter birth control would require a regulatory change by the Department of Health and Human Services.

    Perrigo’s main study tracked nearly 900 U.S. women taking its pill without professional supervision for up to six months. The group included women of different ages, races, educational and cultural backgrounds.

    Women were paid to track and record their use of the pill, including whether they followed instructions to take it during the same 3-hour window each day. That consistency is key to the drug’s ability to block pregnancy.

    But after Perrigo wrapped up its study, the FDA identified a problem: nearly 30% of women erroneously reported taking more pills than they were actually supplied.

    The FDA said Friday these cases of “improbable dosing” call into question the company’s results.

    Perrigo will present a reanalysis of the data that excludes the participants who overreported. The company says the results showed the study still achieved its goal of demonstrating that most women used the pill correctly.

    Women reported taking the pill on a daily basis 92% of the time during the study, the company says.

    The company says its data show there would be about two pregnancies for every 100 women who take its pill for a year. But the FDA called this figure “an imprecise estimate” because the study was significantly smaller than those typically used to evaluate contraceptive effectiveness.

    The most popular birth control pills today contain a combination of synthetic hormone progestin, which helps block pregnancy, plus estrogen. The addition of estrogen can help make periods lighter and more regular but it also carries the risk of rare blood clots.

    Opill contains only progestin, making it a safer option and, according to experts, an easier regulatory switch to over-the-counter status. But progestin-only pills have downsides, including reduced effectiveness if they’re not taken at the same time daily.

    The FDA review also flagged concerns that women with potential health problems will appropriately avoid taking the drug.

    Women with a history of breast cancer should not take the pill, though a few participants in preliminary research incorrectly said they thought they could. And women who have unusual vaginal bleeding are instructed to talk to a doctor first, because it could indicate a medical problem. But the FDA notes that half of women in Perrigo’s study who had unexplained bleeding incorrectly said Opill would be appropriate for them.

    Several major U.S. medical groups, including the American Medical Association, support making the drugs available over the counter. The 60-year history of birth control pills shows “the benefits of widespread, nonprescription availability far outweigh the limited risk,” the group stated in comments submitted to the FDA.

    Catholic groups, including the United States Conference of Catholic Bishops, are opposing Opill’s application, saying women should be evaluated by a doctor before getting it.

    ___

    Follow Matthew Perrone on Twitter: @AP_FDAwriter

    ___

    The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

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  • The Fibroid Foundation Applauds the Introduction of a Resolution Recognizing May as National Menstrual Health Awareness Month

    The Fibroid Foundation Applauds the Introduction of a Resolution Recognizing May as National Menstrual Health Awareness Month

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    ROCKVILLE, Md., May 4, 2023 (Newswire.com)
    –
    The Fibroid Foundation is proud to support H. Res 351, a Congressional resolution recognizing May as National Menstrual Health Awareness Month. After working closely on the resolution with Reps. Grace Meng (D-NY) and Yvette D. Clark (D-NY) over the last few months, we applaud them for their leadership and advocacy on behalf of women, girls, and menstruators and congratulate them on the introduction of the resolution earlier this week. Although half of the world’s population menstruates, menstrual stigma still exists. The introduction of this resolution will begin to end that stigma.

    The Fibroid Foundation’s mission is to support the fibroid community and to erase the menstrual stigma that has created health disparities impacting pelvic health concerns. We believe that eliminating menstrual stigma is the foremost challenge to achieving equity regarding pelvic health to benefit those with fibroids and other pelvic health-related conditions. Responding to the introduction of the resolution, Sateria Venable, Founder & CEO of The Fibroid Foundation, said, “Erasing the stigma of menstruation is fundamental to prioritizing the health of women, girls, and menstruators.”

    Menstrual health is defined as a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity, in relation to the menstrual cycle.”1 The United Nations Population Fund defines menstruation as a Human Right. “Human rights are rights that every human being has by virtue of his or her human dignity. Menstruation is intrinsically related to human dignity – when people cannot access safe bathing facilities and safe and effective means of managing their menstrual hygiene, they are not able to manage their menstruation with dignity.   Menstruation-related teasing, exclusion, and shame also undermine the principle of human dignity.”2

    The Fibroid Foundation will host a Congressional briefing on Wednesday, May 17, 2023, at 2 p.m. ET in conjunction with the introduction of the National Menstrual Health Awareness Month Resolution. Speakers will include Rep. Grace Meng, Dr. Elizabeth Stewart of the Mayo Clinic, Dr. James Segars of Johns Hopkins Hospital, PERIOD., patient advocates, and more. Click here to register for the briefing.

    We would also like to thank the advocacy organizations who endorsed the resolution: American College of Obstetricians and Gynecologists, Girls Inc., PERIOD., Alliance for Period Supplies, Black Women’s Health Imperative, CARE USA, Congressional Black Caucus Foundation, Days for Girls International, the Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Endometriosis Association, HealthyWomen, National Organization for Women, the Pad Project, PCOS Challenge: The National Polycystic Ovary Syndrome Association, PAI, the Red Alert Brand, Society for Women’s Health Research, the University of Chicago Department of Obstetrics and Gynecology, and the White Dress Project.

    About The Fibroid Foundation

    The Fibroid Foundation was founded in 2013 by fibroid patient Sateria Venable. As the premier global community of fibroids patients, their mission is to:

    • Be the voice of women living with fibroids.
    • Create and support initiatives to find a cure for fibroids.
    • Advocate for ongoing funding of patient-sensitive fibroids research.
    • Erase the “Stigma of Silence” around menstrual health and menopause.
    • Minimize treatment disparities with layered patient support.

    The Fibroid Foundation, with members in most U.S. states, and 135 countries, develops annual programming centered on education, advocacy, innovation and access to treatment. 

    1Menstrual Health: a definition for policy, practice and research

    2Menstruation and Human Rights: Frequently asked questions

    ###

    If you are interested in partnering with The Fibroid Foundation, please visit https://www.fibroidfoundation.org/partners/.

    Source: The Fibroid Foundation

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  • Two hospitals under federal investigation over care of pregnant woman who was refused abortion | CNN

    Two hospitals under federal investigation over care of pregnant woman who was refused abortion | CNN

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    CNN
     — 

    The Centers for Medicare and Medicaid Services is investigating two hospitals that “did not offer necessary stabilizing care to an individual experiencing an emergency medical condition, in violation of the Emergency Medical Treatment and Labor Act (EMTALA),” according to a letter from US Health and Human Services Secretary Xavier Becerra.

    Under EMTALA, health care professionals are required to “offer treatment, including abortion care, that the provider reasonably determines is necessary to stabilize the patient’s emergency medical condition,” Becerra said Monday in his letter to national hospital and provider associations.

    The National Women’s Law Center, which said in a statement that it filed the initial EMTALA complaint on behalf of Mylissa Farmer, identified the hospitals as Freeman Hospital West of Joplin, Missouri, and the University of Kansas Health System in Kansas City, Kansas.

    The patient was nearly 18 weeks pregnant when she had a preterm premature rupture of membranes, Becerra wrote, but she was told that her pregnancy wasn’t viable.

    “Although her doctors advised her that her condition could rapidly deteriorate, they also advised that they could not provide her with the care that would prevent infection, hemorrhage, and potentially death because, they said, the hospital policies prohibited treatment that could be considered an abortion,” Becerra wrote.

    Becerra added in a statement Monday, “fortunately, this patient survived. But she never should have gone through the terrifying ordeal she experienced in the first place. We want her, and every patient out there like her, to know that we will do everything we can to protect their lives and health, and to investigate and enforce the law to the fullest extent of our legal authority.”

    Abortion is banned in Missouri, with limited exceptions, such as to save the mother’s life. State law requires counseling and a 72-hour waiting period. In Kansas, abortion is generally banned at or after 22 weeks of pregnancy, with a 24-hour waiting period and counseling required.

    Passed in 1986, EMTALA requires that hospitals provide stabilizing treatment to patients who have emergency medical conditions, or transfer them to facilities where such care will be provided, regardless of any conflicting state laws or mandates.

    Changes to state laws in the wake of the US Supreme Court decision that overturned the right to an abortion have left many hospitals and providers uncertain or confused about the steps they can legally take in such cases. HHS issued guidance last year reaffirming that EMTALA requires providers to offer stabilizing care in emergency cases, which might include abortion.

    Hospitals found to be in violation of EMTALA could lose their Medicare and Medicaid provider agreements and could face civil penalties. An individual physician could also face civil penalties if they are found to be in violation.

    HHS may impose a $119,942 fine per violation for hospitals with more than 100 beds and $59,973 for hospitals with fewer than 100 beds. A physician could face a $119,942 fine per violation.

    The National Women’s Law Center says the new actions are the first time since Roe v. Wade was overturned that EMTALA has been enforced against a hospital that denied emergency abortion care.

    “The care provided to the patient was reviewed by the hospital and found to be in accordance with hospital policy,” the University of Kansas Health System said in a statement to CNN. “It met the standard of care based upon the facts known at the time, and complied with all applicable law. There is a process with CMS for this complaint and we respect that process. The University of Kansas Health System follows federal and Kansas law in providing appropriate, stabilizing, and quality care to all of its patients, including obstetric patients.”

    Freeman Hospital did not immediately respond to CNN’s request for comment.

    An HHS spokesperson told CNN that both hospitals are working toward coming into compliance with the law.

    In the law center’s statement, Farmer said she was pleased with the investigations, “but pregnant people across the country continue to be denied care and face increased risk of complications or death, and it must stop. I was already dealing with unimaginable loss and the hospitals made things so much harder. I’m still struggling emotionally with what happened to me, but I am determined to keep fighting because no one should have to go through this.”

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  • Feds: Hospitals that denied emergency abortion broke the law

    Feds: Hospitals that denied emergency abortion broke the law

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    WASHINGTON — Two hospitals that refused to provide an emergency abortion to a pregnant woman who was experiencing premature labor put her life in jeopardy and violated federal law, a first-of-its-kind investigation by the federal government has found.

    The findings, revealed in documents obtained by The Associated Press, are a warning to hospitals around the country as they struggle to reconcile dozens of new state laws that ban or severely restrict abortion with a federal mandate for doctors to provide abortions when a woman’s health is at risk. The competing edicts have been rolled out since the Supreme Court overturned the constitutional right to an abortion last year.

    But federal law, which requires doctors to treat patients in emergency situations, trumps those state laws, the nation’s top health official said in a statement.

    “Fortunately, this patient survived. But she never should have gone through the terrifying ordeal she experienced in the first place,” Health and Human Services Secretary Xavier Becerra said. “We want her, and every patient out there like her, to know that we will do everything we can to protect their lives and health, and to investigate and enforce the law to the fullest extent of our legal authority, in accordance with orders from the courts.”

    The federal agency’s investigation centers on two hospitals — Freeman Health System in Joplin, Missouri, and University of Kansas Hospital in Kansas City, Kansas — that in August refused to provide an abortion to a Missouri woman whose water broke early at 17 weeks of pregnancy. Doctors at both hospitals told Mylissa Farmer that her fetus would not survive, that her amniotic fluid had emptied and that she was at risk for serious infection or losing her uterus, but they would not terminate the pregnancy because a fetal heartbeat was still detectable.

    Ultimately, Farmer had to travel to an abortion clinic in Illinois.

    “It was dehumanizing. It was terrifying. It was horrible not to get the care to save your life,” Farmer, who lives in Joplin, said of her experience. “I felt like I was responsible to do something, to say something, to not have this happen again to another woman. It was bad enough to be so powerless.”

    Farmer’s complaints launched the first investigations that the Centers for Medicare & Medicaid Services, or CMS, has publicly acknowledged since Roe v. Wade was overturned last year. Across the country, women have reported being turned away from hospitals for abortions, despite doctors telling them that this puts them at further risk for infection or even death.

    President Joe Biden’s administration has prodded hospitals not to turn away patients in those situations, even when state law forbids abortions. Weeks after the Supreme Court’s ruling, the Democratic administration reminded hospitals that federal law requires them to offer an abortion when a pregnant woman is at risk for an emergency medical condition. The federal government can investigate hospitals that receive Medicare and Medicaid money — which encompasses most facilities in the U.S. — for violations of the law.

    Abortions are largely banned in Missouri, but there are exceptions for medical emergencies. In Kansas, when Farmer visited the hospital, abortions were still legal up to 22 weeks. It’s unclear why University of Kansas Health refused to offer Farmer one. Neither hospital immediately provided comment on the case.

    CMS has not announced any fines or other penalties against the two hospitals in its investigation, but it did send them notices warning that they were in violation of the law and asking them to correct the problems that led to Farmer being turned away. Federal Medicare investigators will follow up with the hospitals before closing the case.

    That likely won’t be enough to convince hospitals and doctors that they should provide abortions in states where they’re operating under the threat of prison time or large fines if they terminate a pregnancy, said Mary Ziegler, a law professor at the University of California, Davis.

    “I don’t know how much this approach really helps matters. The possibility of being criminalized for providing care is still there for a lot of these doctors,” Ziegler said. “The incentive here would be to do nothing. The incentive here would be to turn the patient away.”

    Nationwide, doctors have reported uncertainty around how to provide care to pregnant women, especially in the nearly 20 states where new laws have banned or limited the care. Doctors face criminal and civil penalties in some states for aborting a pregnancy.

    But in a letter sent Monday to hospital and doctors’ associations that highlights the inquiries, Becerra said he hopes the investigations clarify that the organizations must follow the federal law, the Emergency Medical Treatment and Labor Act, or EMTALA.

    “While many state laws have recently changed,” Becerra wrote, “it’s important to know that the federal EMTALA requirements have not changed, and continue to require that health care professionals offer treatment, including abortion care, that the provider reasonably determines is necessary to stabilize the patient’s emergency medical condition.”

    ___

    Follow the AP’s coverage of abortion at https://apnews.com/hub/abortion.

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  • A Texas family fought for weeks to regain custody of their newborn. Experts say the case shows how Black parents are criminalized. | CNN

    A Texas family fought for weeks to regain custody of their newborn. Experts say the case shows how Black parents are criminalized. | CNN

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    CNN
     — 

    A Black Texas couple has been reunited with their newborn daughter after authorities removed the baby and placed her in foster care last month citing a doctor’s concerns about how they were treating a jaundice diagnosis.

    Rodney and Temecia Jackson of DeSoto, Texas, regained custody of their daughter, Mila, on April 20 following a nearly month-long battle with the state’s Child Protective Services, according to The Afiya Center, a reproductive justice advocacy group.

    A spokesperson for the Texas Department of Family Protective Services, which includes CPS, confirmed to CNN that the office had recommended a dismissal of the case to an assistant district attorney. Mila’s release was granted on Thursday, according to a court filing.

    The Jacksons had been pleading for Mila’s return in videos posted to social media, and news conferences as reproductive justice activists protested and rallied behind the family.

    The removal, the Jacksons say, was sparked by their decision to let their midwife treat Mila’s jaundice instead of taking her to the hospital for care as their doctor had recommended. Temecia Jackson said during a news conference earlier this month that she gave birth to Mila at home on March 21 with the help of a midwife and wanted that same trusted midwife to provide medical care for her baby. But Mila’s pediatrician disagreed with this decision and ultimately contacted CPS, Temecia Jackson said.

    “We’ve been treated like criminals,” Rodney Jackson said during the news conference. “This is a nightmare that I wouldn’t wish on anyone.”

    Reproductive justice advocates say Mila’s removal is just the latest example of the criminalization of Black parents, who lose their children to the child welfare system at disproportionate rates. In the US in 2018, Black children made up 23% of youth in foster care, but only 14% of the nation’s child population, according to the Annie E. Casey Foundation. Additionally, one study found that between 2003-2014, 53% of Black children were the subjects of child welfare investigations by the time they reached age 18.

    Marsha Jones, executive director of The Afiya Center – a Dallas, Texas, based non-profit that advocates for Black women and girls – said there is a systemic problem with the child welfare system that unfairly targets Black parents. In many cases, Black families have their first experiences with the criminal justice system in family court, Jones said.

    “It’s almost unspoken and unseen because there is just this thought that Black women are not good parents and that we are criminalized because of poverty,” Jones told CNN. “This is not new.”

    Jones said the center stepped in last month to support the Jackson family and put pressure on public officials to return Mila home. She believes this played a role in reuniting the family last week.

    “There’s no reason this baby should have been removed from her home,” Jones told CNN. “This family was not being heard. The Black midwife wasn’t being heard.”

    Rodney and Temecia Jackson could not be reached for comment.

    In a letter to CPS obtained by CNN affiliate WFAA, the family’s pediatrician, Dr. Anand Bhatt, who is with the Baylor Scott & White healthcare system, wrote that while the Jacksons “are very loving and they care dearly” about Mila, “their distrust for medical care and guidance has led them to make a decision for the baby to refuse a simple treatment that can prevent brain damage.”

    “I authorized the support of CPS to help get this baby the care that was medically necessary and needed,” the letter continued.

    CBS News, which obtained a copy of the affidavit filed by the Texas Department of Family and Protective Services, reported that Bhatt reached out to a DFPS investigator on March 25 and indicated that Mila’s bililrubin test showed levels of 21.7 milligrams.

    A bilirubin test can screen for jaundice and other conditions. That level was “cause for a lot of concern,” Bhatt told the investigator, according to CBS News, and could lead to brain damage, he said, “because the bilirubin can cross the blood brain barrier.”

    Bhatt said he reserved a bed for Mila at Children’s Medical Center of Dallas and asked the Jacksons to take her there or he would call police for a welfare check, according to court documents obtained by CBS News. WFAA reported that Bhatt wanted Mila to receive phototherapy – a common treatment for jaundice.

    But court documents, according to CBS News, say Rodney Jackson told Bhatt he and Temecia Jackson planned to treat their baby “naturally” and didn’t believe in “modern medicine.”

    The midwife, Cheryl Edinbyrd, told CBS News the family had ordered a blanket and goggles to provide light therapy to treat Mila’s jaundice.

    When the Jacksons didn’t show up at the hospital, a CPS investigator and police went to the Jackson’s home at 4 a.m. on March 25 but Rodney Jackson declined to speak with them, according to court documents obtained by CBS News. An hour later, authorities returned with an ambulance and fire truck and Rodney Jackson still denied them entry.

    Authorities returned to the home on March 30 with a warrant and arrested Rodney Jackson on charges of preventing the execution of a civil process, according to CBS News. Police entered the home and took Mila from Temecia Jackson. According to CBS News, the Jacksons’ other two children were not removed.

    Temecia Jackson said in a press conference that when she asked to see the affidavit, she noticed it had the name of a different mother on it.

    “Instantly I felt like they had stolen my baby as I had had a home birth and they were trying to say that my baby belonged to this other woman,” Temecia Jackson.

    Marissa Gonzales, a spokesperson from the Texas Department of Family and Protective Services, said in an email to CNN that her department was given an incorrect name for the initial affidavit. The mistake, she said, was corrected in the case filings.

    Gonzales declined an interview with CNN to discuss the case further, citing “state confidentiality restrictions.”

    “It is always the goal of DFPS to safely reunite children with their parents,” Gonzales also said. “The decision about when that happens rests with the judge who ordered the removal.”

    CNN’s request to interview Bhatt was also denied by Baylor Scott & White.

    “In respect of patient privacy, it is inappropriate to provide comment on this matter,” the health system said in an emailed statement. “We do abide by reporting requirements set forth in the Texas Family Code and any other applicable laws.”

    Advocates say the racial bias of professionals such as teachers, doctors and social workers has created inequity in the child welfare system.

    Dorothy Roberts, a law professor and sociologist at the University of Pennsylvania, said decisions to report neglect and abuse are largely shaped by racist stereotypes of Black families.

    The child welfare system, she said, needs to consider the trauma inflicted on children when they are separated from their families.

    “We have to ask whether there is a better way of addressing children’s medical needs instead of the system we have now where doctors are reporting suspicions, which we know is highly biased, and investigating families, which we know is very traumatic,” said Roberts, author of “Torn Apart: How the Child Welfare System Destroys Black Families – and How Abolition Can Build a Safer World.” “Hospitals should not be places of fear for parents.”

    Roberts said there is also a longstanding cultural conflict between the healthcare system and midwives who are often devalued. Black midwives provided care for mothers for hundreds of years, delivering the babies of enslaved women and even slave owners’ wives. But as medicine became more professionalized in the late 1800s, male doctors wanted to take control of childbirth, with some suggesting midwives were unfit, according to a report by Vox.

    Monica Simpson, executive director of Sistersong, a reproductive justice organization advocating for women of color, said many Black women are choosing midwives because they have lost trust in doctors and hospitals.

    Much of that is driven by the harrowing statistics: Black women are 2.6 times likelier to die of pregnancy-related complications than White women, according to the most recent data from the National Center for Health Statistics.

    Black infants also die at more than twice the rate of White infants, according to the Centers for Disease Control and Prevention.

    Simpson said the child welfare system is broken. She said racism has played a part in the continued criminalization and separation of Black families.

    “There’s been this narrative that Black women can’t parent their children properly,” Simpson said. “We have been battling these narratives for decades. The way that Black women are criminalized around their motherhood, it’s horrible.”

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  • Opinion: Mifepristone saved my life | CNN

    Opinion: Mifepristone saved my life | CNN

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    Editor’s Note: Roxanne Jones, a founding editor of ESPN The Magazine and former vice president at ESPN, has been a producer, reporter and editor at the New York Daily News and The Philadelphia Inquirer. Jones is co-author of “Say it Loud: An Illustrated History of the Black Athlete.” She talks politics, sports and culture weekly on Philadelphia’s 900AM WURD. The views expressed here are solely hers. Read more opinion on CNN.



    CNN
     — 

    The ruling earlier this month by a Texas federal judge to suspend the US Food and Drug Administration’s approval of a drug that is used frequently for medication abortions, is very personal for me.

    That’s because I took mifepristone years ago during a miscarriage, and it saved my life.

    When I was prescribed mifepristone, it had not yet taken center stage in America’s abortion wars. I did not have to make a rushed road trip across state lines to get my medicine, unlike many women who need the drug but live in one of the many states that have restricted access to medication abortion or passed near-total bans on abortion.

    I was not forced to set up a secret meet-up with a stranger in order to buy my medicine on the black market, as several women I spoke to recently said they planned to do. Nor did I have to order mifepristone online and find myself navigating the many scammers taking advantage of the current patchwork of state abortion laws in the US.

    Mifepristone is one of two drugs used in a medication abortion and the other, misoprostol, was not subject to the ruling by the Texas judge. The two drugs can be administered to someone having a miscarriage, allowing them to terminate the pregnancy when the fetus is not viable.

    It happened some years ago: After experiencing more than a day of hemorrhaging during the first trimester of my pregnancy, I visited my ob-gyn, who explained after examining me that my blood pressure was dropping rapidly and the heavy bleeding I was experiencing was an unmistakable sign of a miscarriage.

    For many women, being prescribed mifepristone is part of their routine medical care. Not so in my case: As my doctor explained, I was facing a dire medical emergency. I was grateful for the medication that saved my life.

    My miscarriage took me by surprise. I had loved being pregnant the first time around, about a decade earlier. And as a healthy woman, I had no reason for fear when I became pregnant again. By the time I was administered mifepristone, I was losing a life that I had already begun to love. And like many other women, despite my level of education or economic status, I could not outrun the statistics that put Black women at higher risk.

    Up to one in four known pregnancies will end in a miscarriage. And for Black women, the numbers are alarmingly higher. According to an analysis of 4.6 million pregnancies in seven countries, the risk of a miscarriage for Black women is 43% higher than for White women.

    In the Black community, women have traditionally been taught to bear their burdens silently — keep your business to yourself — even after something as devastating as pregnancy loss. We are conditioned to do as I did back then, and keep it moving as we try to outrun the long list of statistics that tell us our lives are in danger from every direction, whether it be from health care risks to societal injustices or other stressors.

    During my miscarriage, I was a woman who was afraid, hemorrhaging and in excruciating pain, in desperate need of safe, emergency medical care. Thanks to the administration of mifepristone, I was allowed dignity during my miscarriage. It’s what every woman deserves — whether it be facing a potentially life-threatening miscarriage or seeking an abortion.

    I learned from my experience that every miscarriage matters. Women must have access to whatever medicines and counseling we need to help us heal and that includes mifepristone. What we don’t need is to be criminalized by politicians and punitive reproductive laws that have long been out of step with public opinion. Despite the continuing political attacks on women’s reproductive rights, more than 61% of US adults say abortion should be legal in all or most cases, according to Pew Research Center.

    After the US Justice Department asked the Supreme Court to intervene, Justice Samuel Alito issued a temporary order to preserve the status quo, ensuring access to the drug while giving the justices more time to study the issue.

    I am hoping the justices can put politics aside and focus on the science surrounding the safety of mifepristone, a drug that, thankfully, I had access to when my life was in danger. Mifepristone, a synthetic steroid, is even safer than common prescription drugs including penicillin and Viagra.

    Following the science demands that, regardless of where you stand on the issue of abortion, consideration must be made for cases like mine and the millions of other women who for years have safely used this medication for complications surrounding miscarriages.

    We do not know how the legal fight over medication abortion will unfold. But women across the nation – in blue and red states alike – are watching. Punitive laws like the one signed last week by Florida Gov. Ron DeSantis seek to criminalize reproductive care providers. And worse, they are stripping us of rights that men take for granted – it’s unlikely they will be prohibited by the law from making health care decisions about their own bodies.

    It must end. And I’m betting that whether it be with our voice or our votes, women will have the last word.

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  • Couple Struggling To Conceive Considers Trying Sexual Intercourse

    Couple Struggling To Conceive Considers Trying Sexual Intercourse

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    NEW YORK—Saying they had struggled for years with infertility and were open to any new approach that might help them conceive, local married couple Nina and Joe Klasfeld told reporters Monday they were considering sexual intercourse. “It would be a last resort, obviously, but since we’ve had so much trouble getting pregnant, we’re seriously thinking about having sex,” said Nina Klasfeld, who added that while sex seemed like a long shot, she and her husband had already tried fertility drugs, hormone treatments, and using an ovulation calendar to time their kissing, all to no avail. “Maybe it’s a coincidence, but a lot of my friends seem to get pregnant after they start having sex. On the one hand, I’m skeptical, because sexual intercourse just sounds like it’s some kind of weird, old-fashioned folk remedy for infertility. But on the other hand, what do we have to lose at this point? We really want a baby.” At press time, the Klasfelds confirmed the pregnancy tests were still coming back negative even though they were having so much sex they had worked their way through a 36-pack of Trojans.

    Things No One Tells You About Being A Sperm Donor

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  • Rival rulings on medication abortion hypercharge the post-Roe legal war | CNN Politics

    Rival rulings on medication abortion hypercharge the post-Roe legal war | CNN Politics

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    CNN
     — 

    A pair of conflicting federal court rulings on Friday created arguably the most contentious and chaotic legal flashpoint over abortion access since the Supreme Court’s ruling last summer that overturned Roe v. Wade and ended the right to an abortion nationwide.

    Within less than an hour, two major rulings came down in separate, closely watched cases concerning medication abortion – in lawsuits that are completely at odds with each other.

    In one case, filed by anti-abortion activists in Texas, a judge said the FDA’s 2000 approval of mifepristone – one of the drugs used to terminate a pregnancy – should be halted. But the court paused its ruling for a week so that it can be appealed, and that appeal is already under way.

    In the second case, where Democratic-led states had sued in Washington to expand access to abortion pills, a judge ordered the federal government to keep the drug available in the 17 states, plus the District of Columbia, that brought the lawsuit.

    On their face, both cases deal with the administrative law that controls how the US Food and Drug Administration goes about regulating mifepristone. The disputes did not rely directly on the question of whether there is a right to an abortion – the question that was at the center of the Supreme Court’s ruling last June. But tucked in the Texas ruling, by US District Judge Matthew Kacsmaryk, was the idea that embryos could have individual rights that courts can consider in their rulings.

    Both cases emerge from a political environment that was unleashed by the Supreme Court’s Roe v. Wade reversal and a willingness to push the legal envelope that the Supreme Court ruling created. The abortion issue is now on a path back to the Supreme Court, as higher courts are asked to sort out the contradictory commands of Friday night’s decisions.

    Because the Texas judge has paused his ruling, it has no immediate impact on the availability of medication abortion drugs. But the next several days stand to be a dramatic and combustible legal fight over the order – a fight ratcheted up by the rival ruling in Washington.

    Besides pausing his ruling for one week, Kacsmaryk – an appointee of former President Donald Trump who sits in Amarillo, Texas – seemed to hold nothing back as he ripped apart the FDA’s approval of mifepristone and embraced wholeheartedly the challengers’ arguments the drug’s risks weren’t adequately considered.

    Kacsmaryk, whose anti-abortion advocacy before joining the federal bench was documented by a recent Washington Post profile, showed a striking hostility to medication abortion, which is the method used in a majority of the abortions in the United States.

    Leading medical organizations have already condemned his opinion and pushed back at the judge’s analysis of the safety of medication abortion.

    The judge said that the FDA failed to consider “the intense psychological trauma and post-traumatic stress women often experience from chemical abortion,” in what was a repeated invocation of “chemical abortion,” the term preferred by abortion opponents. Kacsmaryk suggested that the FDA’s data was downplaying the frequency with which the drug being mistakenly administered to someone who had an ectopic pregnancy, i.e. a pregnancy outside the cavity of the uterus. He repeated the challengers’ accusations that the FDA’s approval process had been the subject of improper political pressure.

    He said the FDA’s refusal to impose certain restrictions on the drug’s use “resulted in many deaths and many more severe or life-threatening adverse reactions.”

    “Whatever the numbers are, they likely would be considerably lower had FDA not acquiesced to the pressure to increase access to chemical abortion at the expense of women’s safety,” he said.

    Jack Resneck Jr., the president of the American Medical Association, said in a statement that Kacsmaryk’s ruling “flies in the face of science and evidence and threatens to upend access to a safe and effective drug.”

    “The court’s disregard for well-established scientific facts in favor of speculative allegations and ideological assertions will cause harm to our patients and undermines the health of the nation,” the AMA president said.

    Kacsmaryk’s opinion paid no heed to the argument made by the FDA’s defenders that cutting off access to medication abortion would put the health of pregnant people at risk and that it would force abortion seekers to terminate their pregnancies through a surgical procedure instead.

    Instead, the judge wrote that a ruling in the challengers’ favor would ensure “that women and girls are protected from unnecessary harm and that Defendants do not disregard federal law.”

    As he explained why the preliminary injunction – which was being handed down before the case could proceed to a trial – was justified, he said that embryos had their own rights that could be part of the analysis. That assertion goes farther than what the Supreme Court said in its June ruling, known as Dobbs v. Jackson Women’s Health.

    “Parenthetically, said ‘individual justice’ and ‘irreparable injury’ analysis also arguably applies to the unborn humans extinguished by mifepristone — especially in the post-Dobbs era,” Kacsmaryk said Friday.

    Whereas Kacsmaryk had been asked by the challengers in Texas to block medication abortion, US District Judge Thomas Owen Rice, who sits in Spokane, Washington, was considering whether abortion pills should be easier to obtain.

    Rice, an Obama appointee, granted the Democratic attorneys general who brought the lawsuit a partial win.

    They had asked Rice to remove certain restrictions – known as REMS or Risk Evaluation and Mitigation Strategy – the FDA has imposed on mifepristone, with the blue states arguing the drug was safe and effective enough to make those restrictions unnecessary.

    While Rice is rejecting that bid for now, he granted a request the states also made that the FDA be ordered to keep the drugs on the market. But Rice’s ruling only applies in the 17 plaintiff states and the District of Columbia.

    His decision maintains the status quo for the availability of abortion pills in those places and he specifically is blocking the agency from “altering the status quo and rights as it relates to the availability of Mifepristone under the current operative January 2023 Risk Evaluation and Mitigation Strategy.”

    Rice’s opinion was a striking split screen to Kacmsaryk’s. While the Texas judge said the FDA did not adequately take into account the drug risks, Rice showed sympathy to the arguments that the rules for mifepristone’s use were too strict and that the agency should be taking a more lenient approach to how the abortion pill is regulated.

    Ultimately, he said he would not grant the Democratic states’ request that he remove some of the drug restrictions at this preliminary stage in the proceedings, because that would go well beyond maintaining the status quo while the case advances. He noted that if he had granted that request, it would also undo a new FDA rule that allows pharmacies to dispense abortion pills. That would reduce its availability and would run “directly counter to Plaintiffs’ request.”

    If Kacsmaryk’s ruling halting mifepristone’s approval is allowed to go into effect, it will run headlong into Rice’s order that mifepristone remain available in several states. Kacsmaryk’s ruling is a nationwide injunction.

    The Justice Department and Danco, a mifepristone manufacturer that intervened in the case to defend the approval, both filed notices of appeal. Both Attorney General Merrick Garland and Danco said in statements that in addition to the appeals, they will seek “stays” of the ruling, meaning emergency requests that the decision is frozen while the appeal moves forward.

    They’re appealing to the US 5th Circuit Court of Appeals, which is sometimes said to be the country’s most conservative appeals court. Yet some legal scholars were skeptical that the 5th Circuit, as conservative as it is, would let Kacmsaryk’s order take effect.

    Washington, where the blue states’ lawsuit was filed, is covered under the 9th Circuit, a liberal appellate court. But it’s unclear if the ruling from Rice will be appealed. Garland said the Justice Department was still reviewing the decision out of Washington. A so-called circuit split would increase the odds that the Supreme Court would intervene. But given how the practical impact of the two district court rulings contradict each other, the Supreme Court may have no choice but to get involved.

    The lawyer for the challengers in the Texas case, anti-abortion medication associations and doctors, said Friday evening that he had not reviewed the Washington decision, so he could not weigh in on how it impacted Kacsmaryk’s order that the drug’s approval be halted.

    “I’m not sure whether there’s a direct conflict yet and with the Washington state decision just because I haven’t read it yet, but there may not be a direct conflict,” Erik Baptist, who is an attorney with Alliance Defending Freedom, said. “But if there is a direct conflict then there may be – it may be inevitably going to the Supreme Court, but I’m not convinced that it’s necessary at this point to make that conclusion.”

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  • 660-mile rescue flight highlights Alaska’s unique challenges

    660-mile rescue flight highlights Alaska’s unique challenges

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    ANCHORAGE, Alaska — The Alaska Air National Guard this week traveled nearly 660 miles (1,062 kilometers) to rescue a pregnant woman on a small island 2 miles (3 kilometers) from Russia, reflecting the challenges patients face in the nation’s largest state where the most remote areas have no roads and hospitals can be hundreds of miles away.

    There was no air strip for a fixed-wing aircraft, so the crews flew a twin-engine combat search and rescue helicopter from the Anchorage area to the island in the Bering Strait. A long-range search and rescue aircraft guided the helicopter through mountain passes and refueled it in the air several times during the 5-hour flight.

    Russian aircraft routinely fly near the Bering Strait, but Alaska Air National Guard Maj. Sara Warren, who was the on-duty rescue officer, said they took every measure to avoid any conflict, including staying on the U.S. side of the international date line.

    “There was absolutely no activity from them,” she said of the Russians.

    These types of extreme rescues by both the guard and other agencies are common in a state that is almost 2 1/2 times the size of Texas and has more shoreline than the lower 48 states combined. The Alaska Air National Guard has conducted 14 such rescues already this year, the agency said.

    “It’s very different here in Alaska because we don’t have the infrastructure that they have down in the lower 48,” said Alaska National Guard spokesperson Alan Brown. “You’re looking at the civilian agencies (that) have a more robust capability; there are more of them.”

    Alaska, with a population of only about 730,000 people, is remote, spread out and often has extreme weather, forcing everyone to team up to conduct life-saving missions. A total of 41 people worked on the recent rescue mission on the small island.

    “Our guys, fortunately, because of the nature of their federal mission for search and rescue, they have to be capable,” Brown said. “They have to train regularly in extreme weather conditions all across the region and that just makes them prime for this type of rescue.”

    The rescue call came Monday morning, said Warren. They were informed of a pregnant woman with severe abdominal pains in Diomede, a village of 80 people on the western side of Little Diomede Island. It’s a traditional Ingalikmiut Eskimo village, whose residents live a subsistence lifestyle, hunting seal, polar bears and blue crab. There are no medical professionals living on the island.

    It’s separated from Big Diomede Island, which is owned by Russia, by 2 miles (3 kilometers) of frozen Bering Sea ice this time of the year. The international date line runs between the two islands.

    Compounding the rescue was not only lingering fog from sea ice, but also a power outage in Diomede, Warren said. Townspeople would call the nearest hospital in Nome, 130 miles (209 kilometers) away, every hour providing updates on the woman’s condition and then shut the phones off to conserve power. A doctor in Nome would then relay the most current information back to those at Joint Base Elmendorf-Richardson in Anchorage.

    A civilian medical crew was on standby in Nome, but they were unable to fly their helicopter because of the poor weather conditions, so the National Guard aircraft launched from Anchorage. The plane would fly ahead after fueling the helicopter to perform weather reconnaissance, leading the helicopter away from storms, through several passes of the Alaska Range and to Diomede. Warren and others at the base monitored all of it in real time.

    “They eventually did get her out without causing any kind of incidents,” Warren said.

    The woman was then flown to Nome and was doing fine, she said.

    Such a complex mission is second hand to the Alaska Air National Guard as compared to other states, where guard crews might be involved in search and rescue missions. This incident involved the Alaska Air National Guardsmen of 210th, 211th and 212th Rescue Squadrons.

    In Alaska, guardsmen are accustomed to handling complex missions, factoring in bad weather, solving time-distance problems and dealing with harsh terrain, mainly because they train in these conditions as well.

    The Guard considers — and even counts on — such missions part of their regular training and thus could not provide a cost estimate for the rescue. The missions provide “exceptional real-world training opportunities not otherwise available,” Brown said.

    “Standing up and planning for these types of missions, flying through challenging conditions over varied terrain and saving lives keeps our skills sharp and perfectly translates into mission capability for our national defense,” he added.

    The guard’s 176th Wing conducted 55 missions in 2022 and 57 in 2021.

    Of the most recent rescue, Warren said, “That was just another Monday.”

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  • Florida Senate passes 6-week abortion ban | CNN Politics

    Florida Senate passes 6-week abortion ban | CNN Politics

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    Washington
    CNN
     — 

    Florida’s state Senate on Monday passed a bill that would ban most abortions in the state after the gestational age of six weeks, or about four weeks of pregnancy.

    The bill’s advance, which still needs to pass the state’s GOP-led House, comes one year after Gov. Ron DeSantis signed a 15-week ban into law. The new legislation likely further burnishes the conservative credentials of DeSantis, a potential 2024 presidential candidate, and it was met with outrage by state Democrats, two of whom were arrested during a protest near the state Capitol Monday night.

    The current bill would impose restrictions on telehealth abortions and medication. It would include exemptions for women facing life-threatening harm while pregnant and victims of rape, incest and human trafficking.

    The bill targets both physicians who perform abortions and those who “actively participate in” them, and should the bill become law, any person who violates it could be charged with a third-degree felony.

    The “Heartbeat Protection Act” passed the Florida Senate in a 26-13 vote.

    A protest over the bill near the state Capitol resulted in the arrests of 11 people who were charged with trespassing after a warning, Tallahassee police said. Florida Democrats said state party Chairwoman Nikki Fried and Florida Senate Minority Leader Lauren Book were among them.

    “As the Democratic leader in the Florida Senate, it’s my job to a lead this incredible group of 11 Democrats, other than myself, to fight against these extreme policies,” Book told CNN on Wednesday. ‘Women will die as a consequence of this piece of policy.”

    Other abortion rights advocates say the Florida bill unfairly seeks to ban abortions before many even know they are pregnant.

    “This bill will unfairly and disproportionately impact people who live in rural communities, people with low incomes, people with disabilities, and people of color,” Kara Gross, the legislative director and senior policy counsel at the American Civil Liberties Union of Florida, said in a statement.

    “Hundreds of thousands of pregnant people will be forced to travel out of state to seek the care they need. Many people will not even know they are pregnant by six weeks, and for those who do, it is unlikely they will be able to schedule the legally required two in-person doctor’s appointments before six weeks of pregnancy,” Gross said.

    The White House has also criticized the pending bill.

    “The President and Vice President believe women should be able to make health care decisions with their doctors and families – free from political interference. They are committed to protecting access to reproductive care, and continue to call on Congress to restore the protections of Roe v. Wade in federal law,” White House press secretary Karine Jean-Pierre said in a statement when the bill was first introduced.

    State Sen. Clay Yarborough, one of the bill’s Republican sponsors, said “unborn children deserve the strongest protections possible under our laws.”

    The legislation underscores the ongoing efforts across the country to restrict access to abortion in a post-Roe world. Other Republican-led states have also pursued six-week abortion bans that have been met with legal challenges.

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  • Why Are Uterine Fibroids Particularly Common in Black Women?

    Why Are Uterine Fibroids Particularly Common in Black Women?

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    Kristamarie Collman, MD, had long had heavy menstrual periods. But 4 years ago, she started to notice other things that seemed off. She felt unusual pressure in her lower abdomen. She was going to the bathroom more often. The ab exercises that were part of her fitness routine had become harder to do. The combination of symptoms prompted Collman, who is a family doctor in Orlando, to see her doctor. 

    The diagnosis: uterine fibroids. These are tumors in the uterus that are almost always not cancer. Uterine fibroids are very common. Experts estimate that up to 80% of women develop them by age 50. No one knows exactly what causes them; a mix of factors are likely involved.

    Some women have uterine fibroids and don’t know it because they have no symptoms. Others have a much harder time. Symptoms can include heavy bleeding, painful periods, pain during sex, reproductive problems, and other issues.

    Collman had suspected that she might have fibroids. “But it’s not something that runs in my family,” she says. When she was diagnosed, “I was a little surprised but not completely shocked because we know Black women have a higher chance of getting diagnosed with fibroids,” Collman says.

    Black women develop fibroid tumors 10 years earlier than white women do and are four to five times more likely to have one or more tumors, says Serdar Bulun, MD, the John J. Sciarra Professor of Obstetrics and Gynecology at Northwestern University.

    The reasons for that aren’t clear. Even though uterine fibroids are very common, they aren’t studied enough, Bulun says. 

    Even though fibroids are almost never cancerous, “the symptoms can be really, really devastating although they are not malignant,” Bulun says. He directs the only National Institutes of Health-funded basic science research program focusing on fibroids in the U.S.

    What’s Behind the Disparity?

    It’s a question with no simple answer. Complex factors are involved in this common disease, says Erica Marsh, MD, professor of obstetrics and gynecology at the University of Michigan Medical School.

    Genes and hormones likely play a role in who develops uterine fibroids. For instance, fibroids often stop growing or even shrink in menopause, when hormone levels are lower. 

    There are also some other general patterns: Fibroids are also more likely if they run in your family, you’re overweight, or you eat a lot of red meat or ham, according to the U.S. Department of Health & Human Services Office on Women’s Health. And some research shows that women diagnosed with uterine fibroids are more likely to have depression and anxiety than women without fibroids. It’s not clear why that is or which comes first.

     

    The disparity in uterine fibroids may be partly influenced by the following things, according to Marsh and Bulun: 

    Chronic stress. This is stress that lasts a long time. It’s long been linked with many health conditions. And it can include stress from racism. “We know that one of the most significant forms of chronic stress that Black individuals experience is that of racism,” Marsh says. 

    Marsh and colleagues reviewed studies of racial disparities in who gets fibroids and another condition, endometriosis. Their findings, published in the journal Fertility and Sterility in March 2023, show a link between certain life experiences, including exposure to racism, and fibroids in Black women. 

    It’s not possible to prove that racism causes fibroids. But “there’s at least evidence, epidemiologic or preliminary data, that says there is an association between exposure to racism and increased risk of fibroids,” Marsh says.

    In a separate study, Bulun and his team analyzed uterine fibroid tissues from white American, Black American, and Japanese patients. The biggest differences were between the fibroids of Black American women and Japanese women. “We found that Black patients’ fibroids had increased estrogen formation and they were making more estrogen, and that’s also contributing to fibroid growth,” he says. 

    Bulun says that genes and ancestry play a role in this and that it’s “totally plausible that chronic stress can increase estrogen production in the body.” 

    Exposure to phthalates. Phthalates are chemicals found in a wide variety of products, including chemical hair straighteners. Bulun’s team analyzed levels of a particular phthalate in 712 uterine fibroid patients. They found a strong link between that phthalate and uterine fibroids. Their study, published in the Proceedings of the National Academy of Sciences in November 2022, didn’t trace the source of the phthalates in the women and doesn’t prove that those chemicals cause fibroids. But Bulun and colleagues had previously reported a possible link between chemical hair straighteners and uterine fibroids. “We believe that phthalates are more commonly present in hair straighteners,” Bulun says. “These products are more commonly used by Black women versus other populations.”

    MED12 genetic mutation. Finnish researchers found that some 70% of fibroid tumors are linked to a genetic mutation called MED12. Bulun says that this mutation happens during the second half of a woman’s menstrual cycle when cells in the myometrium, or smooth muscle of the uterus, multiply in preparation for pregnancy. 

    The Finnish study didn’t specify the racial or ethnic background of the women whose fibroids were studied. “It’s possible that Black women of sub-Saharan ancestry might be more prone to genetic alterations or mutation formation in that MED12 gene for reasons we don’t understand,” Bulun says. He notes that it’s also possible that chronic stress could stimulate the tumors to grow big enough for doctors to find them. More research is needed to learn whether this is happening and how it unfolds.

    Having lived with fibroids herself, Collman has this advice for women: “I would advise anyone reading this story to not wait, not second-guess themselves. If they don’t feel like something’s right, they notice a change, they notice certain symptoms, then I would encourage them to seek help, whether it’s with their doctor [or] health care team. They should not dismiss their symptoms.”

     

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  • Bindi Irwin reveals 10-year battle with endometriosis on International Women’s Day | CNN

    Bindi Irwin reveals 10-year battle with endometriosis on International Women’s Day | CNN

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    CNN
     — 

    The Australian conservationist Bindi Irwin revealed Wednesday she has undergone surgery for endometriosis after a decade-long battle with the condition that affects the uterus.

    “For 10 years I’ve struggled with insurmountable fatigue, pain and nausea,” Irwin shared in posts on social media alongside an image of her in a hospital bed.

    “A doctor told me it was simply something you deal with as a woman and I gave up entirely, trying to function through the pain.”

    Irwin’s posts coincided with both International Women’s Day and Endometriosis Awareness Month.

    Endometriosis is “a condition in which the tissue that normally lines the uterus grows outside the uterus,” according to the United States’ National Institutes of Health.

    Symptoms can include pelvic pain, heavy bleeding during periods and fertility issues.

    Irwin, 24, said doctors had found 37 lesions, some of which were “very deep and difficult to remove,” but she was now “on the road to recovery.”

    “I’m sharing my story for anyone who reads this and is quietly dealing with pain and no answers. Let this be your validation that your pain is real and you deserve help,” she added.

    Anyone with a uterus who is of reproductive age can suffer from the disease but it’s most common among women in their 30s and 40s. Approximately one in 10 people born with a uterus has endometriosis, according to the World Health Organization. The disease affects around 190 million women and girls globally.

    Irwin is a celebrity conservationist who has starred in “Crikey! It’s the Irwins,” a reality TV show that chronicles her family’s work at the Australia Zoo in Queensland, which her mother owns.

    She won “Dancing With the Stars” in 2015 and comes from a family of conservationists that includes her father Steve, the late ‘Crocodile Hunter’ who was killed by a stingray while filming in the Gerat Barrier Reef in 2006.

    She gave birth to a daughter, Grace, in March 2021.

    “Please be gentle and pause before asking me (or any woman) when we’ll be having more children,” Irwin wrote in her post Wednesday. “After all that my body has gone through, I feel tremendously grateful that we have our gorgeous daughter. She feels like our family’s miracle.”

    Soon after her posts, her family took to social media to share their support.

    Her husband Chandler Powell said, “Seeing how you pushed through the pain to take care of our family and continue our conservation work while being absolutely riddled with endometriosis is something that will inspire me forever.”

    Irwin’s brother Robert added on Instagram that, “You never know who’s suffering in silence, let’s make this a topic that we all freely talk about.”

    Irwin is the latest in a series of celebrities to have opened up about their struggles with endometriosis.

    In a Paramount Plus docuseries released last year, comedian Amy Schumer discussed her decades-long battle with what she called a “lonely disease.” Schumer had her uterus removed in 2021 and shared video on her Instagram following the surgery.

    Comedian Lena Dunham and actress Padma Lakshmi have also been vocal about their experiences with the disease.

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  • Texas sued by women who say state’s abortion bans put their health at risk | CNN Politics

    Texas sued by women who say state’s abortion bans put their health at risk | CNN Politics

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    CNN
     — 

    Several women who say Texas’ abortion bans posed significant risks to their health have sued the state this week, opening a new front in the legal battles that have emerged since the Supreme Court overturned national abortion rights protections last year.

    Five women allege in the lawsuit that uncertainty around when medical emergency exemptions in Texas’ abortion laws apply exacerbated medical emergencies that put their lives, health and fertility in danger.

    “To the extent Texas’s abortion bans bar the provision of abortion to pregnant people to treat medical conditions that pose a risk to the pregnant person’s life or a significant risk to their health,” the lawsuit says, “the Bans violate pregnant people’s” rights under the state constitution’s provisions protecting fundamental rights and the right to equality.

    The lawsuit is not seeking to block Texas’ abortion bans outright. Rather, the women – who are joined by two medical providers in the lawsuit – ask the court to clarify that abortions can be performed when a physician makes a “good faith judgment” that “the pregnant person has a physical emergent medical condition that poses a risk of death or a risk to their health (including their fertility).”

    The women’s complaint details harrowing stories of being denied abortion care when they faced emergency complications in their pregnancies, which were all wanted. They filed the lawsuit in state court in Austin, Texas.

    Texas, its Attorney General Ken Paxton, the Texas Medical Board and its Executive Director Stephen Brint Carlton are listed as defendants in the lawsuit. Neither Paxton’s office nor a spokesperson for the state medical board responded to a request for comment from CNN. Gov. Greg Abbott’s office also did not immediately respond to CNN’s inquiry.

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  • Rihanna tells us she’s pregnant in the most entertaining way | CNN

    Rihanna tells us she’s pregnant in the most entertaining way | CNN

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    CNN
     — 

    Rihanna didn’t introduce a new song during her Apple Music Super Bowl LVII Halftime Show performance Sunday night but she did introduce a new pregnancy.

    The entertainer sang a medley of her biggest hits while visibly pregnant with her second child, her representative has confirmed to CNN.

    Online speculation about the pregnancy began as Rihanna opened her performance in Glendale, Arizona, on a floating stage wearing an all-red ensemble that appeared to show off a baby bump.

    Last May, Rihanna welcomed her first child with rapper A$AP Rocky.

    The singer spoke about motherhood during an interview as she prepared for her halftime show performance, saying becoming a mother made her feel like she can do anything.

    “When you become a mom, there is something that just happens where you feel like you can take on the world,” said the musical icon and entrepreneur.

    “The Super Bowl is one of the big stages in the world, so as scary as that was – because I haven’t been on stage in seven years – there’s something exhilarating about the challenge of it all,” said Rihanna, who last toured in 2016. “It’s important for me to do this this year. It’s important for representation. It’s important for my son to see that.”

    The pregnancy didn’t appear to slow Rihanna down during the performance break from the Kansas City Chiefs and Philadelphia Eagles showdown. She danced and belted out some of her best-known hits, surrounded by a crew of dancers dressed in white. She opened the show with “B**ch Better Have My Money,” before moving on to other entries on her long list of chart toppers, including, “We Found Love,” “Rude Boy,” “Work,” “Only Girl (In the World)” and “Umbrella.”

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  • Opinion: Women don’t have to die from cervical cancer | CNN

    Opinion: Women don’t have to die from cervical cancer | CNN

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    Editor’s Note: Dr. Eloise Chapman-Davis is director of gynecologic oncology at NewYork-Presbyterian/Weill Cornell Medical Center and Weill Cornell Medicine. Dr. Denise Howard is chief of obstetrics and gynecology at NewYork-Presbyterian Brooklyn Methodist Hospital and a vice chair of obstetrics and gynecology at Weill Cornell Medicine. The views expressed in this commentary are their own. Read more opinion on CNN.



    CNN
     — 

    As doctors who specialize in women’s reproductive health, we are on the front lines of a preventable crisis. Imagine treating a woman with advanced cancer who has a five-year survival rate of 17%, knowing that she should have never developed the deadly disease in the first place.

    This is what we are facing with cervical cancer. Yet we have the clinical tools not only to lower but also eliminate nearly all the roughly 14,000 new cases and 4,300 deaths from cervical cancer each year.

    Denise Howard

    We have effective screenings: the traditional Pap smear and the HPV test. If these screening tests are abnormal, additional tests can determine who needs further treatment to prevent the development of cancer. Importantly, we have the HPV vaccine, which protects against high-risk human papillomavirus (HPV) types that cause the majority of cervical cancer cases and is nearly 100% effective, according to the National Cancer Institute.

    A report published earlier this month shows the vaccine’s tremendous impact. The US saw a 65% drop in cervical cancer rates from 2012 through 2019 among women ages 20-24, the first to have received the vaccine. The vaccine, combined with screening, could wipe out cervical cancer and make it a disease of the past.

    But the percentage of women overdue for their cervical cancer screening is growing, and, alarmingly, late-stage cases are on the rise.

    We have had the heartbreaking experience of seeing mothers in the prime of life die from this avoidable disease, leaving small children behind — even women who had an abnormal screening but never received follow-up care. It’s devastating to see an otherwise healthy person slowly die from a preventable cancer.

    Simply put, cervical cancer should never occur. This Cervical Cancer Awareness Month, we should commit to making that a reality. Here is what needs to happen.

    Eliminating cervical cancer requires commitment at multiple levels, from public awareness campaigns with culturally appropriate messaging that broadcasts the power of the vaccine and screenings to prevent cancer to resources that ensure all women have easy access to routine health exams.

    Timely screening reminders and systems to prioritize follow-up care are essential. Too many women with abnormal screenings don’t receive their results, reminders or follow-up instructions they understand and, therefore don’t receive the proper treatment. Barriers also include logistical challenges like transportation and language issues. Studies suggest that 13% to 40% of cervical cancer diagnoses result from lack of follow-up among women with an abnormal screening test.

    Gynecology and primary care practices should be vigilant about reaching and monitoring patients with suspicious test findings. Large health systems can leverage the power of the electronic health record to track abnormal tests and ensure these women receive the proper follow-up.

    Pediatricians should encourage parents of children 9 and older to get the HPV vaccine and stress its safety. About 60% of teenagers are up to date on their HPV vaccines, according to the US Centers for Disease Control and Prevention. Physicians not recommending the vaccine and parents’ rising concerns about its safety, despite more than 15 years of evidence that it is safe and effective, have been cited as top reasons why more children aren’t receiving this lifesaving vaccine.

    College campuses should do large-scale, catch-up vaccination outreach. These students are at high risk for contracting HPV, yet only half report having received the full HPV vaccine series. This service should be provided at no cost to students.

    Stark racial disparities also must be addressed. As Black women physicians, we are frustrated that Black women continue to be more likely to die from the disease than any other race, according to the American Cancer Society. The system failures contributing to this tragedy range from Black women receiving less aggressive treatment to barriers around access to affordable routine health care and the high-quality, specialized treatment needed to treat cancer. Everyone deserves access to quality care.

    Older patients should be told that approval of the HPV vaccine has been extended up to age 45 and to discuss with their doctor whether it’s right for them. Insurance providers should cover the cost of the vaccine for these older ages.

    Women should see a gynecologist on a regular basis well into their older years. We see patients with cervical cancer in their 60s and 70s who haven’t been screened in 20 years. Many people stop seeing a gynecologist after childbearing or menopause, but this shouldn’t be the case. Getting quality gynecological exams throughout a woman’s life is critical to preserving it.

    We also need to empower women to be their own advocates through health education. Women should receive their screening result with an explanation of what it means and any next steps clearly delineated. No news after a screening is not good news. In an ideal world, women would see their HPV status as essential information with the power to save their lives.

    Education makes a difference. At NewYork-Presbyterian and Weill Cornell Medicine, we produced a series of easy-to-understand, publicly available videos on cervical cancer and the HPV vaccine. We showed several of the vaccine videos to more than 100 parents in one of our pediatric practices that serves mostly low-income families as part of a pilot study. Their knowledge scores on a questionnaire about the vaccine and HPV that they completed before and after watching the videos increased nearly 80%, and roughly 40% of the unvaccinated children received the HPV vaccine within one month. We aim to expand this effort.

    We have the tools to prevent cervical cancer but fail to use them effectively. It’s unacceptable, and we can no longer ignore the problem. It’s time for a full-scale offensive focused on all fronts to make cervical cancer a disease of the past.

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  • Alabama attorney general says people who take abortion pills could be prosecuted | CNN Politics

    Alabama attorney general says people who take abortion pills could be prosecuted | CNN Politics

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    CNN
     — 

    Alabama’s Republican attorney general said this week that women in the state who use prescription medication to terminate their pregnancies could be prosecuted under a chemical-endangerment law, even though Alabama’s anti-abortion law does not intend to punish women who receive abortions.

    Steve Marshall made the comments in the wake of a decision earlier this month by the US Food and Drug Administration to allow certified pharmacies to dispense the abortion medication mifepristone to people who have a prescription.

    “The Human Life Protection Act targets abortion providers, exempting women ‘upon whom an abortion is performed or attempted to be performed’ from liability under the law,” Marshall said in a statement to AL.com on Tuesday. “It does not provide an across-the-board exemption from all criminal laws, including the chemical-endangerment law—which the Alabama Supreme Court has affirmed and reaffirmed protects unborn children.”

    The chemical endangerment law was passed in 2006 amid high drug usage in Alabama with aims of protecting children from chemicals in the home, but district attorneys have successfully applied the law to protect fetuses of women who used drugs during pregnancy.

    It’s unclear if there are any pending cases against women in Alabama in the wake of the FDA’s announcement. CNN has reached out to Marshall’s office for comment.

    At least one Democrat, Alabama state Rep. Chris England, argued on Twitter that the chemical endangerment law is “extremely clear” and under it, a woman could not be prosecuted for taking a lawfully prescribed medication.

    “Any prosecutor that tries this, or threatens it, is intentionally ignoring the law,” England wrote on Thursday morning.

    Emma Roth, an attorney with Pregnancy Justice, a nonprofit that provides legal representation for women charged with crimes related to pregnancy, said on Twitter that the effect of Marshall’s comments will be to create “a culture of fear among pregnant women.”

    The comments are “extremely concerning and clearly unlawful,” Roth elaborated in a statement to CNN. “The Alabama legislature made clear its opposition to any such prosecution when it explicitly exempted patients from criminal liability under its abortion ban.”

    The chemical endangerment law says it does not require reporting controlled substances that are prescription medications “if the responsible person was the mother of the unborn child, and she was, or there is a good faith belief that she was, taking that medication pursuant to a lawful prescription.”

    Mifepristone can be used along with another medication, misoprostol, to end a pregnancy. Previously, these pills could be ordered, prescribed and dispensed only by a certified health care provider. During the Covid-19 pandemic, the FDA allowed the pills to be sent through the mail and said it would no longer enforce a rule requiring people to get the first of the two drugs in person at a clinic or hospital.

    Marshall’s comments underscore the legal uncertainty wrought by the Supreme Court’s decision last year to end the federal right to an abortion. In the wake of the Dobbs decision, several Republican-led states passed strict anti-abortion laws, while several others, including Alabama, that had passed so-called trigger laws anticipating an eventual overturn of Roe v. Wade, saw their new restrictions go into effect.

    While the anti-abortion movement seeks to prevent abortions from taking place, it has often opposed criminalizing the women who undergo the procedure.

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  • NICU mom stays by her son’s side after his nurses leave to strike | CNN Business

    NICU mom stays by her son’s side after his nurses leave to strike | CNN Business

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    New York
    CNN
     — 

    Lora Ribas hasn’t left her son’s bedside in four days.

    Her one-year-old baby, Logan, has been in the neonatal intensive care unit (NICU) since he was born. For the past three and a half months, he’s been under the care of Mount Sinai Hospital where thousands of nurses are currently striking.

    Logan was born prematurely at 27 weeks and is on a ventilator because his lungs were underdeveloped.

    Mount Sinai’s NICU has been consistently understaffed even before the strike, Ribas said. But since Mount Sinai’s nurses began picketing Monday, new travel nurses have replaced Logan’s primary care nurses – nurses who don’t fully understand her son’s needs, she said.

    Ribas said she’s too scared to leave her son alone under the care of the new travel nurses. She took a leave from work to stay by his side.

    “It’s scary to think that I can’t even go to the bathroom without me being concerned,” Ribas told CNN.

    Although the travel nurses are trying to compensate, they “don’t really know my son” and are still learning where supplies are around the unit, Ribas said.

    They aren’t able to give him one-on-one care because of the staffing shortages, according to the mom, and she said the staffing levels are even lower at night.

    Two nurses currently working inside Mount Sinai Hospital told CNN Monday that additional traveling nurses have not shown up as expected on their floors to replace nurses that are striking, causing stress for patients and staff.

    Mount Sinai Health System did not immediately respond to CNN’s request for comment.

    In preparation for the strike, Mount Sinai announced Friday it would transport newborns in its intensive care unit to other area hospitals. But the most critical babies – like Logan – have stayed in the hospital’s NICU unit. One NICU nurse at Mount Sinai who spoke to CNN on condition of anonymity, said moving a NICU baby to another hospital can be a risky move.

    “It’s a big journey for a baby who’s never been outside the hospital,” she told CNN. “It’s not anything that we want to happen. We want our babies to stay.”

    The more critical the baby’s condition is, the more complicated a transfer to another hospital becomes, the nurse explained.

    “You would need at least a doctor or nurse practitioner, a respiratory therapist if the patient is on respiratory support and a transport nurse to work the pumps and administer medicine if needed,” she said.

    Ribas said her son’s primary nurses who are striking right now are heartbroken they had to leave him and have been calling her to check on his status.

    “He has really wonderful primary nurses,” she said. “They were in tears having to leave him because my baby suffered cardiac arrest two days before the strike happened, and so now I’m dealing with that plus the shortage of staff. Which is very scary.”

    The nurses strike at two private New York City hospitals – Montefiore and Mount Sinai – involving over 7,000 nurses entered its second day Tuesday. Montefiore said it was holding bargaining sessions Tuesday. Mount Sinai has no plans to do so, according to the nurses’ union.

    The sticking point continues to be enforcing safe staffing levels, New York State Nurses Association (NYSNA) union officials said.

    A pediatric oncology nurse at Mount Sinai who administers chemotherapy to children with cancer said it’s hard to leave her patients to strike, but she knows it’s in the best interest of their care.

    “We love these patients more than anything,” Melissa Perleoni said, “and it breaks our heart – at least it breaks my heart – to be out here but I have to do this for the future of their care.”

    Ribas said she hopes hospital management reaches a contract with the nurses soon.

    “The nurses are the heart of the NICU, and they do need to figure it out before it becomes a different situation – because every single minute, every hour, the babies are running a very, very high risk of even dying in here.”

    “There’s nothing that could bring your kid back. Nothing,” she said.

    – CNN’s Tami Luhby, Vanessa Yurkevich and Mark Morales contributed to this report

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  • Nurses at Mount Sinai Morningside and West reach tentative agreement as more than 7,000 nurses still due to strike | CNN Business

    Nurses at Mount Sinai Morningside and West reach tentative agreement as more than 7,000 nurses still due to strike | CNN Business

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    New York
    CNN
     — 

    Mount Sinai Morningside and West hospital reached a tentative agreement with the state nursing union on a new contract Sunday, avoiding a strike Monday morning, according to a news release from the union.

    Nurses at two other area hospitals, Mount Sinai Hospital and Montefiore Bronx, are still due to strike after not reaching agreements.

    Both hospitals are back at the bargaining table with New York State Nurses Association nurses today – if a tentative agreement is not reached, then approximately 3,625 nurses at Mount Sinai and approximately 3,500 nurses at Montefiore Bronx will strike at 6 a.m. Monday. The union said during a news conference Sunday morning that negotiations could go into the early morning.

    The new tentative agreement at Morningside and West brings the anticipated number of nurses to strike down from 8,700 to about 7,125. The tentative agreement improves staffing, protects benefits and increases salaries over three years.

    That brings seven of the 12 New York hospitals in negotiations to reach tentative agreements or new contracts.

    “The time is now to settle fair contracts that help nurses deliver the care that all New Yorkers deserve. We are fighting to improve patient care and will do whatever it takes to win,” NYSNA President Nancy Hagans said in a statement Sunday.

    New York City’s Mount Sinai Hospital is continuing to move infants out of intensive care units to other area hospitals, is diverting ambulances to other facilities and postponing elective surgeries and heart surgeries ahead of a planned nursing strike Monday.

    In a statement late Saturday, the hospital said it has been negotiating “in good faith” with the nursing union on a new contract. Mount Sinai has agreed to meet with NYSNA nurses after walking out on a bargaining session Thursday, the union said Sunday.

    A Mount Sinai spokesperson told CNN on Saturday the hospital system is actively bargaining with the Mount Sinai Morningside and West campuses under separate union agreements.

    But if agreements aren’t reached at several New York City area hospitals, thousands of nurses will strike on Monday morning.

    The hospital said Sunday its current wage offer “is identical” to ratified agreements at NewYork-Presbyterian and Maimonides – and would increase a Mount Sinai nurse’s base salary by 19.1 percent over three years.

    “But NYSNA’s inconsistent bargaining, unwillingness to accept this offer, and insistence on moving forward with a strike has left us no choice but to take significant actions to care for our patients,” the hospital statement said.

    Seven neonatal intensive care unit infants were safely transferred Saturday to partner hospitals in New York City, a hospital spokesperson told CNN on Sunday. Another six will be transferred Sunday from the NICUs at Mount Sinai Hospital and Mount Sinai West, the spokesperson said.

    “In addition, we have transferred close to 100 patients from the affected hospitals – The Mount Sinai Hospital, Mount Sinai West and Mount Sinai Morningside – to unaffected hospitals within the Mount Sinai system and partner hospitals in NYC and we continue to safely discharge patients who were schedule to go home.” All elective surgeries have been postponed, the spokesperson said.

    The NYSNA hit back Saturday at comments from Mount Sinai, which said Friday it was transferring infants in its neonatal intensive care units to other area hospitals because of the strike notice, adding the hospital was dismayed by the union’s “reckless” actions.

    “As a labor and delivery nurse who helps mothers to bring babies into this world, I find it outrageous that Mount Sinai would compromise care for our NICU babies in any way. We already have NICU nurses caring for twice as many sick babies as they should,” Matt Allen, the union’s regional director, said.

    “It’s unconscionable that Mount Sinai refuses to address unsafe staffing in our NICU and other units of the hospital but is now stirring fears about our NICU babies in contract negotiations,” he added.

    In a statement Saturday, the NYSNA said nurses at BronxCare and The Brooklyn Hospital Center reached tentative agreements that will improve safe staffing levels and enforcement, increase wages by 7%, 6%, and 5% annually during their three-year contract, and retain their healthcare benefits.

    On Saturday, nurses at NewYork-Presbyterian announced they had agreed to ratify their deal, but it was a close vote – 57% nurses voted yes and 43% were against.

    “Voting on whether to ratify a contract is a key component of union democracy. Just like in any democracy, there is rarely 100 percent consensus,” Hagans said in a statement.

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