What’s new at ANSIRH

  • Katrina Kimport's book "Queering Marriage" wins Charles Tilly Prize
  • ANSIRH study finds that a 2012 law that restricts later abortion care in Georgia impacts women throughout the South, the Midwest, and parts of the Northeast
  • Announcing ANSIRH's New Director, Dr. Dan Grossman
  • New ANSIRH study shows Louisiana Admitting Privileges Law would drastically limit abortion access
  • Increased access to oral contraceptives would result in public sector cost savings, study finds
  • New ANSIRH study published in Obstetrics & Gynecology shows that major complications after abortion are extremely rare
  • Carole Joffe publishes new textbook, Reproduction and Society
  • Former director Tracy Weitz honored with Irvin M. Cushner Award
  • Diana Taylor honored with inaugural Hysterical Hero Award
  • Tracy Weitz receives 2014 ACN Vision Award
  • Katrina Kimport publishes new book, Queering Marriage
  • California bucks the trend: New law will increase abortion access
  • Katrina Kimport's book "Queering Marriage" wins Charles Tilly Prize

    Kimport_Cover_Final.inddKatrina Kimport’s book Queering Marriage: Challenging Family Formation in the United States wins the Charles Tilly Distinguished Contribution to Scholarship Book Award for 2015. This award is granted by the American Sociological Association’s Section on Collective Behavior and Social Movements.

    In the book, Dr. Kimport uses in-depth interviews with participants in the 2004 San Francisco weddings to argue that same-sex marriage cannot be understood as simply entrenching or contesting heterosexual privilege. Instead, she contends, these new legally sanctioned relationships can both reinforce as well as disrupt the association of marriage and heterosexuality.

    During her deeply personal conversations with same-sex spouses, Dr. Kimport learned that the majority of respondents did characterize their marriages as an opportunity to contest heterosexual privilege. Yet, in a seeming contradiction, nearly as many also cited their desire for access to the normative benefits of matrimony, including social recognition and legal rights. Dr. Kimport’s research revealed that the pattern of ascribing meaning to marriage varied by parenthood status and, in turn, by gender. Lesbian parents were more likely to embrace normative meanings for their unions; those who are not parents were more likely to define their relationships as attempts to contest dominant understandings of marriage.

    By posing the question—can queers “queer” marriage?—Dr. Kimport provides a nuanced, accessible, and theoretically grounded framework for understanding the powerful effect of heterosexual expectations on both sexual and social categories.

    Read reviews and learn more here.

    ANSIRH study finds that a 2012 law that restricts later abortion care in Georgia impacts women throughout the South, the Midwest, and parts of the Northeast

    See the full article in the American Journal of Public Health (requires subscription), the related infographic, and the press release.

    georgia-news2The goal of the study was to describe groups of women affected by a Georgia state law that went into effect in January 2013 that prohibits providers from performing abortions after viability. Data were collected from women who had an abortion at or beyond 20 weeks gestation in 2012 and 2013 within Georgia facilities that provide later abortions.

    The results of the study showed that women traveled from throughout the South, the Midwest, and parts of the Northeast to obtain post 20-week abortion care in Georgia. This finding illustrates that when a type of abortion care, such as later abortion care, is already scarce in a geographic region, banning it in one state in that region has an impact on women’s health and access well-beyond that state.

    Georgia was the 10th state to pass a 20-week abortion ban and the first state to pass such a ban where a considerable number of abortions after 20 weeks were being provided. The implications of Georgia’s 20-week ban are important to consider because Georgia is one of only two states in the Southeast where outpatient abortion care after 20 weeks is provided. And, prior to part of the ban going into effect in January 2013, Georgia was the only state in the Southeast and Midwest that provided outpatient abortion care after 24 weeks LMP.

    “The ban that went into effect in January 2013 has resulted in a lack of access to this healthcare service throughout the Southeast. As assuring availability of health care services is an essential public health service, the findings from this study indicate that the public health role of assuring availability of abortion care services has not been met,” explained Dr. Roberts. If Georgia’s entire 20 week ban goes into effect, the situation will become even more dire.

    Authors of this study are Sarah Roberts, DrPH, Heather Gould, MPH, and Ushma Upadhyay, PhD, MPH.

    Announcing ANSIRH's New Director, Dr. Dan Grossman

    Dan Grossman, MD

    ANSIRH is thrilled to announce that Dr. Dan Grossman will become Director of Advancing New Standards in Reproductive Health (ANSIRH) on September 1, 2015. In announcing the appointment, Chief, SFGH Division, Department of Ob/GYN & R.S., Dr. Rebecca Jackson says “Dr. Grossman brings to ANSIRH a perfect combination of rigorous research, high-impact policy work, global health expertise and a powerful media presence.” “We are overjoyed to have him lead our organization,” adds Dr. Diana Greene Foster, Interim Director of ANSIRH.

    Dr. Grossman is currently Vice President for Research at Ibis Reproductive Health. He is a respected researcher with an extensive research portfolio and over 100 articles published in peer-reviewed journals. In recent years, Dr. Grossman has emerged as a leading spokesperson in the media and legal worlds on cutting-edge topics such as over-the-counter oral contraceptives, restrictions on access to abortion care and telemedicine. Dr. Grossman is an abortion provider and will continue his clinical practice as Professor in the Department of Obstetrics, Gynecology and Reproductive Sciences at UCSF.

    “I feel very honored to have been chosen to lead such a distinguished group of researchers, and I look forward to helping ensure that ANSIRH’s work has the greatest possible impact on practice and policy,” said Dr. Grossman.

    ANSIRH is grateful to Dr. Diana Greene Foster for her leadership as Interim Director. She has helped ANSIRH continue its mission and ANSIRH has grown significantly in faculty, staff and funding under her direction. Dr. Foster will return to her role as Director of Research when Dr. Grossman takes the helm in September.

    Lastly, ANSIRH would like to thank Dr. Rebecca Jackson and the entire search committee for their tireless work to identify our new Director. We are also grateful for the support of the UCSF Department of Obstetrics, Gynecology and Reproductive Sciences, the UCSF National Center of Excellence in Women’s Health, and the San Francisco General Hospital Division of the UCSF OBGYN Department.

    We look forward to Dr. Grossman’s leadership in guiding ANSIRH’s rigorous, innovative social science research on complex and controversial issues related to reproduction.

    New ANSIRH study shows Louisiana Admitting Privileges Law would drastically limit abortion access

    New ANSIRH study shows that the Louisiana Admitting Privileges Law would drastically limit abortion access.

    A Louisiana law that could close all of the state’s abortion facilities by requiring providers to have hospital admitting privileges would force three-quarters of the state’s women to travel 150 miles or more each way for services, an analysis by ANSIRH researchers has found.

    A Louisiana law that could close all of the state’s abortion facilities by requiring providers to have hospital admitting privileges would force three-quarters of the state’s women to travel 150 miles or more each way for services, an analysis by ANSIRH researchers has found.

    Researchers looked at data from the 5,641 women who received abortions at three of Louisiana’s five facilities between Sept. 1, 2013, and Aug. 31, 2014, the year before the admitting privileges law was scheduled to go into effect. About 80 percent of these women lived in Louisiana; the rest came from other states, mostly Texas.

    Louisiana requires the facilities to collect the women’s place of residence, among other data, and the researchers were able to measure the distance that women currently travel for an abortion and how far they would have to travel if all of Louisiana’s facilities closed as a result of the admitting privileges law. The results were published Wednesday, March 4, in Contraception.

    The data showed that the Louisiana women in the study had traveled, on average, 58 miles each way to have an abortion. If all of Louisiana’s facilities close, the researchers estimate the average distance would more than triple to 208 miles each way, about the distance from New York to Boston or New Orleans to Jackson.

    The authors note that the study may actually underestimate the distance women would have to travel, since three of the closest states to Louisiana—Texas, Mississippi and Alabama—also have passed admitting privilege laws and other restrictions that could close more abortion facilities. Since the Texas admitting privileges law took effect, it has caused almost half of that state’s abortion facilities to close. All of these laws, including Louisiana’s, have been challenged in court.

    Researchers noted that forcing Louisiana women to travel further would likely add to financial difficulties that women already have paying for abortion and contribute to delays in receipt of abortion care.

    “Abortion is already a safe procedure, and there’s no evidence that admitting privileges would make it any safer,” said first author Sarah Roberts, DrPH, an assistant professor in the UCSF Department of Obstetrics, Gynecology and Reproductive Sciences.

    Other authors of the study are Liza Fuentes, MPH, of Ibis Reproductive Health, in Oakland, Calif.; Rebecca Kriz, RN, MS, and Ushma Upadhyay, PhD, MPH at UCSF; and Valerie Williams, MD, of Louisiana State University School of Medicine in New Orleans.

    See the full article on the study, the related infographic, and the press release.

    Increased access to oral contraceptives would result in public sector cost savings, study finds

    Removing the prescription barrier, particularly if pill packs are available at low or zero out-of-pocket cost, could increase the use of effective methods of contraception and reduce unintended pregnancy and healthcare costs for contraceptive and pregnancy care.Researchers at ANSIRH/UCSF and Ibis Reproductive Health have just published a study in Contraception on how making oral contraceptive pills (OCPs) available without a prescription could affect contraceptive use, unintended pregnancies and associated contraceptive and pregnancy costs among low-income women.

    Based on published figures, the study looked at two scenarios—low over-the-counter (OTC) use and high OTC use—of the proportion of low-income women likely to switch to an OTC pill and predicted the rate of adoption of OCPs based on cost. Twenty-one percent of low-income women at risk for unintended pregnancy were found to be very likely to use OCPs if they were available over the counter (OTC).

    In addition, women’s use of OTC OCPs was found to vary widely depending on the out-of-pocket pill pack cost. In a scenario assuming no out-of-pocket costs for the OTC pill, an additional 11–21% of low-income women would use the pill. This would result in a 20–36% decrease in the number of women using no contraception or a method less effective than the pill. Depending on the level of use and related contraceptive failure rates, that would translate to a 7–25% decrease in the number of unintended pregnancies.

    The researchers then estimated cost savings under each scenario by comparing the total public sector costs of providing OCPs OTC and of providing medical care for unintended pregnancy. They found that the combined costs would be reduced for public health plans covering oral contraceptives as an OTC product.

    The implications are twofold. Interest in OTC access to oral contraceptives is high. Removing the prescription barrier, particularly if pill packs are available at low or zero out-of-pocket cost, could increase the use of effective methods of contraception and reduce both the rates of unintended pregnancy and the healthcare costs associated with contraceptive and pregnancy care.

    The research was conducted by Diana Greene Foster, PhD, and M. Antonia Biggs, PhD, of ANSIRH; Kathryn A. Phillips, PhD, of the UCSF School of Pharmacy; and Kate Grindlay, MSPH, and Daniel Grossman, MD, of Ibis Reproductive Health.

    See the full article on the study in Contraception.

    New ANSIRH study published in Obstetrics & Gynecology shows that major complications after abortion are extremely rare

    Obstetrics & Gynecology logo

    In the most comprehensive look yet at the safety of abortion, ANSIRH researchers have found that major complications occur in less than a quarter of a percent of all abortions, about the same frequency as major complications in colonoscopies. The study, published online on Monday, Dec. 8, 2014, in Obstetrics & Gynecology, analyzed data from more than 50,000 women enrolled in the Medi-Cal fee-for-service program who obtained abortions from 2009 to 2010, and looked for complications that occurred within six weeks of the procedure.

    The rate is similar to what has been found in previous studies, but this is the first study in which researchers have based their conclusions on complete data on all of the health care used by women who have received abortions. Since some women must travel long distances to find abortion providers, they tend to receive follow-up care at facilities closer to where they live. For many women, this means their local emergency department. But, up until now, no study has systematically examined emergency department use for post-abortion care.

    “Our study had very complete follow-up data on all of the women in it, and we still found a very low complication rate,” said Ushma Upadhyay, PhD, MPH, the lead author of the study. “Abortion is very safe as currently performed, which calls into question the need for additional regulations that purportedly aim to improve safety.”

    Other authors of the study include Tracy A. Weitz, PhD, MPA, and Patricia Anderson, MPH, of ANSIRH; Sheila Desai, MPH, who did the research while at ANSIRH; Diana Taylor PhD, RNP, an emeritus professor in the UCSF School of Nursing; Daniel Grossman, MD, of the UCSF Department of Obstetrics, Gynecology and Reproductive Sciences and Ibis Reproductive Health; and Vera Zlidar, MHS, who did the research while at John Snow, Inc.

    The researchers said they expect the study to contribute to the national debate over abortion safety. Many state legislatures have recently passed laws that have the effect of reducing access to abortion by requiring providers to have transfer agreements or admitting privileges with hospitals or to construct their clinics so that they meet the requirements of an ambulatory surgical center. But the researchers said that these restrictions were likely to make women travel further to get abortions or induce them on their own using unsafe methods, both of which may increase the risks for women.

    See the full article on the study (downloadable pdf), the related issue brief, and ANSIRH’s press release.

    Carole Joffe publishes new textbook, Reproduction and Society

    Reproduction and Society coverANSIRH research and faculty member, Carole Joffe, PhD, releases her latest book, Reproduction and Society: Interdisciplinary Readings, on September 15, 2014. Framed with original introductions, Reproduction and Society is a collection of essays edited by Joffe and Jennifer Reich, PhD, that includes selections by present and past members of the UCSF ANSIRH and Bixby Center for Global Reproductive Health communities: Lori Freedman, PhD; Tracy Weitz, PhD; Naomi Stotland, MD (writing about the prison work of Carolyn Sufrin, MD), as well as Joffe herself. Divided into six rich and varied sections, this book offers students and instructors a broad overview of the social meanings of reproduction and offers opportunities to explore significant questions of how resources are allocated, individuals are regulated, and how very much is at stake as people and communities aim to determine their own family size and reproductive experiences. This is an ideal core text for courses on reproduction, sexuality, gender, the family, and public health. 

    Former director Tracy Weitz honored with Irvin M. Cushner Award

    Dr. Tracy Weitz, recipient of ARHP's 2014 Irvin M. Cushner AwardTracy A. Weitz, PhD, MPA—co-founder and former director of ANSIRH and now the director of domestic programs at the Susan Thompson Buffett Foundation—will be honored with the Association of Reproductive Health Professionals’ Irvin M. Cushner Award. The award will be presented in September at Reproductive Health 2014, ARHP’s annual conference.

    The annual Cushner Lectureship is awarded to a layperson, public figure, or health care professional who has raised public awareness and inspired public policy debate regarding a pressing current issue in the field of health care, especially one pertaining to reproductive health. It is named after Dr. Irvin Cushner, who helped develop the field of social obstetrics and guidelines for the legalization of abortion in the state of Maryland. Dr. Cushner served as deputy assistant secretary for population affairs for the U.S. Department of Health, Education, and Welfare.

    Congratulations, Tracy!

    Diana Taylor honored with inaugural Hysterical Hero Award

    Dr. Diana Taylor honored by Women's Community Clinic with inaugural Hysterical Hero AwardDiana Taylor is the recipient of the inaugural Hysterical Hero Award at the 2014 Hysteria Benefit for the Women’s Community Clinic. Taylor is a longtime Board Member, volunteer clinician, and tireless advocate for the Clinic.

    “We built the kind of place where we want to receive care,” Taylor says. “The Clinic has been volunteer-driven since our opening; our volunteers are incredible – lay volunteers who are passionate about educating women about improving their health as well as the expert nurses and doctors who volunteer so they can provide care the way we believe it should be provided!”

    “The Clinic not only fills an important need but is educating women to take care of themselves and training future health professionals,” she says. “We believe health is wealth and that women’s health means family and community health.”

    Congratulations for a much-deserved award, Diana!

    Tracy Weitz receives 2014 ACN Vision Award

    Dr. Tracy Weitz awarded 2014 Vision Award by Abortion Care NetworkThe Abortion Care Network (ACN) holds an annual meeting in which they honor three individuals who exemplify excellence in our field.  This year ACN dedicated its 2014 Conference to the Center for Reproductive Rights for its extraordinary advocacy for independent clinics and its visionary campaigns to end the stigmatization of abortion. ACN honored Amy Hagstrom-Miller, CEO of Whole Woman’s Health with the David Gunn Lifetime Achievement Award; Tracy Weitz, former Director of ANSIRH, with the Vision Award; and Jodi Jacobson of RH Reality Check with the ACN Person of the Year Award.

    The Vision Award, given to “person or persons who challenge the stigma of abortion in every day practice,” was awarded to our own Tracy Weitz for her creativity and leadership in her years as Director of ANSIRH.

    Congratulations, Tracy!

    Katrina Kimport publishes new book, Queering Marriage

    Queering MarriageAs we celebrate Freedom to Marry Day on February 12th, we also celebrate the recently published book by ANSIRH research and faculty member Katrina Kimport, PhD.  In Queering Marriage: Challenging Family Formation in the United States, Kimport uses in-depth interviews with participants in the San Francisco weddings to argue that same-sex marriage cannot be understood as simply entrenching or contesting heterosexual privilege. Instead, she contends, these new legally sanctioned relationships can both reinforce as well as disrupt the association of marriage and heterosexuality.

    During her deeply personal conversations with same-sex spouses, Kimport learned that the majority of respondents did characterize their marriages as an opportunity to contest heterosexual privilege. Yet, in a seeming contradiction, nearly as many also cited their desire for access to the normative benefits of matrimony, including social recognition and legal rights. Kimport’s research revealed that the pattern of ascribing meaning to marriage varied by parenthood status and, in turn, by gender. Lesbian parents were more likely to embrace normative meanings for their unions; those who are not parents were more likely to define their relationships as attempts to contest dominant understandings of marriage.

    By posing the question – can queers “queer” marriage? – Kimport provides a nuanced, accessible, and theoretically grounded framework for understanding the powerful effect of heterosexual expectations on both sexual and social categories.

    California bucks the trend: New law—based on ANSIRH research—will increase abortion access

    California State Capitol

    Today Governor Jerry Brown signed Assembly Bill 154 (AB154). AB154 removes barriers to abortion provision for nurse practitioners, certified nurse midwives, and physician assistants, allowing them to perform to the fullest extent of their education and competency and provide more comprehensive reproductive health care for women throughout California.

    The bill is based on ANSIRH’s six-year study, Health Workforce Pilot Project #171, which showed that these skilled health professionals can safely and competently provide early abortion care and that women appreciated receiving care in their own communities from providers they know and trust. ANSIRH is proud that our research played a part in an important law change in California that will remove barriers to abortion provision for advance practice nurses and physician assistants and help to increase access to needed services throughout the state.