Ibis Reproductive Health

January 2010

In a recent post on the blog for Health Affairs, a health policy journal, Ibis Senior Associate Dan Grossman and colleagues from UCSF and Princeton examine data about out-of-pocket health expenses by the uninsured to demonstrate the burden of cost that could result if proposed restrictions to abortion coverage are made into law through health care reform in the US. The data show that out-of-pocket costs are higher for young, uninsured women than for young, uninsured men. The average cost for first trimester abortion is about double, and second trimester abortion costs almost four times, the current average out-of-pocket expenditures for young, uninsured individuals. Excluding abortion coverage from health care reform not only places an unfair financial load on women, it betrays the goals of health care reform to equalize access and reduce barriers to care.

December 2009

MSNBC’s list of the nine most intriguing research studies related to sexuality of 2009 includes the review and commentary published in Contraception on withdrawal as a contraceptive method. In a review of previous research on withdrawal, the authors found that withdrawal’s typical use effectiveness was only slightly less effective than the typical use effectiveness rates for condoms. Based on qualitative research which finds that withdrawal use is more frequent than is often cited, the authors conclude that further research on the method, which is often written off, is warranted, as withdrawal may be a useful contraceptive strategy for many couples. To read more about the firestorm reaction to the article click here.
Ibis’s research on low-income women’s access to contraception after Massachusetts health care reform identified many positive outcomes, including substantial evidence that many more low-income women have access to preventive and reproductive health care services. However, challenges were also discovered. These challenges are explored in blog posts on RH Reality Check by Ibis President Kelly Blanchard and Project Manager Amanda Dennis, both members of the study team that conducted the surveys with family planning providers and focus groups with low-income women. Dennis poses the question of whether low-income women can be counted as insured when they can’t afford and access care, even with insurance.

Blanchard’s post enumerates the new challenges to contraceptive access that have arisen as a result of health care reform in the Commonwealth, including inconvenient prescription requirements, the requirement that women switch providers because their trusted provider is not covered by their health insurance plan, and confusing plan information that both providers and patients have trouble deciphering. All of these findings are important lessons that should be taken into consideration as national health care reform legislation is crafted and considered and as other states look to overhaul their own health systems.

November 2009

Based on research analyzing emails submitted to “Not-2-Late.com,” Ibis and colleagues have developed a set of tools for clinicians to use with patients to clarify common sexual misconceptions. Patient handouts in Arabic, French, Chinese, English, and Spanish cover the most commonly asked questions and misconceptions expressed in more than 1,100 emails sent to The Emergency Contraception Website, a website providing medically accurate information about emergency contraception, during the study period. In addition, a summary of the study is available through The Female Patient.
On November 14, 2009, The Boston Globe printed a letter to the editor from Ibis staff, which cited Ibis's research on young adults’ access to reproductive health care after Massachusetts health care reform. In research conducted for the REaDY Initiative, Ibis found that young adult-targeted health plans may not provide the full range of contraceptive services. Ibis urges the Commonwealth to take steps to improve young adults’ access to contraceptive information and services.
Ibis is pleased to share that two more Ibis staff have been recognized for their exemplary work in the field of reproductive health. Senior Associate Dr. Angel Foster will be given the American Public Health Association Population, Reproductive and Sexual Health Section’s Outstanding Young Professional Award at the section meeting on November 9, 2009, for being “an influential advocate and researcher for women's reproductive health,” especially for her work in underserved regions like the Middle East and North Africa. In addition, Senior Associate Dr. Daniel Grossman was named a 2009 Visionary Partner by the Pacific Institute for Women’s Health. This new award “is given to individuals who work across the globe to support women’s access to the full range of reproductive health options, including the latest reproductive health technologies.” Please join us in congratulating Drs. Foster and Grossman!

In addition, in September Ibis President Kelly Blanchard was named the recipient of the 2009 Darroch Award, sponsored by the Guttmacher Institute.

We are proud of these accomplishments by our staff, and are honored to receive this recognition from our respected reproductive health colleagues.

September 2009

September 29, 2009 -- Though many women and family planning providers in Massachusetts express overall satisfaction with health care reform, they identify family planning providers as an integral part of the public health safety net in Massachusetts, providing specific outreach to and services for hard-to-reach and underserved populations and mitigating some of the challenges with implementing health care reform.

Ibis Reproductive Health and the Massachusetts Department of Public Health (MDPH) Family Planning Program collaborated on an assessment of the effects of health care reform in Massachusetts on low-income women’s access to contraception. The research project included a systematic review of the government-subsidized insurance plans available to low-income Massachusetts residents, surveys and in-depth interviews with family planning providers around the Commonwealth, and English- and Spanish-language focus group discussions with low-income women.

Women and providers agree that reform has increased access to both health insurance and services. Women in the study identified other positive effects, such as the ability to seek preventive care and reduced stigma from having insurance. However, some new challenges have resulted; both women and providers have difficulties finding information about insurance coverage of services, women struggle to maintain and prove eligibility for subsidized insurance plans, and family planning providers have taken on increased administrative and fiscal responsibilities.

“Women talk about the emotional benefits of knowing they have insurance, and how that might encourage use of health services,” says Kelly Blanchard, president of Ibis Reproductive Health. “At the same time health care reform has spread some of the challenges inherent in the private insurance model, which appears to have created barriers to access to contraception for some women.”

New barriers to contraception access have arisen from reform, even though most women who participated in the study reported that they continue to have relatively easy access. Limits to the amount of contraception dispensed at once, high copays, inconvenient pharmacy locations, pharmacists’ lack of knowledge about what prescriptions are covered by the new subsidized plans, and even women’s unfamiliarity with how to use prescriptions were named as new challenges to contraceptive access for previously uninsured women accustomed to accessing services from clinics and community health centers.

In addition, health care reform has left out some populations of women, including immigrants, young women, those with unstable employment or income, and those experiencing common life changes such as moving or pregnancy.

“Family planning providers continue to provide essential services and play a role as advocates,” says Karen Edlund, Director of the MDPH Family Planning Program. “They are the voice for women in Massachusetts who continue to be forgotten and excluded from improvements to health care.”

Contraception is an essential preventive health service. It is critical that women have access to the complete range of methods and that women and health care providers have accurate information about contraception and insurance coverage of reproductive health services in the wake of reform in the Commonwealth. Read the executive summary and the full report for more detailed information about the findings and the recommendations of the project team.

This study was supported by the National Institute for Reproductive Health and the Title X Regional Office for New England.

Learn more about Ibis's other work related to Massachusetts health care reform.
We are proud to share the exciting news that Ibis’s president, Kelly Blanchard, has been named the winner of the 2009 Darroch Award for Excellence in Sexual and Reproductive Health Research, sponsored by the Guttmacher Institute. This award is given every two years to recognize a leader who has contributed outstanding research that has practical implications for public policy and sexual and reproductive health programs.

The Darroch Award was named for Jacqueline Darroch, PhD, former senior vice president for science at Guttmacher and currently a senior fellow at the Institute, whose three decades at Guttmacher exemplified rigorous and innovative work on sexual and reproductive health issues and commitment to the practical application of research to policy and programs. Kelly joins a group of luminary researchers who have received the Darroch Award in previous years: Elizabeth G. Raymond, MD, MPH, a researcher at Family Health International and a practicing obstetrician-gynecologist, and Sandra G. García, ScD, director of reproductive health for Latin America and the Caribbean at the Population Council.

“Kelly’s award is hard earned, and we thank the Guttmacher Institute and our colleagues in the reproductive health field for recognizing Kelly’s contributions with this prestigious honor. In the past five years Kelly has established a strong and collaborative organization that continues to make significant contributions to reproductive health,” said Ibis’s board chair, Beth Fredrick.

Please join the Ibis board and staff in congratulating Kelly!

Click here to see the press release from the Guttmacher Institute.

August 2009

August 18, 2009 - Ibis Reproductive Health is pleased to announce the release of our new report (and executive summary) on the contraceptive coverage of young adult-targeted health plans in Massachusetts, research undertaken as part of the Reproductive Empowerment and Decision Making for Young Adults (REaDY) Initiative. The REaDY Initiative is a coalition of Massachusetts health service providers, advocates, and researchers collaborating on a unique, statewide project to reduce unplanned pregnancy among young adults in the wake of health care reform in the Commonwealth. This multi-pronged initiative is focused on better understanding the individual, community, provider, and structural factors that influence the contraceptive behaviors of young adults aged 18 to 26 and on developing strategies to ensure that this age group has the resources they need to lead healthy sexual and reproductive lives.

Massachusetts Health Care Reform Law represents a groundbreaking effort to increase access to affordable, high-quality health care. Passage of the law in 2006 set in motion a series of reforms that considerably reduced the uninsurance rate, including individual and employer “mandates,” expansion of subsidized care, and market reforms. Young adults, a population that has historically been disproportionately uninsured and faces a high rate of unintended pregnancy, have been proactively incorporated into health care reform efforts. Ibis's report summarizes research findings and recommendations from a systematic review of the contraceptive and other sexual and reproductive health coverage of two types of plans specifically designed to give young adults affordable health insurance in Massachusetts: the Student Health Program and the Young Adult Plans. This is the first of the three formative research components of REaDY. Results from all three components of the project will be available toward the end of 2009.

REaDY is led by an Executive Committee of multiple organizations and agencies within the Commonwealth. Ibis is leading the formative research component, and the statewide, multi-agency taskforce is chaired by the Massachusetts Department of Public Health Family Planning Program and coordinated by the Pro-Choice Massachusetts Foundation. Other Executive Committee members include the Massachusetts Family Planning Association, youth development specialist TiElla Grimes, and the Boston Public Health Commission.

Learn more about the REaDY Initiative
Learn more about Ibis's other work related to Massachusetts health care reform

June 2009

June 1, 2009 - Ibis Reproductive Health mourns the unspeakable loss of our colleague and an inspiring figure in our field, Dr. George Tiller, who was murdered while attending church services in his hometown of Wichita, Kansas, the morning of May 31, 2009. Dr. Tiller cared for women and families for over 35 years and was one of a handful of physicians in the country who performed later-term abortions. He was a kind, caring, and generous man and had an unwavering commitment to helping women requesting his services, despite continued harassment, threats, and attempts on his life.

“Dr. Tiller’s murder is a tragedy and a huge loss for American women. It is also an outrage that the harassment and murder of physicians, nurses, and clinic staff who provide women with high-quality, life-saving, and legal abortion services continue in this country,” said Kelly Blanchard, president of Ibis.

As the number of abortion providers continues to decline and restrictions on abortion at the state level increase, it is becoming more and more difficult for women to access abortion care in the United States. This particularly affects poor women, women in rural areas and in states with few providers, and women needing services later in pregnancy. Dr. Tiller provided an essential service for women, many of whom traveled hundreds, if not thousands of miles to see him, in addition to providing comprehensive care to women and families in Wichita.

Our thoughts are with Dr. Tiller’s family, friends, and community at this terrible time; he will be greatly missed.
Ibis is co-sponsoring the opening reception for the “Invisible Lives” photo show which will take place on June 18, 2009 from 6-8pm at powerHouse Books (37 Main Street, Brooklyn, NY 11201). “Invisible Lives” is a book and photo show project presenting images to raise awareness of the ongoing civil war in eastern Burma which has driven more than two million people into Thailand and neighboring countries. The images of “Invisible Lives” bring the worlds of these refugees and illegal migrants into the open. Proceeds from the “Invisible Lives” event and book sales will fund reproductive health education for adolescents living along the Thai/Burma border.

May 2009

On May 13, 2009, Ibis and the Guttmacher Institute released the second in a series of papers on abortion restrictions, “The Impact of State Mandatory Counseling and Waiting Period Laws on Abortion: A Literature Review,” which found that most laws mandating counseling and waiting periods before abortion have little impact on birth and abortion rates. These findings imply that counseling requirements do not cause women to change their minds about having an abortion, and that waiting period requirements do not impose significant barriers to abortion services. Yet, according to the paper, which analyzes the relevant literature, these laws may postpone the timing of some abortions. Also, laws requiring in-person counseling caused additional delays and created additional burdens for women by forcing them to take more time off from work, arrange child care, or stay away from home overnight when the distance to the clinic is great. Ibis President Kelly Blanchard and Project Manager Amanda Dennis are co-authors of the paper.

Blanchard is a co-author on a second paper, released on May 15, 2009, a commentary highlighting that withdrawal is only slightly less effective than the male condom at preventing pregnancy. Published in the June 2009 issue of Contraception, “Better Than Nothing or Savvy Risk-Reduction Practice? The Importance of Withdrawal,” examines the lack of enthusiasm for the method which persists despite its relative effectiveness, as well as the consequences of the method’s lack of popularity.

April 2009

Please click here to read a summary of the results from Ibis’s study, commissioned by the National Women’s Law Center, assessing hospital policies and practices regarding ectopic pregnancy and miscarriage management. This qualitative study focused on the influence of the Ethical and Religious Directives for Catholic Health Care Services on policies and practices and included interviews with clinicians and hospital administrators at Catholic, non-Catholic, and recently merged hospitals in ten states. For a copy of the full report, please contact Dr. Angel Foster.

March 2009

On March 27, Mexico City’s Ministry of Health dedicated a public health clinic to the memory of Charlotte Ellertson, Ibis’s founder who passed away from breast cancer in 2004. Charlotte was an energetic and innovative researcher in the field of reproductive health, and prior to founding Ibis, she spent four years as the Population Council’s Director of Reproductive Health for Latin America and the Caribbean in Mexico City. In addition to the using her amazing research skills to generate evidence to support changes in policy and health care provision in Mexico, Charlotte loved the country on a personal level. Both her daughters were born in Mexico City and both have Mexican middle names, which will forever serve as treasured reminders of their mother and her time there. The Population Council and the Mexico City Ministry of Health organized a dedication ceremony to honor Charlotte’s vision, leadership, and tireless dedication to improving the lives of women, which helped promote the sexual and reproductive rights of women in Mexico City. As we at Ibis continue Charlotte’s work and add our own passion to hers, we are touched and excited by the news of this dedication.
Ibis Reproductive Health and the Guttmacher Institute released on March 11 a new publication, "The Impact of Laws Requiring Parental Involvement for Abortion: A Literature Review." As of 2008, 34 states in the US have laws in effect that mandate parental involvement in minors’ abortions. According to this review, these laws appear to do little to reduce teen abortion or pregnancy rates and may cause harm to minors by forcing many to travel to states without parental involvement requirements or navigate complicated judicial bypass systems to obtain waivers. These barriers delay access to the procedure, reducing safety and resulting in later, more costly abortions. Many gaps in knowledge about parental involvement laws remain, available data is less than ideal, and no study has evaluated minors' experiences with these types of laws. Ibis Project Manager Amanda Dennis is the lead author on the report. Read the entire report here, or click here to read the press release.

January 2009

A blog post on RH Reality Check by Ibis board member Frances Kissling criticizes President Obama's decision to remove the family planning provision from the economic stimulus package that passed the U.S. House of Representatives on January 28, 2009. Kissling argues that the President's decision betrays his promises to determine policy based on science and evidence and to defend women's rights.
Three days into his term, United States President Barack Obama took an important step to improve women’s health by signing an executive order lifting the funding ban to international organizations which provide abortion services, education, or referrals. The "Global Gag Rule" reduced the availability of family planning services to millions of the world’s poorest and most vulnerable women over the past eight years. This shift in policy is a great victory for the reproductive health and rights community, and for women around the world. See the websites of several of our colleague organizations (Ipas, Engender Health, and CHANGE) for more about this policy change.
A January 5 New York Times article, "For Privacy's Sake, Taking Risks to End Pregnancy," explored the topic of self-induced abortion in New York Latin American immigrant communities and discussed ongoing research by Ibis Reproductive Health and Gynuity Health Projects. The Times piece generated coverage and critiques in many blogs and online magazines, including Forbes.com, RH Reality Check, The Angry Black Woman, and SF Weekly. Ibis Senior Associate Dan Grossman, the principal investigator on the study, was also interviewed on KCBS radio in San Francisco, CA.

While we at Ibis were thrilled for our work to be highlighted in the New York Times, we were sorry that the article emphasized the risks of misoprostol, even though a great deal of research has demonstrated that this drug is very safe and effective at inducing abortion (although it is more effective when used in combination with mifepristone, the FDA-approved regimen for medical abortion). In some developing country settings where abortion is heavily restricted, use of misoprostol alone has helped to avert deaths from unsafe abortion, and a modeling exercise undertaken by Ibis and UCSF showed that increased use of misoprostol alone could reduce abortion-related mortality by half. A letter to the editor from Ibis and Gynuity published in Medical News Today and Hispanic Trending expressed our concerns about how the Times and these outlets mischaracterized our research and the issue of self-induced abortion in US immigrant communities. Letters to the editor published in the Times also raise important issues about abortion access and affordability for low-income and immigrant women in the United States.

December 2008

Ibis is proud to share our new Organization Report for the years 2006-2008. This new report provides an overview of Ibis's portfolio of projects over the past three years in our three main areas of work: abortion, contraception, and HIV and sexually transmitted infections (STIs). In the report, you will learn more about Ibis's research to simplify medication abortion and improve second trimester abortion care, our contributions to US legislation on emergency contraception, our efforts to reform reproductive health education and training in nursing and medical schools worldwide, and other exciting work Ibis has executed in recent years. Download an electronic copy of the report, or contact us at jstone@ibisreproductivehealth.org to request a hard copy.
On December 4, 2008, from 3-5:30 pm, Ibis Reproductive Health will co-sponsor an event coordinated by the Massachusetts Emergency Contraception Network. "New Media: Youth Voices on Sexual Health and EC" will feature two videos from Lowell and Harlem made by youth, for youth. Some of the teens involved in the project will be part of a panel to discuss their experiences. Breakout sessions will follow on how media can be used as a tool to educate youth about sexual health and to empower them to make healthy decisions.

October 2008

A blog post by policy experts at the National Women’s Law Center cited an article co-authored by Ibis Senior Associate Angel Foster entitled, "Can I get pregnant from oral sex? Sexual health misconceptions in e-mails to a reproductive health website." The blog post focuses on the divide in America between conservative and liberal views on teen sex and pregnancy and can be read at www.womenstake.org.
The Ibis staff and board mourn the passing of Dr. Allan Rosenfield, who served as an Ibis board member from 2002 until his death on October 12, 2008

September 2008

World Contraception Day is a worldwide campaign aiming to raise awareness of contraception and the need to reduce the high levels of unplanned pregnancy and to improve the level of education regarding sexual and reproductive health. It takes place on September 26th each year. One of Ibis's areas of work focuses on simplifying and increasing access to contraception. Ibis coordinates the Working Group on Moving Oral Contraceptives Over-the-Counter, a coalition of more than 70 researchers, advocates, and clinicians who are exploring the feasibility of an over-the-counter switch in the US. Ibis Senior Associate Dan Grossman's opinion piece on making oral contraceptives available without a prescription appeared in the recent issue of Contemporary OB/GYN.

July 2008

Ibis Reproductive Health, in collaboration with the Women's Health Research Unit (WHRU) at the University of Cape Town, will soon finish the first phase of data collection in a research project that could reveal important information about abortion services in the Western Cape Province of South Africa. Funded by the Safe Abortion Action Fund managed by the International Planned Parenthood Federation, Ibis and WHRU are investigating ways to improve second trimester abortion services in South Africa.

Though South Africa has a model abortion law, barriers to access, including a shortage of providers, provider opposition, stigma associated with abortion, and a lack of providers trained to perform abortions and facilities certified to provide abortions, can result in women resorting to unsafe abortion. Additionally, these barriers lead to a high proportion of second trimester terminations, which are inherently more risky. In South Africa 30% of abortions are performed at a gestational age of greater than 12 weeks, while in the United States approximately 10% of abortions are performed in the second trimester. The high rate of second trimester abortion in South Africa is a public health concern, given that every additional week of gestational age increases the risk of serious complication or death.

In the first phase of the project, which is currently underway and scheduled to finish in July, Ibis and WHRU are collecting baseline data on women's knowledge and attitudes about second trimester abortion. We are interviewing women who have undergone second trimester abortion procedures in five public hospitals in the Western Cape Province; two of the facilities involved in the study use medical induction, and three use a surgical technique called dilation and evacuation to perform second trimester abortions. The interviews explore women's experiences with referrals, barriers to obtaining the procedure, women's experience with counseling, support, and pain management available before, during, and after the procedure, and the specifics of the procedures the women undergo. So far, we have completed 219 interviews of a target of 250. In this first phase we will also interview staff at all five facilities to assess their opinions and attitudes regarding current service provision and the possibilities for expanding or improving second trimester abortion services.

These interviews are the first part of a larger project with an overall goal to improve access to high-quality second trimester termination services in the Western Cape Province of South Africa and create a model of care that could be scaled up on a national level. Eventually, Ibis also hopes to use this project as a stepping stone to a study which would randomize women seeking abortion in the second trimester in South Africa to a medication or surgical method. This research is crucial because there is very little clinical and acceptability evidence directly comparing surgical and medical methods of second trimester abortion.

Ibis's office in Johannesburg is uniquely situated to lead groundbreaking research like this study on second trimester abortion. We are also involved in a number of other projects in South Africa, including participating in a coalition of partners working to increase access to medication abortion and a project to improve sexual and reproductive health services for young women in Soweto, South Africa.

June 2008

From June 2-6, Ibis, PATH, and the INFO Project are hosting a global online forum to discuss health professionals' experiences with diaphragms in diverse settings and their role in family planning programs and other health care services. This free forum is part of the Implementing Best Practices (IBP) in Reproductive Health Knowledge Gateway's online discussion series. Click here to learn more and to register.

April 2008

Dr. Courtney B. Jackson and colleagues at Ibis Reproductive Health received the 2008 National Abortion Federation Scientific Poster Award. Entitled “Abortion training experiences among newly graduated Ob/Gyn residents,” the poster presents the results of a qualitative study dedicated to the factors influencing residents’ decisions to train in and intentions to provide abortion care. The findings reveal that training opportunities in pregnancy options counseling, abortion procedures counseling, and first trimester abortion procedures need to be strengthened and that requiring residents to use elective time to receive abortion training is impractical. A sociologist whose research focuses on increasing access to abortion care and addressing the abortion provider shortage, Dr. Jackson is the 2006-2008 Ellertson Fellow at Ibis Reproductive Health. Poster coauthors include Co-Principal Investigator Dr. Angel M. Foster and former Ibis intern Samantha Charm. The award was sponsored by SCI International, Inc. This study is one part of a mixed-methods project dedicated to investigating abortion training in Ob/Gyn residency programs. The larger project includes three components: 1) a content analysis of 246 Ob/Gyn residency program websites; 2) a survey of approximately 1,000 residents who completed residency in 2007; and 3) in-depth interviews with 36 physicians who completed residency in 2007. The study was commissioned by Physicians for Reproductive Choice and Health and supported by the Charlotte Ellertson Social Science Postdoctoral Fellowship in Abortion and Reproductive Health. For information about the study, please contact Dr. Jackson (cjackson@ibisreproductivehealth.org) or Dr. Foster (afoster@ibisreproductivehealth.org).
- Download poster abstract (PDF)
- Download poster (PDF)
Many other Ibis staff also made presentations at the 2008 NAF Annual Meeting. Senior Associate Dr. Deborah Kacanek gave a scientific paper on the availability of public funding for abortions in the US under the Hyde Amendment. Dr. Angel Foster and colleagues presented two posters, one on the physical, legal, and institutional barriers to abortion access in the West Bank, and another about a survey of the reproductive health content of Massachusetts nursing programs. Senior Associate Dr. Dan Grossman and colleagues presented a poster on the cost of medication abortion compared to aspiration abortion in Mexico City. Dr. Grossman was also a panelist on a session addressing how Latinas in the US and Latin America talk and feel about abortion.

In addition, the Ellertson Fellowship Program, coordinated at Ibis, organized the 5th Annual Social Scientists Networking Meeting, which brought together social scientists from diverse disciplines to share current and future research ideas and to discuss political and methodological challenges to research on abortion, particularly in the context of the US political climate.

Ibis, along with many other Boston-area women’s organizations, will co-present screenings of Flying: Confessions of a Free Woman on April 17, 18, and 19 at the Museum of Fine Arts in Boston. Directed by Jennifer Fox, Flying is a six-part, six-hour documentary about the female experience in the 21st century. As the filmmaker struggles to define her own life, she employs a technique called “passing the camera” to capture intimate conversations with women from 17 countries who talk about their experiences with everything from abortion and HIV/AIDS to marriage, motherhood, pregnancy, and sexuality. The New York Times described Flying as “a personal memoir, feminist manifesto, and diagnosis of global woman.” Click here for times and ticket information. To learn more about the film, visit www.flyingconfessions.com.
Ibis and the Massachusetts Department of Public Health (MDPH) Family Planning Program received a grant from the National Institute for Reproductive Health’s Low-Income Access Program for a project that will explore the impact of Massachusetts health care reform on low-income women’s access to contraception. In 2006, Massachusetts became the first state to pass legislation mandating that all residents have health insurance. As of July 2007, all state residents are required to be enrolled in a health insurance plan, and low-income residents may enroll in government-subsidized plans, which include family planning as a benefit. Together with the MDPH Family Planning Program, Ibis will collect preliminary data to examine whether health care reform is improving access to contraception for low-income women and to identify potential barriers created by reform. This project will help inform other state and federal efforts to expand health care coverage, lay the groundwork for future, more in-depth evaluations, and identify ways that advocates and policymakers concerned about reproductive health care can work to improve these programs.

March 2008

We are pleased to announce the 2008-2010 Charlotte Ellertson Social Science Postdoctoral Fellows in Abortion and Reproductive Health. Ellertson Fellows participate in a two-year postdoctoral research and leadership training fellowship. We selected five fellows for the third cohort of the Ellertson Fellowship, one at each of the five fellowship sites:
- Danielle Bessett, PhD expected May 2008 in Sociology from New York University, based at Ibis Reproductive Health
- Silvia De Zordo, PhD expected May 2008 in Social Anthropology from Ecole des Hautes Etudes en Sciences Sociales, based at Columbia University
- Megan Kavanaugh, DrPH expected August 2008 in Behavioral and Community Health Sciences from University of Pittsburg, based at the Guttmacher Institute
- Alison Norris, MD, PhD 2006 in Epidemiology and Public Health from Yale University, based at Johns Hopkins University
- Julia Steinberg, PhD expected May 2008 in Psychology from Arizona State University, based at the University of California, San Francisco
The objectives of the fellowship are to support a multidisciplinary cohort of promising new social science researchers who study abortion and reproductive health, and to produce and share research that informs policy and program design. Fellows are committed to research on abortion and careers that include a focus on scholarship and advocacy. To read the full announcement of the 2008-2010 Fellows, click here. For further information about the Ellertson Fellowship, please contact at fellowship(at)ibisreproductivehealth.org, or visit www.ibisreproductivehealth.org/fellowship/index.cfm.

February 2008

Ibis Senior Associate Dan Grossman quoted in Brownsville Herald article about women who self-induce their abortions using misoprostol

January 2008

On the 35th anniversary of the landmark Roe v. Wade ruling, Ibis board member Frances Kissling and former NARAL president Kate Michelman discuss the challenges facing the pro-choice movement in the Los Angeles Times.

December 2007

On December 5, 2007, Ibis Reproductive Health held its 5th anniversary fundraising event at the Radcliffe Gymnasium in Cambridge, MA. Guests enjoyed food and beverages donated by many local and community-minded businesses. In addition, Ibis staff members made the desserts, including the three-tiered birthday cake made by Ellertson Fellow Courtney Jackson. Jazz duo Carmen Staaf and Kendall Eddy gave an outstanding performance and guests engaged in competitive bidding at the silent auction, comprised of items donated by local businesses and from many of the regions in which Ibis works.

The evening’s highlight was Ibis board member Frances Kissling, who spoke about the state of reproductive health and rights in the US and internationally and encouraged the reproductive health professionals and allies in the room to continue to nurture and grow our community—because that is how movements are strengthened and sustained.

Click here to view photos and the list of sponsors and other businesses that contributed to the event.
Ibis recommends Abstinence Comes to Albuquerque, a documentary film about the events that unfolded when abstinence-only education was introduced in New Mexico’s public schools. Through interviews with national experts, state public health officials, parents, and others, the film highlights the differences between abstinence-only and comprehensive sex education. The 2005 film was recently revised to include discussion of the congressionally mandated Mathematica study on abstinence education programs and an update on what has happened in New Mexico. The film runs 45 minutes and is available for free, along with a discussion guide, at www.der.org/films/abstinence-comes-to-albuquerque.html.

November 2007

Research conducted by Ibis staff is cited in the Emergency Contraception (EC) Education Act of 2007, sponsored by Senator Patty Murray (D-WA). Recognizing that EC can be a safe and effective means of preventing unintended pregnancy, but that EC use and awareness are low, the bill proposes the creation of an EC public awareness and education program. Among its findings, the bill references Ibis’s research on the availability of EC in hospital emergency rooms. The study cited, which was published in the Annals of Emergency Medicine, included a survey of emergency room staff at Catholic and non-Catholic hospitals in the US and was authored by Ms. Teresa Harrison, SM. The study found that 42% of non-Catholic hospitals and 55% of Catholic hospitals said they do not dispense EC for any reason, including sexual assault. Further, very few hospitals provide EC without restrictions, even though EC is safe and has no contraindications, will not harm an existing pregnancy, and is most effective if taken within 24 hours of unprotected intercourse. Ibis commends Senator Murray and the bill’s co-sponsors for proposing this legislation. For more information about the study, please contact admin(at)ibisreproductivehealth.org.

October 2007

On October 13, 2007, the Lancet published a comment by Ibis board member Beth Fredrick written in response to new research on worldwide abortion rates and trends from the Guttmacher Institute and the World Health Organization published in the same issue. In her piece, Ms. Fredrick argues that we are not doing enough to stop unsafe abortion and need to invest in legal, policy, and health care reform as well as bolster advocacy efforts.

“In all of the data, one fact stands out: safe and legal abortion saves women’s lives and protects their health. There is no acceptable reason to allow women to die, fall ill, or become infertile as a result of unsafe abortion when the world community has both the knowledge and the means to prevent these deaths.”

Ms. Fredrick is the executive vice president of the International Women’s Health Coalition. View Lancet comment (registration required).

September 2007

Ibis board member Vanessa Northington Gamble has been named University Professor of Medical Humanities at The George Washington University in Washington, DC. An internationally recognized scholar on race, ethnicity, and justice in American medicine and public health, she is the first woman to hold the prestigious, endowed faculty position. Dr. Gamble comes to GW from Tuskegee University in Alabama, where she was director of the university’s National Center for Bioethics in Research and Health Care. Download press release.

Ibis Senior Associate Dan Grossman received the Ortho Outstanding Researcher Award at Reproductive Health 2007, a meeting sponsored by the Association of Reproductive Health Professionals, Planned Parenthood® Federation of America, the Society for the Advancement of Reproductive Care, and the Society of Family Planning. The award was for Dr. Grossman’s presentation entitled, “Self-screening for contraindications to oral contraceptives: evidence for the safety of over-the-counter access.” This study examined how well women from the general population could self-screen for contraindications to combined oral contraceptives (COCs) using a checklist. It concluded that over-the-counter provision of COCs would likely be safe, especially for younger women and if independent blood pressure screening were encouraged.

For more information, contact admin(at)ibisreproductivehealth.org.
Ibis was awarded a grant from the Society of Family Planning to study women’s experiences with abortion self-induction in San Francisco, Boston, and New York City. The study will use a mixed-methods approach to better understand this phenomenon, as well as to highlight the barriers that low-income women and women of color—especially Latinas—face in accessing abortion services in the US. Ibis will partner with Gynuity Health Projects to perform the portion of the study in New York. Click here for a complete list of the Society of Family Planning 2007 grant recipients.

August 2007

Research by Ibis and colleagues at PATH and the Population Council is highlighted in the current id21 focus, dedicated this month to the topic of unsafe abortion. Conducted before Mexico City’s recent move to legalize abortion, the study sought to estimate the economic costs of unsafe abortion from the perspective of the Mexico City health care system. It concluded that improved access to safe abortion would likely result in significant cost savings, in part by reducing the incidence of complications from unsafe abortion.

Click here to download the publication or request a printed copy by sending an email to admin(at)ibisreproductivehealth.org.

July 2007

July 13, 2007 – The Methods for Improving Reproductive Health in Africa (MIRA) trial found that the use of diaphragms and lubricant gel in addition to condoms for HIV prevention is no more effective than condoms alone. Ibis was a collaborating partner in the MIRA trial, led by researchers at UCSF, which enrolled more than 5,000 women in South Africa and Zimbabwe. The results are reported in an article published today online and in an upcoming edition of The Lancet.

To date, male and female condoms remain the only proven barrier methods for HIV prevention. Ibis supports continued research into new HIV prevention methods that give women and girls the power to protect their health.

Additional resources:
- For detailed information about the results, including a Q&A document, a fact sheet, and links to press coverage, visit the Cervical Barrier Advancement Society, coordinated at Ibis.
- Read the article and related commentary at www.thelancet.com. (Free registration required to view the article. Commentary available to subscribers only.)
- Learn more about female-controlled methods for HIV/STI prevention.
If you have any difficulty acessing these links or materials, please email admin(at)ibisreproductivehealth.org.

June 2007

Ibis is pleased to announce that it has received a grant award from the Safe Abortion Action Fund for a project to improve second trimester abortion services in the Western Cape Province of South Africa. Administered by the International Planned Parenthood Federation, the Safe Abortion Action Fund (SAAF) aims to reduce unsafe abortion worldwide and was established with funding from the governments of Denmark, Norway, Sweden, Switzerland, and the United Kingdom. Click here for more information about SAAF.
An article by Ibis President Kelly Blanchard, Senior Associate Dan Grossman, and colleagues at the University of California, San Francisco appeared in this month’s International Journal of Gynecology and Obstetrics. Named one of the “Editor’s Selections,” the article models how wider use of misoprostol could reduce maternal deaths resulting from unsafe abortion in resource-poor countries. The journal’s editors provided the following write-up:

“As has been reported in this journal on many occasions, unsafe abortion is a significant contributor to maternal mortality, especially in developing countries. The present paper addresses the issue of the potential use of misoprostol to induce elective abortion as a simple intervention to reduce maternal mortality, especially in the developing world. The basis of the evaluation is to determine the impact on maternal mortality if misoprostol were used to replace other, riskier, abortion techniques that are presently being used. The statistical analysis tested the above hypothesis and demonstrated that an increased use of misoprostol, which is an option already available for pregnancy termination in many countries, could significantly reduce maternal mortality due to abortion. As the authors appropriately point out, for misoprostol abortion to have the greatest impact on mortality, timely access to post-abortion care at hospitals and clinics is necessary. The obvious follow-up to this paper is documentation of the actual reduction in mortality rates in medical pregnancy termination as misoprostol use increases in developing countries. Maternal mortality is a terrible tragedy, and anything that we can do to reduce maternal morbidity and maternal death merits our attention.”

To request a copy of the article, please send an email to admin(at)ibisreproductivehealth.org.

Full citation: Harper CC, Blanchard K, Grossman D, Henderson JT, Darney PD. Reducing maternal mortality due to elective abortion: Potential impact of misoprostol in low-resource settings. Int J Gynecol Obstet 2007;98:66–69.

April 2007

Ibis Reproductive Health staff member Dr. Angel M. Foster and colleagues at a leading university in Palestine received the 2007 National Abortion Federation Scientific Poster Award. Entitled “Illicit sex, abortion, and so-called ‘honor-killings’: Attitudes and opinions of female university students in Palestine” the poster highlights the preliminary results of a study that investigates unmarried Palestinian women’s experiences with and attitudes toward pregnancy termination. The results reveal that among university students the permissibility of abortion is tied to the illicitness of the sexual encounter, and that abortion is often viewed as protective in cases in which the woman is unmarried. Completed in 2006, collaborating colleagues include co-investigator Francoise Daoud, MPN, BSN, RN from the Faculty of Nursing & Health Sciences, Bethlehem University and study-team members Sahar Abed, Katy Abu Sa'da, and Hiba Al-Ayasah from Bethlehem University. The award was sponsored by Ortho Women’s Health & Urology, a division of Ortho-McNeil Pharmaceutical, Inc.

This study is part of a larger multi-country project dedicated to the sexual and reproductive health knowledge, attitudes, and behaviors of never-married women in the Middle East and North Africa. For information about the study, please contact Dr. Foster (afoster(at)ibisreproductivehealth.org).
- Download poster abstract (PDF)
- Download poster (PDF)

We are pleased to announce the publication of a new Cochrane systematic review, “Advance provision of emergency contraception for pregnancy prevention.” We collaborated on this review with lead author Chelsea Polis, a doctoral student at Johns Hopkins and former Ibis staff member.

Women deserve the chance to protect themselves from unintended pregnancy, and emergency contraception (EC) provides a safe, effective option to do so. Our evaluation of current interventions to give women an advance supply of EC found that EC has not had an effect on population-level pregnancy rates. However, we also found that advance provision of EC does not appear to have harmful effects on sexual behavior or on the use of regular contraceptives for teens or adult women.

Click here to read The Cochrane Library’s press release. To receive a copy of the review, please send an email to admin(at)ibisreproductivehealth.org.

March 2007

On March 21st Ibis Reproductive Health Associate Dr. Angel M. Foster appeared as a guest on The Riz Khan Show. During the interactive live program dedicated to HIV/AIDS in the Middle East, Dr. Foster spoke about the importance of identifying and addressing the needs of unmarried women and the intersection between HIV and reproductive health. Other guest experts on the Al Jazeera English (AJE) program included Dr. Oussama Tawil UNAIDS Middle East Regional Director and Elie Aaraj, Executive Director of Soins Infirmiers et Développement Communautaire (Lebanon). Broadcast globally via satellite and cable to over 80 million households, AJE is the third largest English language news outlet worldwide and is the sister network to Al Jazeera Arabic.

For more information about our Middle East and North Africa Program, please contact Dr. Foster (afoster(at)ibisreproductivehealth.org).

November 2006

“Kelly Blanchard, President of Ibis Reproductive Health, receives Outstanding Young Professional Award.” November 15, 2006 | Boston, MA. Last week at the annual American Public Health Association meeting, Kelly Blanchard, the President of Ibis Reproductive Health, received the annual Outstanding Young Professional Award from the Population, Family Planning and Reproductive Health Section for her contributions to the field. Each year the section gives the award to a young professional who has made important contributions early in her/his career. “It is really an honor to receive this award, and I am thrilled to join the list of extraordinary individuals who have won the award in the past; I am also very proud to consider many of them close colleagues,” said Blanchard. Ibis Reproductive Health Board Chairman Chris Elias said, “It is wonderful to have the important contributions Kelly has made both at Ibis and in her career overall recognized in this way. We on the Ibis Board are very proud of her achievements.” Ms. Blanchard has published more than 35 articles in peer-reviewed journals on family planning and reproductive health. She joined Ibis Reproductive Health in 2003, opening the Johannesburg office, and in November 2004 was appointed President.

Additional resources: