House Democrats spent hours in caucus last Wednesday debating how to proceed on the Senate Bill 776, which would ban the abortion of a fetus by removing the fetus until the head or fetal trunk is outside a woman's body before completing the abortion. The procedures banned by the bill are collectively referred to by opponents as partial birth abortion, though the term has no medical relevancy. Doctors sometimes recommend the procedure for pregnancies that pose risks to the mother's health.
When they emerged from caucus, Majority Floor Leader Steve Tobocman, D-Detroit, used a parliamentary maneuver to quickly adjourn session. That move prevented action on the bill and led to chants of "776" by some House Republicans.
The bill, which allows for exceptions only in situations of threat to a woman's life, is a replica of a federal law that was upheld by the U.S. Supreme Court in January. Michigan is covered under the federal law.
Nonetheless, Ed Rivet, legislative director for Michigan Right to Life, has said his group was engaged in "active negotiations" with House Speaker Andy Dillon, D-Redford Township, to bring the bill to a floor vote and planned to use the day a couple hundred of its members descend on the Capitol to push for the bill.
"There isn't any reason the deal can't be done," Rivet said April 16. "The pressure isn't necessarily on the Speaker so much as on pro-choice Democrats who find this unpalatable."
The Republican-led State Senate passed the bill in January. It was then sent to the Democratic-led House, where it has stalled in the Judiciary Committee.
Though Democrats' decision to sit on the bill Wednesday represents a defeat for Michigan Right to Life, it may be only temporary. Yesterday's lack of action didn't kill the bill, and Republicans' dramatic chants indicate they don't intend to let it die.
]]>The Republican-led state Senate in January passed Senate Bill 776, which would prevent so-called partial birth abortions, defined in the bill as removing a fetus until the head or fetal trunk is outside a woman's body with the intention of aborting it. It allows for exceptions only if a woman's life is threatened. The bill is a replica of a federal law that was upheld by the U.S. Supreme Court in January. Michigan is covered under the federal law.
The state bill won't change anything for women and their doctors facing the difficult decisions around late-term abortion. The bill's fate is uncertain at best. After passing the Michigan Senate, it was sent to the Democratic-led House for consideration, where it has stalled in the Judiciary Committee.
"We think this bill is totally unnecessary and completely an effort by Right to Life to do a political move in an election year," said Margy Long, spokeswoman for Planned Parenthood of Mid and South Michigan. "It's identical to the federal bill, so there is no need for Michigan to have a similar law. This is really just Right to Life pushing to have all the legislators on record as to whether they would support an anti-abortion ban."
Ed Rivet, legislative director for Michigan Right to Life, said his group is engaged in "active negotiations" with Dillon about how to move the bill forward.
"These negotiations can be tricky," Rivet said. "We're hoping to break through in the next day or two. Then timing becomes less critical. Once we agree what we're going to do, we can decide when we're going to do it."
The window for the negotiations, Rivet said, will close this week. Next Wednesday the group has its annual lobby day, when about 200 of its members come to the Capitol to promote anti-abortion legislation.
"This has been something we discussed with [Dillon] since the beginning of the session," Rivet said. "The Speaker has been very involved."
Rivet said his group has been waiting a long time for this bill to pass, and he alluded to political consequences for legislators if they refuse to take it up.
"We're moving toward action in one format or another," he added. "We want to negotiate the least amount of collateral damage on the House floor, on both sides."
The Judiciary Committee is chaired by Rep. Paul Condino, D-Southfield, a left-leaning legislator with a history of staring down Republicans. But Dillon could move for a discharge motion, whereby a majority of the House could vote to remove the bill from committee and bring it to a floor vote. Dillon and Condino could not be reached for comment.
Michigan's bill, like the federal ban, does not allow the procedure in situations where there is a threat to a woman's health - only when there is a threat to her life. The ban is opposed by numerous medical organizations, including the American College of Obstetricians and Gynecologists and the American Nurses Association.
Rivet said the groups' opposition is "just part of their abortion ideology" and rooted in a "longstanding pro-abortion stance."
But Long disagreed. "The Michigan chapter of ACOG - that's a group of physicians," she said. "I think they're more knowledgeable about health care and the best way to practice health care than Michigan Right to Life is."
Both Rivet and Long agreed that the majority of the House supports the ban. But Long said she's optimistic that legislators on both sides of the issue will pressure Dillon to avoid taking up a redundant bill.
"We just have to wait and see," she said. "I think the legislators know it's not necessary. It's not about making policy in Michigan, it's about a political vote for Right to Life."
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The study, released last Tuesday at a conference in Chicago, was the first of its kind on this age group. It found that 3 million teen-age girls nationwide have an STD, with human papilloma virus, which causes cervical cancer, the leading infection. It also found that nearly half of all black girls have an STD, compared with 20 percent of white and Mexican-American girls.
"Certainly the study just underscored what we've know for years - that teens need to know how to protect themselves against STDs and unintended pregnancy, and the way they do that is by real, live sex education," said Lori Lamerand, president and CEO of Planned Parenthood Mid and South Michigan.
Indeed, some of the studied teens identified sex as vaginal intercourse only, even though other forms of sexual contact can spread STDs.
"The first thing is I think they're in denial," said Dr. Natalia Turner, an attending physician at Children's Hospital in Detroit and clinical professor at Wayne State University's Division of Adolescent Medicine. "They think if they have sex, they aren't going to get pregnant and aren't going to get an STD. It's part of being mature enough to have abstract thinking."
Turner encourages parents to vaccinate their daughters against HPV and the study renewed calls by medical providers for widespread vaccination. The vaccine, however, is expensive and typically not covered by insurance. And some parents resist vaccinating their daughter against a disease that is only transmitted through sexual contact.
"It's all about HPV being sexually transmitted is what really blocks it," Lamerand said. "When parents say, `I'm not going to vaccinate my 14-year-old daughter because that's giving her permission to have premarital sex,' my jaw hits the floor."
HPV can cause genital warts as well as cervical cancer, but often has no symptoms. Chlamydia and trichomoniasis, the second- and third-leading infections, respectively, can be treated with antibiotics. The CDC recommends annual chlamydia screening for all sexually active women under age 25. It also recommends the HPV vaccine for all females younger than 26.
The astronomical rates of STDs among black girls are especially troublesome in Metro Detroit. The numbers reflect African-Americans' inequitable access to health care across the board, Turner said, adding, "Look at statistics for breast cancer - the mortality rate is much higher among African-Americans because they don't get mammograms and they don't get health care."
Lamerand agreed. "Health disparities among races is a given in our society, but it's unconscionable," she said. "Some of it is related to what happens in schools. Unfortunately Southeast Michigan, where most minorities live, is also where schools aren't addressing this with comprehensive education."
Turner said routine preventive health care with a physician who specializes in treating adolescents is key to teens' health and keeping them free of STDs.
"Preventive health care is what they really need. … But parents don't bring them in," she said. "At those appointments I explore how they're reacting with parents, school, community, a healthy lifestyle. If they come every year to their health provider, one who has special training in adolescent medicine, they're going to stay healthy."
]]>The results support a federal recommendation that all females ages 11 to 26 should get the vaccine, the study's lead researcher said.
The study finds that using risk factors including sexual history would not only exclude about 80 percent of eligible women but also would likely vaccinate a large number of women already infected with at least one of the four HPV strains the vaccination helps protect against.
"We found that the more risk factors a woman had, the more likely they were infected with one of the four strains of HPV, but we couldn't find a specific threshold of risk factors that would predict which women would have HPV and which wouldn't," said lead researcher Dr. Amanda Dempsey.
"What we found was whether you used risk factors or didn't, either was very poor for selecting women who were at risk for HPV," she added. "There's really no way to use risk factors to sort out women into who would or wouldn't benefit from the vaccine."
The study was published Wednesday in the journal Vaccine by researchers at U of M's C.S. Mott Children's Hospital's Child Health Evaluation and Research Unit.
The study was an attempt to address issues raised by the vaccine's high cost and conflicting recommendations for which patients should be vaccinated.
The American Cancer Society advocates vaccinating all females younger than 18, and selectively vaccinating women ages 19 to 26 based on a discussion between the patient and her doctor about her sexual history. However, the U.S. Centers for Disease Control and Prevention's Advisory Committee on Immunizations Practices recommends universal vaccination for all females ages 11 to 26, regardless of sexual experience.
The HPV vaccine is the most expensive routinely recommended vaccine and is not fully covered by all insurance plans or by state and federal financing. So researchers set out to see if there was a way to target its use based on a woman's risk factors for contracting the virus, Dempsey said.
"It's very exciting for people in medicine because now there's a way you can potentially prevent cancer through vaccination," Dempsey said. "That's the positive side. On the less exciting side is … there are some concerns raised as to whether the price will serve as a major barrier to vaccination."
The researchers used data from the National Longitudinal Study of Adolescent Health to test the effectiveness of a targeted approach to vaccination. The study looked at 3,276 women, ages 19 to 24.
There are more than 100 strains of HPV; about 40 of those effect the genital area and about 15 of that 40 can cause cancer. It's estimated that within about three years of becoming sexually active, about half of all women will be infected with genital HPV, even those with only one partner, Dempsey said. Most people who are infected have no outward symptoms, though the virus can be detected during an annual pap smear.
The vaccine helps protect against two high-risk HPV strains responsible for about 70 percent of cancer cases and two low-risk strains responsible for more than 90 percent of genital warts cases.
The researchers made no personal recommendations, but Dempsey said their conclusions support the Advisory Committee on Immunizations Practices' guidelines. She said the American Cancer Society's recommendations to use a selective approach for women over 18 "isn't a reasonable goal to be able to achieve."
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