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women s health

Democracy

What to know about the 1864 abortion ban Arizona's Supreme Court says is 'now enforceable'

The legal code it comes from also outlaws interracial marriage and forbids minorities from testifying against white people in court.

Peter Zillmann (HPZ)/Wikimedia Commons, Brandon Friedman/Twitter

Arizona's borders may soon be even more consequential.

When the 2022 Dobbs decision overturned the federal protection of medical privacy in reproductive decisions, leaving abortion law up to the states, experts warned of the legal and medical consequences to come: People in states with old laws on the books would find themselves facing abortion restrictions the likes of which had not been seen in over 50 years since Roe vs. Wade became "settled as a precedent of the Supreme Court," and medical providers would face legal conundrums that threatened patient care.

Nearly two years later, we've seen the fallout on multiple fronts, from women suing states for denying them medically necessary care to children who have been raped and impregnated being forced to travel across state lines to get an abortion.

And the latest development has Arizona set to enact a near-total abortion ban based on a 1864 legal code, after the Arizona Supreme Court ruled that the law "it is now enforceable."

Here's what to know about the 160-year-old law:


There is only one abortion exception allowed for in the law—to save the life of the mother. As medical providers have made clear, that kind of exception is a murky gray area that leads to impossible questions like "How imminent does a mother's death need to be?" for a doctor to take action without fearing legal repercussions.

Civil War-era historian Heather Cox Richardson shared some of the details about how the law came about and the context in which it was written on Facebook, and the historical facts paint a picture of how utterly absurd it is for the law to go into effect in 2024.

"In 1864, Arizona was not a state, women and minorities could not vote, and doctors were still sewing up wounds with horsehair and storing their unwashed medical instruments in velvet-lined cases," wrote Richardson. She pointed out that the U.S. was in the midst of the Civil War, and that the law didn't actually have much to do with women and reproductive care.

"The laws for Arizona Territory, chaotic and still at war in 1864, appear to reflect the need to rein in a lawless population of men," she explained, sharing that the word "miscarriage" was used in the criminal code to describe various forms of harm against another person, specifying dueling with, maiming and poisoning other people.

Richardson offered that detail as the context in which the law states that "a person who provides, supplies or administers to a pregnant woman, or procures such woman to take any medicine, drugs or substance, or uses or employs any instrument or other means whatever, with intent thereby to procure the miscarriage of such woman, unless it is necessary to save her life, shall be punished by imprisonment in the state prison for not less than two years nor more than five years."

How did the law even come about? At that time, the newly formed Arizona Territorial Legislature was composed of 27 men. The first thing they did was authorize the governor to appoint a commissioner to draft a code of laws, but a judge named William T. Howell had already written one up. After some discussion, the legislators enacted Howell's laws, known as "The Howell Code."

The code included laws like, "No black or mulatto, or Indian, Mongolian, or Asiatic, shall be permitted to give evidence in favor of or against any white person," as well as "All marriages of white persons with negroes or mulattoes are declared to be illegal and void."

Richardson also pointed out that the code set the age of consent for sexual intercourse at 10-years-old.

Essentially, a law written by one man, 48 years before Arizona was officially a state, over half a century before women were allowed to vote, when it was perfectly legal to enact and enforce racist laws and see 10-year-olds as old enough to consent to sex, is now considered "enforceable" by the Arizona Supreme Court.

As Richardson pointed out, the difference now is that women can vote. And Americans have proven time and again that draconian abortion laws are wildly unpopular across the political spectrum. Even some Republican lawmakers and politicians are flip-flopping on previous praise for the 1864 law, saying that the Arizona legislature needs to do something about the law to prevent it from taking effect.

Health

After a tragic birth story out of Atlanta, an OBGYN breaks down 'maneuvers of last resort'

"A shoulder dystocia, if you don't know, is an obstetric emergency."

OB-GYN breaks down shoulder dystocia after tragedy in Atlanta.

TRIGGER WARNING: This story contains graphic details of childbirth trauma and infant loss.

A couple in Atlanta, Georgia, experienced a devastating loss that by all stretches of the imagination seems impossible. Unfortunately, the unimaginable is one of the rarest of rare birth complications that resulted in the loss of their newborn son.

Jessica Ross and her partner, Treveon Taylor, were excitedly awaiting the delivery of their first child when during the pushing stage of labor, baby Treveon Taylor Jr.'s shoulder got stuck. According to the Cleveland Clinic, shoulder dystocia is when one or both of the baby's shoulders get stuck behind a bone in the pelvis, which doesn't allow the baby to exit the birth canal.

Ross found herself in this very situation, which eventually resulted in an emergency situation in which the doctor had to dislodge the baby from the pelvis and perform a Cesarean section. It is suspected that the force with which the baby was dislodged caused the infant's decapitation.


Doctors and nurses on TikTok have been taking to the app in an attempt to explain how a situation like this occurs. Dr. Fatima Daoud, OB-GYN uploaded two separate videos expanding on information about shoulder dystocia and what she says are "maneuvers of last resort." She explains in the video that maneuvers of last resort are actions taken by the provider that may cause harm to the baby but are necessary to save the baby's and/or mother's life.

"The first thing I'm going to say is that shoulder dystocia, it's rare. But when it does happen it's an unpredictable, unpreventable medical emergency," Daoud explains. "There are risk factors, sure, for shoulder dystocia. But actually, the majority of shoulder dystocias happen in people who have no risk factor at all."

This essentially means that there's no way for a doctor or midwife to know that you may experience shoulder dystocia while delivering your baby. But when it happens, things have to move extremely quickly because once the baby's face hits the air, the clock has started. There are only a few minutes to get the baby out before they've been deprived of oxygen for too long. During this time doctors and nurses try multiple different ways to dislodge the baby's shoulder but if all else fails, they have to move to the maneuvers of last resort.

Daoud explains that decapitation due to shoulder dystocia is "astronomically, astronomically rare" before revealing that it doesn't always mean malpractice has occurred.

@doctordaoud

#stitch with @wykeishaforthecommunity Major content warning here, but I do feel that as medical professionals we have an obligation to responsibly and respectfully weigh in on prominent medical-related news.

"Is because, when we're trying to resolve a shoulder dystocia when it happens, there are multiple maneuvers that we do. Three of them are what we call maneuvers of last resort. The extreme stuff," Daoud continues. If the extreme stuff doesn't work, what are you going to do? If nothing is working, what are you going to do? And a decapitation is the answer. I'm so sorry to say this, but that doesn't automatically mean malpractice took place."

The OB-GYN apologized multiple times in the video understanding that it's not pleasant information, but it's necessary information to have in order to understand how the couple's doctor may have gotten to that point. It has been reported that this couple's baby died before the Cesarean took place due to how long he was stuck in the birth canal.

In a follow-up video, Daoud goes into more detail about the three last-resort maneuvers before something as horrific as a decapitation occurs. One involves breaking the baby's clavicle to force the shoulders past the pubic bone, and the very last one is the "Zavanelli maneuver," in which they attempt to push the baby back into the uterus via the birth canal.

"Performing a Cesarean in the middle of shoulder dystocia is very much different than performing a Cesarean section that's scheduled or in labor," Daoud says. "It's not even comparing apples to oranges. It's like comparing an apple to a truck."

She goes on to explain that if the Zavanelli Maneuver is unsuccessful and you've attempted all of the other maneuvers of last resort prior to the Zavanelli, the focus becomes saving the mom. Daoud is clear that she is not speculating on the case from Atlanta but explaining how an infant death like this can occur.

It's a tragic thing to consider and an even more tragic thing to experience. Everyone is wishing the parents currently experiencing this unimaginable loss comfort during this difficult time.

@doctordaoud

Replying to @RaideretteRaiderLicious It’s not as simple as making a cut and scooping the baby out like a typical c-section, though I obviously cannot say what did and did not take place during this tragedy. #zavanellimaneuver #shoulderdystocia

Health

A female scientist’s discovery may lead to the first 'on-demand' male birth control pill

“Men need an option so that the burden of contraception is not on females anymore,” says Dr. Melanie Balbach.

Close up of a man taking a pill.

Even though men have condoms and vasectomies, throughout history, the burden of contraception has ultimately been felt by women because they bear the ultimate responsibility if they become pregnant. To maintain their reproductive freedom, women must take hormone-altering pills, wear patches or insert hormone-filled rings into their vaginas.

They also deal with copper IUDs, shots and spermicide-soaked sponges.

Women also have to manage the cost and hassle of doctors' visits to get their contraception and are at the mercy of the state if they have an unwanted pregnancy. Isn’t it time more men stepped up and took responsibility for contraception?

The good news is that new medical development may provide hope for the countless women who are tired of the pills, IUDs and headaches that come with female contraceptives. The cool thing is that a woman is behind its discovery.


A new pill developed by Weill Cornell Medicine could become the first “on-demand” male oral contraceptive. The drug has been found to stop sperm “in their tracks” and prevents pregnancies in preclinical models.

The pill is fast-acting and can have a man ready for sex 30 to 60 minutes before intercourse. That’s about as long as it takes for Viagra to work its magic.

"Our inhibitor works within 30 minutes to an hour," Dr. Melanie Balbach, a postdoctoral associate in their lab, said in a statement. "Every other experimental hormonal or nonhormonal male contraceptive takes weeks to bring sperm count down or render them unable to fertilize eggs."

The inhibitor was discovered by Dr. Balbach accidentally while working on a treatment for an eye condition. Dr. Balbach found that when mice took a drug that inactivates soluble adenylyl cyclase (sAC), they produced sperm that could not propel themselves through the vaginal tract.

Research shows that men who cannot produce sAC due to genetic mutations are infertile.

After the drug takes hold, the sperm are rendered useless for about 24 hours and then return to normal. So, the drug is not only fast acting but rapidly reversible.

“What I like about the proposed contraceptive in this study is the on-demand option,” says Ulrike Schimpf at the KTH Royal Institute of Technology in Sweden. “It would act rapidly, temporarily, and is efficient at the first dose.”

The discovery could be a sea change in how males approach contraception. But some are rightfully afraid that men may lie about taking the pill in the heat of the moment.

After all these years that women have had to bear the burden of responsibility, there’s something poignant about the first potential male contraceptive pill being discovered by a woman.

“We need more [birth control] options, and men need an option so that the burden of contraception is not on females anymore,” Balbach told New Scientist. “We’re very optimistic that once men take the inhibitor, it will have the same effect.”

Dr. Balbach and Dr. Jochen Buck, a professor of pharmacology at Weill Cornell Medicine, are currently working to develop a new version of the drug that lasts longer before testing it on humans. They hope to go to clinical trials by 2025.

via Freepik

A new mother struggling with postpartum depression.

We may be just months away from having the first-ever pill to help treat postpartum depression (PPD). The drug, called Zuranolone, was developed by Sage Therapeutics and Biogen, two companies out of Cambridge, Massachusetts. The FDA has given the drug’s application priority review and the period ends on August 5, 2023.

Currently, there is only one FDA-approved medication for PPD, Zulresso, which is only available through a 60-hour, one-time infusion and can cost up to $35,000 per treatment.

If the medication is approved, it can also be used to treat major depressive disorder (MDD).


What’s unique about the drug is that it is fast-acting. "We feel a tremendous responsibility to patients with MDD and PPD to deliver a potential new treatment option, which is so desperately needed. Most current approved therapies may take weeks or months to work. We are committed to advancing treatments that could help physicians and patients by addressing depression symptoms quickly," Dr. Laura Gault, chief medical officer at Sage Therapeutics Inc., said in a statement.

Zuranolone causes full remission of clinical depression within 45 days in 53% of women versus 30% who received the placebo, according to the study published in the Journal of the American Medical Association Psychiatry.

The new drug could be a godsend to the 500,000 women who suffer from PPD every year. In these women, what starts as a typical case of the “baby blues” can linger and become more intense and lead to an overwhelming loss of energy, irritability, inability to concentrate or make decisions and thoughts of harming themselves or their babies. It also severely inhibits their ability to care for their newborn child.

Symptoms of PPD can begin as early as during pregnancy and as late as a year after giving birth. In rare cases, it can develop into postpartum psychosis, an extreme mood disorder.

PPD is caused by the intense hormonal changes that happen within a woman’s body before and after giving birth. It can also result from numerous anxieties women feel after giving birth, such as the stress of being a “perfect mother,” the effect that pregnancy has on their bodies, being overtired and a lack of free time.

happy mom, happy baby, postpartum depression

A happy, healthy mother and child.

via Pexels.

Zuranolone could also provide faster relief for people dealing with MDD. In 2020, over 14 million Americans were diagnosed with MDD, which creates a persistent feeling of sadness and a loss of interest in things they used to enjoy. It can also affect their ability to have happy, healthy relationships.

In rare situations, MDD can lead to suicidal ideation. Studies show that MDD accounts for up to 89% of all suicides.

If Zuranolone is approved, it will give doctors another vital tool in improving people’s mental health that can relieve debilitating depression in less time. It will also help countless babies that need extra care in their early days from a loving and healthy mother.

If you or someone you know is having thoughts of suicide, call the Suicide and Crisis Lifeline at 988 for free, confidential support.