Pass the Pregnant Workers Fairness Act: Bring the Workplace to the 21st Century

By Amal Bass, WLP Staff Attorney

Women are often surprised to learn that they do not have as many rights in the workplace as they expect to have in the 21^st Century. More often than not, an employer does not have to grant a pregnant woman’s request for a minor job modification, such as a chair or help lifting heavy boxes, which some women need as their pregnancies progress. As a result, pregnant women who could have worked with a reasonable accommodation lose their jobs and find themselves without economic security and without health insurance at a time when access to health care is essential.

Existing anti-discrimination laws, such as Title VII of the Civil Rights Act of 1964, as amended by the Pregnancy Discrimination Act (PDA), and similar state laws like the Pennsylvania Human Relations Act, prevent employers from treating pregnant women differently from non-pregnant employees who are similar in their ability or inability to work.  But these laws do not protect pregnant employees in nearly as many situations as they should.

For example, courts have ruled that the PDA does not offer a pregnant employee legal protections unless she can identify a non-pregnant employee (1) who works in the same role, (2) has virtually the same limitations, and (3) is treated better by the employer than the pregnant woman.  Many pregnant employees are unable to identify such a person, often because they simply do not know what kinds of accommodations their employers have granted to other employees or what limitations those other employees have. Furthermore, some courts have allowed employers to refuse to accommodate pregnant employees even when they accommodate non-pregnant employees with similar limitations, if those limitations are work-related.

While some states have laws that protect these pregnant employees better than the current federal law does, Pennsylvania does not.

The Pregnant Workers Fairness Act would fill this gap in the law on a national level, ensuring that pregnant women who are able to work with reasonable accommodations can keep their jobs. S.942 was reintroduced on May 14, 2013 by Senators Bob Casey and Jeanne Shaheen and Representatives Jerrold Nadler, Carolyn Maloney, Jackie Speier, Susan Davis, and Marcia Fudge, the Pregnant Workers Fairness Act would:

• Require employers to make reasonable accommodations to employees who have limitations on the job related to their pregnancy, childbirth, or related medical condition, unless the accommodation would impose an undue hardship on the employer.
• Prohibit employers from retaliating against employees who need an accommodation.
• Prohibit employers from forcing a pregnant employee to accept an accommodation she does not want.

Prohibit employers from forcing a pregnant employee to take unpaid or paid leave if a reasonable accommodation is available.

If passed, this law would help pregnant women stay employed, promoting the health and well-being of mothers and their families, while imposing only a minimal and temporary burden on employers.

One woman who would have benefited from a law like this — a woman who lives in Pennsylvania and called the Women’s Law Project for help — worked at a garden center and needed help lifting heavy plants while pregnant.  Her employer refused her request, and she had no choice but to leave her job.

Women should not have to make a choice between having a healthy pregnancy and keeping their jobs. It’s time to change the law.

Please contact your Representative and Senator to tell them that they should support the Pregnant Workers Fairness Act.

Pregnant Workers Fairness Act: Press Conference Tomorrow

Tomorrow, September 14, 2012, U.S. Senator for Pennsylvania, Bob Casey, will announce the introduction of a companion bill to the Pregnant Workers Fairness Act (H.R. 5647) at a press conference at 10:30 AM (in the large conference room at 2000 Hamilton Street, Philadelphia).  If you plan to attend the press conference, please RSVP to ecusack@maternitycarecoalition.org.

In the post below, the Women’s Law Project discusses the need for this legislation, which, if passed, would ensure that pregnant workers have the right to reasonable accommodations if pregnancy limits their ability to perform certain job functions.

Reposted from 5/8/2012:  The Pregnant Workers Fairness Act Offers Hope for Women in the Workplace, If Congress Passes It

“Tina,” who is pregnant and works as a health aide in a nursing home, is told by her doctor that she should not lift more than 35 pounds.  Her job description requires lifting 40 pounds regularly, but lighter duty jobs, such as answering the phone and working at the reception desk, are available.  Nevertheless, her employer stops scheduling her for shifts and tells her she must take unpaid Family Medical Leave, which would run out before the delivery of her baby and leave her without the income she needs to pay the 50% of her medical insurance her employer does not cover.  Left with no choice, Tina loses her job.

“Jessica,” who is pregnant and works as a pharmacist’s assistant, needs to sit down occasionally throughout her day.  Chairs are available for customers, but the pharmacy does not permit the staff to use them.  As a result, Jessica loses her job.

For women like Tina and Jessica, whose stories are based on the experiences of real women who have called the Women’s Law Project, current anti-discrimination laws often do not go far enough.

Title VII of the Civil Rights Act of 1964, as amended by the Pregnancy Discrimination Act (PDA), prevents an employer from treating a pregnant woman differently from how that employer treats non-pregnant employees who are similar in their ability or inability to work.  Some courts, however, have limited the protections of this federal law by requiring pregnant employees to identify a non-pregnant employee who works in the same role and has almost identical limitations but is treated better by the employer in order to succeed with a lawsuit.  Some courts even permit employers to refuse to accommodate pregnant employees when they accommodate non-pregnant employees because pregnancy is not a work-related condition.  In short, despite the PDA, pregnant women are often treated differently from other employees with similar limitations.

Other laws do not provide better protections for pregnant women. Courts interpret the Pennsylvania Human Relations Act (PHRA) similarly to Title VII/PDA.  In addition, the Americans with Disabilities Act (ADA), which requires employers to provide reasonable accommodations to disabled employees, usually does not apply to women experiencing ordinary pregnancy.

A handful of states have laws that prevent employers from terminating women from employment or forcing them to take paid or unpaid leave when a reasonable accommodation is available, but Pennsylvania is not one of those states.  As a result of this gap in the law, many pregnant women in Pennsylvania, like Tina and Jessica, find themselves unemployed suddenly, without economic security and often without health insurance at a time when access to health care is crucial.

For Pennsylvania’s pregnant women and for women in many other states, the proposed federal Pregnant Workers Fairness Act would offer important workplace protections.  Introduced on May 8, 2012 by Representative Jerrold Nadler (D-NY) and other representatives in the House, the Pregnant Workers Fairness Act would:

• Require employers to make reasonable accommodations to employees who have limitations on the job related to their pregnancy, childbirth, or related medical condition, unless the accommodation would impose an undue hardship on the employer.
• Prohibit employers from retaliating against employees who need an accommodation.
• Prohibit employers from forcing a pregnant employee to accept an accommodation she does not want.
• Prohibit employers from forcing a pregnant employee to take unpaid or paid leave if a reasonable accommodation is available.

The Pregnant Workers Fairness Act is modeled after the Americans with Disabilities Act, which has been in effect for over two decades.  Thus, the Pregnant Workers Fairness Act employs a familiar framework that simply requires that employers provide reasonable accommodations that do not present an “undue burden.”  If passed, this law would help pregnant women stay employed and maintain their economic security and benefits, promoting the health of mothers and their families, while imposing only a minimal, temporary burden on employers.

Please contact your representative and tell them that they should support the Pregnant Workers Fairness Act.  To call your representative, dial 202-224-3121 and tell the operator the name of your representative.

For more information on this bill, take a look at the National Women’s Law Center’s Fact Sheet.

To learn more about the effects of sex bias and discrimination in the workplace on women’s health, see WLP’s report, Through the Lens of Equality: Eliminating Sex Bias to Improve the Health of Pennsylvania’s Women.

The Affordable Care Act Extends No-Cost Preventive Care to Women

Nikki Ditto, WLP Intern

Wednesday, August 1^st  is an important day for women’s health. After this date, all new insurance plans must cover certain women’s preventive health services, including contraceptives, without co-pays or deductibles. This represents an essential change in access to health care for women. Women, who have long been subjected to denial of access to insurance coverage for essential health services are more likely than men to forgo needed health care due to cost.  The number of women who can access these benefits will continue to expand as older plans lose their “grandfathered” status and become subject to the ACA’s preventive health services requirements.  For now, many college and university students will benefit if they receive health insurance through their schools, as those plans usually begin their health plan years around the start of the school year.  Other insurance policies that are renewed with substantially different content (usually on January 1^st) will also comply with the new law.

Women whose insurance plans fall under the new guidelines will now have access to a number of services that will “keep them healthier and…catch potentially serious conditions at an earlier, more treatable stage,” according to Secretary of Health and Human Services, Kathleen Sebelius. This includes annual well-woman visits, as well as screening and counseling for HPV, HIV, and STIs. Insurance policies will also have to cover testing for gestational diabetes, breastfeeding support, and domestic violence screening and counseling. Perhaps most significantly, women will also have access to birth control and other forms of contraception without a co-pay, though exceptions have been made for religious institutions and self-funded plans. These services add to the no-cost coverage that has already been implemented for pap smears and mammograms.

The Department of Health and Human Services reports that 20.4 million women have been and will be affected by this expansion in coverage. A startling 52% of women “report delaying needed medical care because of cost,” a number that will be decreased under the ACA. The Women’s Law Project (WLP) explained in its report Through the Lens of EQUALITY: Eliminating Sex Bias to Improve the Health of Pennsylvania’s Women that “lack of access to the full range of women’s health care has many adverse health consequences.”  Many women are unable to afford contraceptives, which range from $15 to more than $1,000 up front depending on the method.  The contraceptive coverage rule will increase women’s access to these methods of contraception, which will help them plan pregnancies and address other health concerns, such as polycystic ovarian syndrome, for which birth control pills are a common treatment.

Controversy continues over the provision requiring employer-provided insurance plans to cover birth control and other forms of contraception, including sterilization. As WLP blogged about today, twenty-four legal challenges are still pending in courts. The ACA already provides exceptions for religious institutions, and allows religiously affiliated businesses to push cost and administration on to the insurance companies. These accommodations, however, have not stopped the debate. WLP has blogged before about lawsuits that challenge the constitutionality of the provision on the basis of the First Amendment. As Terry Fromson, WLP’s Managing Attorney, explained, “the First Amendment does not give church leaders any right to impose their beliefs about contraception on women.”

Overall, the implementation of this provision of the ACA represents an important and necessary change to the way we view women and women’s health. Reproductive and sexual health must be seen as central to ensuring the health and well-being of all women, and not as a secondary concern. America will be healthier if women are given better access to the services necessary to care for themselves and their families, and increasing access to contraception is a step in the right direction.

The Hypocrisy of Cuts to Medicaid Reimbursements for Newborn Care

Amal Bass, WLP Staff Attorney

When Pennsylvania’s politicians say they are for protecting the unborn, they mean it literally: the minute you’re born, you’re on your own.

Last month, Pennsylvania’s Department of Public Welfare (DPW), which is run by Governor Tom Corbett’s political appointees, yanked the rug out from under maternity wards state-wide by eliminating the $1,155 payment it used to make to hospitals for a newborn’s regular care when the mother is on Medical Assistance (Pennsylvania’s name for Medicaid).  DPW will continue to reimburse hospitals for the mother’s care, but it will no longer reimburse hospitals for the baby’s care unless the baby develops complications or needs to stay longer than normal for observation.

Nearly half of all births in Pennsylvania are paid for by Medical Assistance, so the reimbursement cuts will significantly impact hospitals across the state that provide maternity care, forcing them to absorb even more of the cost for the services they provide to pregnant women and their babies. Even prior to these cuts, hospitals typically lost money on Medicaid deliveries. One community hospital reported that every Medical Assistance delivery costs the hospital between $7,800 and $8,400, while the Medicaid reimbursement prior to May 1st was a mere $6,867 for both mother and baby. Now it is just $5,712.

Large hospitals that also serve many privately-insured mothers might be able to spread the loss among other deliveries, or even among other departments in the hospital. However, independent community hospitals that already have trouble breaking even will face greater financial difficulties.  As a result, they may have to close their maternity wards and lay off employees, making it even harder for Pennsylvania’s pregnant women to receive maternity care within a reasonable distance from their homes. Already, as the Women’s Law Project explores in our recent publication, Through the Lens of Equality: Eliminating Sex Bias to Improve the Health of Pennsylvania’s Women, many women in Pennsylvania, particularly if they are poor, have few options when choosing obstetrical providers. For these women, the result of the shrinking number of obstetrical providers that accept Medical Assistance is a delay or a denial in receiving prenatal care, medical care that is important for the health of pregnant women and their babies. DPW’s cuts to hospital reimbursements will only exacerbate an already dire situation for women who receive Medicaid.

DPW’s decision to cut hospital reimbursements for newborn care is another example of how misguided Governor Corbett’s administration is on issues relating to women’s and children’s health.  The governor pressed for controversial legislation that would mandate women undergo medically-unnecessary transvaginal ultrasounds prior to receiving abortions, justifying the bill by claiming these women can just “close their eyes,” but his administration will not even use a combination of federal and state funds to pay for the medical assessments and procedures newborn babies need in the crucial first 72 hours after they are born.

If Governor Corbett and DPW truly believed in the sanctity of life, they would promote policies that help women have healthy pregnancies and healthy babies. Their hypocrisy couldn’t be more apparent than in cutting maternity reimbursements for the care of newborn babies.

The Pennsylvania General Assembly Should Hold Public Hearings on SB 1063 and HB 1957 to Insure Motherhood

Pennsylvania’s women deserve to have maternity coverage in their health insurance.  Individual health insurance policies often do not cover maternity care, leaving many women at risk of having inadequate or no insurance when they become pregnant.  Furthermore, pregnant women applying for health insurance are denied maternity coverage because pregnancy is considered a “pre-existing condition.”  Currently, there is no law ensuring maternity benefits to women in Pennsylvania who purchase an individual policy of insurance.  The Affordable Care Act, which will not be fully implemented until 2014, assuming the United States Supreme Court does not overturn the law, may address these gaps in the law, but women need coverage now.  SB 1063 and HB 1957 would ensure that coverage.

It is important for the Pennsylvania General Assembly to hold public hearings on these bills.  Please urge Senator White and Representative Micozzie to move forward with these pieces of legislation:

Chair, House Insurance Committee: Nicholas Micozzie, 717-783-8808
Chair, Senate Baking & Insurance Committee: Donald White, 717-772-1589

For more information, see our post, Pennsylvania: Stop Insurers from Denying Essential Maternity Coverage to Women.

The Pregnant Workers Fairness Act Offers Hope for Women in the Workplace, If Congress Passes It

“Tina,” who is pregnant and works as a health aide in a nursing home, is told by her doctor that she should not lift more than 35 pounds.  Her job description requires lifting 40 pounds regularly, but lighter duty jobs, such as answering the phone and working at the reception desk, are available.  Nevertheless, her employer stops scheduling her for shifts and tells her she must take unpaid Family Medical Leave, which would run out before the delivery of her baby and leave her without the income she needs to pay the 50% of her medical insurance her employer does not cover.  Left with no choice, Tina loses her job.

“Jessica,” who is pregnant and works as a pharmacist’s assistant, needs to sit down occasionally throughout her day.  Chairs are available for customers, but the pharmacy does not permit the staff to use them.  As a result, Jessica loses her job.

For women like Tina and Jessica, whose stories are based on the experiences of real women who have called the Women’s Law Project, current anti-discrimination laws often do not go far enough.

Title VII of the Civil Rights Act of 1964, as amended by the Pregnancy Discrimination Act (PDA), prevents an employer from treating a pregnant woman differently from how that employer treats non-pregnant employees who are similar in their ability or inability to work.  Some courts, however, have limited the protections of this federal law by requiring pregnant employees to identify a non-pregnant employee who works in the same role and has almost identical limitations but is treated better by the employer in order to succeed with a lawsuit.  Some courts even permit employers to refuse to accommodate pregnant employees when they accommodate non-pregnant employees because pregnancy is not a work-related condition.  In short, despite the PDA, pregnant women are often treated differently from other employees with similar limitations.

Other laws do not provide better protections for pregnant women. Courts interpret the Pennsylvania Human Relations Act (PHRA) similarly to Title VII/PDA.  In addition, the Americans with Disabilities Act (ADA), which requires employers to provide reasonable accommodations to disabled employees, usually does not apply to women experiencing ordinary pregnancy.

A handful of states have laws that prevent employers from terminating women from employment or forcing them to take paid or unpaid leave when a reasonable accommodation is available, but Pennsylvania is not one of those states.  As a result of this gap in the law, many pregnant women in Pennsylvania, like Tina and Jessica, find themselves unemployed suddenly, without economic security and often without health insurance at a time when access to health care is crucial.

For Pennsylvania’s pregnant women and for women in many other states, the proposed federal Pregnant Workers Fairness Act would offer important workplace protections.  Introduced on May 8, 2012 by Representative Jerrold Nadler (D-NY) and other representatives in the House, the Pregnant Workers Fairness Act would:

• Require employers to make reasonable accommodations to employees who have limitations on the job related to their pregnancy, childbirth, or related medical condition, unless the accommodation would impose an undue hardship on the employer.
• Prohibit employers from retaliating against employees who need an accommodation.
• Prohibit employers from forcing a pregnant employee to accept an accommodation she does not want.
• Prohibit employers from forcing a pregnant employee to take unpaid or paid leave if a reasonable accommodation is available.

The Pregnant Workers Fairness Act is modeled after the Americans with Disabilities Act, which has been in effect for over two decades.  Thus, the Pregnant Workers Fairness Act employs a familiar framework that simply requires that employers provide reasonable accommodations that do not present an “undue burden.”  If passed, this law would help pregnant women stay employed and maintain their economic security and benefits, promoting the health of mothers and their families, while imposing only a minimal, temporary burden on employers.

Please contact your representative and tell them that they should support the Pregnant Workers Fairness Act.  To call your representative, dial 202-224-3121 and tell the operator the name of your representative.

For more information on this bill, take a look at the National Women’s Law Center’s Fact Sheet.

To learn more about the effects of sex bias and discrimination in the workplace on women’s health, stay tuned for WLP’s forthcoming report, Through the Lens of Equality: Eliminating Sex Bias to Improve the Health of Pennsylvania’s Women, which will be available online the week of May 14, 2012.

Declining Rate of Reproductive Health Services Among Young Women

Data from the National Survey of Family Growth polls show an 8% decline in reproductive health services among young women from 2002 to 2008. Low-income women were shown to be the least likely to have obtained reproductive health services. Researchers identified several factors which may have contributed to this decrease. Among those factors identified were: “the decline in public sector clinics serving economically disadvantaged women; increasing unemployment and the corresponding lack of health insurance; updated gynecological health screening guidelines that require fewer Pap tests; and legislation that has increased mandatory parental participation in adolescent sexual and reproductive health care.”

The authors of the study postulated that their findings might reflect “‘changing social, economic, and political contexts in which reproductive services were needed…over the last decade’” but added that “new provisions for care under healthcare reform may bring some of those women back into care.” Shortly after healthcare reform was passed, the Guttmacher Institute released a news brief which summarizes some of expansions of reproductive healthcare services that healthcare reform will bring. It notes that “a provision expanding eligibility to all Americans with a family income below 133% of the federal poverty level will allow 16 million more Americans to join Medicaid by 2019 than would otherwise be the case.” The Medicaid expansion will allow more Americans access to the program’s guarantee of family planning services without cost sharing. Additionally, healthcare reform will allow those who are currently uninsured with incomes above 133% of the federal poverty line to purchase private insurance through the new health care exchanges, most of which will provide a similar package of reproductive healthcare to what Medicaid offers.

Given the risky behaviors among young people reported by the National Campaign to Prevent Teen and Unplanned Pregnancy, it is evident that supporting the implementation of healthcare reform as well as other efforts to make reproductive healthcare services more widely available is incredibly important. The Campaign’s data showed that among the young people polled, “nearly half of those who are in a sexual relationship either don’t use contraception at all or use it inconsistently, and almost 20% of all respondents predict that they’ll have unprotected sex within the next three months.” The result of this risky behavior is that “Seven in 10 pregnancies in the 18-to-29 age group are unintended, and men and women in their 20s have among the highest rates of sexually transmitted infections of any age group, including chlamydia, gonorrhea and syphilis.”

If you are interested in learning more about this issue, the National Survey of Family Growth study is available online, published by the American Journal of Public Health. 

To learn more about the Women’s Law Project’s work on women’s health, including on the implementation of Healthcare Reform and on reproductive health, visit our website, and stay tuned for our forthcoming publication, Through the Lens of Equality: Discrimination, Health, and a New Vision for Pennsylvania’s Women.

Pennsylvania: Stop Insurers from Denying Essential Maternity Coverage to Women

Women in Pennsylvania need comprehensive maternity insurance coverage.  While federal and state laws protect access to maternity coverage for many women who receive health insurance through their employers, there is no law ensuring maternity benefits to women in Pennsylvania who purchase an individual policy of insurance.  Individual health insurance policies typically do not cover maternity care, leaving these women at risk of having inadequate or no insurance when they become pregnant.  In addition, women who are pregnant when they apply for insurance often are denied coverage for pregnancy, which is considered a pre-existing condition.  The Affordable Care Act (ACA) may protect these women by 2014 because it requires maternity coverage as part of its essential benefits package.  However the ACA does not define what maternity benefits means. So the U.S. Department of Health and Human Services (HHS) must adopt a broad definition of maternity care to make sure full coverage is provided in 2014.  In the meantime, women need full coverage now. 

To fill the gap, Pennsylvania State Senator Farnese has introduced the Insuring Motherhood Bill, S.B. 1063, which would (1) ensure that individual and small group health plans provide women with essential maternity coverage and (2) stop insurers from denying maternity coverage to women by classifying pregnancy as a pre-existing condition.

Comprehensive Maternity Coverage is important for the health of women and children.  Early initiation of prenatal care allows the medical provider to diagnose and treat problems with the pregnancy as soon as possible and also gives the provider an opportunity to educate women about behavioral risks, such as smoking.  This type of care is critically important for reducing the maternal mortality rate, reducing the rate of neonatal death, lowering the likelihood of having a baby with low birth weight, and lowering the likelihood of delivering preterm.  Postpartum care is also important for addressing a range of health issues, such as postpartum depression, breastfeeding, bladder/bowel dysfunction, and concerns about sexuality and contraception. 

The Women’s Law Project (WLP) believes that comprehensive maternity coverage is vital to meet the health needs of mothers and babies, and so strives to eliminate sex discrimination in insurance and to expand insurance coverage.  To meet this goal, WLP managing attorney Terry Fromson recently commented before HHS about the need to define maternity benefits broadly, while implementing the ACA.  Fromson emphasized the importance of defining maternity and newborn coverage to include prenatal care, hospitalization for delivery, and postpartum care to ensure that insurers do not deny these important elements of coverage to women the way they often do today. 

Prior to 2014, the effective date of the ACA, Pennsylvania must pass S.B. 1063 to provide women and newborns with insurance coverage for essential care.  WLP worked with the Maternity Care Coalition and Senator Farnese’s office on drafting the bill, and has joined the Insuring Motherhood Coalition, which seeks to pass S.B. 1063.  

To get involved in the campaign to insure healthy motherhood: 

•  Contact your Pennsylvania legislator to urge them to support this bill.
• Ask Sen. Donald C. White to hold a public hearing on S.B. 1063 and express your support for the legislation.
• “Like” the Insuring Motherhood in Pennsylvania facebook page and share it with your friends.
• Share your story if you have experienced a pregnancy-related insurance obstacle.
• Contact the U.S. Department of Health and Human Services to urge them to adopt a comprehensive definition of maternity care under the ACA:

Secretary Kathleen Sebelius
The U.S. Department of Health and Human Services
200 Independence Avenue, S.W.
Washington, D.C. 20201

Also see Women Care About Healthcare on WLP’s website.

Undocumented Women in Custody Forced to Give Birth in Chains

The Huffington Post recently published an expose on the barbaric treatment of some undocumented women who are incarcerated while pregnant. Being shackled during childbirth is illegal in 14 states including Pennsylvania (except in cases where it is determined that the woman “represented a substantial risk of imminent flight” or “other extraordinary medical or security circumstances”) and The U.S. Immigration and Customs Enforcement (ICE) policy discourages the practice. However, women can “still legally be handcuffed to their hospital beds by state authorities in the 36 other states. Those women can also be denied the right to have a family member in the birthing room, or to hold their newborns for longer than 24 hours.” Several undocumented women have recently come forward with stories of being forced to give birth in chains while incarcerated.

While many immigration related violations are civil cases which would not entail incarceration, the ICE defines other immigration related violations (such as re-entry after deportation) as criminal offenses. Undocumented women who are apprehended for a non-violent immigration related criminal offense may be shackled and forced to remain so even during labor. Even though the ICE has a policy against shackling during labor, in 36 states imprisoned women are still at the mercy of the state correctional facility’s discretion as to whether or not they must be chained during childbirth.

Alma Chacon and Juana Villeges are two undocumented women whose experience of being dehumanized during, before, and after childbirth is indicative of how dangerous not having a state law mandating decent treatment of pregnant inmates can be.

Chacon was detained for a non-violent criminal offense and shackled to her hospital bed. Chacon was allegedly not allowed to nurse or hold her baby until she was released from immigration custody almost 70 days later when she gave birth in.

For Juana Villegas, going into labor while in prison meant that her ankles were cuffed together on the ride to the hospital, and that she was denied a breast pump by local authorities after she was given one by medical professionals. Without a breast pump, “she was in great pain” after she gave birth and had trouble sleeping in prison, [Elliott] Ozment, her attorney, said in a phone interview.

We have blogged before about the negative health implications of being chained during labor and the utter senselessness of forcing women to give birth in this inhumane way. The American College of Obstetricians and Gynecologists’ oppose shackling during labor since this poses an increased risk of clotting due to the inability for the woman to properly position herself during labor, decreased blood flow to the fetus, interference with the mother’s ability to breastfeed her child after delivery, and delays that are presented from having to remove shackles before an emergency procedure. In addition to the health benefits of unshackling women before, during, and for a reasonable amount of time after labor, doing so presents no security risks. Women in labor are obviously a low-flight risk and no inmates in labor have ever attempted escape.

Shackling during labor is a cruel and inhumane practice to subject women to. Unfortunately, in 36 states no law prohibits this treatment and undocumented women are particularly vulnerable to being mistreated in this way. To learn more about the plight of pregnant undocumented women in America’s prisons, read the entire Huffington Post expose here.

Crisis Pregnancy Centers: the New Face of Women’s Health Care?

Since we last blogged about Crisis Pregnancy Centers, a new development has increased the threat they pose to women’s access to comprehensive reproductive health care. A new initiative by several pro-life groups aims to fund CPCs’ conversion to medical clinics, staffing them with doctors and nurses and expanding their health care offerings – while they continue to oppose abortion and contraception and block or impede women’s access to those alternatives (we blogged about the misinformation provided by CPCs here).

AlterNet has the full story in their August 18 article, “The Anti-Choice Plan to Lure Women to Christian Pregnancy Centers.” Author Tana Ganeva calls our attention to the efforts of Focus on the Family and the National Institute of Family and Life Advocates to make CPCs even more important players in women’s health care. NIFLA’s Life Choice project, established in 1998, gives CPCs legal advice as they transition to medical clinic status, and trains nurses and doctors to work in the newly created clinics. Since 2004, Focus on the Family has been funding the conversion of particularly high-impact CPCs into medical clinics. CPCs have long offered biased counseling and limited prenatal services to pregnant women, as well as post-natal services in some cases. As medical clinics, with doctors, nurses, ultrasounds, pregnancy tests, and perhaps even PAP smears, CPCs become more attractive to women who need these services and do not necessarily know about the ideology driving the centers.

This is particularly disturbing in light of the increasingly precarious situation of Planned Parenthood, on whose clinics many women have long relied for their health care. As many conservative governors have slashed funding for Planned Parenthood while funneling funds to CPCs through programs that support abstinence-only education, women are beginning to see their options constrict. The New York Times featured Texas as an example of this trend in an article last month.

 A CPC turned licensed medical clinic, with a doctor and nurses, may soon be the most accessible pregnancy care option for many women, who could walk in the door not knowing they have entered an explicitly anti-abortion zone where they may not be presented with all of their options.