So often, public health interventions are boring — recommend more education, evaluate an existing program, come up with a list of resources….yawn.
But although they don’t always make headlines, there are lots of fantastically innovative people working to improve women’s health. I’m always excited to see these types of projects which have the potential to do so much good.
Here are five truly different approaches to improving women’s health:
- Naturopathic Oncology. Seems like a contradiction, right? Wrong. I’ve been intrigued by efforts to initiate more natural approaches to cancer treatment ever since I researched breast cancer activism in graduate school and met the woman who started this great project. But apparently, naturopathic oncology has started to take hold in the more mainstream medical field, and the Seattle Cancer Treatment and Wellness Center actually has naturopaths on staff.
- Cultivating and caring for “mad gifts”. The Icarus Project has a completely unique approach to mental health. Rather than calling it “mental illness” they “envision a new culture and language that resonates with our actual experiences of ‘mental illness’ rather than trying to fit our lives into a conventional framework.” So important, and so rare.
- Midwifery and fertility services for the rest of us. Not surprisingly, most prenatal care is very straight-oriented. But Maia Midwifery takes a different approach, prioritizing the needs of queer families. I love that the approach is so radically different from some of the overly granola earth-mama stuff that is part and parcel of most midwifery practices. Also in California is ReCLAIM Midwifery, which focuses on transgender health. This is true innovation, but it will probably be a very long time before this approach is incorporated into mainstream prenatal services.
- Real sex education. Rather than the lip service paid to sex education that happens in schools, Scarleteen is a resource for teenagers that provides a wide range of resources. Created in response to 1998 abstinence only policies, the site uses message boards, tweets, Tumblr feed, SMS (and Facebook and even Pinterest) to connect with its audience, and has zillions of real life questions and answers. I hope it’s still around when my four year old is a teenager.
- Telling and talking. Speaking of four year-olds, after a completely useless preschool lesson on Martin Luther King Jr. (my son learned that King “changed our world” but had absolutely no idea why or how) he told the teacher that he would like to learn about where babies come from. Awkward. We took a trip to the library afterwards, and I satisfied his curiosity with a picture book called It’s so Amazing. But this isn’t the end of these types of questions, so I’m excited about this series of books developed specifically for families with children conceived with donor assistance.
What about you? Have you heard of exciting, cutting edge programs or innovations in women’s health?
When I was pregnant, I was in the hospital for 2 weeks before I gave birth. When my son was born, he was three months premature and weighed only two pounds. Less than 24 hours later, I was given my walking papers and sent home.
To say I experience postpartum anxiety and depression is a bit of an understatement. The experience left me shaken and shattered. On the exterior I think I appeared to be handling it well (maybe not, but that’s the image I thought I was projecting), but at home I clearly wasn’t. Whenever I closed my eyes I saw a nurse roughly handling my tiny child’s naked body. I was plagued by the thought of them touching him with their cold hands. At work I was terrified every time the phone rang, sure that it was a doctor calling to tell me that my baby had died. I would wake up in the middle of the night and not be able to stop crying. I couldn’t concentrate long enough to read a sentence, cook a meal, or even have a decent phone conversation.
Luckily, the hospital where I visited my baby every day did a good job of monitoring mothers for postpartum issues. Luckily again, my partner was attuned to my mental state and made me get the help I needed. I ended up visiting a psychiatrist and got medication which I’m convinced to this day saved my life.
My son is almost four, and it’s just this year that the haze has begun to clear. The past four years have been fantastic is so many ways, but one morning not that long ago I woke up and I finally felt like myself again. It was shocking. As this article describes, postpartum depression can last along time. It’s not just the baby blues. It’s not just not being able to get out of bed or wanting to hurt your child. It’s not just ennui experienced by bored, white middle class women. Postpartum depression is complex, it manifests itself in many ways, and it affects women around the world.
Postpartum mental health issues are, I think, among the most hidden and most taboo. There are a few very brave celebrities who have spoken about their experiences (Alannis Morissette, Brooke Shields), but women are still bombarded with the message that they should ease gracefully into their new role.
One thing that initially stopped me from wanting to get help was a fear that my child would be taken away from me, particularly as a gay woman. My child was in the hospital, and I was worried that if I exhibited anything less than stellar behavior, the social workers and doctors would decide that he couldn’t ever come home with me. To this day, I rarely tell anyone about the experience. It’s too scary to admit. It means failure, it means weakness, it means the threat of losing my child.
The scope of reproductive health issues that women face is so large that it can’t possibly fit under the umbrella of family planning. Postpartum depression is one of the most common complications of having a baby, but we don’t see it addressed nearly enough in discussions about reproductive health.
Among the many things that Obama’s Affordable Care Act will put into law is the H.R. 20 — Melanie Blocker Stokes Mom’s Opportunity to Access Health, Education, Research, and Support for Postpartum Depression Act.
What does Mitt Romney have planned?
It’s been another great week!
I started a new series, profiling women in health. If you would like to be profiled or have an idea of someone you think I should talk to, please let me know.
I’ve been pitching lots of stories about women’s health to a variety of news outlets and blogs, and will hopefully have some good news to share soon.
And a confession – I didn’t watch the veep debate. I listened to part of it on the radio, but missed the visual antics. Oh well, I’ll be watching on Tuesday as the presidential candidates face off for the last time.
Here’s what caught my eye in health news this week:
- Injections in the spine never seems like a great idea, but even worse when the medication is full of fungus. Some things definitely need lots of regulatory oversight!
- In a valiant effort to take the mind-body connection seriously, two studies look at the role stress when it comes to breast cancer and maternal well being.
- Floridians are voting on whether ban state funding for abortion, in addition to the existing ban on federal funding for abortion, put in place by the Hyde Amendment. Will they also be voting on whether to increasing state funding for birth control?
- Scientists have come to a consensus that formaldehyde causes cancer. So why are lobbyists trying to keep this information under wraps?
- No one wants to go on a job interview when they’re pregnant, and lots of women are nervous to tell their employers that they are pregnant even when they already have the job. Been there.
- The UK takes a big step, and makes treatment available for HIV positive patients who need them, regardless of immigration status. Public health in action.
- 3D mammograms: twice the radiation, three times the fun?
Thanks for reading! Have a great fall weekend, and see you on Monday.
Oh, occasionally a women’s health blog/fair/publication/clinic will include information about heart disease, or nutrition, or even chronic illness. For the novelty factor, it might include something about HIV. But most of the time the term “women’s health” is about getting knocked up, not getting knocked up, and boobies.
I’m as guilty as the next person when it comes to limiting my scope: I wrote a dissertation on breast cancer, a master’s thesis on breast feeding, and worked for an organization that focused on reproductive health.
Unlike womb health and boob health, mental health isn’t typically classified as a women’s health issue. That’s unfortunate, because mental health could possibly be the most important topic when it comes to women’s health. After all, if you don’t have your (mental) health, nothing else matters.
Whether it’s post-traumatic stress disorder, postpartum depression, bi-polar disorder, depression and anxiety, or even loneliness, mental health is something that is shaped by gender.
According to the World Federation on Mental Health, depression is not only a worldwide crisis that affects 350 million people a year, it is also a highly gendered affliction:
While depression is the leading cause of disability for both males and females, the burden of depression is 50% higher for females than males (WHO,2008). In fact, depression is the leading cause of disease burden for women in both high-income and low- and middle-income countries (WHO, 2008). Research in developing countries suggests that maternal depression may be a risk factor for poor growth in young children (Rahman et al, 2008).
This risk factor could mean that maternal mental health in low-income countries may have a substantial influence on growth during childhood, with the effects of depression affecting not only this generation but also the next.
Treatment is different for women too. We’re more likely to be diagnosed with depression than men, even if we both give the same list of symptoms. And women are more likely to be prescribed mood altering psychotropic drugs.
Furthermore, there are significant health disparities when it comes to women’s mental health, and not just having to do with unipolar depression:
- Women experience twice as much serious mental illness as men
- Women have a life-time prevalence of alcohol dependance that is more than twice as high as that for men
- Postpartum depression and anxiety are common, but poorly diagnosed and treated. That means many (if not most) women suffer through this alone.
- Women and girls are at least twice as likely to have an eating disorder than are men or boys.
What’s the reason for these disparities?
It’s complicated, but the inequalities inherent in patriarchal societies bear some of the responsibility.
Eating disorders emerge because of an unrealistic image of the female body that is presented in the media. Postpartum depression goes untreated, and can lead to further mental health problems. Women experience more poverty, more workplace harrassment, and do more caregiving for family members than do men.
Furthermore, according to the World Health Organization, the high prevalence of sexual violence to which women are exposed and the correspondingly high rate of Post Traumatic Stress Disorder (PTSD) following such violence, means that women are the largest group of people affected by this disorder.
We don’t like to talk about mental illness in this country, and we don’t do a great job of treating it. We throw drugs at it (there’s been a gigantic increase in the number of Americans on anti-depressants, but are we mentally healthy?) We pay lip service to it. But more often than not, we ignore it.
In the US, even if you are lucky enough to have insurance, chances are that it doesn’t offer mental health parity.
For once, the US is not the only country doing a shabby job of providing healthcare. According to the WHO:
Mental, neurological, and substance use disorders are common in all regions of the world, affecting every community and age group across all income countries. While 14% of the global burden of disease is attributed to these disorders, most of the people affected – 75% in many low-income countries – do not have access to the treatment they need.
Reading this onslaught of bad news may not make you feel very mentally healthy, whether or not you’re a woman. But it’s important to share this information as a reminder that mental health is a major health issue for women and that it should be addressed under the umbrella of women’s health.
It’s easy to focus on babies and boobies, but looking at other health issues through a gendered lens may help decrease women’s morbidity and increase quality of life.
What do you think? Do you know any women’s health organizations that are working on this issue? What does the research show about mental health disparities? Are there things that clinicians can do to better protect the mental health of their female patients?