Study Details How Women Pay for Abortion Care, Why Many Do Not Use Insurance Coverage
Prior research has shown that most abortion patients with health insurance do not use it to pay for the procedure, but little is known about the reasons why. The Guttmacher Institute's Rachel Jones and Ushma Upadhyay and Tracy Weitz of Advancing New Standards in Reproductive Health analyzed a survey of more than 600 abortion patients to assess their insurance coverage, whether they used it and why, and how they paid for the procedure and related expenses. The majority of participants who had insurance did not use it to pay for the abortion -- usually because it was not covered or they didn't know if it was -- while 16% of participants used Medicaid to pay for it and 7% used private insurance. The researchers call for increased efforts to "reduce the financial burdens and increase access to abortion care," including repeal of the Hyde Amendment.

More Data Needed Before Possible Switch to Two-Dose HPV Vaccine Series, Editorial Argues
In a Journal of the American Medical Association editorial, Jessica Kahn of Cincinnati Children's Hospital Medical Center and David Bernstein of the University of Cincinnati College of Medicine write that moving from a three-dose to two-dose series for the human papillomavirus vaccination "could lead to a substantial increase in the number of girls completing the vaccine series for the same cost, ensuring that greater numbers are protected." They review three studies suggesting that a two-dose series can produce as strong of an immune response as a three-dose series. However, more data are needed on the efficacy of the two-dose series -- particularly in the long-term -- before determining whether new recommendations regarding the HPV vaccine are warranted, they conclude.

Study Explores Barriers to Second-Trimester Abortion Practice Among Family Planning Subspecialists
Although 96% of second-trimester abortions involve dilation and extraction (D&E), access "is limited by a lack of trained physicians," according to a study by researchers from the University of California-San Francisco. To assess barriers to D&E provision, the researchers surveyed ob-gyns who participated in a family planning fellowship that includes subspecialty training in abortion. Sixty-eight of 105 respondents reported barriers, with "unsupportive nurses" being the most common issue. Barriers varied geographically, with concern for personal safety more commonly reported in more-restrictive regions and institutional barriers being more common in less-restrictive areas.

United Nations Guidance Frames Maternal Mortality and Morbidity as 'Human Rights Imperative'
In a commentary for The Lancet, Navanethem Pillay of the United Nations writes that maternal mortality and morbidity "continue to be a serious human rights concern," with an estimated 287,000 women dying of maternal causes in 2010. She outlines how a 2012 report released by her office can be used to "strengthen the bridges between [the] sectors" that need to work together to make progress on maternal health. The guidance "presents an opportunity to move from rhetoric to reality in implementing policies and programmes on the ground that explicitly work toward the realisation of women's human rights," she states.

Review Evaluates Challenges, Effective Strategies in Care for Families After Preterm Birth
Clinical management related to preterm births tends to focus on prevention, rather than care of the new mother and her family. In a review of health care practices after preterm births, Ira Kantrowitz-Gordon -- a midwife and senior lecturer at the University of Washington School of Nursing -- discusses postpartum care after a preterm birth and offers "effective strategies for midwives and other obstetric clinicians to leverage the high level of trust gained during pregnancy in order to assist mothers and their families" during this period. In addition to maintaining a therapeutic relationship with the mother, obstetric providers can help implement "specific, evidence-based interventions" -- such as kangaroo care and planning for future pregnancies -- to help families after preterm births, she writes.