Title

A Comparative State Policy Analysis of Sexual Health Bills in the US Concerning Abortion, Maternal Mortality, Postpartum Depression, and Medicaid

Date

11-8-2021 11:55 AM

Abstract

Purpose: Women of color (WOC) have faced a long history of sexual health injustice. Racial inferiority has exacerbated discriminatory health care practices and state policies negatively affecting access, eligibility, and resources. WOC may be most vulnerable to constraints on reproductive rights as they face additional barriers in accessing high-quality reproductive health care free from race bias and discriminatory policies.
Research Question: We documented and analyzed the landscape of all 50 U.S. bills from 2019-2020 related to women’s sexual health. We asked, what bills use racial/ethnic language to address women's sexual health and what bills exist in regards to four categories: abortion, maternal mortality, postpartum depression, and Medicaid.
Methods: Using the official legislative websites for each of the 50 states we searched for bills using the following key terms: abortion, maternal mortality, postpartum depression, Medicaid, sexual health, pregnancy, women of color, and health. We documented a total number of bills that were introduced, passed, and/or vetoed by the governor for each of our four categories.
Results: For abortion, a majority of the states introduced punitive and restrictive bills. For maternal mortality, 15 bills in 7 states were introduced and 4 states passed bills for creating a committee to investigate the racial/ethnic disparities in their states. There was more limited attention to PTSD. A total of 20 bills were introduced and only one passed in the state of Texas to address postpartum depression. Overall, we found the least number of bills under Medicaid as it relates to women’s sexual health. A total of 4 passed. 3 provided Medicaid coverage for key resources such as lactation, doula and 1 extended resources during the postnatal period.
Discussion: Similar to previous research, we found a higher number of abortion bills that are restrictive and punitive. Interestingly, none of the bills use racial/ethnic language outside of the maternal mortality category. There is an opportunity for a greater number of states to use a racial/ethnic language given the strong evidence documenting racial disparities among BIPOC women. Overall, there was a lack of attention to immigrants, LGBTQ+, socioeconomic factors, and women who suffer from disabilities. State government officials have a long way to go in order to develop more inclusive sexual health bills and ultimately pass policies that address the needs of all women.

Biographies

Yuliana Hernandez Paniagua Health Sciences (pre-med track) and Pre-Clinical Health Sciences

Yuliana Hernandez Paniagua is double majoring in health sciences, on the pre-med track, and pre-clinical health sciences. She is currently a McNair Scholar as well as a BUILD EXITO Scholar. She is also a mentor for GANAS, which is a program dedicated to helping students who are first-generation, low income, and/or from diverse and multicultural backgrounds. Currently, Yuliana’s research interests include how policies affect BIPOC women’s sexual reproductive health and how, therefore, it affects them so that they are more susceptible to low birth and preterm babies. Her hope is to gain more knowledge regarding maternal health because that’s her main focus overall and correlates with her career goals as well, considering she wants to be an obstetrician. She will begin her research in the summer of 2021, and in the future hopes to become a practicing provider as a clinician but also to be part of the knowledge production as an academic clinician. She wants to be able to prevent women of color from suffering anymore by the hands of doctors who are ignorant, lack the connection, patience and knowledge that people of color are owed.

Dr. Cirila Estela Vasquez Guzman, Faculty Mentor, Department of Family Medicine at OHSU

Dr. Vasquez Guzman is an Assistant Professor in the Department of Family Medicine at Oregon Health & Science University. Estela trained at the University of New Mexico, where she specialized in medical sociology, race, and ethnicity. Dr. Guzman has specific interest in social-cultural-structural-humanistic curriculum for medical students and residents as well as investigating inequities in medicine, health, and health delivery among Native American and Latinx communities. As a first generation Latina immigrant indigenous scholar, she aims to bridge the gap between theory and practice from an equity and inclusion perspective because we all win when we have a compassionate, representative, and humanistic healthcare system.

Disciplines

Medicine and Health Sciences

Persistent Identifier

https://archives.pdx.edu/ds/psu/36194

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Aug 11th, 11:55 AM

A Comparative State Policy Analysis of Sexual Health Bills in the US Concerning Abortion, Maternal Mortality, Postpartum Depression, and Medicaid

Purpose: Women of color (WOC) have faced a long history of sexual health injustice. Racial inferiority has exacerbated discriminatory health care practices and state policies negatively affecting access, eligibility, and resources. WOC may be most vulnerable to constraints on reproductive rights as they face additional barriers in accessing high-quality reproductive health care free from race bias and discriminatory policies.
Research Question: We documented and analyzed the landscape of all 50 U.S. bills from 2019-2020 related to women’s sexual health. We asked, what bills use racial/ethnic language to address women's sexual health and what bills exist in regards to four categories: abortion, maternal mortality, postpartum depression, and Medicaid.
Methods: Using the official legislative websites for each of the 50 states we searched for bills using the following key terms: abortion, maternal mortality, postpartum depression, Medicaid, sexual health, pregnancy, women of color, and health. We documented a total number of bills that were introduced, passed, and/or vetoed by the governor for each of our four categories.
Results: For abortion, a majority of the states introduced punitive and restrictive bills. For maternal mortality, 15 bills in 7 states were introduced and 4 states passed bills for creating a committee to investigate the racial/ethnic disparities in their states. There was more limited attention to PTSD. A total of 20 bills were introduced and only one passed in the state of Texas to address postpartum depression. Overall, we found the least number of bills under Medicaid as it relates to women’s sexual health. A total of 4 passed. 3 provided Medicaid coverage for key resources such as lactation, doula and 1 extended resources during the postnatal period.
Discussion: Similar to previous research, we found a higher number of abortion bills that are restrictive and punitive. Interestingly, none of the bills use racial/ethnic language outside of the maternal mortality category. There is an opportunity for a greater number of states to use a racial/ethnic language given the strong evidence documenting racial disparities among BIPOC women. Overall, there was a lack of attention to immigrants, LGBTQ+, socioeconomic factors, and women who suffer from disabilities. State government officials have a long way to go in order to develop more inclusive sexual health bills and ultimately pass policies that address the needs of all women.