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September 18, 2013

Despite some advances women's health care remains under studied and under siege

by Rep. Susan A. Davis 

Throughout my time in Congress, women’s health has been one of my top priorities. Improving access to and quality of women’s health care is vital to women, their families, and our nation as a whole. Our nation has made important strides in women’s health during my lifetime. Advances in women’s health care and expanded access to health services have dramatically lowered maternal mortality rates over the past century, while the availability of family planning options has given more women the opportunity to enter the workforce and gain financial independence.

However, we cannot take this progress for granted. In the last 15 years, counties across the nation have seen a dramatic decline in women’s life expectancy. Maternal mortality in the US has doubled over the past 25 years, despite the US having the highest prenatal care and childbirth costs in the world. At the same time, many states are working to curtail access to the same services that proved so effective at improving the health and lives of women.

Family planning, for example, has been found to reduce pregnancy-related deaths. Yet in states across the country, organizations that provide these vital services are being defunded and restricted. In Mississippi, Alabama, and other states, unnecessarily strict regulations have forced all but a few clinics to close their doors. Texas and twelve other states have banned termination after 20 weeks, and North Dakota has banned it after six. The unclear and unscientific language of proposed personhood bills in Mississippi and other states, while meant to restrict abortion, may even threaten access to contraception.

Anti-choice efforts affect more than women’s access to contraception and abortion services. Organizations such as Planned Parenthood offer a range of women’s health services, and hundreds of thousands of women rely on their clinics for prenatal care, cancer screenings, and other vital testing and treatment. When these providers are defunded or otherwise forced to close, poor women in underserved areas lose what is often their only access to life-saving reproductive health care.

While attacks on abortion and contraception providers constitute a significant threat to women’s health, reproductive health is not the only area in which women’s health faces challenges. Women in the United States are at a significant risk for non-gender specific diseases such as diabetes and heart disease. Yet decades of insufficient medical research on women has left our understanding of how these diseases work in women and how best to treat them underdeveloped.

 To this day, women are critically underrepresented in medical research and clinical trials. Concerns about women’s monthly hormonal cycles muddling research findings, coupled with worries over the impact of medications on a developing fetus should a female participant become pregnant, have resulted in a preference for men as research subjects. Research has shown that, even in studies of cancers that affect both men and women, women make up far less than half of participants. And although more women than men die from heart disease in the U.S., women generally make up less than half (and sometimes as few as 10%) of participants in clinical trials on heart disease.

While including women may complicate medical research, ignoring them is not an option. Men and women have important physiological differences that go beyond reproductive functions, and because of this diseases often manifest differently based on sex. For example, a study last year revealed that women experience very different heart attack symptoms than those commonly seen in men. When women don’t recognize these symptoms, they are less likely to seek medical care and more likely to die from a heart attack. Additionally, a treatment or medication that is effective in men may work differently in women, or not at all. Their underrepresentation in clinical trials may be why women are nearly twice as likely to experience negative side effects from medications.

Excluding women from research and trials puts them at serious risk. In 1993, Congress recognized this and passed NIH Revitalization Act, which mandated the inclusion of women in clinical research. However, two decades later, the imbalance persists and remains a serious issue in women’s health.

As we refight yesterday’s battles on contraception and choice, we must also work to ensure that women benefit from future medical discoveries. So long as we continue to exclude them from medical progress and treat their health needs as fodder for politics, women are at risk. Our mothers, sisters, and daughters deserve better.

This piece originally appeared in The Hill.

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