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Call for right to therapeutic abortion amid PDu30 SONA personal view on abortion

“Legal medicine books by Filipino medico-legal writers recognize the right to therapeutic abortions to preserve the life of the woman and to preserve her health.  In law, practice and policy, therapeutic abortions are allowed,” said Atty. Clara Rita Padilla, Executive Director of EnGendeRights.

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During President Duterte’s SONA speech, he mentioned as an aside that he is personally against abortion. 

“In Philippine jurisprudence it is recognized that therapeutic abortion is allowed to save the life of the woman.  This has been held in the 1961 Supreme Court case of Geluz v. CA.  Even Fr. Joaquin Bernas, a constitutionalist and a priest, has opined that abortion is allowed under the 1987 Constitution to save the life of the woman.  Legal medicine books by Filipino medico-legal writers recognize the right to therapeutic abortions to preserve the life of the woman and to preserve her health.  In law, practice and policy, therapeutic abortions are allowed,” said Atty. Clara Rita Padilla, Executive Director of EnGendeRights.

“There are many cases where therapeutic abortion can be allowed to save the life of a woman or to prevent disability.  Pregnant women with conditions such as dwarfism, hypertensive disorders, tuberculosis, diabetes, bronchial asthma, goiter, HIV, malaria, severe anemia, malnutrition, and pregnant women who are less than 18 or greater than 35 years of age, have a fourth or more children, are battered by their husbands or partners, and have spinal metal plates may die from complications from pregnancy and childbirth and may need access to safe abortion to save their lives and prevent life-long disability.

Worldwide, many women die from pregnancy and childbirth, e.g., 27.1% due to post-partum hemorrhage, 14% due to hypertensive disorders, and about 9% due to various reasons,” added Atty. Padilla.

Atty. Padilla continued, “Many of these conditions are common to Filipino pregnant women and girls.  In August 2016, a 21-year old rape victim who became pregnant as a result of the rape died a day after giving birth due to complications from her risky childbirth resulting from her dwarfism condition.  Her mother lamented that her daughter might be alive today had her daughter been able access to safe and legal abortion.”

“A woman may also have suffered a previous post-partum hemorrhage (PPH) in the past and may want to induce abortion to avoid risk to her health and life due to PPH.  Although interventions exist to prevent these maternal deaths and address the preexisting health concerns of women, the services and information regarding the health services may not be accessible to poor, rural, and young women,” stressed Atty. Padilla.

“There are women who become suicidal because of their pregnancy.  These include rape victim-survivors who suffer depression, become suicidal, and resort to clandestine and unsafe abortion.  Some incest rape victim-survivors who became pregnant after being raped by their own fathers whether adolescents or adults have resorted to clandestine and unsafe abortion risking their health and lives.  About one in every nine Filipino women who induce abortion are rape victim-survivors.  Without access to safe and legal abortion, they end up part of the statistics of women who die from unsafe abortion complications.  These cases fall under the ambit of therapeutic abortions to save the life and health of the woman,” explained Atty. Padilla.

“Abortion is common in the Philippines with about 70 women inducing abortion every hour.  Due to lack of access to safe and legal abortion, three women die every day from unsafe abortion complications and 11 women are hospitalized every hour.  The archaic Spanish colonial law on abortion has not decreased the number of women who induce abortion rather it has made it dangerous for women who resort to clandestine and unsafe abortion.  It is time to make abortion safe and legal.  Making abortion safe and legal in the Philippines and clearly recognizing in law, practice and policy that therapeutic abortions are allowed will save the lives of at least three women every day,” emphasized Atty. Padilla.

Atty. Padilla added, “Predominantly Catholic countries have liberalized their laws on abortion including Spain in 2010 with Prime Minister Zapatero at the helm of legalizing abortion on request during the first 14 weeks of the pregnancy and thereafter on specific grounds and countries such as Belgium, France, and Italy allow abortion upon a woman’s request; Poland allows abortion to protect a woman’s life and physical health and in cases of rape, incest, and fetal impairment; Hungary allows abortion up to 12 weeks of gestation;  Portugal allows abortion up to 10 weeks of gestation; Brazil and Ireland on certain grounds.   Almost all former Spanish colonies, mostly with predominant Catholic populations, have liberalized their laws on abortion such as Argentina, Bahamas, Bolivia, Colombia, Costa Rica, Cuba, Ecuador, Guatemala, Jamaica, Mexico, Panama, Paraguay, Peru, Puerto Rico, Trinidad and Tobago, Uruguay, and Venezuela, allowing abortion on certain grounds leaving the Philippines to contend with its antiquated colonial Spanish law.  Mexico City, a predominantly Catholic city, even provides safe and legal abortion for free.   This leaves the Philippines as one of a handful countries worldwide which continue to penalize their women and adolescent girls for having an abortion.”

“Other countries with same constitutional protection of the life the unborn from conception allow abortion under certain exceptions such as Hungary, Costa Rica, South Africa, Ireland, Slovak Republic, Poland, and Kenya,” Atty. Padilla concluded.

See:

EnGendeRights December 2016 publications on Access to Safe and Legal Abortion and Post-Abortion Care:

1) Policy Brief – EnGendeRights, “Access to Safe and Legal Abortion and Post-Abortion Care Can Save Filipino Women’s Lives”, Clara Rita Padilla
http://pinsan.ph/wp-content/uploads/2017/03/1-EnGendeRights-Policy-Brief-Safe-Legal-Abortion-Final-Circulation.pdf

2) Fact Sheets series entitled, “Safe and Legal Abortion Saves Women’s Lives”:

2.1) FACT SHEET 1 – EnGendeRights, “Safe and Legal Abortion Saves Women’s Lives: Public Health Concerns and Social Costs of Lack of Access to Safe and Legal Abortion and Post-Abortion Care”, Clara Rita Padilla
http://pinsan.ph/wp-content/uploads/2017/03/2-EnGendeRights-Fact-Sheet-1-2016.pdf

2.2) FACT SHEET 2 – EnGendeRights, “Safe and Legal Abortion Saves Women’s Lives: Liberalizing Abortion Laws Will Save Women’s Lives: Asian, Predominantly Catholic Countries, and Former Spanish colonies Allowing safe and Legal Abortion; The Philippine Constitution Allows Access to Safe and Legal Abortion”, Clara Rita Padilla
http://pinsan.ph/wp-content/uploads/2017/03/3-EnGendeRights-Fact-Sheet-2-2016.pdf

2.3) FACT SHEET 3 – EnGendeRights, “Safe and Legal Abortion Saves Women’s Lives: Constitutional Guarantees, Comparative Law, International and Regional Human Rights Standards Support the Right to Safe and Legal Abortion”, Clara Rita Padilla
http://pinsan.ph/wp-content/uploads/2017/03/4-EnGendeRights-Fact-Sheet-3-2016.pdf

Resources are also available via:
https://drive.google.com/drive/folders/0B-w7gIHkZJhgblBIQmJKUS0xSG8?usp=sharing

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Study links coffee consumption to metabolic health and sex hormones

Despite having a similar body mass index (BMI), individuals with higher coffee consumption had lower total and visceral fat and greater skeletal muscle mass than those who consumed less coffee.

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Coffee is one of the world’s most widely consumed beverages, and previous research has linked its consumption to a lower risk of conditions such as type 2 diabetes and cardiovascular disease. However, the biological mechanisms behind these benefits remain unclear. A new Finnish study links habitual coffee consumption to healthier body composition and metabolic markers, while revealing distinct associations with sex hormones in men and women.

The study, conducted at the University of Oulu, analysed data from 2,264 participants aged 46 in the Northern Finland Birth Cohort 1966. Researchers examined how habitual coffee consumption was associated with circulating metabolites, cardiometabolic risk markers and sex hormones.

Despite having a similar body mass index (BMI), individuals with higher coffee consumption had lower total and visceral fat and greater skeletal muscle mass than those who consumed less coffee.

In both men and women, higher coffee consumption was correlated with lower circulating levels of branched-chain amino acids, biomarkers that have previously been linked to insulin resistance and an increased risk of type 2 diabetes when chronically elevated.

The strongest sex-specific associations were observed in men. Higher coffee consumption was linked to a more favourable glucose–insulin profile, higher concentrations of total and bioavailable testosterone, and increased levels of sex hormone-binding globulin (SHBG). At the same time, free testosterone and the free androgen index were modestly lower. In women, hormonal associations were more limited and were primarily characterised by higher SHBG and lower measures of free androgens.

“Coffee is consumed by millions of people every day, yet we still know surprisingly little about how it relates to our metabolism and hormones. What stood out in our findings was a distinct hormonal signature that didn’t disappear even after we took into account BMI and lifestyle factors, with several of these associations differing between men and women,” says Luca Verroest, lead author of the study and Doctoral Researcher at the University of Oulu.

The results suggest that hormonal pathways may partly explain the relationship between coffee consumption and metabolic health. However, as this was an observational study, the findings demonstrate associations rather than cause-and-effect relationships.

The study is particularly relevant in Finland, one of the world’s highest coffee-consuming countries, where annual consumption averages around 11.8 kilograms per person.

The researchers say the findings provide a foundation for future studies aimed at determining whether coffee itself drives these biological changes and identifying the compounds responsible. These questions are currently being investigated in animal models, with the long-term goal of progressing to human intervention studies. Further research will be needed before the findings could inform dietary recommendations.

The study, Associations of habitual coffee intake with testosterone and cardiometabolic markers: the Northern Finland Birth Cohort 1966 study, has been published in the European Journal of Nutrition.

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Scheduling dental care during prenatal visits boosts oral health care during pregnancy

Scheduling a dental appointment during prenatal clinic visits—a simple, no-cost task that doesn’t require extra staff—increases the likelihood that patients later see a dentist during pregnancy.

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Prenatal visits might include bloodwork, discussions of due dates and vitamins, and ultrasounds. What if these visits could also improve oral health care among pregnant patients?

New research shows that scheduling a dental appointment during prenatal clinic visits—a simple, no-cost task that doesn’t require extra staff—increases the likelihood that patients later see a dentist during pregnancy.

The study, published in the American Journal of Public Health, demonstrates the benefit of coordination among health providers and integrating oral health into prenatal care, especially for vulnerable patient populations.

Historically, dentists avoided treating women during pregnancy unless it was an emergency, or only provided care during the second trimester. This guidance changed once studies showed that routine and emergency dental care is safe during pregnancy—and current obstetric and dental guidelines stress that dental care can and should be provided during this critical period.

Moreover, pregnancy increases the risk of some oral health conditions, including gum inflammation and sometimes tooth decay, making routine dental care even more important during pregnancy. Some oral health issues may affect the fetus or even be transmissible to the child after birth. 

Marginalized groups, including low-income individuals and those insured by Medicaid, are known to have higher rates of dental disease. Yet women enrolled in Medicaid are far less likely to see a dentist for a cleaning during pregnancy compared to women with private insurance.

“Many of those vulnerable to oral disease enter pregnancy with dental disease, and this may worsen during pregnancy,” said study author Stefanie Russell, associate professor at Rutgers School of Dental Medicine and an adjunct associate professor at NYU College of Dentistry, who led this research while at NYU.

One way to try and increase dental care among pregnant women is to reach them where they already are: their prenatal appointments. To bridge this gap, researchers and clinicians at NYU College of Dentistry teamed up with neighboring NYC Health + Hospitals/Bellevue, the oldest public hospital in the US, to create the New York University/Bellevue Prenatal Oral Health Program. 

During weekly sessions at Bellevue’s prenatal clinic, pregnant patients receive a standardized screening to assess their oral health. Those with dental needs are referred to NYU College of Dentistry for follow-up care, educated about the importance and safety of dental care during pregnancy, and informed that Medicaid covers dental care in New York.

From 2018 to 2020, 420 prenatal patients with Medicaid coverage were referred to NYU Dentistry for follow-up dental care; the majority were Hispanic, and roughly half spoke Spanish as their first language. Referrals for dental care took two forms: immediately scheduled dental appointments made before the patient left the prenatal clinic or through a patient navigator. The patient navigator—a bilingual professional—educated patients regarding oral health, reminded patients of their upcoming dental appointments, and followed up after to identify any issues. 

Nearly 44 percent of patients referred to NYU College of Dentistry followed through with a dental appointment. Both immediate appointment scheduling and the patient navigator increased the chances of a patient receiving dental care, but those who had appointments scheduled at their prenatal visit were 2.6 times more likely to see a dentist than those without appointments scheduled—even more likely than those who worked with the patient navigator.

“This suggests that immediately scheduled dental appointments can be an effective way to increase dental care utilization during pregnancy, without needing to hire extra staff,” said study author Shulamite Huang, assistant professor of epidemiology and health promotion at NYU College of Dentistry.

The authors conclude that integrating oral health screening in a prenatal clinic is feasible and increases engagement with dental care during pregnancy. They are continuing their research to measure whether this care improves oral health outcomes and to better understand how dental screening can be successfully integrated with prenatal care in other settings.

“A warm hand-off is key for addressing part of the barriers to dental care during pregnancy. Our team plans to further investigate and optimize interventions addressing both patient-, provider-, and healthcare system-level barriers to dental care during pregnancy,” said Huang.  

Additional study authors include Richard Heyman and Mary Kang of NYU Dentistry; Belkys Saba, formerly of NYU Dentistry; Chloe Bird of the Tufts University School of Medicine; and Chengwu Yang of the Florida Atlantic University Schmidt College of Medicine.

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Why a UTI hurts — and why that might be a good thing

Australian researchers have discovered a previously overlooked group of bladder nerves that help detect urinary tract infections (UTIs) and trigger the body’s response to clear them, providing a potential new target for future bladder pain therapies.

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Australian researchers have discovered a previously overlooked group of bladder nerves that help detect urinary tract infections (UTIs) and trigger the body’s response to clear them, providing a potential new target for future bladder pain therapies.

The study shows that bladder nerves located close to the lining of the bladder act as a frontline infection sensor, helping the body recognise UTIs and trigger responses that reduce the severity and spread of infection.

UTIs are among the most common bacterial infections worldwide, with more than 400 million cases reported every year. Nearly one in three women will experience UTIs before the age of 24, and many elderly people and those with bladder issues from spinal cord injuries can experience multiple UTIs in a single year.

Symptoms often include frequent urination, a sudden urge to urinate, pain during urination, and pelvic discomfort can be debilitating for some patients.

Flinders University’s Dr Luke Grundy says that while scientists have long understood how the bladder senses as it fills and triggers urination, the role of a specialised group of bladder nerves near the bladder lining has remained unclear.

“Most bladder nerves act like a fuel gauge, telling the brain when the bladder is filling up and needs emptying,” says Dr Grundy, Head of the NeuroUrology Research Group at Flinders University.

“The nerves we studied in this research are different. They sit close to the bladder lining and appear to act more like an early warning system, detecting infection and inflammation.

“They don’t just sense infection. They help coordinate the body’s response to it by triggering pain and urinary frequency, behaviours that appear to help clear bacteria from the bladder as part of the body’s defence system.”

Lead author and recently graduated PhD student Dr Cindy Tay says the discovery changes how these nerves are understood.

“These mucosal nerves have puzzled scientists for almost two decades because they stay quiet while the bladder fills and empties, which is the main job of the bladder,” says Dr Tay.

“What we’ve found is that they have a hidden job — acting as an early warning system that springs into action the moment infection takes hold.”

The research team developed a novel method to selectively study a specialised group of sensory nerves in the bladder lining of mice, revealing that while these nerves play little role in normal bladder function, they become highly responsive during a UTI and help detect and respond to infection.

“When the bladder is healthy, these nerves are relatively quiet, but during a urinary tract infection they become highly sensitive and respond to the presence of bacteria and inflammation,” says Dr Grundy.

“It may feel unpleasant, but urinating more frequently actually helps clear the infection by flushing out the harmful bacteria.”

The study also helps explain why people with conditions affecting nerve function may be more prone to recurrent or severe UTIs.

“If the nerves that detect infection aren’t working properly, the body may not respond as effectively,” says Dr Grundy.

Building on previous research, the new study reveals a deeper understanding of how UTIs affect bladder function and the nervous system, and could help develop new treatments that target these nerves to relieve UTI-related symptoms.

“Our findings provide new insight into how the bladder detects and responds to infection, helping explain the biological processes that drive the pain, urgency and discomfort commonly experienced during UTIs,” says Dr Grundy

Researchers say the next challenge is to develop therapies that ease the pain and urgency associated with UTIs while preserving the protective role these nerves play in fighting infection.

The paper, ‘Bladder mucosal afferents detect UTI and aid pathogen clearance,’ by Cindy Tay, Harman Sharma, Stewart Ramsay (University of Adelaide), Georgia Bourlotos, Sarah K Manning, Natalie E Stevens, Sophie J Miller, Geraint B Rogers, David J Lynn, Feargal J Ryan, Andrea M Harrington (University of Adelaide), Vladimir Zagorodnyuk, Steven L Taylor and Luke Grundy was published in Proceedings of the National Academy of Sciences (PNAS).

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