February 2007 RNR

February 2007

IWPR’s Research News Reporter is distributed monthly to highlight informative, innovative, and sometimes controversial research related to women and their families. Each selection includes a short description of the research and either a link to the report or a citation.

1. Who Decides? Status of Women’s Reproductive Rights in the United States
2. The Work, Family, and Equity Index: How Does the United States Measure Up?
3. Cost-Effective Investments in Children
4. Childbirth at a Crossroads in Southeastern Pennsylvania

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1. Who Decides? Status of Women’s Reproductive Rights in the United States

NARAL Pro-Choice America

January 2007

This annual report, the sixteenth in a series, documents current policy issues regarding reproductive rights at the federal and state level. The report provides comprehensive updates on legislative measures introduced and passed around the country in 2006, for example to reverse anti-choice laws, to improve reproductive health research and service access, and to support child bearing. The report combines the legislative updates with data on abortion clinic access published by the Guttmacher Institute to rank the states on the cumulative barriers to reproductive health care faced by women.

Findings from the report include:

• States considered 470 pro-choice measures and enacted 56 of those in 2006.
• States also considered 650 anti-choice measures and enacted 45 of those in 2006.
• The nationwide grade for women’s reproductive rights was a D-.
• California achieved the highest ranking, with a grade of A+, followed by Washington State (A+), Connecticut (A), Hawaii (A), and Maryland (A).
• Louisiana ranked the lowest with a grade of F, followed by Kentucky (F), Pennsylvania (F), Mississippi (F), and Missouri (F).

The report summarizes key successes from the past year and outlines the work that remains to be done, concluding that advocates and lawmakers must continue to advance legislation that will allow women across the country open access to improved reproductive and health services in the future.

The full report can be found at http://www.prochoiceamerica.org/choice-action-center/in_your_state/who-decides/introduction/who_decides_2007_full.pdf

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2. The Work, Family, and Equity Index: How Does the United States Measure Up?

Jody Heymann, Alison Earle, and Jeffrey Hayes

The Institute for Health and Social Policy

February 2007

This report measures work/family policies across 177 countries and discusses the successes and failures of United States family labor policies in a global context. Based on updated and expanded research from the 2004 Work, Family¸ and Equity Index report, this study provides a comparative look at public policies that have been implemented around the world, noting where the United States is succeeding and where it continues to fall behind the rest of the world. Data collected for the study come from a variety of international sources, including NATLEX, an online global database of labor and human-rights legislation maintained by the International Labour Organization (ILO) and numerous country-specific government sources.

Findings from the study include:

• Out of 173 countries, the United States is one of 5 countries that do not offer guaranteed paid leave to women in connection with childbirth. The other countries on this list include Lesotho, Liberia, Papua New Guinea, and Swaziland.
• The United States does not guarantee paid paternity or paid parental leave, though 66 other countries do.
• The United States does not protect working mothers’ right to breastfeed, though 107 other countries do. Paid breaks are mandated in 73 out of those 107 countries.
• At least 126 countries require employers to provide a mandatory day of rest each week. The U.S. does not guarantee workers this 24-hour break.

The authors enumerate a number of work/family supports the United States could implement to better provide for the health and economic security of working families. These policies include paid parental leave, support for breastfeeding, restrictions on work hours, and paid sick days for illness and family care.

The full report can be found at http://www.mcgill.ca/files/ihsp/WFEIFinal2007.pdf

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3. Cost-Effective Investments in Children

Julia B. Isaacs

Brookings Institution

January 2007

This report is one in a series of papers written by the Brookings Institution’s Budgeting for National Priorities Project. It compiles and reviews the results of a variety of benefit-cost analyses to make the case for targeted investments that will promote future economic growth by investing in children and youth programs that have had demonstrably positive long-term outcomes. The report identifies four target areas for new government spending: high-quality early childhood education programs; nurse home-visiting programs to promote prenatal care among low-income, first- time mothers and the healthy development of their infants and toddlers; enrichment programs that focus on improving outcomes for children in high-poverty elementary schools; and teen pregnancy prevention programs.

More specifically, the paper proposes:

• Investing $18 billion in new spending on early childhood education for the first year and $94 billion over five years for early education investment in the form of high-quality half-day center-based programs for three- and four-year old children.
• Expanding the Nurse-Family Partnership, a two-year nurse home-visiting program to cover low-income pregnant women expecting their first birth and their children nationwide, requiring an investment of $1.3 billion the first year and $14.2 billion over five years.
• Investing $3.2 billion in the first year and $16.9 billion over five years to expand programs and fund demonstration reforms that seek to improve the quality of teachers in public schools. Such programs would focus on kindergarten through third grade and provide education enrichment and parental involvement services for elementary schools in high-poverty communities.
• Increasing spending by $1.5 billion in the first year, and $7.7 billion over five years for the Teen Outreach Program, a structured volunteer service and youth development program that has documented success of reducing teen pregnancies.

The report argues that these programs have proven to result in positive child outcomes and long-term social and economic benefits. They have led to government savings through reduced spending on the criminal justice and welfare systems and increased tax revenues from children who are able to find (better) paid work in their adult years. Despite financial constraints and an environment of fiscal austerity, Isaacs concludes that these new investments for children and youth should be a budget priority.

The full article can be found at http://www.brookings.edu/views/papers/200701isaacs.pdf

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4. Childbirth at a Crossroads in Southeastern Pennsylvania

Joan Gene Bishop

Maternity Care Coalition

2006

This report examines the state of maternal and child health in Southeastern Pennsylvania, highlighting trends of provider shortages, healthcare inequities, and obstacles for accessing healthcare across the diverse populations of the region. Research is drawn from interviews with hospital administrators, physicians, midwives, nurses, insurers, government officials, academics, and maternal/child health advocates, as well as community dialogues, roundtable discussions, organized focus groups, and publicly available data from city, county and state health departments.

Key findings include:

• While English is not the primary language spoken in 1 out of 5 homes in Philadelphia and in 1 out of 10 homes in suburban counties, translation services are not available at most hospitals or the city’s obstetric practices.
• Data show that 11.4% of women ages 18-39 in Southeastern Pennsylvania lack health insurance. Approximately 50% of all births in Philadelphia are to low-income women, but few obstetricians accept Medicaid. Limited health care options for low-income women can translate into delays in early prenatal and postpartum care.
• Thirteen out of 45 hospitals and birth centers have discontinued obstetric services since 1997 despite steady birth rates across the region. Most of these closures were made without advance planning on the part of other regional hospitals.
• Infant mortality rates for infants in the first year of life are twice as high for African Americans (16/1,000) as for whites (8/1,000) in Philadelphia County.
• Maternal mortality rates across Pennsylvania show a more drastic inequity. For African American women, the maternal mortality rate is 25.1/100,000 live births, and for white women it is 6.3/100,000 live births.

The author concludes that if actions to reverse these trends are not taken, the lack of appropriate health care and access to services and the disparities in maternal and child health will persist. The report offers policy recommendations for improving healthcare choices and outcomes for childrearing families and the community at large, including improving insurance coverage for unemployed and low-income women to include maternity care and reproductive services more adequately; conducting consistent data collection on maternal and child health policies throughout the region; and promoting work/family supports such as parental leave and flexible work schedules.

The full article is available at http://www.momobile.org/pdf/MCC_Childbirth at a Crossroads.pdf

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