{"id":151629,"date":"2021-11-10T15:44:31","date_gmt":"2021-11-11T01:44:31","guid":{"rendered":"https:\/\/www.hawaii.edu\/news\/?p=151629"},"modified":"2021-11-10T15:44:31","modified_gmt":"2021-11-11T01:44:31","slug":"postpartum-sterilization-policy","status":"publish","type":"post","link":"https:\/\/www.hawaii.edu\/news\/2021\/11\/10\/postpartum-sterilization-policy\/","title":{"rendered":"Discriminatory postpartum sterilization regulations for low-income patients"},"content":{"rendered":"Reading time: <\/span> 2<\/span> minutes<\/span><\/span>
\"Melanie
Melanie Maykin<\/figcaption><\/figure>\n

A maternal-fetal medicine fellow at the University of Â鶹´«Ã½<\/span> at M\u0101noa John A. Burns School of Medicine<\/a> (JABSOM<\/abbr>) brings focus to discriminatory regulations on postpartum sterilization for Medicaid recipients, particularly women from low-income backgrounds. Melanie Maykin<\/strong>\u2019s article<\/a> was published in a November 10 issue of The Lancet Regional Health—Americas<\/em>. The manuscript also led to Â鶹´«Ã½<\/span> Senate Concurrent Resolution 191 (SCR191<\/abbr>), Urging the United States Department of Health and Human Services to amend its policies relating to postpartum sterilization waiting periods for Medicaid recipients<\/em>.<\/p>\n

“We\u2019re excited to bring awareness to this issue, especially as we reflect on systemic discrimination and inequities within our healthcare system. Still, there is much more work to do,” said Maykin, who is with JABSOM<\/abbr>\u2019s Department of Obstetrics, Gynecology and Women\u2019s Health. <\/p>\n

Postpartum sterilization, a permanent form of birth control, is a procedure performed prior to a woman\u2019s release from the hospital. Under the existing Medicaid insurance regulations, women must complete the mandated Medicaid Title XIX<\/abbr> form at least 30 days in advance of the procedure or risk being denied or personally billed for the procedure. This rule does not apply to those who have commercial insurance. However, publicly insured (Medicaid) women who would appreciate the convenience, the economy and the autonomy in planning the size of their family with this procedure, are faced with existing barriers.<\/p>\n

State legislation introduced<\/h2>\n

Maykin\u2019s manuscript received the attention of Â鶹´«Ã½<\/span> State Sen. Chris Lee, who was inspired to write SCR<\/abbr>191, which passed committees in the Â鶹´«Ã½<\/span> House and Senate during the 2021 Legislature. The measure seeks to abolish the time factor that has become obstructive to low-income women and their families. <\/p>\n

“This [federal] legislation, which was initially implemented to protect individuals from reproductive coercion, ultimately created barriers to equal access specifically for low-income people,” Maykin said. “It’s an important reminder that when creating legislation or attempting to repair the harm we’ve caused with existing policy, we must intentionally center the voices of affected communities.”<\/p>\n

According to Lee, SCR<\/abbr>191 puts the state of Â鶹´«Ã½<\/span> on record as objecting to the Medicaid requirement. The resolution was also sent to Â鶹´«Ã½<\/span>‘s Congressional delegation, and federal department agencies. <\/p>\n

“As far as I know, this is the first time a state has come out against this inequitable practice,” Lee said. “There are individuals and organizations pushing against this, but Â鶹´«Ã½<\/span> is the first state.”<\/p>\n

Supporting testimonies at the Â鶹´«Ã½<\/span> Legislature were presented by the Â鶹´«Ã½<\/span> Section of the American College of Obstetricians and Gynecologists, among whom were OB-GYN<\/abbr> practitioners, fellows and JABSOM<\/abbr> faculty. <\/p>\n

Maykin said that providing informed consent 30 days prior to birth, which is already a very unpredictable event, assumes that patients have the privilege of continuity in healthcare to see the same provider or group who knows them well.<\/p>\n

“Moreover, this system depends on reliable transmission of the consent form to labor and delivery units. That is just not the reality for many low-income patients,” Maykin said. <\/p>\n

Read more on the JABSOM<\/abbr> website<\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"

A UH<\/abbr> medical school fellow\u2019s manuscript also led to new legislation being introduced. <\/p>\n","protected":false},"author":16,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[26],"tags":[31,1286,158,9],"class_list":["post-151629","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-community","tag-john-a-burns-school-of-medicine","tag-obstetrics-and-gynecology","tag-publication","tag-uh-manoa","entry","has-media"],"aioseo_notices":[],"jetpack_featured_media_url":"","_links":{"self":[{"href":"https:\/\/www.hawaii.edu\/news\/wp-json\/wp\/v2\/posts\/151629","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.hawaii.edu\/news\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.hawaii.edu\/news\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.hawaii.edu\/news\/wp-json\/wp\/v2\/users\/16"}],"replies":[{"embeddable":true,"href":"https:\/\/www.hawaii.edu\/news\/wp-json\/wp\/v2\/comments?post=151629"}],"version-history":[{"count":9,"href":"https:\/\/www.hawaii.edu\/news\/wp-json\/wp\/v2\/posts\/151629\/revisions"}],"predecessor-version":[{"id":151655,"href":"https:\/\/www.hawaii.edu\/news\/wp-json\/wp\/v2\/posts\/151629\/revisions\/151655"}],"wp:attachment":[{"href":"https:\/\/www.hawaii.edu\/news\/wp-json\/wp\/v2\/media?parent=151629"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.hawaii.edu\/news\/wp-json\/wp\/v2\/categories?post=151629"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.hawaii.edu\/news\/wp-json\/wp\/v2\/tags?post=151629"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}