Maternal Mortality: A National Embarrassment

Americans spend more money on childbirth than any other country, but we’re not getting a good return on our investment.

Less than a century ago, approximately one mother died for every 100 live births — an occurrence so common that nearly everyone belonged to a family, or knew of one, that was devastated by such a loss. Fortunately, in most nations, those tragedies have declined over the years. In fact, in the decade between 2003 and 2013, only eight countries saw their maternal mortality rates rise.

Unfortunately, the United States was one of those eight countries, joining a club that also includes Afghanistan and South Sudan. Within the 31 industrialized countries of the Organization for Economic Cooperation and Development, an American woman is more likely to die as a result of pregnancy than a citizen of any other country besides Mexico. Among developed countries, the United States has one of the highest maternal mortality rates — and those rates are only getting worse.

Graph: CDC

U.S. maternal mortality has attracted the attention of organizations whose oversight you wouldn’t expect. Amnesty International, which most Americans associate with the fight against human rights abuses in far-flung authoritarian regimes, considers our high maternal mortality rates to be a violation of human rights. Additionally — and pathetically — one of the biggest sources of funding for maternal health in the United States comes not from taxpayers but from the pharmaceutical company Merck. The Economist quoted a Merck spokesperson as saying, “We expected to be doing all our work in developing countries.” Continue reading

Book Club: Her Body, Our Laws

By 2014, law professor Michelle Oberman was no stranger to El Salvador. She had already spent four years making research trips to the Central American country, but that June she would need a local guide during her travels. An activist had volunteered to accompany her on the interview she needed to conduct, a task that required a two-and-a-half-hour trip outside the city to an area that is not well mapped — in fact, to a village where there are “no signs or numbers” to help visitors find their way among the cinder-block houses and the patchwork of land where the clucks and lowing of livestock punctuate the silence.


Paid maternity leave, monthly child allowances, and affordable day care and health care decrease demand for abortion.


Once in the village, it took Oberman and her guide an additional 45 minutes to find the house they needed to visit. Inside, a curtain was all that separated the main room from a small bedroom in the back. A bucket and outdoor basin served as a shower, and an outhouse completed the bathroom facilities. The living conditions there were not uncommon — not in a country where roughly 40 percent of the population lives in poverty.

That poverty was both the cause and consequence of a conflict between left-wing rebels and government forces that lasted from 1979 to 1992. In many ways, that conflict set the stage for the abortion war in El Salvador, the subject of Oberman’s recently published book, Her Body, Our Laws: On the Frontlines of the Abortion War from El Salvador to Oklahoma (Beacon Press, 2018).

From Civil War to Abortion War

In the early 1980s, the small republic of El Salvador was in the grip of civil war, while in the U.S., debates raged over the emerging Sanctuary Movement that was aiding Salvadoran and other Central American refugees. The movement began in 1981, when Quaker activist Jim Corbett and Presbyterian Pastor John Fife, both of Tucson, pledged to “protect, defend, and advocate for” the many people fleeing warfare and political turmoil in El Salvador and neighboring countries. Tucson was at the forefront of the movement as refugees crossed through Mexico and arrived at the Arizona border. Continue reading

Pro-Choice Friday News Rundown

  • Planned Parenthood Arizona is fighting for DACA! (Buzzfeed)
  • In case you hadn’t heard, Republicans are trying for the umpteenth time to repeal the ACA. Nevertheless, they stupidly persisted. (WaPo)
  • In line with pretty much all other Republican-sponsored legislation, the consequences for women would be grave. (Jezebel)
  • Black women are 3.5 times more likely to die from being pregnant than white women. THIS is why being pro-choice ultimately translates into being “pro-life.” (Tonic)
  • The Arizona Supreme Court has unanimously affirmed the equal rights of same-sex parents! (Slate)
  • In other Arizona news: Two of our worst politicians, Mark Brnovich and Michele Reagan, are, as the Phoenix New Times puts it, on “Emily’s Sh*t List” for being woefully sucktacular on the issue of women’s health-care rights. (Phoenix New Times)
  • Abortion access has gotten easier in Missouri thanks to Planned Parenthood and, uh … other sources. (Double X)
  • One of my personal heroes, Dr. Willie Parker, gave a great interview to The Atlantic to discuss his Christian faith, teen moms, and what’s next for abortion access. (The Atlantic)
  • More than 1 in 5 women in Mexico is married before she turns 18. Unsurprisingly, teen pregnancy is usually a precursor. (Teen Vogue)

Celebrating Mexico’s Contributions to the Birth Control Pill

September 15 to October 15 is National Hispanic Heritage Month. We’re celebrating by shining the spotlight on Mexico’s role in developing the birth control pill, one of the most important medical breakthroughs of the 20th century.


Humanity cannot fully unlock its potential until we release the bonds of oppression from all marginalized groups.


Underneath the surface of a large swath of Southern Mexico’s jungles lay the enormous roots of a wild yam, Dioscorea composita, known locally as barbasco. Mostly it was considered a nuisance, as it could get in the way of subsistence agriculture, but it did have its uses in traditional medicine — and it would change history forever when scientists figured out how to wrest valuable chemical compounds from it, a discovery that led directly to the development of the birth control pill.

Russell Marker. Image: Penn State University ArchivesIn the 1940s, hormones held an untapped potential for research, but there was no cost-effective method of producing large quantities of them — including progesterone, the Pill’s essential ingredient. An American chemist named Russell Marker set out to find a way to synthesize progesterone in abundance, hypothesizing that plants from the genus Dioscorea, which includes yams and agaves, would be a good source for starting material. After some research, he set his sights on wild-growing yams that were found only in Mexico.

Marker’s hunch brought him south of the U.S. border, where locals helped him find and gather these yams, enabling him to develop a method for synthesizing large batches of progesterone — more than had ever been in one place. When pharmaceutical companies would not invest in further research in Mexico, Marker relocated to Mexico City and put his money where his mouth was. In January 1944, he co-founded a lab named Syntex — a portmanteau of “synthesis” and “Mexico” — devoted to finagling hormones from wild Mexican yams. That yam was called barbasco by the indigenous population, and it was the industry’s choice for the raw material in hormone synthesis. Continue reading

After Charlottesville: The Role of Gender-Based Hatred in White Nationalism

Memorial at the site of Heather Heyer’s death. Photo courtesy of Tristan Williams Photography, Charlottesville.

Like many people, I spent the weekend of August 12 and 13 glued to the news coming out of Charlottesville, Virginia, where white nationalists had descended with torches and swastikas for a Unite the Right rally, prompted by the community’s moves to remove a statue of Confederate general Robert E. Lee. At home I watched photos and articles fill my Facebook feed. At the recreation center where I work out, I watched network news on the wall-mounted TV.


The synergy between race- and gender-based hatred has deep roots in the United States.


Hostility toward racial diversity was the driving force behind the rally — and it showed in the racial makeup of the crowds of people chanting Nazi slogans like “Sieg heil” and “blood and soil” — but I also noticed a serious lack of gender diversity as photos and videos circulated. Women were few and far between. However much I kept seeing it, though, I didn’t spend a lot of time thinking about it. I grew up half Asian in a very white community, so seeing the dynamics of race has always come easily to me — and they were taking obvious form in Charlottesville. Having grown up cis-male, though, I don’t always catch the dynamics of gender on the first pass.

Then Monday came, and I was reminded, once again, of how gender played out at the Unite the Right rally. I read news that a white nationalist website, the Daily Stormer, was losing its domain host due to comments it published about the violence in Charlottesville. Continue reading

One Simple Kit

A community health worker teaches how to make cloth pads. Photo: Nyaya Health

A community health worker teaches how to make cloth pads. Photo: Nyaya Health

Last week, I texted a friend of mine and told her: I have a hard choice before me. When she asked what that was, I smiled as I replied: I must choose between replenishing the MAC mascara that I just ran out of and buying the new Harry Potter book. We both laughed. But really, even as a single mom who falls beneath the poverty level, this was my choice of the day.

I have known hard times. I have lived in my car with my two dogs and I have had to volunteer my time cleaning my son’s school to ensure that he gets an education because I couldn’t afford the monthly tuition. I have taken hits by the ones I love, both physical and metaphorical, and I have had my innocence stolen from me by a boy I hardly knew.


One simple kit is combating poverty, hunger, and gender inequality.


Yet somewhere across a sea, a young girl sits in her room, blood gushing from her for reasons unbeknownst to her. Fear brings tears to her eyes as she struggles to understand why God has cursed her. That is what her mother has taught her. That if such a thing occurs, it is a curse from her creator for being a filthy creature. A girl her age tells her that she has contracted a disease, something she couldn’t remember the three letters to reference, but she knew was deadly.

In a rural region in southern Malawi, a girl who has had her first period may be expected to undergo a “sexual cleansing” ritual, in which she is made to have unprotected sex with a man called a hyena — a risky proposition in a country in which nearly 1 in 10 adults has HIV. Her choice to deny such an offer could result in her entire family being stricken ill or even dead — at least that is what she is told. Continue reading

The History of the Birth Control Pill, Part 6: Los Campesinos

Welcome to the final installment of our series chronicling the history of the birth control pill. In earlier installments, we learned how chemists were able to extract a chemical from a wild yam called barbasco and convert it into progesterone, the active ingredient in the Pill.

In 1960, the FDA approved oral contraceptives for marketing. At this time, more than 2 million Americans were already using the Pill — and more than 100,000 Mexican campesinos (a Spanish word for peasants) were harvesting barbasco, the wild yam necessary for its production. By 1974, 125,000 Mexicans were collecting and selling barbasco. Every week, during the barbasco trade’s peak, an excess of 10 tons of the plant were removed from tropical Mexico.


Until the barbasco supply started to dwindle in the 1970s, Mexico enjoyed prominence as the world’s supplier of progesterone.


Though they were paid subsistence-level wages for their labors (half a peso per kilo of dried root), and the work itself was dangerous and backbreaking, they were putting Mexico on the map in the scientific community. After establishing a hormone synthesis industry in Mexico, the European stranglehold on hormones was loosened and the price of progesterone plummeted from $80 per gram to less than a dollar per gram. By 1954, Syntex, a Mexican laboratory, was the largest producer of steroids in the world, having usurped Europe’s monopoly.

Scientists depended on the campesinos’ knowledge of soil conditions and growth cycles, as well as their ability to differentiate between different species of yams. The campesinos relied on their knowledge of weather patterns, differences in root coloration, and size variations to determine when they could dig up roots with the highest concentrations of sapogenin, the chemical that was converted into progesterone in the laboratory. Over the decades, the campesinos slowly gained an education in organic chemistry. Continue reading