Washington, DC -- The American College of Obstetricians and Gynecologists (The College) today voices its endorsement of marriage equality for same-sex couples. In applauding the recent Supreme Court ruling providing equal treatment for legally married same-sex couples, The College says that legalizing gay marriage benefits women’s health.
“As ob-gyns, we must be strong advocates for all of our patients’ health and well-being,” said Jeanne A. Conry, MD, PhD, president of The College. “We know that access to health care and the health of women and their families is tied to financial security. Marriage helps provide this financial security for many women, regardless of sexual orientation.” Some of these financial protections include access to Social Security benefits and rights to shared property.
In addition to providing financial security, marriage equality has other important health benefits. Studies show that same-sex couples in states that legally recognize their marriages have lower levels of stress and fewer mental health and substance abuse disorders compared with same-sex couples who lack legal marriage recognition.
Same-sex couples are far less likely to receive employer-sponsored dependent health care coverage compared with married heterosexual couples and, thus, are more than twice as likely to be uninsured. “This has real consequences for our lesbian patients,” Dr. Conry said. “When women don’t have health insurance, they may not get screened for cervical and breast cancer or receive other important well-woman care.”
An important result of the Supreme Court decision (The United States v. Windsor) is wider access to the federal Family Medical Leave Act (FMLA). Under FMLA, individuals in same-sex marriages living in states that legally recognize their marriages can now take up to 12 weeks of unpaid leave each year to care for immediate family members (spouse, child, or parent).
According to the Human Rights Campaign, there are 1,138 legal protections and rights afforded to couples when they marry in the United States. For instance, surviving spouses in heterosexual marriages can sign to release their deceased spouse’s body from the hospital for funeral arrangements. This same right does not apply for the surviving partner in a lesbian relationship living in a state that prohibits same-sex marriage.
“As a society, we have made enormous progress, but we won’t have full marriage equality until same-sex marriage is legal in every state,” said Dr. Conry.
Committee Opinion #574 “Marriage Equality for Same-Sex Couples” is published in the September issue of Obstetrics & Gynecology.
For additional resources on lesbian health visit http://bit.ly/12UzzQZ
Also see Committee Opinion #525 “Health Care for Lesbians and Bisexual Women”
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Other recommendations issued in this month’s Obstetrics & Gynecology:
Committee Opinion #571 “Solutions for Surgical Preparation of the Vagina” (NEW!)
ABSTRACT: Currently, only povidone-iodine preparations are approved for vaginal surgical-site antisepsis. However, there are compelling reasons to consider chlorhexidine gluconate solutions for off-label use in surgical preparation of the vagina, especially in women with allergies to iodine. Although chlorhexidine gluconate solutions with high concentrations of alcohol are contra-indicated for surgical preparation of the vagina, solutions with low concentrations of alcohol (eg, 4%) are both safe and effective for off-label use as vaginal surgical preparations and may be used as an alternative to iodine-based preparations in cases of allergy or when preferred by the surgeon.
Committee Opinion #572 “Reproductive Health Care for Adolescents with Human Immunodeficiency Virus” (NEW!)
ABSTRACT: Adolescents make up an increasing percentage of the US population with human immunodeficiency virus (HIV). Adolescent-focused care is critical to identify and reduce at-risk behavior, comorbidities, and partner transmission. Optimal medical and reproductive health care, both now and in the future, with an adolescent-focused approach, are important for HIV-infected adolescents. Adolescents who are infected with HIV should receive care that allows them to realize their sexual and reproductive goals while maximizing their personal health and minimizing the risk of unintended pregnancy, acquisition of new sexually transmitted infections, and transmission of infection to partners or offspring. Key strategies for preventing the spread of infection include early diagnosis, guideline-based treatment, and partner notification of HIV status.
Committee Opinion #573 “Magnesium Sulfate Use in Obstetrics” (NEW!)
ABSTRACT: The US Food and Drug Administration (FDA) advises against the use of magnesium sulfate injections for more than 5–7 days to stop preterm labor in pregnant women. Based on this, the drug classification was changed from Category A to Category D, and the labeling was changed to include this new warning information. However, the FDA change in classification addresses an unindicated and nonstandard use of magnesium sulfate in obstetric care. The American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine continue to support the short-term (usually less than 48 hours) use of magnesium sulfate in obstetric care for appropriate conditions and for appropriate durations of treatment, which includes the prevention and treatment of seizures in women with preeclampsia or eclampsia, fetal neuroprotection before anticipated early preterm (less than 32 weeks of gestation) delivery, and short-term prolongation of pregnancy (up to 48 hours) to allow for the administration of antenatal corticosteroids in pregnant women between 24 weeks of gestation and 34 weeks of gestation who are at risk of preterm delivery within seven days.
Practice Bulletin #138 “Inherited Thrombophilias in Pregnancy” (Revised)
ABSTRACT: Inherited thrombophilias are associated with an increased risk of venous thromboembolism and also have been linked to adverse outcomes in pregnancy. However, there is limited evidence to guide screening for and management of these conditions in pregnancy. The purpose of this document is to review common thrombophilias and their association with maternal venous thromboembolism risk and adverse pregnancy outcomes, indications for screening to detect these conditions, and management options in pregnancy.