Completing our Political Action Plan

In addition to the stakeholders previously contacted (Planned Parenthood Advocates for Virginia, Todd Osbourne from WIC, Diane J. Mancino the Executive Director of the National Student Nurses Association, Virginia Nurses Association and the American Nurses Association Political Action Committee, Sander M. Levin chairman for the Committee on Ways and Means, and Senator Jim Webb of Virginia), we continued to contact other possible influential persons. In our political action plan we identified current sponsers, local legislators, and key stakeholders that could be influential in the passing of our bill. In every e-mail sent we included a link to our online petition and blog along with information to increase awareness. We continued to contact Robert Casey and Lincoln Davis (current sponsors) and the remaining three chairmen of the four committees that our bill is currently in (Henry Waxman, George Miller, and Collin Peterson). Furthermore we contacted local public groups in an attempt to increase regional awareness. These included Rockingham Memorial Hospital, the President of James Madison University’s Nursing Student Association Julie Penfield, Pastor David Nelson of Muhlenberg Lutheran Church, Jim Curran the Director of Catholic Campus Ministry, Lutheran Campus Ministry at Muhlenberg , JMU Chi Alpha Christian Fellowship, JMU Intervarsity President, and Bishop DiLorenzo of the United States Conference of Catholic Bishops.
The only response received thus far from those e-mailed was James Pickral who handles government relations for the Virginia Nurses Association. He informed us that they focus on Virginia legislation and do not advocate on the federal level believing that the American Nurse Association is responsible for such tasks.

We need these people on board!

Multiple key stakeholders, legislators, and organizations were contacted in support for the progression for HR 2035. A strong influence for further push of the bill through congress was the Planned Parenthood Advocates of Virginia (PPAV). This organization is a local office of the Planned Parenthood Federation of America (PPFA). Their mission is "to preserve and broaden reproductive freedom through legislation, public education, electoral activity, and litigation in the Commonwealth of Virginia." The Pregnant Women Support Act would certainly benefit from the PPAV's goal to advocate for pregnant women.

Todd Osborne, the Acting Director of the Division of WIC & Community Nutrition Services with the Virginia Department of Health is another key legislator for this bill. WIC (Women, Infants, and Children) provides federal grants to individual states. These grants go towards supplemental foods, health care referrals, and nutrition education to low-income pregnant, breastfeeding, and non-breastfeeding postpartum women and also to infants and children (up to five years of age) who are at nutritional risk. The Pregnant Women Support Act would benefit from the support of Mr. Osborne and the WIC program.

Another key legislator that was contacted was Diane J. Mancino, the Executive Director of the National Student Nurses Association. We felt that the National Student Nurses Association was a very important organization to reach out to because student nurses represent the future of the nursing profession and it was crucial to education individuals in this organization about what the Pregnant Women Support Act is and the importance of passing this bill. Gaining the support of the National Student Nurses Association is important because it will help to educate the public about the Pregnant Women Support Act.

The Virginia Nurses Association and the American Nurses Association Political Action Committee were simultaneously contacted. Their position was inquired on the bill, what/if they are currently doing to support the bill, and invited them to view our blog. We feel that nursing associations are important for us to contact because of their ability to serve as a resource and increase awareness through their members and other nurses to communities throughout Virginia and the United States.

Sander M. Levin, chairman for the Committee on Ways and Means was also contacted. Our bill is currently being heard by this committee and so we would like to educate the chairperson of this committee about the Pregnant Women Support Act. By increasing the knowledge that each committee member has about this act, we feel that it will increase the chances of the bill being passed. Our blog might serve as a quick source for the members of the committee to get a brief overview of the Pregnant Women Support Act.

Lastly, Senator Jim Webb was also contacted to support HR 2035. Senator Webb is a senator from Virginia. Senator Webb serves on the Joint Economic Committee headed by Congresswoman Carolyn Maloney (D-NY) and Senator Charles Schumer (D-NY). Currently the bill is being discussed within multiple committees, one being the Committee on Energy and Commerce. The Committee on Energy and Commerce on numerous occasions have similar agendas to the Joint Economic Committee, one in which Senator Webb poses as an influential role. Therefore, it would not be surprising to find HR 2035 referred to the Joint Economic Committee for further debate.

There has been no current update regarding the progression of HR 2035. The bill currently resides in the same committees as it was originally referred to for debate. Effects of the healthcare reform in regards to HR 2035 and pregnant women can be found in this quick 2 minute video embedded in this link (http://www.healthcare.gov/foryou/pregnant/index.html).

Our Political Action Plan

Our first goal is to increase awareness for this bill both locally and at the state and federal levels. We plan on contacting current sponsors of this bill as well as local legislators to provoke further support. We will invite them to view our blog and inquire about ways that we can become involved. In addition to these legislators, we will also contact the chairmen of the four committees that our bill is currently in. This includes: Henry A. Waxman (Committee on Energy and Commerce), Sander M. Levin (House of Ways and Means), George Miller (House of Education and Labor), and Collin C. Peterson (House on Agriculture). Furthermore, we will contact nursing organizations including VNA, ANA and VSNA to inquire about their position on the bill and steps that they may be taking to support it. We will then formulate an online petition to increase local awareness and gain the support of our community. This petition will contain information describing the bill and its importance. It will be sent to various local organizations and hospitals including Nursing Students Association (NSA), Rockingham Memorial Hospital (RMH), and local church groups. Our blog will be kept up to date and will serve as an informational resource for this bill.

Increasing awareness, and the potential passing of this bill, can lead to lower rates of negative birth outcomes on a federal and local level. Negative birth outcomes, such as Intrauterine growth retardation (IUGR) and preterm deliveries, have always been attributed to various medical conditions including smoking or high blood pressure. However, more recently, we have found a correlation between socioeconomic factors and these negative birth outcomes. A study titled “Socio-economic disparities in pregnancy outcome: why do the poor fare so poorly?” that was published in the Journal of Paediatric and Perinatal Epidemiology shows that health disparities among newborns is a multifactoral problem. To solely provide medical interventions is not adequate in improving birth outcomes. Women who are pregnant require not only medical support, but environmental and psychosocial support as well. This point can be exemplified by a quote from the article. “It may not be possible to eliminate the higher risks of IUGR and preterm birth among the poor without eliminating poverty itself” (Kramer et al, 2001). This bill not only addresses the physical healthcare aspects needed to maintain a healthy pregnancy and delivery, but also incorporates the psychosocial aspects needed to promote a healthy birth outcome.

Other studies have yielded similar results. A study conducted by Dejin-Jkarlsson in 2005, and another study conducted by Feldman in 2000, both found that lack of psychosocial resources might increase the risk of giving birth to a baby that is small for gestational age.

Works Cited:

Dejin-Karlsson, E., Hanson, B. S., Östergren, P.-O., Lindgren, A., Sjöberg, N.-O. and Marsal, K. (2000). Association of a lack of psychosocial resources and the risk of giving birth to small for gestational age infants: a stress hypothesis. BJOG: An International Journal of Obstetrics & Gynaecology, 107, 89–100.

Feldman, P., Dukel-Schetter, C., Sandman, C., Wadhwa, P. (2000). Maternal social support predicts birth weight and fetal growth in human pregnancy. Psychosomatic Medicine, 62, 715-725.

Kramer, M., Séguin, L., Lydon, J. and Goulet, L. (2000). Socio-economic disparities in pregnancy outcome: why do the poor fare so poorly? Paediatric and Perinatal Epidemiology, 14, 194–210.

Identified Key Stakeholders

The key stakeholders of this bill include:
-Pregnant women and all women of childbearing age
-Health professionals and health organizations such as Registered Nurses (RN) in the women’s health field and organizations including the Virginia Nursing Association (VNA) and American Nurses Association (ANA)
-Federal health promotion programs including Women, Infants and Children (WIC) and Planned Parenthood Federation of America (PPFA)
-Groups and programs including churches and pro-life committees such as United States Conference of Catholic Bishops

Our Position

We are in full support of this bill. We feel it is important for us, as James Madison University Nursing Students, to advocate for vulnerable populations. Women who are pregnant without support or adequate resources are in need of health professional’s assistance. One way that we can provide this is by developing a political action plan to encourage the support and passing of this bill.

What Does It All Mean?

The Pregnant Women Support Act was sponsored by and introduced to the Senate and the House of Representatives in early 2009 by Pennsylvania Senator Bob Casey and Tennessee Representative Lincoln Davis respectively. Although both of these men are democrats and Pro-Life, Rep. Davis stated that, "It's not about pro-life or pro-choice" it is about "what we can do to bring a reduction to abortions." Davis has emphasized, "Of the 1.29 million abortions performed annually, 73 percent of women seeking abortions list economic factors as contributing to the decision to have an abortion." Sen. Bob Casey has stressed that a decision on this issue should be shaped “by focusing on issues that united us, not the issues that divide us” (Hentoff, 2009). However, this bill is sponsored by Democrats for Life of America.

This bill is co-sponsored by Senators Ben Nelson [D-NE], Artur Davis [D-AL], Trent Franks [R-AZ], Robert Berry [D-AR], Victor Snyder [D-AR], George Radanovich [R-CA], Doug Lamborn [R-CO], Jerry Costello [D-IL], Daniel Lipinski [D-IL], Baron P. Hill [D-IN], Mark E. Souder [R-IN], Joe Donnelly [D-IN], Brad Ellsowrth [D-IN], Charlie Melancon [D-LA], Anh Cao [R-LA], Bill Cassidy [R-LA], Dale E. Kildee [D-MI], James L. Oberstar [D-MN], Collin C. Peterson [D-MN], Gene Taylor [D-MS], Travis Childers [D-MS], Jeff Fortenberry [R-NE], Christopher H. Smith [R-NJ], Mike MsIntyre [D-NC], Heath Shuler [D-NC], Larry Kissell [D-NC], Marcy Kaptur [D-OH], Timothy Ryan [D-OH], Steve Drihaus [D-OH], Tim Holden [D-PA], John P. Murtha [D-PA], Todd Russell Platts [R-PA], Christopher P. Carney [D-PA], Kathleen Dahlkemper [D-PA], James R. Langevin [D-RI], Marsha Blackburn [R-TN], Barton Gordon [D-TN], Zach Wamp [R-TN], John R. Carter [R-TX], Solomon P. Ortiz [D-TX], Pete Olson [R-TX], Rob Wittman [R-VA], Alan B. Mollohan [D-WV], Madeleine Z. Bordallo [D] GU. At this time, President Obama has given no indication that he will back the Pregnant Women Support Act.

The Pregnant Women Support Act was referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, Education and Labor, and Agriculture, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.

The United States Conference of Catholic Bishops (USCCB) have found approximately three out of four women who have an abortion had an annual income that could not support a child, which was one of their key reasons to abort. Overcoming poverty is an important step in supporting pregnant women. According to the U.S. Census Bureau the mean annual income for a female householder with no husband present is $33,369. Sixty-five percent of female householders with no husband present makes less than or equal to $34,000 annually. For a single individual this may be an adequate amount of money to live a comfortable lifestyle, but is not enough to raise and support a child. The USCCB stated, “According to the U.S. Census, a woman with a college degree has a median annual income ($31,309) double that of a woman with only a high school diploma. Access to information and resources while attending school or working, including nutrition assistance and child care, are needed to help women overcome poverty.”

A recent study was done to find out the reasoning as to why women have abortions. “The reasons most frequently cited were that having a child would interfere with a woman's education, work or ability to care for dependents (74%); that she could not afford a baby now (73%); and that she did not want to be a single mother or was having relationship problems (48%). Nearly four in 10 women said they had completed their childbearing, and almost one-third were not ready to have a child. Fewer than 1% said their parents' or partners' desire for them to have an abortion was the most important reason. Younger women often reported that they were unprepared for the transition to motherhood, while older women regularly cited their responsibility to dependents,” (Lawrence, Frohwinth, Dauphinee, Singh, & Moore, 2005).

Similar to everyone else in America, pregnant or not, no access to health care and health insurance are other barriers that prevent many people from seeking medical attention. Numerous health insurance companies consider pregnancy a pre-existing condition, thus denying coverage for prenatal care for new enrollees. No medical care or expensive medical bills can place an individual just above the poverty line into poverty (Doerflinger & Saile, 2008). No medical insurance leads to a higher risk for medical problems resulting in expensive medical bills when needed.

Government objectives for the Pregnant Woman Support Act are as follows (Doerflinger & Saile, 2008):

Establishing a toll-free number to direct women to places that will provide support during and following their pregnancy;

Funding collection of accurate data on abortion;

Providing child care to low income and student parents;

Providing parenting education in maternity group homes;

Making the Adoption Tax Credits permanent;

Ensuring that pregnant women are not denied health care by insurance companies and that coverage is continued for newborns;

Codifying the regulation that extends coverage under the State Children’s Health Insurance Program (SCHIP) to low-income pregnant women and unborn children;

Improving services for pregnant women who are victims of domestic violence;

Providing services to parents receiving a positive test diagnosis for Down syndrome or other prenatally diagnosed conditions;

Increasing funding for the Women, Infants and Children (WIC) Nutrition Program;

Providing grants to institutions of high education to fund pregnant and parenting student services;

Providing new mothers with free home visits by registered nurses.

As stated in the previous section, the governmental objectives of the Pregnant Woman Support Act outline how this bill could potentially impact nurses, clients, and the health care system as a whole. First, nurses have a huge role in regard to the care of pregnant women in many different settings. As a result of this bill, nurses could have increased funding and improved resources to provide this necessary care. Registered nurses will be the professionals directly servicing the population of pregnant women and new mothers with parenting education, free home visits, and guidance for pregnant victims of domestic violence, as described by the bill. Nurses could be responsible for obtaining accurate data on abortion and possibly managing the toll-free number stated in the objectives.

As far as clients are concerned, the Pregnant Women Support Act would again significantly increase funding so that the current services can be improved and new services can be added for this specific population. A very important concern included in the bill regards health care being denied by insurance companies. The bill will ensure that pregnant women cannot be denied coverage based on a “pre-existing condition” and therefore their newborns will also receive coverage. With the current debate surrounding the American healthcare system, this is a vital point that is necessary to address. Another significant change from the bill will be increased funding for the WIC Nutrition Program, which will certainly directly benefit the health of pregnant women who cannot afford to feed themselves and their children properly.

In terms of the health care system collectively, this bill will, again, notably increase funding in many different areas of the care of pregnant women and their children. This increased funding will result in more resources and hopefully considerably better care for these clients. As mentioned previously, health care can no longer be denied to pregnant women and their subsequent newborns under the bill. Also, health care coverage will now be provided to low-income pregnant women and those unborn children. The Pregnant Women Support Act addresses a vulnerable population that can be helped tremendously by the objectives the bill proposes.

Works Cited:

Doerflinger, R., & Saile, K. (2008, February). The United States Conference of Catholic Bishops. Retrieved October 17, 2010, from Department of Justice, Peace, and Human Development: http://www.usccb.org/sdwp/projects/200802pregnantwomenbck.pdf

Hentoff, N. (June 5, 2009). Mr. President, Here is Common Ground on Abortion. Zanesville Times Recorder.

Lawrence, F. B., Frohwinth, L. F., Dauphinee, L. A., Singh, S., & Moore, A. M. (2005). Reasons U.S. Women Have Abortions: Quantitative and Qualitative Perspectives. Perspective on Sexual and Reproductive Health , 110-118.