5/8/09 7:03 PM March 11, 2009: Childbirth (Decision making vs. Medicalization) Medicalization of Child Birth Should pregnancy and childbirth be treated as ?a normal healthy physiological event? or ?a medical problem needing medical intervention?? Many women have the choice to decide their birth-plan. (Midwifes, doctors, homebirth) Egg lives for 12-24 hours. Sperm lives 3-5 days (7-10) A women can become pregnant from intercourse up to 5 days before ovulation Contraceptives prevent contraception Hormonal control combination of estrogen and progesterone Female Sterilization (close fallopian tube) IUD interfere with the implantation of fertilized egg Male Infertility semen analysis and sperm protein test: can use intrauterine insemination or a donor. Men also can be corrected with surgical or non-surgical procedures. Post coital test Female Infertility ovulation problems can be tested by basal body temperature and can be treated by fertility drugs or egg donors. Other treatments include hormonal treatments and in-vitro fertilization. March 23: Violence 1-800-799-safe ( natural domestic violence hotline) Most violence against men 70% is violence from a stranger. Violence against women is 77% from someone that they know We still apply ?Gender Analysis? to an issue that affects both men and women Violence of men homicide 76% men. 24% women (men get hurt more by male murder) Both black women and men get killed more often (4x more) Power and control wheel (abuse by one person to another) can help understand institutional power and control (abuse by one group to another) Effects of Advertising Make violence and bondage of women seem okay Make it seem that women don?t mean it when they say no (women are asking for it) Masculinity is linked to violence 1 in 4 women will be hurt by violence in their relationship Institutionalized oppression Black women may not want to report abuser because of the racism within the legal system and do not want to conform to the stereotypes surrounding their race Article: Power and Control Wheel (Violence) Intimidation- making her afraid Coercion and threats- make and or carry out threats Emotional Abuse Economic Abuse Male Privilege Isolation Denying Blame Ongoing pattern where one person controls many or all aspects of another person?s life Power and Control Wheel (Equality) Negotiation and fairness Respect Partnership (economic/ emotional) Responsibility, honest, trustworthy Article: Adolescent battered Women Isolation, lowered self-esteem and unhealthy coping mechanisms. Violence in teens with be related to other issues later in life Men have dominant behavior over women. Media plays a big role in accepting this type of behavior March 30: Racism and Anti-Oppression Issues Article: Unlearning Racism Institutional racism vs. attitudinal racism Attitudinal racism needs to be changed before institutional racism is fixed. Chapter 1: Undivided Rights 1983- first ever women of color reproductive justice organization. Wanted to attain and defend legal right to an abortion Leading the fight against population control and forced sterilization. Organizations to control internalized and externalized oppression and to promote a new understanding Chapter 2: Undivided Rights 3 important movements: pro-choice, reproductive rights and women?s health, women of color organized together Want to promote self help because it gives women a safe environment to learn how to come together and share their experiences with oppression Many people see reproductive rights as white dominated and reproductive freedom as a struggle for women of color. Hyde amendment federal money could not be used towards abortion (meaning that low-income women could not afford an abortion Cultural Humility: Incorporates a lifelong commitment to self-evaluation and self-critique and to developing mutually beneficial partnership with communities. It is being flexible and humble to accept people April 6: The Pill ?The Pill? Movie Thought that the pill would lead to increased sexual behavior When women got married their gender roles were narrowly defined Margaret Sanger Comstock laws prevented information on contraception methods from being legal and available Sanger broke these laws and challenged courts 1953 Sanger, Katherine McCormick and Gregory Pincus world towards hormonal birth control. Tested 50 women and not one of them ovulated (progesterone suppresses ovulation) 1956 pill was released in Puerto Rico but caused too many side effects 1957 Enovoil pill was introduced as a drug from ?menstrual disorders?. Contraceptive Mentality- Women have control, the assumption that women can plan their own pregnancies Many people saw the pill as the end to western civilization and the end to the traditional lifestyle. (double standard: women should not be promiscuous) With the pill women thought that they were able to have it all. (able to have a job, children, family, husband and able to be sexual without the risks of becoming pregnant) Women went to work! Negatives African American women saw the pill as a way to control fertility and population. Black women got the pills for free. It can be seen as racial genocide, sterilization abuse for blacks in the south. April 8: Infertility Article: Contraceptive Methods for men Permanent contraception by injection: chemicals used to close off vas deferens rather than cutting it Potentially reversible contraception by surgically implantation: implanted vas deferens plug similar to a vast economy but can be reversed Temporary Inject Contraception: interior of the vas deferens is coated with sperm killing solution for up to 5 years Wet Heat method: warm math on the testes every night for 3 weeks Article: 8 new contraceptive methods for men No scalpel Vasectomy Permanent contraceptive injection Male- semen analysis and sperm protein tests are given. Treatment included lower scrotal temperature, alternative insemination Female- test the basal body temp for problems with ovulation. Treatment includes fertility drugs and egg donors April 13: Contraception Ronna Popkin Lecture Conception egg meets sperm in the fallopian tube within 24 hours Pregnancy fertilized egg implanted in the endometrial (HCG) 300 million sperm in an ejaculation, but only 1 is needed to fertilize an egg Sperm can live up to 7 days in the uterus Contraception (Hormonal) Combination pill (Estrogen and Progesterone) prevents ovulation by overriding the system, reduced the risk of both endometrial cancer and cervix cancer Prevent Ovulation *Keeps FSH and LH low ? b/c estrogen and progesterone are high. Suppresses the production of the releasing hormone. Follicle growth, maturation and ovulation do not occur. Fake period happens when taking the placebo pills, withdrawal of estrogen and progesterone leads to bleeding Important to take at the same time everyday May lead to high blood pressure, should not be taken if have any blood disease or are prone to blood clots. Oral estrogen can lead to breast cancer No STI protection Progestin makes sticky cervical fluid that inhibits sperm travel *Smokers do not use the combination pill because it can constrict blood vessels and estrogen can cause blood clots Slow egg transport in fallopian tube Oral Contraception Reduces women?s risk of ovarian and endometrial cancer Orthro Evra (patch) Both estrogen and progesterone work together by preventing ovulation No smoking or breastfeeding 60 times higher dose of estrogen Higher dose of estrogen released so leads to higher risk of blood clots 99% effective, no STI protection Nuva Ring Inserted into the Vagina Ring used for 3 weeks, 1 week off=uterine lining is forced to shed Progestin only: 1)Depo Provera Injection, progesterone only 99% effective but no STI protection Can be used during breastfeeding 2) Progestin only pills Effects of only progestin, not as affective 3) Mirena (Hormonal IUD) Causes an inflammation in the endometrial lining of the uterus, causes attack of antibodies and white blood cells that attack the sperm (sensing danger). Progestin works to create sticky cervical fluid preventing implantation 4) Emergency Contraception (plan B) morning after pill, Plan B high dose of progesterone, take 2 pills together and is effective after 5 days sticky cervical fluid, decreased mobility in the fallopian tube Delays ovulation so sperm dies before Menstrual Suppression Seasonale, seasonique, lybrel Annually 23% increase of hormones Seaonale exposes women to 9 extra weeks of hormones a year Lybrel= never have a period Have not been tested for a long period of time so do not know how safe it is RU- 486 Used to terminate pregnancy only after implantation of a fertilized egg (oral drug) ?Medical Abortion? Blocks the action of progesterone and this provokes a miscarriage. The endometrium begins to erode and the implanted embryo is expelled. Combination of 2 drugs: Mife Pristone- Progesterone Blocker, breaks down endometrial (initiate miscarriage) Miso Prostol- prostaglandin causes uterine contractions Can be used up to 7th week in pregnancy Effects can occur within 24 hours Less invasive than surgery however it is a longer painful process that is more expensive Advertising the pill plays up the benefits and down plays the risks (Yaz decreases bloating and acne) Contraceptive Mentality Women can be in charge of reproductive timing. Women have control over fertility, age of reproduction, how many children they want to have and when they want to have children Article: A Dangerous Combination Many factors come together to influence women?s health or ill health; brining together the history of both direct-to-consumer advertisement for hormonal contraceptives. Negative side effects of teaching abstinence only education. The power of advertising and the lack of sexual education contribute to the social climate that pushes hormonal contraception. (Taking advantage of the consumer) April 15: Infectious Diseases(Lecture Mariamne Whatley) Bacteria single celled organism, able to divide and multiply Toxins produced by bacteria able to multiply with cell visions Viruses (not living) have protein codes with genetic material inside. They attain a host cell and inject their DNA coding into the host, takes over the host cell to produce more viruses and protein codes (antibiotics cannot kill viruses) Antibiotics can cure bacteria. Treat diseases that can be fatal. Can cause harm or interrupt with contraceptive devices. Not able to distinguish good bacteria from bad bacteria so kill off healthy bacteria too. Bacteria Resistance bacteria can mutate to resist antibiotics that were killing them before Immunity Active- antigens introduced, long lasting permanent exposure to disease (vaccine) Passive- antibodies introduced (temporary) ex: getting a shot, breastfeeding HIVHuman Immune deficiency Virus, destroys cells of the body T-lymphocyte T helper cell, introduce HIV virus and destroy cells. Too many destroy cells and are not able to get to the B cells to form antibodies Opportunistic Infectioninfections that take advantage of a weakened immune system (HPV, yeast infections) Seroconversion takes time for blood to change from negative to positive can occur within 3 months. Blood tested for viruses Micro-bodies drugs created to kill bacteria and viruses that can be transmitted sexually (gel/foam) that can be controlled by the partner whose getting it (vaginal or anal) HPV (Human Papilloma Virus) can lead to cervical cancer. Women 14-59, 26.8% have HPV. Gardasil shot is given before a woman is sexually active, given 3 doses over 6 months. (Expensive) April 20 Lecture: Sexuality and Health (Sue Pastor Lecture) People believe that men and women are naturally different Biological Essentialism- belief that men and women are different leads to sexual stereotypes (double standard), criticism of behavior However, physical evidence does not support this? Male and female parts come from the same embryonic tissue Clitoris-penis Outer labia-scrotum Physiological process of arousal is the same in men and women ?Orgasm Gap? 75% of men orgasm during sex 29% of women orgasm during sex with a man Sex education only taught sex in context with reproduction Sexual pleasure for women was not taught The clitoris was described in textbooks but was also hidden. Diagrams showed the clitoris to be tiny and small Women know less about their body because they are not taught about the external female genitalia LGBTQ reluctant to seek health case because they were discriminated against. Were not able to care for their partner because they were not considered family. Need for attitudinal change that will influence institutional change. Homophobia (power and control) Few legal rights, few reproductive rights No access to ?couples rights?, no access to health system through partners insurance Constantly afraid of homophobic attitudes and actions Article: Trans Health Crisis: For Us Its Life and Death Inequalities are a matter of life and death for people who do not have access to the health system Health practitioners are not educated and committed to serving all patients and some refuse to treat transgendered people. April 29 Lecture: Body Image Mythical norm White, young, thin, tall, rich, heterosexual Procedures and products are advertised for women and men to change the way they look to fit the norm Nutritional Diet Calories: women 2/3x, men x Calcium: women 1200 mg, men 1200 mg Women need to ingest more iron daily (because of their contraceptive choices) Amenorrhea- not having a period due to little body fat or because of fast weight gain/loss of 10-20 pounds Pluralistic Society everyone included, all women, all genders, sexualities and diversities Fat Phobia Women put on fat more easily than men do Women are pressures to meet societies; ever changing, ever narrow definition of an ideal body and what it means to be beautiful. Minorities and blacks are more likely to accept their body Average US 25 year old: Men: 14% fat Women: 23% fat People need an excess or deficiency (over time) of 3500 calories to gain or lose one pound body fat 95% of women have anorexia, 85% suffer from bulimia ?Moving the body through one mile of exercise uses up to 100 calories? Women who uses up to 2000 calories a day is on a 1000-calorie diet. It takes her 3 ½ days to lose 1 pound. Fat is the most victim-blaming of all forms of oppression Age of menarche is related to nutrition. It has decreased Fertility is linked to weight (any weight change can affect the cycle) Choice on contraception can increase of decrease nutritional requirements. (All hormonal methods have a dosage appropriate to body weight) Studies have shown that African American women are more accepting of being overweight ?Baby in the River? If the whole class went to the beginning of the river and stopped the person from throwing the babies into the water then people would not have to pull the babies out of the water in the end. **Stopping the problem at the source By the time we find something- it takes the highest technology and lots of money to fix it Downstream?realizing there is a problem after it becomes a problem Upstream?stopping the problem at the source, before it develops May 4th Lecture: Medicalization of Menopause Menopause= no menstruation for one year (Average age= 45-53/ 35-60) Hormonal Changes: Lower estrogen and different types of estrogen Estradiol= strong estrogen (reproductive years) Estrone= weaker estrogen (post menopause) Lower progesterone High levels of FSH and LH Follicles stop responding to FSH Medicalization of menopause means that many women are now routinely offered hormones for pre-menopause, menopause, post-menopause and for the rest of their lives ERT= estrogen ?replacement? therapy (estrogen only) associated with endometrial cancer. Replaces hormones that the ovaries do not produce anymore HRT= hormone replacement therapy (estrogen and progestin) considered safer July 2002: HRT was studied and was shown to cause heart disease instead of preventing heart disease Women taking HRT had 26% increase in breast cancer, 41% increase in stroke, 200% of blood clots **ERT and HRT tests showed that increased risk of strokes outweighed any benefits they had. HRT may be delivered to the body via patches, tablets, creams, troches, IUDs, vaginal rings, gels or, more rarely, by injection ?There was a huge drop (7%) in breast cancer rates in 2003 when many women stopped taking HRT because of a study that showed that breast cancer rates appeared close to the use of hormones? HRT has many negative side effects and it was learned that it did not prevent heart disease but led to other health risks. Goal= the development of new ?designer estrogen? products SERMS (Selective Estrogen Receptor Modulators): Act like estrogen in bones and blood vessels (prevent osteoporosis and heart disease) Act like an anti-estrogen in breasts and endometirum (do not cause breast or endometrial cancer) Block the effects of estrogen in the breasts Tamoxifen: was used as a drug to prevent breast cancer in women who were at high risk of developing breast cancer. (Serious side effects include stroke and blood clots) Raloxifene: Approved to prevent osteoporosis **Problems= too little research and medical trials have been done to test the effects of estrogen Phyto-estrogens- plant estrogens that act like SERMS Xenoestrogens= agents which are not produced in the body but are ?outside chemicals? which interact with the body and have the effect of functioning directly or indirectly as estrogen and thereby increasing one?s exposure to estrogens Ex: DDT, chemicals in makeup and other beauty products, chlorinated products Environmentbring attention to the environment that increase the prevalence of toxic chemicals in out lives- bring attention to the lack of access, support, education, and job opportunities Women?s Studies Final 5/8/09 7:03 PM 5/8/09 7:03 PM
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