In This Issue:

Ibis Celebrates Ten Years in 2012

New Resources for Medicaid Coverage of Abortion

Report Examines Reproductive Health along Thai/Burma Border

New Book Explores the Journey of Emergency Contraception

OTC Access to Oral Contraceptives in the News

New Publications

Staff Updates

Dear Friend,

Ibis is celebrating its 10^th anniversary this year and we are looking forward to a number of activities that bring together our friends and supporters and highlight our accomplishments over the last decade. In this newsletter, we are very pleased to feature some of the key Ibis projects that have helped to improve services and policies to better meet women’s reproductive health needs in the US and internationally.

This month we released a new state brief on Medicaid coverage of abortion in Oregon; this brief is one in a series of state-specific analyses designed for US abortion providers and advocates to expand Medicaid coverage of abortion at the state level. You can read more about our work on the Hyde Amendment and Medicaid coverage of abortion here.

We also share our recent publications, including a comprehensive report by Ibis and the Global Health Access Program on the reproductive health of women living on the Thailand-Burma border, and the newly released book by Ibis Affiliated Scholar Angel Foster on the history of emergency contraception introduction and access in a range of country-specific contexts across the globe.

Finally, don’t miss our selection of the recent media coverage of contraception that has highlighted the potential for moving oral contraceptives over the counter to increase contraceptive access. 

Thank you for your continued support and interest in our work, and we look forward to sharing more news about our anniversary events and materials over the coming months.

Warmly,

Kelly Blanchard, President

Ibis Celebrates Ten Years in 2012

Ibis was founded in 2002 by Dr. Charlotte Ellertson (1966-2004), who envisioned an innovative organization that produced groundbreaking research and contributed to policy analysis and advocacy. Ten years later, Ibis has grown from a start-up in a church basement to an established and flourishing organization conducting work around the world. As we look back on the last ten years, we are proud of the integrity, success, and contributions of our work, and we look forward to Ibis’s promising future. To kick off our anniversary celebration, we focus this newsletter on highlights from the last ten years. Stay tuned for our ten-year report and news about anniversary events happening later this year.

ABORTION
Simplifying access to medication abortion
Medication abortion has promise for increasing abortion access because it can be provided by a broad range of health care providers, or even by the woman herself. But restrictive laws requiring physicians to provide the method and other provision guidelines not grounded in evidence have prevented medication abortion from living up to its potential. Ibis conducted research in South Africa which found that a clinical exam was just as effective as a sonogram for determining women’s eligibility for medication abortion; this research has important implications for expanding medication abortion provision to facilities where there is no ultrasound equipment. We also piloted a high-sensitivity urine pregnancy test which could be used in place of a follow-up visit to confirm completion of an abortion. We synthesized the evidence on ways to simplify the medication abortion regimen and make it more user friendly for women in peer-reviewed publications and this brief.

Medication abortion provided via telemedicine is another innovative way to expand abortion access, particularly in rural settings. In collaboration with the Abortion Access Project, Ibis carried out an evaluation of a telemedicine medication abortion service at Planned Parenthood of the Heartland in Iowa, one of the many US states where by law a physician must dispense the medications to induce an abortion. We found that providing medication abortion using telemedicine is effective, safe, and acceptable to women. Read more about our findings here.

Increased access to medication abortion could also help to reduce maternal and pregnancy-related mortality. Ibis, in partnership with University of California, San Francisco (UCSF), conducted researched that showed increased use of misoprostol alone, an effective medication abortion regimen, could significantly reduce deaths from unsafe abortion, as compared to riskier methods. The model showed that if 60% of unsafe abortions were initiated with misoprostol, abortion-related mortality would decrease by approximately one-half. In Latin American countries like Colombia and Peru, where abortion is legally restricted, Ibis has worked with the Latin American Consortium against Unsafe Abortion (CLACAI) to develop and evaluate a pamphlet to educate women and advocates about how to induce abortion safely using misoprostol.

CONTRACEPTION
Moving oral contraceptives (OC) over the counter (OTC)
Ibis coordinates the OCs OTC Working Group, a coalition of reproductive health, rights, and justice organizations, nonprofit research and advocacy groups, university-based researchers, and prominent clinicians, who share a commitment to providing all women of reproductive age easier access to safe, effective, acceptable, and affordable contraceptives. The working group was established in 2004 to explore the potential of over-the-counter access to oral contraceptives to reduce disparities in reproductive health care access and outcomes, and to increase opportunities for women to access a safe, effective method of contraception. The working group has synthesized and led research on OTC access to OCs and is currently focused on a progestin-only pill as the first candidate for an OTC OC product. In June 2010, the New York Times published an op-ed by Ibis President Kelly Blanchard making the case for moving OCs OTC. The op-ed inspired additional coverage and discussion of OCs OTC in the popular press and blogosphere. For more information, please visit the OCs OTC Working Group website.

HIV
The Methods for Improving Reproductive Health in Africa (MIRA) trial
Completed in 2007, the MIRA trial was a randomized controlled trial that tested  whether the diaphragm used with lubricant gel could reduce HIV transmission. MIRA was led by researchers based at the time at UCSF, and Ibis co-coordinated the trial and led the data, clinical, and laboratory monitoring in South Africa and Zimbabwe. Although the results did not support the addition of the diaphragm to current HIV-prevention strategies, MIRA made significant contributions to the design of HIV-prevention trials, and also provided critical data on HIV/sexually transmitted infection (STI) outcomes as well as diaphragm and condom acceptability, covert use of HIV-prevention technologies, contraception use and effectiveness, and prevention trial recruitment and retention, among other topics. You can learn more about the MIRA trial here.

Ibis continues to lead the Cervical Barriers Advancement Society, which provides information about cervical barriers like the diaphragm for pregnancy prevention and highlights research on female condoms and the potential of cervical barriers to prevent STIs, including HIV.

These are just a few of Ibis’s many projects from the past ten years. You can read about more of Ibis’s work here, and you can contact us to request any articles referenced above. We are looking forward to the next ten years and continuing to produce policy-relevant, action-oriented research that makes a difference in women’s lives.

Photo: Ibis founder Charlotte Ellertson

Ibis Launches New Resources to Expand and Protect Medicaid Coverage of Abortion

Ibis has created a series of state-specific briefs about the availability of Medicaid coverage of abortion care in Florida, Pennsylvania, Illinois, and we are pleased to announce the release of our newest brief for Oregon. These analyses are designed to support providers and advocates and to expand Medicaid coverage of abortion at the state level. In an effort to increase US women’s access to abortion care, Ibis has also created the Take Action series, a set of guides that outline actions that stakeholders can take to help expand women’s access to Medicaid coverage of abortion and reduce abortion providers’ challenges working with Medicaid. In December 2011, Ibis introduced the advocates’ and providers’ Take Action guides.

The state-specific brief series and the Take Action guides are informed by Ibis’s larger body of work documenting the impact of the Hyde Amendment and other public funding bans on abortion in the US. Our research has found that many women eligible for Medicaid are unable to access coverage even in qualifying cases. For more information about Ibis’s work on Medicaid coverage of abortion, please visit our website.

OTC Access to Oral Contraceptives in the News

The current debate in the US over the new requirement that private insurance plans cover contraception with no cost sharing has landed contraception in the news front and center. Related media coverage has highlighted moving oral contraceptives (OCs) over the counter (OTC) as one way to expand access to contraceptives. Last month Ibis Senior Associate Dan Grossman, who leads the OCs OTC Working Group, presented at a US Food and Drug Administration (FDA) meeting exploring new models for making certain drugs, like OCs, available without a prescription. See highlights of the recent media coverage of OCs OTC and the FDA meeting below.

• Bedsider: Should the pill be accessible without a prescription?
• Bloomberg: Fight birth-control battle over the counter
• Bloomberg Businessweek: Doctors pressure FDA on prescription birth control
• Care 2 Make a Difference: FDA considers over-the-counter birth control pills
• Los Angeles Times: A contraception game-changer
• Slate: Of course birth control pills should be sold over the counter
• SFGate.com: Doctors pressure FDA for nonprescription birth control pills

New Book Explores the Journey of Emergency Contraception in 14 Countries

We are thrilled to announce that Emergency contraception: The story of a global reproductive health technology, edited by Ibis Affiliated Scholar Angel M. Foster of the University of Ottawa and L. L. Wynn of Macquarie University, is now available at Barnes and Noble and Amazon.  Emergency contraception examines the journey of emergency contraceptive pills (ECPs) in 14 different countries and contexts and explores the ways this global reproductive health technology is simultaneously inflected with local cultural meaning and influenced by broader international debates. Each chapter is a country-specific portrait that highlights the range of social, cultural, religious, and political factors that shaped the introduction and adoption of ECPs. To learn more about the book or to schedule an event with the editors and contributors, please contact Angel Foster.

Report Examines Reproductive Health inside Burma and along the Thailand/Burma Border

Ibis and the Global Health Access Program (GHAP) released a report in February 2012 that documents the public health emergency in eastern Burma and its effects on reproductive health and maternal mortality. Lack of health care infrastructure for populations inside Burma and along the border, including undocumented Burmese immigrants living as migrants in Thailand, coupled with widespread lack of knowledge and health care supplies in eastern Burma, have contributed to poor conditions and health care options. Women also lack access to emergency contraception as well as abortion care, which is illegal in Burma and restricted in Thailand. “Our hope is that the new Burmese government will someday make it possible for more organizations to provide aid and resources to the people in eastern Burma,” said Cari Sietstra, JD, a consultant at Ibis. “The time has come to rebuild the health and human rights of the millions of men, women, and children affected by this conflict.”

For more information, contact Cari Sietstra.