The goal of breast cancer screening is to prevent women from dying from breast cancer, and for thirty years we have been told by industry that regular mammograms will save our lives. Current science shows that screening mammograms do not reduce the number of women who die from breast cancer and comes with significant harms including false positives, overdiagnosis and overtreatment. Many mainstream public health and breast cancer organizations have neglected to update their positions and educational materials with these evidence-based changes. How can we hold these national organizations accountable for pushing a scientifically invalid message? The author will describe the importance of creating and disseminating an unbiased patient-centered perspective on the evidence about mammography.  Conveying information in an accessible and visually engaging way, the brochure, Should I Have A Mammogram: Understanding the Harms and Benefits of Routine Breast Cancer Screening, is designed to provide important evidence based information for women at “average risk”. As women evaluate their health decisions, they must have access to unbiased information, free from conflict of interest and without the heavy thumb of vested interests tipping the balance. In this session, the author will explore the need 1) to shift away from early detection and focus on preventing breast cancer from developing in the first place, 2) to continue to provide balanced information so women can make informed choices and last, 3) for clear evidence-based guidelines for all communities- including underrepresenting communities.

The Affordable Care Act (ACA) made great strides forward reducing financial barriers to women’s access to important health care services through the Women’s Health Amendment (WHA).  As a result of the WHA, beginning in 2012, all new plans must cover contraception, STI screening, breast pumps and other preventive services with no additional fees.  However, the Women’s Health Amendment also mandated that all new plans cover mammography screening beginning at age 40, despite the fact that the 2009 update of US Preventive Services Task Force recommendations advised against beginning population-wide routine screening before age 50.  By explicitly prohibiting plans from basing their coverage on the most recent edition of the guidelines, Congress disregarded the weight of current evidence and singled out mammography screening to be treated differently than all other women’s health services.  Why did politics play such an out-sized role ACA coverage of mammography screening?  The author will trace the history of Congressional involvement in mammography screening, including the establishment of mammography as the first screening test covered by Medicare, the creation of the federally funded Breast and Cervical Cancer Detection Act, and its use of Congressional oversight authority.  The role of the breast cancer movement will also be explored by examining the differing perspectives of various advocacy organizations.

Considerable progress has been made to improve the sexual and reproductive health of U.S. women. However African American women are disproportionately affected by multiple sexual and reproductive health conditions. African American women represented 64% of the estimated new HIV infections in 2010. Almost 36% of pregnancy-related deaths between 2006-2010 were among non-Hispanic black women. These negative sexual and reproductive health outcomes may be due to the historical context and current racism-related social and health care experiences among African American women in the U.S. Thus, a historical analysis through which racism shapes sexual and reproductive health might improve understanding of their current health outcomes. We reviewed a combination of significant historical events (i.e., peer-reviewed sources and books) from slavery through the post-civil rights eras that potentially play a role in current health outcomes. We also explored the link between the historical experiences, current sexual and reproductive health outcomes and the continuum of racism-related social determinants (i.e., poverty, limited education, and residential segregation) which began in slavery and currently influence the health status of African American women. Lastly, we discussed the need to develop new models for health promotion and strategies to address racism, which may improve African American women’s health across the life course and promote health equity. Comprehensive programs might facilitate long-term, sustainable improvements in health for the larger population of African American women.

Background: Half of all pregnancies in the United States are unintended. The American College of Obstetricians and Gynecologists recommends long-acting reversible contraception (LARC), including the intrauterine device (IUD) and the subdermal implant, as first-line pregnancy prevention for all women and adolescents. Continued reproductive coercion in the United States, especially among underserved populations, problematizes the promotion of LARC methods without considering underlying social and economic issues. Previous research demonstrates ethnicity and socioeconomic status impact health care providers’ recommendations of LARC methods; however, limited research examines the legacy of coercion on LARC method choice.

Methods: This qualitative study examined the impact of reproductive coercion on women’s standpoint and perspectives of LARC methods. Researchers conducted 6 focus groups (n=61) and 18 interviews with women, ages 18-44 years, as part of a larger study about contraceptive choice. Data analyses were completed using HyperRESEARCH 3.5.2. Feminist standpoint theory provided the conceptual lens for data analysis.

Results: The history of reproductive coercion, especially forced sterilization of women of color, emerged in participants’ perspectives of LARC methods. Findings suggest the importance of identity in women’s making meaning of LARC methods. Identifying with women who use LARC methods influenced participants’ understanding of contraceptive choice. Participants indicated that lack of information provided by health care providers served as a barrier to adequate knowledge about LARC methods.

Discussion: Findings from this study offer theoretical and practical opportunities to guide health care practitioners and health communication campaigns aimed at decreasing the burden of unintended pregnancy while maintaining reproductive justice.