July 2019 – UAB Institute for Human Rights Blog

Postpartum Depression Needs Serious Attention

by Marie Miguel

Maternity leave is necessary because it helps with postpartum depression

In the United States, maternity leave is almost non-existent. New parents in the U.S. get an average of three months of maternity leave, and some only get the twelve unpaid weeks of leave that employers are now required to offer under the Family Medical Leave Act. https://www.dol.gov/general/topic/benefits-leave/fmla Depending on where you work and how long you’ve worked for a company, you may not receive any paid maternity leave at all, which can cause a high level of stress for low-income parents and families. According to a study at the University of Maryland, longer maternity leave decreases the risk of postpartum depression. It’s suggested that this is because women can spend more time with their infants, and this is not surprising; if you don’t have the bonding time with your child that you need, it’s going to be depressing for you. You feel like you have to leave your child preemptively, and that’s not fair. Healthcare providers and policymakers need to think about how we can foster a more positive experience with maternity leave and help women get the care that they need. It’s essential that we think about maternity leave as being a preventative measure for postpartum depression.

Postpartum depression is serious

Postpartum depression is a severe mental health condition. Many women go undiagnosed with this mental illness because they unknowingly downplay their emotions to their mental health providers or general practitioners. Postpartum depression is a severe condition, and it needs immediate attention from a medical provider. It’s normal to be emotional after having a baby. But, there’s a difference between feeling down and having PPD. When you have a baby, it’s a huge life transition. You’re now responsible for taking care of a new life. Many moms have a difficult time with this change, and if you’re feeling overwhelmed, sad, or a variety of emotions after giving birth, that’s understandable. It’s when your feelings feel out of control that you need to worry whether or not you have Postpartum Depression. We’ll go over the symptoms of the condition, and you’ll see if you relate to them.

Postpartum Depression is not the baby blues

Postpartum depression is not just “the baby blues,” which affects up to 80% of new mothers. Postpartum depression affects childbearing individuals more severely. When you have PPD, it makes it nearly impossible to function. You feel severely depressed, hopeless, and scared. When a baby is born, you can have extremely intense emotions as a mother, which are frequently caused by changes in your hormone levels. Hormones make your experiences feel more powerful than they would ordinarily. You may be prone to crying or insomnia that occurs even after your baby is asleep, for example. Symptoms that can be considered part of the “baby blues” include mood swings, irritability, anxiety, and trouble sleeping. Postpartum depression, on the other hand, is a diagnosable disorder that exists as a potential side effect of giving birth. Unlike the baby blues, which is categorized by minor dips in mood, postpartum depression can be severely debilitating. Postpartum depression requires treatment, so if you have this condition or think that you might have it, don’t ignore it.

Symptoms of postpartum depression

The symptoms of Postpartum depression leave a mother feeling like she can’t cope with everyday life. You may be wondering what they are. The signs and symptoms of postpartum depression include severe mood swings, depression or depressed mood, feeling overwhelmed, not being able to sleep, feeling hopeless, fearing that you aren’t a good mother, restlessness, severe anxiety, inability to focus or think clearly, feeling worthless, thoughts of death or suicide, and intrusive, disturbing thoughts of harming yourself or your baby.

Postpartum psychosis is another condition to look out for and seek treatment if you think you have it. With postpartum psychosis, you may experience excessive thoughts about the baby, hallucinations or delusions, excessive energy or agitation, paranoia, and self-harm. If you believe that yourself or a loved one is experiencing postpartum psychosis, it’s vital that you seek treatment immediately.

What can we do as a society?

We need to take a stand as a society to help new mothers, and if we can prevent Postpartum depression, One of the things that we can do to help new mothers is to advocate for longer maternity leaves. Allowing new mothers to spend more time with their babies can prevent postpartum depression. In a society that’s so focused on productivity and getting back to work, one of the most important things that we can do to prevent postpartum depression is to push for employees to offer additional time for maternity leave. We want to spend time with our children; that’s only natural. If we’re not able to do that, of course, we’re more likely to experience postpartum depression, but it’s important to note that no new parent is immune to developing it. It’s nothing to be ashamed of, and it’s not your fault. Certain risk factors, such as family history or personal history of mood disorders, financial problems, unwanted pregnancy, and more, can increase a person’s likelihood of developing postpartum depression.

Getting help for postpartum depression

If you feel that you may have postpartum depression or if you’ve been experiencing symptoms of postpartum depression for over two weeks, it’s essential to schedule an appointment to talk to your doctor. Treatment for postpartum depression most often includes medication, if you need it, and most importantly, therapy. You can choose to see a traditional therapist or work with online therapy. New mothers can have the added challenge of trying to get out of the house, making it hard to get mental health treatment. Online therapy provides a forum to get therapy in the privacy of your home. A new mother may not have the energy to get out of the house to go to therapy. Online therapy can be an excellent resource for new mothers to get mental health treatment, prevent PPD or treat it. You can see a counselor with your partner or has individual therapy. Whatever your preference, it’s essential to seek treatment for PPD.

Marie Miguel has been a writing and research expert for nearly a decade, covering a variety of health-related topics. Currently, she is contributing to the expansion and growth of a free online mental health resource with BetterHelp.com. With an interest and dedication to addressing stigmas associated with mental health, she continues to specifically target subjects related to anxiety and depression.

Incarceration and Menstrual Hygiene

Menstrual Hygiene products displayed on a flat surface. — Zubehör für weibliche Hygiene wie Slipenlagen und Tampons auf rosarotem Hintergrund. Source: Marco Verch, Creative Commons

Menstruation is one of many topics that can be difficult and uncomfortable to talk about but is absolutely necessary, as many people do not have the resources they need to manage menstruation within reach. The WHO-UNICEF Joint Monitoring System defines menstrual hygiene management as being when people who experience periods “are able to use sanitary materials to absorb menstrual blood, change and dispose of these materials in privacy as needed, and have access to soap and water to keep clean.” The struggle for accessible menstrual hygiene management can be found in all parts of the world and is even true of some places you would not necessarily expect. One such place is in prisons, where women often have severely insufficient access to products like sanitary pads and tampons. This problem needs to be addressed, as menstrual hygiene products are a necessity. They are not merely items of luxury and should never be treated as a privilege.

However, things are slowly but surely improving. The First Step Act that was enacted in December of 2018 requires the Federal Bureau of Prisons to provide pads and tampons at no cost to the prisoners. While this is a good step forward, it only applies to federal facilities and does not help in state or local ones. Further change continues to be imperative.

Examples of the Problem

Betty Ann Whaley, who was released from the Rose M. Singer Center on Rikers Island in June of 2016, told the New York Times that pads were available “seven out of ten times,” and tampons were even less accessible. It is important to remember that even a nine out of ten times availability would be a serious problem, given the impact it can have on one’s health when menstruating without the means to deal with it.

Even when pads are available, they are often very thin, requiring them to be changed frequently. This leads menstruation to still be difficult to manage, as women in prison often only have access to a small number of pads each month. Chandra Bozelko, who spent some time at York Correctional Institute in Niantic, Connecticut, wrote about her experience with menstrual hygiene management for the Guardian in 2015. Each two-person cell was given five pads each week, giving each woman about ten pads per month. If a woman’s period lasts for five days, she would only have two pads for each of those days. This would not be enough, even if the pads were of high quality.

Topeka K. Sam developed blood clots while she was in prison, meaning she needed sanitary pads that were more absorbent than those available in the commissary. In order to get the menstrual hygiene materials that she needed, she was forced to prove that they were a necessity. She put one of her used pads into a bag and a male staff member determined that she truly needed different pads. Five months had passed by the time she had access to resource she needed.

In some cases, there are even monetary barriers that prevent women from being able to properly manage their menstrual hygiene. Prior to the establishment of the First Step Act, federal prison commissaries charged $5.55 for two tampons and $1.35 for two panty-liners. This is a far greater amount of money than either of these products are worth. For example, you can buy an 18-count box of tampons for $9.19 at Walmart.

Menstrual Hygiene Management in Prisons Is an International Concern

Menstrual hygiene materials are also often difficult to access outside of the United States. In the Bom Pastor women’s prison in Recife, Brazil, Human Rights Watch (HRW) found a few different factors that make proper menstrual hygiene and healthcare difficult. As of March of 2017, tampons had not been distributed to the women since 2015. Water was only available three times each day, which is a barrier to strong menstrual health. There is a risk of infection if there is a lack in adequate soap and water for keeping clean. The prison system of Brazil also only employed 37 gynecologists in 2017, which means there is less than one for every 900 women in the system. HRW also found that 630 women had been placed in a cell that was only built to hold 270. This absence in any privacy and presence of practically no space makes even the act of replacing sanitary products difficult.

According to one study, prisons in Zambia leave inmates responsible for many of their basic- necessities such as menstrual hygiene products and soap. One woman living in a Zambian prison stated, “If others don’t bring them for us, we have nothing. There are lots of people with no relatives here. They have nothing.” The water that is available is often unclean, so they have inadequate ability to keep clean as well. These prisons also have the same overcrowding problem as the Bom Pastor prison, being more than 300% over capacity.

A slightly open jail cell door. — Untitled. Source: Neil Conway, Creative Commons

Impacting Health

Ignoring menstruation is not an option. Not only would that be extremely uncomfortable, but it is also a health and safety issue. Lacking access to necessary menstrual hygiene management materials can have an impact on both the mental and physical health of women living in prisons. In terms of physical health, women who are trying to deal with menstruation while incarcerated might develop health problems such as bacterial infections from trying to use other materials in place of regular menstrual hygiene products.

In terms of mental health, being denied the things one needs to deal with menstruation is a dehumanizing experience. At this point in time, talking about menstrual hygiene feels awkward and uncomfortable for many people. This fact does not change among incarcerated populations. When you add experiences like that of Topeka K. Sam, having to prove that she needed the resources she was asking for, the situation becomes even more difficult.

Why Does It Matter?

Truly accessible menstrual hygiene management resources are undoubtedly a human rights issue. According to Article 25 of the United Nations’ Universal Declaration of Human Rights (UDHR), all people have the right to a standard of living that sufficiently supports their well-being and health. The harm that can be done to one’s physical and mental health when they lack the menstrual hygiene products they need gets in the way of this right.

Potential Solutions

How do we improve menstrual hygiene management in prisons?

The people who are most aware and likely care the most about this issue are people who have been disenfranchised, as only two states allow people convicted of felonies to keep their voting rights, and only 15 states automatically restore their voting rights after they have served their sentence. Additionally, many people would not have the resources they would need to advocate for change, no matter how strong their drive or greatness of their ideas. It would be helpful in trying to solve the problem if we could figure out a way to empower people who have direct experiences with it.

Prisons could potentially switch from providing disposable menstrual hygiene products to reusable ones, like Thinx or Lunapads. While the initial change would be relatively expensive, it would save them more money in the long run, as they would not have to constantly buy more sanitary pads and tampons. This option could significantly improve menstrual hygiene management in prisons, and, as a bonus, it would also be much better for the environment.

Improving this issue is an important step in ensuring that people who have been incarcerated are still treated with dignity and respect as human beings. People are people, no matter what they have done in the past. There is no reason to treat anyone as less than human or prevent them from having access to their fundamental human rights.

If you have an interest in learning more about the need for improved access to hygiene management, check out this post on MHM!

Vaccinations Give People a Shot

by Pam Zuber

a picture of a vaccine syringe — Senior Airman Sonia Vega, 332nd Expeditionary Aerospace Medical Squadron, gauges the right amount of vaccine needed for a shot at Balad Air Base, Iraq, Oct. 19. The main vaccinations administered are Anthrax and Hepatitis. Airman Vega is deployed from Barksdale Air Force Base, LA. Source: Staff Sgt. Joshua Garcia, Public Domain.

“We cannot say this enough: Vaccines are a safe and highly effective public health tool that can prevent this disease and end the current outbreak,” Alex M. Azar II, U.S. Health and Human Services Secretary, 2019.

Despite Secretary Azar’s comments, it looks as if many people aren’t heeding his words. According to the Centers for Disease Control and Prevention (CDC), there have been more than 1,000 cases of measles in the United States from January through mid-June 2019, a period of only about five and a half months. The CDC blames the outbreak on misinformation relating to vaccines.

Should school systems and governments require people to receive vaccinations for measles and other conditions? Do vaccines protect the health and rights of others? If authorities require people to receive vaccinations, does this requirement violate people’s civil rights and impair their ability to make decisions about medical treatment for themselves and their families?

What are vaccines? Why do people support or criticize vaccines?

Vaccines are substances that spur the immune system to produce antibodies to fight diseases. This way, if people encounter diseases later in their lives, their bodies will already contain antibodies that will help them fight them. Vaccinations are the process in which people receive vaccines, often through injections, ingesting agents orally (such as in the form of drops or tablets), or inhaling them in the form of nasal sprays.

To create vaccines, manufacturers use weakened or dead versions of the same germs that cause the disease. They also use other substances, including mercury, formaldehyde, and aluminum. The inclusion of such ingredients has been controversial and have led some people to refuse vaccinations for themselves or their children. While high levels of these substances are indeed dangerous, experts say that the small amounts of such substances found in vaccines do not pose significant risks to people.

A famous (many say infamous) 1998 study disagreed with reassurances about vaccines. It said that there was a link between vaccinations and autism in children. The paper proved extremely popular and fueled efforts against vaccination. Known as the anti-vaxxer or anti-vaxxing movement, this movement remains strong today, despite many other studies that have refuted the claims of the 1998 paper and allege that vaccinations do not, in fact, cause autism.

Fears that vaccines have toxic ingredients and may cause autism to persist. Such fears have led more parents to refuse vaccines for themselves or for their children. Public school systems require students to receive vaccinations to attend their schools, although they do allow students to opt out of vaccinations for certain reasons, such as religious beliefs or health concerns. Many parents have taken these exemptions in recent years, which leads to lower vaccination rates.

Money is another reason people do not give or receive vaccines. Doctors may not be reimbursed for giving vaccinations. Parents may not have money to pay for such vaccinations or the ability to leave work to take their children for immunizations. To counter those obstacles, a number of public health departments offer vaccinations for free or reduced costs. Other government agencies and private companies provide access to immunizations in a variety of settings, such as immunization fairs that offer vaccinations, health information, fun activities, and transportation to such events.

How do vaccines relate to human rights?

For other people who criticize vaccines, using or not using the substances are a matter of rights. They question whether governments and other entities should determine medical decisions for others. Members of organizations such as the National Vaccine Information Center claim that governments that criticize people for not receiving immunizations are no better than dictatorial, oppressive entities such as the Third Reich. This is because people who do not pursue vaccinations are in the minority compared to the people who do seek such vaccinations. In this view, government entities that criticize such minorities – or even force minorities to seek vaccinations, such the Cambridge, Massachusetts Board of Health that required smallpox vaccinations in the U.S. Supreme Court decision Jacobson v. Massachusetts – are as dangerous as Nazi Germany.

What about the rights of people who contract or may contract diseases that vaccines may prevent? After all, immunizations protect many more people than the people who physically receive the vaccinations. Widespread vaccinations may produce a phenomenon known as herd immunity or community immunity. This occurs when diseases can’t affect a community because so many people have been immunized against the diseases. The diseases die a natural death because they can’t gain a foothold.

Herd immunity is especially useful because not all people can receive immunizations. Some people are too young to receive immunizations. Or, if people have compromised immune systems, they’re too weak to receive vaccinations. If they’re too weak to receive vaccinations, they’re definitely susceptible to diseases. When other, healthier people in their communities are immunized, they won’t contract diseases and thus won’t be able to transmit diseases to unvaccinated people with weakened immune systems.

More unvaccinated people in communities means more people may contract highly contagious diseases such as measles. If they can’t receive vaccinations, there’s a good chance that they’ll become infected and develop such diseases. People who couldn’t receive vaccinations didn’t choose to be sick. Have their human rights been violated? Others who have opted against receiving vaccinations or having their children vaccinated when they were eligible to receive vaccinations did make such choices. Are they exercising their human rights to make decisions for themselves? Are they violating the rights of others by potentially exposing them to disease?

a photo of a leprosy vaccine from 1978 — Leprosy vaccine, London, England, before 1978. Source: Burroughs Wellcome and Company, Creative Commons.

How do vaccines affect the community?

It appears that refusing vaccines may indeed harm the greater interests of the community and infringe on human rights. We all have to do many things to serve the greater good, even if we don’t want to do them. We have to stop at streetlights, even though we want to keep driving. We have to pay taxes to fund various government programs, even though we want to keep our hard-earned money. Why shouldn’t vaccinations be any different?

Shots may hurt physically. They may cost money and may be inconvenient, since we may have to take time off from work or school to receive vaccinations. But we may be even more physically uncomfortable if we contract the diseases vaccinations could have prevented. If we’re sick with the diseases, we may miss even more work or school than the vaccination appointments would have taken. If vaccinations are expensive, so are medications and visits to doctors, urgent care facilities, emergency rooms, and other medical facilities that are needed to treat diseases that vaccinations could have prevented.

Not having vaccinations may thus cost diseased people time and money. If they pass these diseases to others, they also pass these costs to others. Since many vaccines prevent diseases that are highly contagious, there’s a good chance that they’ll give these diseases to others. According to the Centers for Disease Control and Prevention (CDC), “Measles is so contagious that if one person has it, up to 90 percent of the people close to that person who are not immune will also become infected.”

Vaccines may prevent this. “In the USA, there has been a 99 percent decrease in incidence for the nine diseases for which vaccines have been recommended for decades,” noted the World Health Organization (WHO). The organization added that the country has also witnessed dramatic declines in mortality and pathological conditions related to such diseases.

People die from the measles. It’s not just an annoying, uncomfortable disease that kids pass among themselves. It’s a potential killer, one we may easily stop. The Declaration of Independence famously said that we are entitled to the unalienable rights of life, liberty, and the pursuit of happiness. Vaccines protect life, give people liberty by enabling healthy and active lives, and promote happiness by preventing the devastation caused by sickness and death. They support human rights and are vital weapons in the public health arsenal.

Pamela Zuber is a writer and an editor who has written about human rights, health and wellness, gender, and business.

The Dynamics of Member States

The United Nations held its 12th Session of the Conference of States Parties to the Convention on the Rights of Persons with Disability, CRPD, between 11th to 13th June 2019. I recently got a graduate assistantship position with the Institute of Human Rights UAB and I was selected as one of the rapporteurs from the institute to attend this prestigious event. Despite being new to the institute, I could not have asked for a better start than going to the United Nations Headquarters, not as a visitor, but a note taker in one of the round table discussions of member states. Although on several occasions, I have always dreamed of visiting the UN Headquarters, yet, I never imagined I would be graced with such an opportunity to experience the spectacle and majesty of the UN as a rapporteur. This has made me realize there is never a dream too big to achieve as all we need to make it a reality lies in our will.

The United Nations serves as an international framework where the world comes together to identify various challenges, share resolutive ideas, discuss developmental strategies and initiatives, and form stronger alliances. The Conference of State Parties to the Convention on the Rights of Persons with Disability serves as one of the platforms that ensure the needs of Persons with Disability (PWD) are adequately met and catered for. This year’s theme focused on improving and increasing accessibility and inclusion of persons with disabilities into all spheres of the society by ensuring utmost respect to the rights of PWD at all levels. Recent evidence suggests that by developing new and improving existing technological, digitized and ICT oriented innovations, it will better aid and assist PWD and increase their accessibility. Another fundamental area involves promoting social inclusion for PWD, by ensuring their access to the highest level of healthcare services and extensive participation in the cultural life, recreation, leisure, and sporting activities within the society.

Coming from a third-world region, Africa remains in constant need of evidence-based initiatives and mechanisms that will aid her in achieving sustainable growth and development at all levels. Over the years, the continent has continuously experienced several cases of inefficiencies at all levels, with little or no evidence of improvement being recorded. One issue that constitutes a major area of concern is the rights of Persons with Disability. PWD are faced with the worst situations you can ever imagine in most African communities. Despite the strong traditional and cultural heritage Africa possesses which constitutes part of the continent’s beauty and charm, it also serves as a curse especially to PWD. There exist different myths, beliefs, customs and misconceptions that negatively affect PWD till date because some traditions and beliefs cannot be abolished. In some cultures, families with PWD (blind, deaf, dumb and cripple most especially) often use their disability as an avenue to beg for alms, while in other cultures, families with PWD are believed to be cursed by the gods or unfortunate which often leads to the entire family being discriminated and treated as outcasts in the community. Other cultures consider specific disabilities such as cripples and hunchbacks, as items for rituals and sacrifices of all sorts.

Although several steps have been taken by various African governments to eradicate these ridiculous myths and beliefs, more needs to be done in ensuring PWD live normal and meaningful lives like others. One major area of concern that limits PWD in Africa is the poor social and political accessibility and inclusion. During the 3rd round table discussion, several member states discussed anticipated and already existing initiatives and programs that will/already include PWDs, and how they plan to sustain such developments. A few that caught my attention was the discussion by the representative of Zambia, Honorable Olipa Makiloni Phiri Mwansa, who spoke about new legislation known as the Zambia Disability Act which assists the nation to develop in-depth demographic characteristics of PWD. The Sri Lanka representative, His Excellence, Dr. Rohan Perera, spoke about the level the nation has gone in ensuring the successful implementation of the National Human Rights Action Plan for PWD by embedding the “Foundation for Inclusion of PWD” into the nation’s constitution. Morocco’s representative, Ambassador Omar Hilale on the other hand, discussed a framework already being implemented, which strictly focuses on providing vocational training for PWD in vulnerable communities to increase their social inclusion. One nation that has fundamentally developed its accessibility and inclusion rate in Mexico. Her representative discussed the 2018 general elections which were considered the most inclusive election in the country’s history as it ensured PWD had easy access to polling units and were also among the electoral officials during the entire election process.

In terms of challenges faced by some member states, the Republic of Ireland representative gave an extensive remark about how several nation-states government and public sector is not adequately and structurally designed to meet the needs and demands of PWD and such inefficiency issues need to be addressed by the UN. Also, the first panelist, Ms. Tytti Matsinen (Disability Inclusion Adviser, Finland), spoke about how several communities presently have poor access to standard technologies which further increases the marginalization of PWD. She advocates that individuals, agencies, and organizations who are outside the job market be integrated into making assistive technological innovations for PWD more available and accessible. Finally, the Association for Deaf People (NGO) elaborated the need for parties and agencies to collaborate with PWD when developing technological and ICT programs and products because they possess a good degree of knowledge of their condition.

This Conference made me understand how much effort the United Nation renders in ensuring member states achieve their desired growth at all levels, but more needs to be done in ensuring certain developmental policies, initiatives, and action plans are efficiently carried out by her members. The CRPD Committee representative spoke about how several member states failed to adopt the Public Procurement Policy which was structured at all levels to achieve greater accessibility standard for PWD. Although he condemned the attitudes of such states, he advised the UN to put in biding sanctions to member states that fail in this regard. At the close of the session, there was a resounding echo of relief by representatives of all member states, each having given meaningful insights and recommendations to various challenges faced at national and international levels.

I am fortunate to have been selected to attend the conference, especially as a rapporteur in one of the round table sessions alongside several other side events which I may write about in subsequent blogs. Based on my love for policy and advocacy, it truly was a learning process and a developmental experience for me and I would like to appreciate the wonderful Dr. Tina Reuter and the Institute of Human Rights, UAB, for giving me this opportunity to see the world at large. I really had a wonderful experience and I am looking forward to many more field trips as this, and I will always be open in assisting and representing the institute at all levels.