Global Translation/Adaptation Program

1. Global Translation/Adaptation Program The Transnational Journey of a Women’s Health Classic Women’s Collective Strength and Knowledge

2. The first newsprint edition appeared in 1970. In 1971 the book was re-titled “Our Bodies, Ourselves.”

3. www.ourbodiesourselves.org In 2005, this eighth edition was produced under the leadership of a new generation

4. GLOBALLY DISPARITIES CONTINUE TO BE STARK • In industrialized countries, one in 7,300 women die during pregnancy or childbirth. • In Africa, the figure is about one in twenty-six women.

5. OBOS ADAPTATIONS NOW UNDERWAYArmenia: ArmenianChina: ChineseIndia: Bengali (for India and Bangladesh)Israel: Arabic and HebrewNepal: NepaliNigeria: Pidgin English and Yoruba Russia: RussianTanzania: Kiswahili (for East Africa)Turkey: TurkishWe are also exploring possible adaptations of OBOS in Finnish, Hindi and Kinyarwanda

6. Article about the Turkish OBOS, 2007 The coordinating group, Mavi Kalem, expects to publish its edition in 2009 and has positioned its website – www.bedenimveben.org – as a key networking and lobbying tool for Turkish women’s groups.

7. Nepal The coordinating group, Women’s Rehabilitation Center, is adapting OBOS into 7 booklets in Nepali. In 2007, despite ongoing political turmoil in the country and persecution by local communities, the coordinating group and its partners facilitated the inclusion of reproductive health and rights in Nepal’s new interim constitution.

8. Nigeria The coordinating group, Women for Empowerment, Development and Gender Reform, is adapting OBOS into Pidgin English and Yoruba, in alternative formats such as posters. In 2009, they will reach 1.5 million people through outreach on the local canoe transport system, peer health educator trainings with village hair dressers, and a motorcycle campaign to bring health information to neighboring villages.

9. IsraelWomen and Their Bodies, a group of Palestinian and Israeli women, is developing new Arabic and Hebrew adaptations. The old versions – depicted below – are out of print. Hebrew 1982, Israel Arabic 1991, Egypt

11. Armenia Menk ou Mer Marmine (We and Our Body) • Type: Cultural Adaptation • Format: Print Edition • Language: Armenian • Country: Armenia • Coordinating Group: Charitable Foundation on Population Development • Published: 2001 • Second edition forthcoming in 2009

12. BulgariaNasheto Tyalo, Nie Samite (Our body, Ourselves) • Type: Cultural Adaptation • Format: Print Edition • Language: Bulgarian • Country: Bulgaria • Coordinating Group: Women's Health Initiative in Bulgaria • Published: 2001

13. China The 1998 Chinese edition – depicted alongside - is out of print. Another group is currently developing content into print and digital format for web downloads and text-capable mobile phones. This pioneering project will reach roughly 1.5 million people in China.

14. SenegalNotre Corps, Notre Sante (Our Body, Our Health)French Edition for French-Speaking Africa • Type: Inspired by Our Bodies, Ourselves • Format: Print Edition • Language: French • Country: Senegal • Coordinating Group: Groupe de Recherche sur Les Femmes et Les Lois au Senegal • Published: 2004; Reprinted in 2007

15. (Left) Codou Bop, the coordinator of “Notre Corps, Notre Sante” in Senegal, and (Right) Jane Pincus, an OBOS co-founder and co-author of “Our Bodies, Ourselves”

16. Japan • Type: Cultural Adaptation • Format: Print Edition • Language: Japanese • Country: Japan • Coordinating Group: Shokado Women’s Bookstore • Published: 1988

17. Korea • Type: Cultural Adaptation • Format: Print and Electronic Editions • Language: Korean • Country: South Korea • Coordinating Group: Alternative Culture Publishing Co. • Published: 2005

18. PolandNasze ciała, nasze życie (Our Bodies, Our Lives) • Type: Cultural Adaptation • Format: Print Edition • Language: Polish • Country: Poland • Coordinating Group: Network of East/West Women - Polska • Published: 2004

19. RomaniaTu Si Curpul Tau Pentru un Nou Secol • Type: Cultural Adaptation • Format: Print Edition • Language: Romanian • Country: Moldova • Coordinating Group: National Women's Studies & Information Center • Published: 2002

20. SerbiaNasa Tela, Mi • Type: Cultural adaptation • Format: Print Edition • Language: Serbian • Country: Serbia • Coordinating Group: Autonomous Women’s Center Against Sexual Violence • Published: 2001

21. Spanish, USANuestros Cuerpos, Nuestras Vidas (Our Bodies, Our Lives) • Type: Cultural Adaptation • Format: Print Edition • Language: Spanish (for the U.S) • Country: United States of America • Coordinating Group: Our Bodies Ourselves • Published: 2000 (Seven Stories Press, NYC)

22. IndiaA Hundred Thousand Questions about Women's Health • Type: Inspired by Our Bodies, Ourselves • Format: Print Edition • Language: Telegu (an English adaptation of this edition called Taking Charge of Our Bodies was published in 2004) • Country: India • Coordinating Group: Hyderabad Women's Health Group • Published: 1991

23. IndiaHealthy Body, Healthy Mind • Type: Inspired by Our Bodies, Ourselves • Format: Print Edition • Language: Tibetan (back-translated into English) • Country: India • Coordinating Group: Tibetan Nuns Project • Published: 2005

24. Lobsang Dechen, coordinator of the Tibetan project

26. Turkey / Turkish Israel / Hebrew & Arabic Nepal / Nepali India / Bengali Nigeria / Local Dialects Tanzania / Kiswahili Editions in Progress Books Inspired by Our Bodies, Ourselves Editions in Progress Published Foreign Editions of Our Bodies, Ourselves

27. What are some key challenges facing women’s health advocates today? • Media portrayals of new medical research are often inaccurate or incomplete • The media often endorse or reinforce our societal tendency to embrace the “quick fix” or “pill for every ill” approach

28. Key Challenges…. • Increasing influence of the pharmaceutical industry over physician prescribing practices as well as the educational and advertising materials aimed at the consumer or patient

29. The failure to utilize best practices largely because of perverse payment incentives well described in Dr. Atul Gawande’s June 1, 2009 New Yorker piece entitled “The Cost Conundrum.”In women’s health, maternity care is a primary arena where there are multiple examples reflecting the failure to utilize best practices. As a result, we have rising cesarean section rates, falling VBAC (Vaginal Birth after Cesarean) rates, rising rates of premature births, rising rates of unnecessary medical interventions that are increasingly shown to be associated with harms, and falling breastfeeding rates in some regions.

30. Evidence-Based Maternity-Care: What It Is and What It Can Achieve Issued by the Milbank Memorial Fund, the Childbirth Connection, and the Reforming States Group (2008)

31. What is Evidence-Based Maternity Care? Definition Uses best available research on the safety and effectiveness of specific practices to help guide maternity care decisions and facilitate optimal outcomes in mothers and newborns Gives priority to effective care paths and practices with least harm

32. What is Evidence-Based Maternity Care? Corollaries Avoid practices with no clear benefit and established or plausible harms Avoid practices with marginal expected benefit that is overshadowed by established harm. FIRST DO NO HARM

33. Imperative for Maternity Care Quality Improvement

34. Imperative for Maternity Care Quality Improvement Scale United States: over 4.3 million births/year Childbirth In United States • the leading reason for hospitalization • mothers & newborns are 23% of all discharges • procedure intensive: 6 of 15 most commonly performed hospital procedures in entire population associated with childbirth

35. Imperative for Maternity Care Quality Improvement Costs and Charges Childbirth especially impacts 2 purchaser groups • private insurers/employers pay for 51% of hospital stays • Medicaid/taxpayers pay for 42% of hospital stays Combined maternal/newborn hospital charges far exceed charges for any other condition: $79,277,733,843 in 2005 • private insurers/employers: $39,726,164,301 • Medicaid/taxpayers: $34,164,460,561

36. Addressing Underuse in Maternity Care Examples of Practices to Use Whenever Possible and Appropriate Smoking cessation interventions Ginger for nausea and vomiting Preterm birth prevention External version to turn breech presentation babies VBAC

37. Addressing Underuse in Maternity Care Examples of Practices to Use Whenever Possible and Appropriate Continuous labor support Non-supine positions for giving birth Measures to relieve pain, bring comfort, and/or promote labor progress Early skin-to-skin contact (versus mother-baby separation) Breastfeeding and interventions to promote its initiation and duration

38. Context: Lactation support ranks lower than pet insurance(thanks to Cate Colburn-Smith) • Starting in 2008, lactation program/designated area was separated into on-site lactation/ mother’s room and lactation support services • Other family-friendly benefits included on-site parenting seminars (4%) and on-site vaccinations for infants/children (3%) • The number of employees with lactation programs has grown from 16% in 1999 Source: Society of Human Resource Management 2008 Benefits Report

39. A Statement by Physicians, Midwives and Women’s Health Advocates who Support Safe Choices in Childbirth • That communities preserve the option of vaginal births after cesarean (so-called “VBACs”) • That options for hospital-based midwifery care (utilizing Certified Nurse Midwives and Certified Midwives) be made available in all communities • That Certified Professional Midwives (CPMs) be licensed and regulated in order to make the option of homebirth as safe as possible.

40. Breast augmentation statistics from the American Society of Plastic Surgeons: 212,500 2000 291,350 2005 329,396 2006 55% increase between 2000 and 2006

41. “Breast augmentation has always been among the top five surgical procedures, but until now has never been number one….” ASPS Press Release, March 22, 2007 (ASPS began collecting statistics in 1992)

42. MORE PUBLIC SCREENINGS OF THE DOCUMENTARY “ABSOLUTELY SAFE” ARE NEEDED. See also the booklet prepared by the US Food and Drug Administration for photographs and descriptions of adverse implant outcomes such as disfigurement, capsular contracture (when the breast becomes hard and misshapen), and deflation: www.fda.gov/cdrh/breastimplants

43. A survey by the American Society of Plastic Surgeons showed that nearly 40 percent of plastic surgery patients believe they should have been more proactive in learning about potential side effects and complications before surgery.

44. Milking Cancer Partners • Eli Lilly is now the sole manufacturer of rBGH — the artificial growth hormone given to dairy cows that increases people’s risk of cancer. Eli Lilly also manufactures breast cancer treatment medications and a pill that “reduces the risk” of breast cancer. Eli Lilly is milking cancer. Tell them to stop making rBGH.

45. A large coalition of groups: See www.safecosmetics.org “Skin Deep” a report of the Environmental Working Group, helps consumers and workers to better protect themselves from known or suspected carcinogens and reproductive toxins.

46. "It is simply no longer possible to believe much of the clinical research that is published, or to rely on the judgment of trusted physicians or authoritative medical guidelines. I take no pleasure in this conclusion, which I reached slowly and reluctantly over my two decades as an editor of The New England Journal of Medicine.” Marcia Angell, MD

47. Direct-to-Consumer Advertising of Prescription Drugs: Misleading Ads and How They Hurt Us

48. The Public Gets Misinformation • Benefits are often overstated, while risks are understated • FDA warning letters are issued after the ads run • Corrective ads are rarely required • Withdrawal of an ad is the only penalty

49. Ads are geared primarily to selling more drug product, not educating the user • The ads work: the most highly advertised drugs, accompanied by promotional campaigns geared to physicians, sell extremely well

50. To promote “The Hunt for the Pink Viagra”(Slide Courtesy of Leonore Tiefer)