How Your Center Can Help Prevent Ebola's Spread


As the Ebola outbreak has spread from West Africa to isolated cases in parts of Europe and now the United States, there has been no shortage of panic and paranoia among Westerners—even those working in the health care fields.

Still, it is an established and repeated fact that Ebola's spread can be prevented simply by following proper safety procedures in a medical setting. An informational page on Ebola published at the World Health Organization's (WHO) website points to the sad reality of Ebola's largely preventable spread:

Health-care workers have frequently been infected while treating patients with suspected or confirmed EVD [Ebola Virus Disease]. This has occurred through close contact with patients when infection control precautions are not strictly practiced.1

As those involved in the life-saving work of pregnancy help in the medical setting, how can you protect yourself, your clinic, and your clients from this deadly virus?

The answer starts with educating yourself, your staff and volunteers, and your clients as to how Ebola spreads, which, again according to WHO, involves the following:

Ebola... spreads through human-to-human transmission via direct contact (through broken skin or mucous membranes) with the blood, secretions, organs or other bodily fluids of infected people, and with surfaces and materials (e.g. bedding, clothing) contaminated with these fluids.2

Consider the functions of your Pregnancy Help Medical Center or Clinic.

  • Could you come into contact with any bodily fluid when handling a urine pregnancy test?
  • What about collecting a specimen for STD/STI testing?
  • Broken skin that can be exposed and contacted while conducting an ultrasound?

With these points of contact posing risks in light of the Ebola virus—in addition to several diseases that are much more likely to spread—make sure your center is paying special attention to policies such as Universal Precautions as defined by the Centers for Disease Control (CDC) and OSHA Regulations.

Under Universal Precautions, blood and certain body fluids of all patients are considered potentially infectious for HIV, (Hepatitis B), and other blood-borne pathogens. Universal Precautions involve the routine wearing of gloves, other protective clothing, hand washing, and such infection control measures that are designed to place a barrier between potentially infectious blood or body fluids and employees.3

For more information on how you can keep your center protected from the spread of viral infection, check out Heartbeat International's Medical Essentials for Pregnancy Help Organizations©.


1. "Ebola virus disease," World Health Organization, (accessed Oct. 17, 2014).

2. Ibid.

3. Medical Essentials for Pregnancy Help Organizations©Heartbeat International, 2014, Part IV, page 4.


Ohio Board of Nursing Response

"The Nurse Practice Act does not provide a list of procedures that may or may not be performed by licensed nurses.  The scope of practice for a licensed practical nurse is located in Section 4723.01(F), ORC. A licensed practical nurse with the necessary knowledge, skill, and competency, under the direction of a registered nurse or a physician, is not prohibited from performing limited obstetrical ultrasounds.  The regulations pertaining to licensed nurses performing nursing tasks beyond basic nursing preparation are located in Chapter 4723-4, OAC.  A licensed nurse providing care beyond basic preparation for a licensed practical nurse must obtain education from a recognized body of knowledge relative to the nursing care to be provided, demonstrate knowledge, skills, and ability to performthe care, maintain documentation satisfactory to the Board of meeting the requirements to provide the care, and have a specific valid order or direction, from an individual who is authorized to practice in this state and is acting within the course of the individual's professional practice.”

“The Nurse Practice Act and the administrative rules adopted thereunder are available for review on the Board's website: in the "law and rule" section.”


HPV Vaccine: Both Sides of the Issue

What is genital HPV infection?

Genital human papillomavirus (also called HPV) is the most common sexually transmitted infection (STI). There are more than 40 HPV types that can infect the genital areas of males and females. These HPV types can also infect the mouth and throat. Most people who become infected with HPV do not know they have it. HPV is not the same as herpes or HIV (the virus that causes AIDS). These are all viruses that can be passed on during sex, but they cause different symptoms and health problems.

How do people get HPV?

HPV is passed on through genital contact, most often during vaginal and anal sex. HPV may also be passed on during oral sex and genital-to-genital contact. HPV can be passed on between straight and same-sex partners—even when the infected partner has no signs or symptoms.

A person can have HPV even if years have passed since he or she had sexual contact with an infected person. Most infected persons do not realize they are infected or that they are passing the virus on to a sex partner. It is also possible to get more than one type of HPV.

Very rarely, a pregnant woman with genital HPV can pass HPV to her baby during delivery. In these cases, the child can develop recurrent respiratory papillomatosis (RRP), a rare condition in which warts grow in the throat. In children, this is also referred to as juvenile-onset recurrent respiratory papillomatosis (JORRP).

Does HPV cause health problems?

In most cases, HPV goes away on its own and does not cause any health problems. But when HPV does not go away, it can cause health problems like genital warts and cancer.

Genital warts usually appear as a small bump or group of bumps in the genital area. They can be small or large, raised or flat, or shaped like a cauliflower. A healthcare provider can usually diagnose warts by looking at the genital area.

Does HPV cause cancer?

HPV can cause cervical and other cancers including cancer of the vulva, vagina, penis, or anus. It can also cause cancer in the back of the throat, including the base of the tongue and tonsils (called oropharyngeal cancer).

Cancer often takes years, even decades, to develop after a person gets HPV. The types of HPV that can cause genital warts are not the same as the types of HPV that can cause cancers.

There is no way to know which people who have HPV will develop cancer or other health problems. People with weak immune systems (including individuals with HIV/AIDS) may be less able to fight off HPV and more likely to develop health problems from it.

The CDC website reports: “Approximately 79 million Americans are infected with human papillomavirus (HPV), and approximately 14 million people will become newly infected each year. Some HPV types can cause cervical, vaginal, and vulvar cancer among women, penile cancer among men, and anal and some oropharyngeal cancers among both men and women. Other HPV types can cause genital warts among both sexes. Each year in the United States an estimated 27,000 new cancers attributable to HPV occur, 17,600 among females (of which 10,400 are cervical cancer) and 9,300 among males (of which 7,200 are oropharyngeal cancers).

There are, however, two HPV vaccines available (Gardasil® and Cervarix®) which protect against the types of HPV infection that cause most cervical cancers (HPV types 16 and 18). Both vaccines should be given as a three-shot series. Clinical trials and post-licensure monitoring data show that both vaccines are safe.

CDC recommends HPV vaccination [PDF - 225 KB] for the prevention of HPV infections responsible for most types of cervical cancer. As with all approved vaccines, CDC and the Food and Drug Administration (FDA) closely monitor the safety of HPV vaccines following licensure. Any problems detected with these vaccines will be reported to health officials, health care providers, and the public. Needed action will be taken to ensure the public’s health and safety.

Two HPV vaccines are licensed by the FDA and recommended by CDC. These vaccines are Cervarix® (made by GlaxoSmithKline) and Gardasil® (made by Merck).  Both vaccines are very effective against diseases caused by HPV types 16 and 18; HPV 16 and 18 cause most cervical cancers, as well as other HPV associated cancers.  Both vaccines are very safe.  Only one of the vaccines (Gardasil®) has been tested and licensed for use in males.  Only one of the vaccines (Gardasil®) has been tested and shown to protect against precancers of the vulva, vagina, and anus.”

General Information

The official Gardisil website states:

 “GARDASIL is the only HPV vaccine that helps protect your child against 4 types of HPV.

  • In girls and young women ages 9 to 26, GARDASIL helps protect against 2 types of HPV that cause about 75% of cervical cancer cases, and 2 more types that cause approximately 90% of genital warts cases.
  • In boys and young men ages 9 to 26, GARDASIL helps protect against approximately 90% of genital warts cases.
  • GARDASIL also helps protect girls and young women ages 9 to 26 against about 70% of vaginal cancer cases and up to 50% of vulvar cancer cases.

GARDASIL may not fully protect everyone, nor will it protect against diseases caused by other HPV types or against diseases not caused by HPV. GARDASIL does not prevent all types of cervical cancer, so future cervical cancer screenings will be important for your daughter. GARDASIL does not treat cervical cancer or genital warts.

GARDASIL is given as 3 injections over 6 months.

Anyone who is allergic to the ingredients of GARDASIL, including those severely allergic to yeast, should not receive the vaccine. GARDASIL is not for women who are pregnant.

The side effects include pain, swelling, itching, bruising, and redness at the injection site, headache, fever, nausea, dizziness, vomiting, and fainting. Fainting can happen after getting GARDASIL. Sometimes people who faint can fall and hurt themselves. For this reason, your child’s health care professional may ask to sit or lie down for 15 minutes after they get GARDASIL. Some people who faint might shake or become stiff. This may require evaluation or treatment by your child’s health care professional.

The Physicians for Life website notes “The HPV vaccine Gardasil is in the list of vaccinations that all female migrants ages 11 to 26 years MUST get before they can obtain GREEN CARD.”


The CDC reports “There have been many studies conducted to determine the safety of HPV vaccines in the United States. An overview of these studies can be found here One study found an increased risk for fainting (also known as syncope). However, there were no serious safety concerns found in any of these studies.

From June 2006-March 2014, approximately 67 million doses of HPV vaccines were distributed in the United States. VAERS (Vaccine Adverse Event Reporting System) received approximately 25,000 adverse event reports occurring in girls and women who received HPV vaccines. As described above, an adverse event is an undesired side effect or health problem that occurs after someone receives a vaccine or medicine. It may -- or may not -- have been caused by the vaccine or medicine. Of the reports to VAERS, 8 percent were classified as “serious”. Among VAERS reports, the most frequently reported symptoms were: fainting, dizziness, nausea, headache, fever, hives, and localized pain, redness, and swelling at the sight of the injection. For more information, see Morbidity and Mortality Weekly Report (MMWR): “Human Papillomavirus Vaccination Coverage Among Adolescents, 2007–2013, and Postlicensure Vaccine Safety Monitoring, 2006–2014 — United States”

Since Gardasil® has been licensed in the United States, CDC and FDA have continually monitored its safety. CDC and FDA have found no reason to be concerned that Gardasil® may be causing premature ovarian failure (a condition in which a woman’s ovaries no longer function as they should).

It is important to note that before Gardasil® was licensed, its safety was extensively studied in clinical trials  [PDF - 4.9 MB]. These trials found no difference in amenorrhea (absence of a menstrual period in women of reproductive age) between recipients of Gardasil®  [PDF - 355 KB] as compared to those receiving placebo (a harmless pill). Premature ovarian failure was not a noted outcome. However, CDC continues to monitor closely for this condition following receipt of Gardasil®.

CDC Recommendations:

All boys and girls ages 11 or 12 years should get vaccinated. Catch-up vaccines are recommended for males through age 21 and for females through age 26, if they did not get vaccinated when they were younger.

The vaccine is also recommended for gay and bisexual men (or any man who has sex with a man) through age 26. It is also recommended for men and women with compromised immune systems (including people living with HIV/AIDS) through age 26, if they did not get fully vaccinated when they were younger.

School Vaccination Requirements

Even after recommendations by the ACIP  (Advisory Committee on Immunization Practices), school vaccination requirements are decided mostly by state legislatures.  Some state legislatures have granted regulatory bodies such as the Health Department the power to require vaccines…

The CDC announced that the HPV vaccine is available through the federal Vaccines for Children (VFC) program in all 50 states, Chicago, New York, Philadelphia, San Antonio and Washington DC. VFC provides vaccines for children ages 9 to 18 who are covered by Medicaid, Alaskan-Native or Native American children, and some underinsured or uninsured children. 

Information about state legislation can be found at

How Effective is the Vaccine?

The following are comments from the Physicians for Life article HPV Vaccines Do Not Cover Most Common HPV Types in Black Women (4/2014)

“The HPV vaccine protects against a virus that in 98% of case, is not the cause of cervical cancer.

The HPV vaccine prevents a type of cancer that can be easily caught and treated by promoting regular gynecological exams and Pap smear tests.

The HPV vaccine offers less protection than what promotion of safe sex practices could accomplish.

“The HPV vaccine prevents just 4 strains that are not frequent among Nigerians and black women in general, out of more than 100 strains of HPV; all of which the immune system can clear up on its own in 90% of all cases anyway.”

Review of HPV Trials Conclude Effectiveness Is Still Unproven

“Last year, a systematic review11 of pre- and post-licensure trials of the HPV vaccine by researchers at University of British Columbia showed that the vaccine’s effectiveness is not only overstated (through the use of selective reporting or “cherry picking” data) but also unproven. In the summary of the clinical trial review, the authors state it quite clearly:

“We carried out a systematic review of HPV vaccine pre- and post-licensure trials to assess the evidence of their effectiveness and safety. We found that HPV vaccine clinical trials design, and data interpretation of both efficacy and safety outcomes, were largely inadequate. Additionally, we note evidence of selective reporting of results from clinical trials (i.e., exclusion of vaccine efficacy figures related to study subgroups in which efficacy might be lower or even negative from peer-reviewed publications).

Given this, the widespread optimism regarding HPV vaccines long-term benefits appears to rest on a number of unproven assumptions (or such which are at odds with factual evidence) and significant misinterpretation of available data.

For example, the claim that HPV vaccination will result in approximately 70% reduction of cervical cancers is made despite the fact that the clinical trials data have not demonstrated to date that the vaccines have actually prevented a single case of cervical cancer (let alone cervical cancer death), nor that the current overly optimistic surrogate marker-based extrapolations are justified.

Likewise, the notion that HPV vaccines have an impressive safety profile is only supported by highly flawed design of safety trials and is contrary to accumulating evidence from vaccine safety surveillance databases and case reports which continue to link HPV vaccination to serious adverse outcomes (including death and permanent disabilities).

We thus conclude that further reduction of cervical cancers might be best achieved by optimizing cervical screening (which carries no such risks) and targeting other factors of the disease rather than by the reliance on vaccines with questionable efficacy and safety profiles.”

11 Current Pharmaceutical Design 2012 Sep 24. [Epub ahead of print]


Pro’s and Cons

CDC and FDA have reviewed all of the safety information available to them for both HPV vaccines and have determined that they are both safe. Gardasil® is safe to use for preventing HPV types 6, 11, 16, and 18, and Cervarix® is safe to use for preventing HPV types 16 and 18.

…”the most expensive federally recommended pediatric vaccine on the US market72 to prevent an infection that is cleared by more than 90 percent of people without a problem:73,74

“A vaccine for a sexually transmitted disease that was tested in fewer than 1,200 children under the age of 1679 using a bioactive aluminum "placebo" as a bogus control in clinical trials80-84

“A vaccine given by pediatricians shielded from legal accountability for vaccine injuries and deaths, just like vaccine manufacturers are shielded from civil liability in US courts86

“A vaccine that by December 13, 2013 had generated nearly 30,000 adverse reaction reports to the US government, including 140 deaths87 - which is only a fraction of the numbers of Gardasil reactions, injuries, and deaths that have actually occurred because most doctors either do not report to the government or make reports directly to Merck.88-90

“Public health officials in Japan no longer recommend Gardasil vaccine because Japan's government is not writing off every death and case of brain inflammation and autoimmunity following Gardasil shots as just a "coincidence."9494.Baklinski T. Japan Withdraws Support of Controversial HPV Vaccine Over Safety Concerns. Lifesite NewsOct. 16, 2013

“Many women are not aware that the HPV vaccine Gardasil might actually increase your risk of cervical cancer. Initially, that information came straight from Merck and was presented to the FDA prior to approval6. According to Merck’s own research, if you have been exposed to HPV strains 16 or 18 prior to receipt of Gardasil vaccine, you could increase your risk of precancerous lesions, or worse, by 44.6 percent.”  6 Gardasil™ HPV Quadrivalent Vaccine May 18, 2006 VRBPAC Meeting (PDF)

“...there are unanswered questions around how long the vaccine will offer immunity.

“...prompting questions about the gains given that women still need regular cervical smears with or without the vaccine.

NZ Herald Jun 8, 2010
“The HPV vaccination could have the unintended consequence that more women with cervical cancer will not be diagnosed, the Ministry of Health has warned. The ministry’s national screen unit is concerned that young women believe they are protected from the disease once they are immunised. But the vaccine does not protect against 30 per cent of HPV types that can lead to cervical cancer. The ministry says there is a risk that these women will not attend regular screenings once they reach the recommended age of 20. cervical cancer rate could start to rise again if a new generation of young women vaccinated against the disease is not encouraged to continue having Pap smears.”

Physicians For Life website the following:

“To be completely immunized, women and girls have to receive a series of three injections over six months. Many women and girls didn’t do so. For example, according to the U.S. Center for Disease Control, in their report of August 2010, although 44% of teenagers had received the HPV vaccine in 2009, only 27% of them received all three doses of the vaccine.]”

“A definite drawback to Gardasil is that girls must get three full doses of the vaccine for it to be effective. How many families are going to understand the urgency of making sure their girls get three full doses over a six months' period of time?” 

“Parents need to evaluate all aspects of the HPV vaccine since there are no long-term studies yet on the way these sixth graders might be affected in future years when it comes time for them to have their own babies. Also, since the vaccine has only followed girls for five years, nobody knows for sure how long the vaccination may last without having a booster.”

“The HPV vaccine covers 4 out of types of HPV (Types 6, 11,16,18) which account for 70% of cervical cancers and 90% of genital warts. That still leaves 30% of cervical cancers and 10% of genital warts which are not covered by the HPV vaccine.”

“Also, it will be important for the public to be continually reminded that there are many more sexually transmitted diseases than just HPV (e.g., chlamydia, herpes, hepatitis, trichomoniasis, gonorrhea, syphilis, HIV/AIDS, etc.)”

“Certainly, no one wants to become a cervical cancer statistic; but so far, the statistics seem to show that girls and women experience a higher rate of adverse effects from the vaccine than from acquiring the cervical cancer.”


73.ARHP. Managing HPV: A New Era in Patient Care. ARHP June 2009.

74.Burg EM. Human Papillomavirus and Cervical Cancer. Clin Microbiol Rev 2003; 16(1): 1-17.

80.Merck. Gardasil Briefing Document. Overview of Safety in Phase III Studies Including Populations Studied and Extent of Exposure. Pg. 71. FDA Vaccines and Related Biological Products Advisory Committee (VRBPAC) May 18, 2006.

81.Kawahara M. Effect of aluminum on the nervous system and its possible link with neurodegenerative diseases. J Alzheimers Dis2005; 8(2): 171-182.

82.Petrick MS, Wong MC et al. Aluminum adjuvant linked to Gulf War illness induces motor neuron death in mice. Neuromolecular Med2007; 9(1): 83-100.

83.Tomlejenovic L, Shaw CA. Aluminum Vaccine Adjuvants: Are They Safe?Current Medicinal Chemistry2011; 19(17): 2630-2637.

84.Tomlijenovic L, Shaw CA. Mechanisms of aluminum adjuvant toxicity and autoimmunity in pediatric populations. Lupus2012 2: 223-230.

86.NVIC. National Vaccine Information Center Cites ‘Betrayal’ of Consumers by USSupreme Court Giving Total Liability Shield to Big Pharma. Business Wire: Feb. 23, 2011.

87.MedAlerts. Gardasil Vaccine (HPV4) adverse event reports through Dec. 13, 2014. VAERS Database on MedAlerts.

88.Rosenthal S, Chen R. The reporting sensitivities of two passive surveillance systems for vaccine adverse events. Am J Public Health1995; 85: pp. 1706-9.

89.Braun M. Vaccine adverse event reporting system (VAERS): usefulness and limitations. Johns Hopkins Bloomberg School of Public Health. Last updated Feb. 15, 2013.

90.Slade BA, Leidel L, Vellozzi C, Woo EJ et al. Postlicensure Safety Surveillance for Quadrivalent Human Papillomavirus Recombinant Vaccine. JAMA2009; 302 (7):750-757.


Adverse Reactions

“Reporting on the first six months after the vaccine was approved, the 2006 report regarding the human papilloma virus Vaccine Safety Analysis of Vaccine Adverse Events Reporting System Reports: Adverse Reactions, Concerns and Implications by NVIC (National Vaccine Information Center) states: “On June 8th 2006, the Food and Drug Administration (FDA) announced the approval of GARDASIL, and on June 29th the Advisory Committee on Immunizations Practices (ACIP) voted to recommend adding GARDASIL human papilloma virus vaccine to the Centers for Disease Control's national childhood recommended immunization schedule. On July 14th the first report of a serious reaction to the vaccine was filed with the federal Vaccine Adverse Event Reporting System (VAERS).

A 16-year-old Illinois girl was vaccinated July 7th and 13 days later developed symptoms eventually diagnosed as Guillian-Barre Syndrome. A 14-year-old girl in the District of Columbia was vaccinated on July 11th and complained of severe pain immediately following the injection, fell off the examining table and experienced a 10 to 15 second fainting spell ending up in the emergency room with a headache and speech problems. The report of this reaction, the first in the nation, was filed on July 14th, 15 days after the ACIP vote.

Six months later, 82 reports of GARDASIL reactions have been submitted to VAERS on behalf of at least 84 young girls and 2 boys. Reaction reports have come in from 21 states and the District of Columbia. Reactions were reported for children and young adults ranging in age from 11 to 27.”

Among the adverse events they reported were:

Syncopal Episodes and Seizures. One-quarter of all reports filed after GARDASIL vaccination were for neurologic adverse events including loss of consciousness, syncope, syncopal events and seizures. An additional five reports included symptoms of dizziness and feeling faint.

Arthralgia, Joint Pain and Fever.

Guillain-Barre Syndrome. Reports state that two recently vaccinated 16-year-old girls - one from Illinois and the other from Mississippi - were diagnosed with Guillian-Barre Syndrome (GBS) following vaccination with GARDASIL.

Other Adverse Reactions. Additionally, a number of other reactions to GARDASIL are noted in VAERS reports and they include: urticaria (hives); pruritus (itching); macular and papular rashes; blisters and vesicles near the injection site; swollen arms; lymphadenopathy (swollen lymph nodes); red, hot swollen knots at injection site; burning, stabbing, severe and radiating pain at the injection site and in the affected limb during and after injection; nausea and vomiting; infections and skin ulcers, and other allergic reactions.

The report also states “Additionally, Merck notes that vaccine ingredients include 225 mcg of aluminum (as amorphous aluminum hydroxyphosphate sulfate adjuvant), 0.78 mg of L-histidine, 50 mcg of polysorbate 80, and 35 mcg of sodium borate. These ingredients are not listed on the CDC's VIS sheet. The public needs this information so that they can identify whether they have "hypersensitivities" to any of the ingredients and whether they are at risk of experiencing a serious allergic reaction. Hypersensitivities and known allergic reactions are critical pieces of information that need to be communicated to prescribing physicians in order to make the safest possible vaccination decisions.”

From MedAlerts (7 HPV vaccine adverse event report to VAERS as of May 13, 2013. Accessed July 10. 9, 2013.) we read ”Other health problems associated with Gardasil vaccine include immune-based inflammatory neurodegenerative disorders, suggesting that something is causing the immune system to overreact in a detrimental way—sometimes fatally.

Between June 1, 2006 and December 31, 2008, there were 12,424 reported adverse events following Gardasil vaccination, including 32 deaths. The girls, who were on average 18 years old, died within two to 405 days after their last Gardasil injection

Between May 2009 and September 2010, 16 additional deaths after Gardasil vaccination were reported. For that timeframe, there were also 789 reports of "serious" Gardasil adverse reactions, including 213 cases of permanent disability and 25 diagnosed cases of Guillain-Barre Syndrome

Between September 1, 2010 and September 15, 2011, another 26 deaths were reported following HPV vaccination

As of May 13, 2013, VAERS had received 29,686 reports of adverse events following HPV vaccinations, including 136 reports of death,7, as well as 922 reports of disability, and 550 life-threatening adverse events"

7 HPV vaccine adverse event report to VAERS as of May 13, 2013. Accessed July 10. 9, 2013.


Problems With HPV Vaccines In United States And Japan

“The United States Federal Government’s Vaccine Adverse Events Reporting System (VEARS) has received over 9,000 reports of problems since the vaccine’s introduction in 2006, which include at least 28 spontaneous abortions, and 7 deaths.

The Japanese government had decided to withdraw its support for the HPV vaccine schedule. This decision came after the government received approximately 2000 reports from women and girls suffering adverse reactions, including long-term pain, numbness, paralysis and infertility.”



“Moreover, another work…, published in Food Chem Toxicol. 1993 Mar;31(3):183-90, was the first to show that the solvent Tween 80 or Polysorbate 80 used for both Gardasil and Cervarix cause infertility; since then, human observations have confirmed fears of this outcome and billions of USD claims have been filed in the USA, UK and Japan. Please protect your children, protect your state, stop this HPV vaccination that does not make medical sense and puts your own children at risk. The Bill Gates sponsored 2.4 million doses was meant to yield 2.4 million infertile couples that would need IVF derived ovarian eggs for sale to Western Biotechnology firms for Embryonic Stem Cell Research."
Academician Prince Dr Philip Njemanze MD.


Dangers of HPV Vaccine Solvent and Histamines

“Polysorbate 80, also called Tween 80, is a detergent (surfactant) used to deliver certain drugs or chemical agents across the blood-brain barrier.
The HPV vaccine and season's flu vaccine made by GlaxoSmithKline, called Fluarix, contains polysorbate 80, as does Novartis' Agriflu.
The HPV vaccine, Gardasil, and a number of other childhood vaccines that carry the potential for serious side effects also contain polysorbate 80.
The scientific study on polysorbate 80 was done by Slovakian scientists and published in the journal Food and Chemical Toxicology in 1993.”

“The researchers injected female rats with Tween 80 …They discovered that Tween 80 accelerated the rats' maturation, prolonged the estrous cycle, decreased the weight of the uterus and ovaries, and caused damage to the lining of the uterus indicative of chronic estrogenic stimulation. The rats' ovaries were also damaged, with degenerative follicles and no corpora lutea (a mass of progesterone-secreting endocrine tissue that forms immediately after ovulation).

Such severe deformities to the ovary can lead to infertility.
The question is whether or not these effects also apply to humans. The answer is simply, we do not know at this time and no clear research has been demonstrated.

Gardasil also contains L-histadine, and histamines have been found to increase clot production fivefold when combined with surfactants. L-histidine can also pass through the placenta to the fetus.”


Long Term Consequences?

"The long-term consequences of Gardasil are not known. The manufacturer admits this and agrees it does not know its effect on young girls’ cancer risk, on their immunity system, on their reproductive system, or its genetic effects.  In due course, we will know this, possibly in twenty or thirty years from now when these young girls, the innocent subjects of the Gardasil experiment have become grown women and then report the consequences of their having taken the medication in their childhood on medical advice."

Cynthia Janak, a freelance journalist and researcher, reported to the American Life League explains ” What we have here is proof that there is scientific evidence that has been published in the past 15 years that states that HPV infection does not bear a direct relationship to the forming of cervical cancer. It also tells us that HPV, if allowed to will be taken care of by our own body’s natural processes. . ."most infections are short-lived and not associated with cervical cancer." With this being said, why do we need Gardasil when our own body is more than capable of eradicating HPV?”

August 8, 2013 ( - The British Medical Journal (BMJ) Case Reports journal has reported that a healthy 16-year-old Australian girl lost all ovarian function and went into menopause after being injected with the human papilloma virus (HPV) vaccine Gardasil.

Dr. Deirdre Little, the Australian physician who treated the girl, provides solid evidence that Gardasil caused the destruction of the girl's fertility.

She also pointed out that Merck Pharmaceutical, the manufacturer of Gardasil, has no supporting information on the effects of the vaccine on ovaries, suggesting that Merck had either done no safety testing on Gardasil in relation to its effects on women's reproductive systems, or had suppressed the information.

"Tens of millions of young girls have received the Gardasil vaccine since its approval by the FDA six years ago. If even a tiny fraction of them have experienced infertility as a result, then these girl children have been denied a very fundamental right, that is, the right to decide how many children they want to have," Mosher said. (Steven Mosher with the Population Research Institute)

ILLINOIS, November 29, 2011 ( - A well-known doctor who has repeatedly warned about the dangers of vaccines and who is particularly concerned about the Gardasil human papillomavirus (HPV) vaccine, has released two video testimonies by young women who were severely harmed after having been injected with Gardasil.

Dr. Joseph Mercola notes that the U.S. government’s Vaccine Adverse Event Reporting System (VAERS) database indicates that Gardasil has been linked to 49 sudden deaths, 213 permanent disabilities, 137 reports of cervical dysplasia, 41 reports of cervical cancer, and thousands of adverse events reports, ranging from headaches and nausea, to outbreaks of genital warts, anaphylactic shock, grand mal convulsion, foaming at the mouth, coma and paralysis.

Dr. Mercola also says it is concerning that HPV vaccines protect against only two of the more common strains of HPV associated with cancer, HPV-16 and HPV-18, even though there are more than 100 different types of HPV, at least 15 of which cause cancer.

Charlotte Haug, writing in the September issue of New Scientist noted, “Vaccinated women show an increased number of precancerous lesions caused by strains of HPV other than HPV-16 and HPV-18 … what effect will the vaccine have on the other cancer-causing strains of HPV? Nature never leaves a void, so if HPV-16 and HPV-18 are suppressed by an effective vaccine, other strains of the virus will take their place. The question is, will these strains cause cervical cancer? Results from clinical trials are not encouraging.”


Coverage for Black Women Insufficient?

In an article on the Physicians for Life website titled HPV Vaccines Do Not Cover Most Common HPV Types in Black Women (4/2014), we read the following:

“The HPV subtypes that are most common in black women in the United States are not targeted by the currently available vaccines Gardasil and Cervarix, according to new research.

The findings suggest that current HPV vaccination will be less beneficial for black women in the US than for their white counterparts, said study coauthor Catherine Hoyo, PhD, MPH, of Duke University, in Durham, North Carolina.

Persistent infection with HPV 16 and/or HPV 18 accounts for about 70% of all cervical cancers, said Dr. Hoyo. These are the subtypes targeted by Gardasil and Cervarix. Gardasil also targets HPV 6 and HPV 11.

Some black women in the new study did, in fact, have infections with HPV 16 and/or HPV 18. But much less often — their rate was about half of that of white women.

The investigators prospectively looked at 572 women at 10 Duke-affiliated clinics with abnormal Pap tests who then underwent colposcopy; the group was about evenly divided among blacks (n = 280) and whites (n = 292).

For whites with CIN1, the most frequent HPV subtypes were 16, 18, 56, 39, and 66.

But for blacks with CIN1, the most frequent HPV subtypes were 33, 35, 58, and 68.

Thus, in blacks, the most common genotypes were not HPV 16 and 18, which defies conventional wisdom about HPV infection.

The HPV vaccines Gardasil covers 6, 11, 16, 18, while Cervarix covers 16, 18."


The Moral Question

Dr. Gerard Nadal writes: “From a strict infectious diseases perspective, the goal of public health is to certainly limit the pool of pathogen within a population, and to eradicate it if at all possible. HPV requires sexual contact. It is that dimension of personal behavior, of choice, that leads to disease transmission and the current debate. Certainly, as Cardinal O’Connor used to say, good morality is good medicine. Virginity followed by fidelity in both parties to a marriage obviates the need in that couple for any immunization against STD’s.

…stress virtue in our children, and would hope that they remain virgins until marriage. Assuming all goes well, there is no guarantee that their spouses will be virgins, despite assurances given verbally. Therein lies the danger.

Given that the vaccine is only effective before one is exposed to the virus, the question of when to vaccinate becomes a real concern for parents. Children from the best and most faith-filled families succumb to peer pressure and have sex. Many identify virginity with vaginal intercourse and settle on oral and anal sex as compromise activities…

The problem is that HPV can be spread from the genitals to the mouth and oropharynx, with 35% of all throat cancers being caused by HPV. HPV can also be spread from the mouth to the genitalia.

In the strictest sense, vaccinating our children against this pathogen can save a great many women from cervical cancer, males from penile cancer, and both women and men from throat cancer. That’s simply a fact.

The problem comes in with some 68 reported deaths from Gardasil given to girls, and tens of thousands of reported adverse side-effects.

The question arises: What is an acceptable risk in vaccinating?  No vaccine is 100% safe.

Do we risk our children’s lives and health today in an attempt to hedge our bets on their behavior years down the line, or of their future spouses’ premarital behaviors?”

“Do we really want to go down the path of vaccinating children against deficits of moral intelligence and willpower? Gardasil therefore represents a new departure in medicine, where vaccines are used to protect people from the consequences of poor behaviour.”

“There is also the argument that teens who tend to practice risky behavior (like sex outside of marriage) at a greater rate than other subgroups of the populace will be more likely to do so if they are given an even greater false sense of security. Offering a “vaccine” against one of the most prolific STI’s could serve this purpose.

Noted moral theologian Dr. Janet Smith of Sacred Heart Seminary addressed the moral implications of the vaccine, aside from its cost and/or medical risks.

Her response: “I believe Catholic moral principles permit parents in both having their daughters vaccinated and refusing to have their daughters vaccinated. Parents who have concerns about possible adverse side effects, who believe having their daughters vaccinated will send the message that they approve of non-marital sex or who believe their daughters will remain chaste before marriage and will not marry a man carrying the HPV, would be justified in refusing to have their daughters vaccinated.

Parents who believe their daughters will remain chaste before marriage, or who have concerns about possible adverse side effects, or who will not marry a man carrying the HPV, and/or who believe having their daughters vaccinated will send the message that they approve of non-marital sex, would be justified in refusing to have their daughters vaccinated. (I would hope many parents could have such confidence about their daughters.)”


National Vaccine Information Center

If You Vaccinate, Ask 8! 

What You Need to Know Before & After Vaccination  

Under the National Childhood Vaccine Injury Act of 1986, nearly $3 billion has been awarded to children and adults for whom the risks of vaccine injury were 100%.  Vaccines are pharmaceutical products that carry risks, which can be greater for some than others. NVIC encourages you to become fully informed about the risks and complications of diseases and vaccines and speak with one or more trusted health care professionals before making a vaccination decision. 

  1. Am I or my child sick right now?
  2. Have I or my child had a bad reaction to a vaccination before?
  3. Do I or my child have a personal or family history of vaccine reactions, neurological disorders, severe allergies or immune system problems?
  4. Do I know the disease and vaccine risks for myself or my child?
  5. Do I have full information about the vaccine’s side effects?
  6. Do I know how to identify and report a vaccine reaction?
  7. Do I know I need to keep a written record, including the vaccine manufacturer’s name and lot number, for all vaccinations?
  8. Do I know I have the right to make an informed choice?

If you answered yes to questions 1, 2, and 3, or no to questions 4, 5, 6, 7 and 8 and do not understand the significance of your answer, you may want to explore information on NVIC's website to better understand the importance of your answer. These questions are designed to educate consumers about the importance of making fully informed vaccine decisions.  Click here to learn more about the role of informed consent in vaccination.

If you choose to vaccinate, always keep a written record of exactly which shots/vaccines you or your child have received, including the manufacturer’s name and vaccine lot number. Write down and describe in detail any serious health problems that develop after vaccination and keep vaccination records in a file you can access easily.


Recognizing Vaccine Reaction Symptoms

If you or your child experiences any of the symptoms listed below in the hours, days or weeks following vaccination, it should be reported to VAERS.  Some vaccine reaction symptoms include: 

  • Pronounced swelling, redness, heat or hardness at the site of the injection;
  • Body rash or hives;
  • Shock/collapse;
  • High pitched screaming or persistent crying for hours;
  • Extreme sleepiness or long periods of unresponsiveness;
  • Twitching or jerking of the body, arm, leg or head;
  • Crossing of eyes;
  • Weakness or paralysis of any part of the body;
  • Loss of ability to roll over, sit up or stand up;
  • Loss of eye contact or awareness or social withdrawal;
  • Head banging or onset of repetitive movements (flapping, rubbing, rocking, spinning);
  • High fever (over 103 F)
  • Vision or hearing loss;
  • Restlessness, hyperactivity or inability to concentrate;
  • Sleep disturbances that change wake/sleep pattern;
  • Joint pain or muscle weakness;
  • Disabling fatigue;
  • Loss of memory;
  • Onset of chronic ear or respiratory infections;
  • Violent or persistent diarrhea or chronic constipation;
  • Breathing problems (asthma);
  • Excessive bleeding (thrombocytopenia) or anemia.

There are other symptoms, which may indicate that you or your child has suffered a vaccine reaction. Not all symptoms that occur following vaccination are caused by the vaccine(s) recently received, but it cannot be automatically concluded that symptoms which do occur are NOT related to the vaccine. Therefore, it is important for your doctor to write down all serious health problems that occur after vaccination in the permanent medical record and to report ALL serious symptoms or dramatic change in physical, mental or emotional behavior that does occur following vaccination to VAERS.  It is also important that re-vaccination does not continue until it has been determined that the serious health problem which developed after vaccination was not causally related to the vaccination(s). Continued vaccination in the presence of serious health deterioration could lead to vaccine injury or death.

You May Be Surprised What an LPN Can Do!

by Susan Dammann RN, LAS, Heartbeat International Medical Specialist

Is an LPN permitted to perform Limited Obstetrical Ultrasounds?

Maybe yes. Maybe no. 

Recently a center in Ohio was challenged and told they could not use an LPN to perform Limited Obstetrical Ultrasounds. Apprehension struck the leadership of the organization, as they currently had an LPN on staff doing Limited OB scans. This challenge sent them on a research mission to determine if the law in Ohio had changed since the last time this issue had been examined three years previously.

After doing their due diligence to determine the current law in Ohio, it turned out that the challenge was invalid.  Rather, they were found to be perfectly within the scope of practice for LPN’s in the state of Ohio.

Following is from the response received from the Ohio Board of Nursing in response to their inquiry. “A licensed practical nurse with the necessary knowledge, skill, and competency, under the direction of a registered nurse or a physician, is not prohibited from performing limited obstetrical ultrasounds.”  Please remember this response pertains only to Ohio nurses.

Link to the full response.


Researching Other States

Megan from the Missouri State Board of Nursing Practice Department stated “There is nothing in the Missouri rules and statutes that defines what LPN’s can or cannot do. It is based on their education, knowledge, skills, training, judgment, and facility policies and procedures.”

The Louisiana Board of Practical Examiners stated there is no restriction prohibiting LPN’s in the state of Louisiana from performing limited OB ultrasounds with the appropriate training.

The Louisiana State Board of Practical Nurse Examiners opinion on the scope of practice of the LPN:

The Louisiana State Board of Practical Nurse Examiners (LSBPNE) has no "laundry list" of tasks/skills an lpn can perform. Such lists tend to limit practice. Scope of practice is a fluid concept. It changes as knowledge and technology expand. Lpns must possess the knowledge, skill, and ability to perform their duties, therefore, scope of practice comes down to the competency of the individual lpn.

We formulate this opinion based on the Louisiana Administrative Code, Title 46, Professional and Occupational Standards, Part XLVII. Nurses, Subpart 1. Practical Nurses, Chapter 9, Subchapter E., Curriculum Requirements-

B. The curriculum shall ensure that program graduates possess the knowledge, skill, ability, and clinical competency to practice safely and effectively as an entry level practical nurse in the state of Louisiana.

The Pennsylvania Board of Nursing stated: “The question of LPN’s doing limited ultrasound is not a question they would be able to answer because it is asking for an advisory opinion or approval for a particular conduct or specific conduct which the board is not permitted to do.” I was referred to the following documents:

Practical Nurse Law

Section 2.  (1) The "practice of practical nursing" means the performance of selected nursing acts in the care of the ill, injured or infirm under the direction of a licensed professional nurse, a licensed physician or a licensed dentist which do not require the specialized skill, judgment and knowledge required in professional nursing.

Pennsylvania Code § 21.148. Standards of nursing conduct.

 (a)  A licensed practical nurse shall:

    1. Undertake a specific practice only if the licensed practical nurse has the necessary knowledge, preparation, experience and competency to properly execute the practice.

Conversely, there may be other states in which LPN’s are not permitted to perform Limited Obstetric Ultrasounds. It is Heartbeat’s recommendation for each center to check the primary authority for nursing practice or more than one source within your state to determine what your state permits in this regard. Your state Board of Nursing and the Nurse Practice Act are good places to begin your research.

“Typically the boards have basic practice acts and documents related to scope of practice, including the education and training that is required for the practice of practical nursing, and what work LPN basic education allows. Most boards then allow for expanded practice with additional education.”

The article LPNs? What do they do? Where can they work? from the University of Phoenix states the following:

“Well, the answer to this question is highly dependent upon the state or province in which the LPN practices nursing. Some state boards of nursing, such as the ones in Texas and Oklahoma, have extremely wide scopes of practice that permit LPNs to do almost anything that individual facility policies will allow. LPNs in states with wide scopes of practice are usually allowed to perform most of the same skills that their RN coworkers can do… Other boards of nursing, such as the ones in California and New York, have narrow scopes of practice that severely limit what LPNs in those two states are allowed to do.

The LPN works under the supervision of a registered nurse (RN) or physician in most states; however, the LPN is often the only licensed nurse present in many facilities. LPNs also supervise nursing assistants in certain healthcare settings. With the right mix of experience, LPNs can be promoted to administrative positions such as wellness directors, assistant directors of nursing, wound care clinicians, staffing coordinators, and case managers.”


“Best” Practice

If an LPN is legally within the scope of practice in your state then the question of “best” practice come into the picture. Is allowing LPN’s to perform scans in the pregnancy help medical clinic the best practice?  In the case of the center in Ohio, they absolutely felt it was. Their LPN has been with them for many years and proven her high level of expertise and excellence. She has gone through the appropriate training and demonstrated a high level of competency.

Which “best” practice are we evaluating? The “best” practice of ultrasound for any patient? The “best” practice of including ultrasound for an at-risk patient?

When resources are scarce, in general or for particular shifts while a center is open, isn’t the question of “best” practice really more about what is “better” for the strongest outcome(s) for the patient? Is it “better” for her to be engaged now or ask her to return later, perhaps another day? For an appropriately trained LPN, whom the Medical Director recognizes as competent, providing the patient with a timely ultrasound seems to be better than risking a potential no-show at a later time.

For any pregnancy help medical clinic which finds that LPN’s are permitted in their state to perform scans, it will ultimately be the decision of the Medical Director consistent with Board policy.

Do you know your state laws regarding LPN’s?  Do you have LPN’s on staff performing scans? Have you contacted your state Board of Nursing?  Have you researched the Nurse Practice Act in your state? Has your Medical Director and Board addressed this question and set policy? Has every LPN practicing in your clinic gone through the required training and demonstrated competent skill levels?

Having done their due diligence in researching what the law is in Ohio this center can now move forward in confidence. Going through the process has made them stronger in the end, and will do the same for all who accept the challenge to go through the research process. 

Article updated June 2017

The Buzz from the Medical Tracks

LOL Email Main

We love hearing from you in the pregnancy help medical community.

Here's a sampling of what attendees said about the 2014 Heartbeat International Conference in Charleston, South Carolina. The Conference featured 78 workshops, including six each in the Medical Matters and Ultrasound Advancement tracks, in addition to two medically focused in-depth all-day workshop sessions and a special keynote from John Bruchalski, M.D., founder of Tepeyac Family Center & Divine Mercy Center.

1. "I feel much more confident after these workshops and webinars. Thank you!"
Jo-Ellen O'Keefe, Pregnancy Help and Information Center (Ectopic Pregnancy, Audrey Stout RDMS)

2. "Very interesting and groundbreaking information – this will change things!"
Reagan Nielson, Vitae Foundation (Update on Abortion Pill Reversal, Dr. Delgado)

3. "Dr. Delgado's presentation was so very exciting! It was interest peaking, informative and empowering. I'm grateful for his work and research regarding the APR. (Abortion Pill Reversal)"
Jamie Koser, Heartline Pregnancy Center (Update on Abortion Pill Reversal, Dr. Delgado)

4. "Very creative teaching! Lots of light bulbs went off!"
Cheryl Didrekson, Kimberly Home, Inc. (Flipping Uterus, Roxanne Ertel RDMS)

5. Amazing presentation! I have been scanning for 12 years and finally understood the anatomy of the uterus on U/S! Thank you!"
Jennifer Snowden, New Beginnings Women's Center (Flipping Uterus, Roxanne Ertel RDMS)

6. "Super excellent."
Katherine Niemiec, Family Life Services Clinic and Pregnancy Center (Flipping Uterus, Roxanne Ertel RDMS)

7. "Thank you! This was the most enlightening session of the week and worth the entire trip to learn these nuggets."
Patti White, New Beginnings (Flipping Uterus, Roxanne Ertel RDMS)


When am I Due? Why Should I be Concerned?

Healthy Pregnancy/Healthy Baby Series: Part 1

By Helen Risse RN MSN

baby-bumpIf you work with pregnant women, you have a great opportunity to improve birth outcomes. When a new client visits your pregnancy help organization, this may be the only contact you have with her.

What should she be sure to know before she leaves you? Does she know her due date? Will you be telling her based on the first day of her last menstrual period?

It is important to define due date and term pregnancy. Remind your new mother that her due date is really a due time that looks at two weeks before to two weeks after that date as being "term". Many people still think of pregnancy in terms of nine months. Explain that pregnancy is defined as 40 weeks or 10 lunar months.

At the end of 2013, the American College of Obstetrics and Gynecology (ACOG) redefined the meaning of "term".

  • Early term: Between 37 weeks, 0 days and 38 weeks, 6 days.
  • Full term: Between 39 weeks, 0 days and 40 weeks, 6 days.
  • Later term: Between 41 weeks, 0 days and 41 weeks, 6 days.
  • Post term: Between 42 weeks, 0 days and beyond.

Research has noted that the brain of a baby at 35 weeks, 0 days grows in size by two-thirds in the following four weeks.

Research has noted that although the weight of a baby may look normal, babies born before 39 weeks are sleepier babies. These babies do not latch and suckle as well as babies born at 39 weeks 0 days. They have more problems with higher bilirubin levels. These concerns can lead to serious consequences. The choice of an elective delivery date must factor in these findings.

Women should also be taught the signs of preterm labor. Teach women about contractions. Explain what they may feel and describe those symptoms that should put them on alert.

Describe contractions as feeling like:

  • Menstrual cramps
  • Low, dull backache
  • Pelvic pressure—feeling that the baby is pushing down
  • Heavy feeling in your pelvis (pelvic congestion)
  • Stomach cramps—with or without diarrhea
  • The abdomen may tighten or get firm then relax or soften

Describe vaginal discharge or bleeding:

  • An increase or change in your normal vaginal discharge
  • Red, brown or pink discharge or spotting

Describe water breaks:

  • Gush of fluid from vagina
  • Slow trickle of fluid from vagina-(panties feel wet and you don't know why)

General feeling that something is not right.

What should she do if she thinks she may be having preterm labor? Below are some guidelines you may discuss with your Medical Director to develop a policy/procedure for your center.

  • Empty bladder
  • Drink 1-2 glasses of water or juice (no caffeine, sugar, or sports drinks)
  • Lie down on your side and time the contractions from the beginning of one to the beginning of the next. Write down when the contractions start.

If the contractions are coming more than every 15 minutes or 4-6 in an hour, call your doctor.

It is important to stay well hydrated. Dehydration can often cause a woman to experience contractions.
Women should know the risks that increase concerns for preterm labor. Women who are at greatest risk for preterm labor are those who have had a previous preterm birth, as well as those who are pregnant with multiples, and those with certain abnormalities of their uterus or cervix.

Other risk factors include smoking, drinking alcohol, using illegal drugs, domestic violence, including physical, sexual or emotional abuse, or lack of support.

Additional risks factors related to her health include infections, including urinary tract infections, sexually transmitted infections, diabetes, high blood pressure, second trimester bleeding from the vagina, being underweight before pregnancy, obesity, and a short time period between pregnancies.

When asked if there is anything that can be done to prevent preterm labor, tell a woman to:

  • See her doctor early and regularly during pregnancy,
  • Eat nutritious meals and snacks,
  • Drink at least 8 glasses of water, juice or milk every day, and
  • Avoid cigarettes, alcohol, drugs and medications not prescribed by her doctor.

If you have one visit from a pregnant woman and pass on this information, you may contribute to an improved outcome. Every extra day her baby is in a healthy intrauterine environment is positive for the development of her baby, which in turn can be a big help to a new mother.


Spong CY. Defining "Term" Pregnancy: Recommendations From the Defining "Term" Pregnancy Workgroup. JAMA. 2013;309(23):2445-2446. doi:10.1001/jama.2013.62

ACOG Clinical Guidelines: Definition of term pregnancy. Committee Opinion No. 579. American College of Obstetricians and Gynecologists. Obstet Gynecol 2013;122:1139–40.35
Go the Full 40 Campaign tool Kit :

The last weeks of pregnancy count: July 5th, 2012l Kit:


Improving Your Medical Release Authorization Form (or Is Your Medical Release Form Legal?)

By Ellen L. Foell, Legal Counsel, Heartbeat International

medicalfilesWhat does a good medical records release authorization look like? Many centers have pieced together authorizations through the years in response to an increased understanding and awareness of the need for confidentiality.

With the passage of HIPAA in 1996, followed by HITECH in 2009, many states have made further efforts to supplement and buttress privacy rights. These states have passed statutes to further define patient rights with respect to confidentiality, access to medical records, and privacy expectations from health care providers.
Some of those state-level statutes mimic HIPAA. Others expand the definition of "health care provider" and consequently, suck pregnancy help organizations into the proverbial HIPAA vortex. Still other statutes, thankfully, delineate the areas in which HIPAA is not expanded.

All this to say, with regard to privacy expectations, confidentiality requirements, and specifically, a patient's rights to access medical records, one size does not fit all.

What About Medical Records Release Authorizations?

Not all states address the requirements of an authorization, though some states specify exactly what should be included in a medical records authorization. But note, simply because a state has a statute outlining what a records release authorization should incorporate, it does not automatically follow that the statute applies to a pregnancy help organization.

The statutes typically are included in the statutes for health care providers, physicians, or state governmental agencies that provide medical care and are thereby usually under the rule of HIPAA. It is Heartbeat's position that most pregnancy help organizations, even pregnancy help medical centers, do not come under the authority of HIPAA because they do not engage in the eight specified transactions necessary to qualify an organization as required to be HIPAA compliant.

However, if by some operation of the state definitions, your pregnancy center falls within the meaning of the statute, then statutory specifics pertaining to privacy and access to medical records, for example, should be applied.

For more detailed information, see Heartbeat's Frequently Asked Questions about HIPAA and Pregnancy Help Organizations (available to Heartbeat Affiliates only) and the Heartbeat Academy course, "HIPAA, Privacy Laws, and You".

How to Understand if HIPAA Applies to Your Center

Perhaps some examples might help our understanding.

Ohio law specifically gives a patient or a personal representative the right to obtain or examine a copy of all or part of one's medical record. The patient, his personal representative, or an authorized person must submit such a request in writing to the provider. The patient must make the request in writing, it must be signed by the patient, requesting the release within 60 days of the request. The request must also specify the recipient of the records including an address, or specify that the patient will personally pick up the records.

The provider must comply with the request unless disclosure would be medically contraindicated, in which case the provider will provide the record to a designated physician or chiropractor. A patient, his personal representative or an authorized person may bring a civil action against any provider who fails to furnish a medical record to enforce the patient's right of access to the record.

Like Ohio, Indiana's statute is very specific requiring the following as mandatory components for a valid authorization for release of medical records:

  1. The name and address of the patient.
  2. The name of the person requested to release the patient's record.
  3. The name of the person or provider to whom the patient's health record is to be released.
  4. The purpose of the release.
  5. A description of the information to be released from the health record.
  6. The signature of the patient, or the signature of the patient's legal representative if the patient is incompetent.
  7. The date on which the consent is signed.
  8. A statement that the consent is subject to revocation at any time, except to the extent that action has been taken in reliance on the consent.
  9. The date, event, or condition on which the consent will expire if not previously revoked.

South Carolina
South Carolina also has a statute specifying that health care providers (South Carolina's definition of a health care provider does not imply nor explicitly include a pregnancy help organization) must include the following information in any authorizations:

  1. Name and date of birth or social security number
  2. Statement of who is authorized to release records and who is authorized to receive records
  3. Purpose of Disclosure
  4. Type of information to be disclosed
  5. Psychiatric records or infectious diseases (i.e. HIV, Hepatitis C, TB, etc.) must be clearly marked or checked before they will be released and must be physician approved except for payment, treatment, or operations
  6. Statement acknowledging the patient's right to revoke or cancel authorization
  7. Statement indicating the patient's right to refuse the release of information
  8. Statement that information disclosed pursuant to the authorization may be subject to re-disclosure and is no longer protected under this authorization
  9. Statement that will not condition treatment on patient providing authorization
  10. An expiration date
  11. Signature of patient or patient's representative

On the other hand, California's statute reiterates the HIPAA requirements as the standard for medical records release authorizations.

The Takeaway

No two state statutes are exactly alike in breadth or in applicability, which is why this article is intended to be instructive, not directive. A center should take the following into consideration when evaluating its authorization to release medical records:

  1. Is the center a covered entity under HIPAA? If a center is a covered entity, the center should follow HIPAA regulations for releasing medical records.
  2. Is the state's definition of health care provider broad enough to include a pregnancy medical help center? If so, HIPAA regulations might still apply.
  3. If the state definitions of health care providers do not include, implicitly or explicitly, pregnancy medical help centers, then the attendant laws on authorizations will most likely not apply.
  4. However, a center can examine state statutes on access to medical records, and authorizations to release medical records for instruction on what a comprehensive authorization would include.
  5. Instructive state statutes regarding authorizations are often found in the context of workers' compensation statutes, physician-patient relationship statutes, and statutes governing governmental agencies.

A suggested comprehensive medical records authorization form is included here.



1. Health Insurance Portability and Accountability Act of 1996 42 U.S.C.§1320d-5(d) (2006)

2. Health Information Technology for Economic and Clinical Health, passed as part of the American Recovery and Reinvestment Act, (Pub.L. 111–5)

3. 45 C.F.R.§160.103

4. As an example, Texas has passed a statute which so expansively defines health care provider that pregnancy medical help centers are included in the definition. Consequently, the laws applying to health care providers apply. Texas Health and Safety Code § 181.001(b)(2)(B)

5. Ohio Revised Code, §3701.74(B)

6. Ind. Code § 16-39-1-4

7. S.C. Code of Regulations R. 69-58 § 17, 18

8. California Civil Code § 56.11, 45CFR § 164.508

9. 45 CFR 164.508(b)(1) and 164.508(c)(1)(i)



At the Heart of What it Takes to go Mobile

by Michele Chadwick, Director of Operations, ICU Mobile

ICUtruckHeartbeat's Betty McDowell gave an encouraging message in her presentation at the 2014 Heartbeat International Conference, which came down to a single phrase: I see you. The God of the universe acknowledges and recognizes you. You are valid.

At ICU Mobile, our name and mobile ultrasound ministry (ICU, think "I See You") was born out of a call to proactively reach out to help mothers see their babies in the womb, identifying that every life is valid—sometimes for the first time in a mother's heart.

Revealing and affirming life is at the heart of all our ministries, serving a vital, essential role in life-affirming work. When a pregnancy center provides medical ultrasound imaging, its representatives affirm that the act of visibly revealing life is essential to the ability to fully inform a pregnant mother of the life she carries.

Going mobile medically brings this vital life-imaging service to mothers outside of the center. At ICU Mobile, we believe that at the heart of an accomplished mobile medical clinic, as in the pregnancy center, is a commitment to offer services with faith, wisdom, and experience as our guide. We are committed to standing strongly on the strategic operating principle of extending the reach of our services for women into the –community—in the community of others.

A mobile medical clinic, when operating well, is a tool with the capability of joining a community together under the umbrella of life, drawing pregnancy resource centers together with the church and other community and organizational resources, in support of each other in the service of women.

Key factors that help encourage this united front include neutral branding, a process to provide a full continuum of care for the client, operating from each other's strengths through shared service models, and encouraging good stewardship through shared resources.

CBQuotePregnancy help expert Kirk Walden, in his book, "The Wall" (and who also presented at the Heartbeat Conference!) makes the case for uniting the community to serve women. He asks the question, "What happens if we're the first choice?" The "we" in this question is key. The "we" is all of us working together to be a mother's first choice. A mobile medical clinic can be the "vehicle" (no pun intended) for building this unity.

Mobile operations in joining others together can become one of the most effective ways to reach abortion-minded women. Mobile services provide an effective way to expand your reach without having to build a satellite office, expand internally, or require more space, and it allows a center the flexibility to move to locations to adjust to demographic changes and population shifts.

Further, going mobile avoids the issue of no-show appointments at your center, as well as helping to balance the number of clients seeking social support services and those seeking medical services. Going mobile alleviates the expense of renovation or expansion of services in your center, while providing opportunities to build network supports with other pregnancy help organizations in the community surrounding the center.

Each of these considerations factor into the thought process of going mobile in a community.

When considering the possibility of adding a mobile medical clinic, it is first important—as with adding any medical service—to recognize the seriousness of the endeavor and requires the highest level of commitment to a professional quality medical experience for the client, as it is visible and the first contact with a mother.

Equally important for an organization to note is that going mobile is a unique approach that influences how a center operates, affecting the procedural processes that are needed to accommodate a moving center. A board, leaders, staff, and the connected community must pray and seek wisdom and recognition of the call to serve in this mission capacity.

We recommend you seek others who already operate a mobile medical clinic to learn about effective methods of operation, strategies that work, and the significance of working together in community to serve. It is God who builds these mobile communities, so it will be God who lays the possibility and provides the opportunity for success.

As Kirk Walden asked at the Heartbeat Conference, "What can we do to join hands?" Mobile done in community with others will join hands, and as we are blessed to say at ICU Mobile, it joins hands for little feet.
Here are some practical questions and steps toward adding mobile services:

  1. Do you have a need to reach women in multiple locations who would benefit from the ability to change locations daily?

  2. Is your board and staff ready to take a logistically challenging step that would involve a comprehensive team effort?

  3. Contact ICU mobile and ask questions that would be important for you to consider when incorporating a new program.

  4. Once the board has the buy-in, meet with top donors to survey their interest in the project.

  5. Investigate friends and "influencers" on local college campuses to assess their interest.

Welcome to Heartbeat!

Heartbeat International is the first network of pro-life pregnancy resource centers in the U.S. and the largest and most expansive in the world. Since 1971, Heartbeat has supported, strengthened and started pregnancy help organizations, including pregnancy medical clinics, pregnancy resource centers,  maternity homes, and adoption agencies all over the world. Currently, Heartbeat serves over 2,500 affiliate locations on all six inhabited continents to provide alternatives to abortion.

We are a nonprofit, interdenominational Christian association of faith-based pregnancy resource centers, medical clinics, maternity homes, and nonprofit adoption agencies endorsed by Christian leaders nationwide.

Heartbeat's Life-Saving Vision... to make abortion unwanted today and unthinkable for future generations.

Heartbeat's Life-Saving Mission... to Reach and Rescue as many lives as possible, around the world, through an effective network of life-affirming pregnancy help, to Renew communities for LIFE.

To achieve our mission, we do the following:

We REACH those who are abortion-vulnerable through Option Line's® 24-hour call center and cutting-edge website,

"Reach down your hand from on high; deliver me..." - Psalm 144:7

We RESCUE those who are reached through our life-support network of pregnancy centers providing true reproductive health care, ministry, education, and social services where lives are saved and changed.

"Rescue me, O Lord, from evil men; protect me from men of violence. " - Psalm 140:1

We RENEW broken cities around the world, by developing pregnancy centers where abortion clinics are the only alternative for abortion-vulnerable women.

"He sent me to bind up the proclaim the year of the Lord's favor... They will renew the ruined cities that have been devastated for generations." - Isaiah 61:1-4

Heartbeat Principles:

  • Heartbeat affiliates propose and offer, through education and creative services, positive choices for the woman challenged by pregnancy.
  • Heartbeat affiliates shall not discriminate in their services on the basis of race, creed, color, national origin, age, or marital status.
  • Heartbeat affiliates’ services are personal, confidential, and non-judgmental.
  • Heartbeat affiliates shall not advise, provide, or refer for abortion or abortifacients.
  • Heartbeat affiliates encourage chastity as a positive lifestyle choice.

Heartbeat Program Policies

  • Heartbeat international does not promote abortion or abortifacients.
  • Heartbeat international does not promote birth control (devices or medications) for family planning, population control, or health issues, including disease prevention.
  • Heartbeat International does promote God's Plan for our sexuality: marriage between one man and one woman, sexual intimacy, children, unconditional/unselfish love, and relationship with God must go together.
  • Heartbeat International does promote sexual integrity/sexual purity before marriage and sexual integrity faithfulness within marriage.
  • All Heartbeat international policies and materials are consistent with Biblical principles and with orthodox Christian (Catholic, Protestant, and Orthodox) ethical principles and teaching on the dignity of the human person and sanctity of human life.

 Advancing Life-Affirming Pregnancy Help Worldwide

Experts to Help! Pro-Life Maternal-Fetal Medicine Docs

Two important resources for your center and medical director


by Susan Dammann RN, Medical Specialist

Dedicated to the care and preservation of both mother and fetus in every pregnancy, Pro-Life Maternal Fetal Medicine (MFM) is an association of pro-life doctors of like mind to AAPLOG (American Association of Pro-Life Obstetricians and Gynecologists).

This unique organization represents a contingent of life-minded Maternal Fetal Medicine (MFM) practitioners. (MFM is a subspecialty of Obstetrics and Gynecology dealing with all matters that can affect the health of a mother or fetus from before conception to the postpartum period.)

Members of Pro-Life MFM are also affiliated with the Society for Maternal-Fetal Medicine, a special interest group of the American College of Obstetrics and Gynecology who have received additional training and performed research in the care and management of pregnant women and fetuses.

The Role of Pro-Life MFM Practitioners

MFM professionals are specialists in high-risk pregnancy situations, and hold a uniquely expert place in relation to rank-and-file OB/GYN physicians or oncologists. MFM specialists are involved in guiding the management of medical and surgical complications a mother may encounter during pregnancy.

MFM specialists also provide diagnosis and management of medical and surgical conditions for the fetus. Care may include in utero treatment, modification of delivery timing or mode, and facilitation and coordination of care for the infant after delivery.

When a client presents in your center with a negative maternal or fetal diagnosis, there are alternatives to help ensure the survival of both mother and baby. For example, many women with a breast cancer diagnosis have carried their pregnancies to term and done better than women who abort.
Are you looking for a pro-life Maternal-Fetal Medicine specialist in your area? Visit Pro-Life MFM’s physician directory.

Hear from a Pro-Life MFM Expert

Dr. Murphy Goodwin, a well-known pro-life maternal fetal medicine specialist, wrote an excellent article called Medicalizing Abortion Decisions. Dr. Goodwin, whose obstetric practice in the Los Angeles area has been the largest in the United States for most of the last 15 years, serves many of the high-risk deliveries in the area.

While describing five cases of successful delivery where a mother had abortion recommended to her, Dr. Goodwin states that because of the dangerous combination of an ambivalent attitude toward the developing human in the medical community and fear of liability issues (owing to the unbalanced legal burden of informed consent and “wrongful birth”), physicians are often not providing readily available information that could affect their patients’ judgment regarding abortion when that mother has a major medical problem in pregnancy or any medical problem.

To suggest or recommend that abortion is the safest route carries no such responsibility, as there is no set legal precedent for a physician’s liability in a case where abortion was recommended on supposed medical grounds—even if that recommendation was subsequently found to be baseless or misrepresented.

Tragically, as Dr. Goodwin points out, “There is no counterweight to ‘wrongful birth.’ There is no ‘wrongful abortion.’

These are two helpful resources you’ll want to keep handy and make available to your medical director!

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