WOMEN’S HEALTH; THEORY, RESEARCH, POLICIES, PRACTICES HLTH 5465 3.0 , Winter 2014 Professor Pat Armstrong Class: 2.30-5.30 Tuesdays, Vari Hall 1158 Office Hours: after class or by appointment Vari Hall 2118, extension 22550 Email: patarmst@yorku.ca Course description: Women’s health is too frequently reduced to their reproductive organs, understood as universal and universally interpreted, treated and experienced. This course challenges those assumptions, locating women’s health within global, national, regional and local contexts and in what Dorothy Smith calls relations of ruling. Bodies are not irrelevant, but from this perspective they can only be understood within specific locations, times, spaces and relations. Although the focus is Canada and Canadian research, policies and practices, Canada has to be understood within the larger context of global patterns and exchange. And although the main emphasis is on feminist political economy, the class is open to, and informed by, other perspectives. Course objectives: There are two main purposes for this course. One is to trouble the categories and ways of seeing women’s health in the dominant research, policies and practices. The second is to acquire a critical understanding of research, policies and practices related to women’s health. In this way, the course will go well beyond what is often thought of as women’s health. The course has an additional and equally important, objective; namely, to critically engage students in the creation and conduct of the course. What follows is a suggested outline, suggested readings and suggested assignments. All are open to change and alternative methods. Students will be expected to read at least 100 pages for each class, selecting from among the suggested readings or from related ones. Given our short time frame for this course, it is strongly recommended that students begin reading well before classes begin. Course assignments: Every student is expected to participate fully in each class, coming prepared by reading and engaging in both presentations and debates. For each class, students will prepare a point form critical assessment of a reading or readings. These assessments will be no longer than four pages. These assessments will be cumulative in the sense of building on earlier readings and class discussions to reflect on new readings. These assessments will be handed in at each class and returned with comments but no grade. At the end of the term, students will hand in all the returned assignments and add a covering commentary in essay style on the entire body of work, a commentary of no more than ten pages Class # 1, January 7 This class will be devoted to introductions, discussion of the course content and theoretical approaches. We will come to an agreement on the contents, process, readings and assignment, although any of these may be subject to change after collective discussion and agreement. We will begin our discussion of theories related to women’s health, emphasizing feminist political economy and the determinants of health. 1 Browne, A. J., Smye, V.L. & Varcoe, C. (2007). Postcolonial-feminist theoretical perspectives and women’s health. M. Morrow, O. Hankivsky and C. Varcoe (eds.), Women’s Health in Canada: Critical Perspectives on Theory and Policy (pp. 124-142). Toronto: University of Toronto Press. Im, E.O. and Ai Meleis (2001) An international imperative for gender-sensitive theories in women’s health Journal of Nursing Scholarship 33(4):309-14. Jackson, Beth (2012) Theory and methods for thinking women Chapter 1 in P. Armstrong et al. (eds.)Thinking Women and Health Care Reform in Canada. Toronto: Women’s Press. McGibbon, Elizabeth (2012) Oppression: A Social Determinant of Health Black Point, Nova Scotia: Fernwood Withers, A.J. (20120 Disability Politics and Theory.Halifax: Fernwood Class #2, Jan 14 Assessing the Evidence and Understanding Methods There are critical issues to be raised about what constitutes evidence in health care and whose evidence counts. In addition, we can ask significant questions about the extent to which research takes gender and other social locations into account when developing our methods. Greaves, Lorraine (2009) “Women, Gender, and Health Research” pp.3-20 in Pat Armstrong and Jennifer Deadman, eds. Women’s Health. Intersections of Policy, Research, and Practice. Toronto: Women’s Press. Hankivsky, O, Reid, C., Cormier, R, Varcoe, C, Clark, N. Benoit, C., Brotman, S. (2010). Exploring the promises of intersectionality for advancing women’s health research. International Journal for Equity in Health, 9(5): 1-15. Kelly, Michael P., Antony Morgan, Josiane Bonnefoy, Jennifer Butt and Vivian Bergman (2007). The social determinants of health: Developing an evidence base for political action. WHO, October 2007. 03 Dec. 2007. http://www.who.int/social_determinants/resources/mekn_report_10oct07.pdf Messing, Karen (1998). One-Eyed Science Occupational Health and Women Workers. Philadelphia: Temple University Press. Morrow, M. & Hankivsky, H. 2007. Feminist methodologies and health research: Bridging trends and debates. M. Morrow, O. Hankivsky & C. Varcoe (eds.), Women’s Health in Canada: Critical Perspectives on Theory and Policy (pp. 93-123). Toronto: University of Toronto Press. Oudshoorn, Nelly (2011) Telecare Technologies and The Transformation of Healthcare Basingstoke: Palgrave McMillan, 2011 Read, S. & Maslin-Prothero, S. (2011). The involvement of users and carers in health and social research: The realities of inclusion and engagement. Qualitative Health Research, 21(5): 704–713. 2 Smith, Bonnee and Beth Hutchison (eds.) (2004). Gendering Disability. New Jersey: Rutgers University Press. World Health Organization (2006) Gender Equality, Work and Health: A Review of the Evidence www.who.int/gender/en World Health Organization (2007) Final report of the Women and Gender Equity Knowledge Network - Unequal, unfair, Ineffective and Inefficient. Gender inequity in health: why it exists and how can we change it www.who.int/social_determinants/themes/womenandgender/en/index.html Class #3, Jan.21. Body Matters Do bodies matter and how do they matter? Whose body is it anyway and which bodies are we talking about when? In this class, we will explore old and new debates about female bodies Suggested readings: Armstrong, Pat and Hugh Armstrong (1983): "Beyond Sexless Class and Classless Sex: Towards Feminist Marxism", Studies in Political Economy, 10 (Winter): 7-43, or (2010) The Double Ghetto: Canadian Women and Their Segregated Work Toronto: McClelland and Stewart. Chapter 4. Einstein, G. & Shildrick, M. (2009). The Postconventional Body: Retheorising Women’s Health. Social Science & Medicine, 69: 293–300. Fausto-Sterling, A (2006). "Bare Bones of Sex: Part II, Race and Bones", Social Studies of Science. Fausto-Sterling, A (2005). "Bare Bones of Sex: Part I, Sex & Gender." Signs, 30 (2): 1491-528. Fausto-Sterling, A (2000). Sexing the Body: Gender Politics and the Construction of Sexuality London: Routledge Gatrell, Caroline (2008) Embodying Women’s Work New York: Open University Press Hird, Myra (2004). Sex Gender and Science. New York: Palgrave. Johnson, Joy, Lorraine Greaves and Robin Repta (2009) “Better Science with sex and gender: facilitating the use of sex and gender-based analysis in health research” International Journal for Equity in Health, 8:14 (March) http://www.equityhealthj.com.content/8/1/14 Oudshoorn, Nelly (1994) Beyond the Natural Body. An Archeology of Sex Hormones. London: Routledge,. 1994 Price, Janet and Margrit Shildrick (1999). Feminist Theory and the Body: A Reader. New York: Routledge. 3 Rieker, P. P., & Bird, C. E. (2005). Rethinking gender differences in health: why we need to integrate social and biological perspectives. Journals of Gerontology, 60B: 40-47. Class #4. Jan. 28. Understanding Health How do bodies relate to health? And what do we mean by health? Thinking through health for women in a global and local context is the objective of this class. Doyal, Lesley (1995). What Makes Women Sick: Gender and the Political Economy of Health. New Brunswick: Macmillan Press. Lorber, Judith (2000). Gender and the Social Construction of Illness. New York: Altamira Press. Mancini Billson, Janet and Carolyn Fluehr-Lobban (eds.) (2005). Female Well-Being. Toward a Theory of Social Change. London: Zed Books. Mervat, Nassar, Karen Baistow and Janet Treasure (2007). The Female Body in Mind. New York: Routledge. Moss, Pamela and Isabel Dyck (2003). Women, Body and Illness. Oxford: Rowman and Littlefield. (Especially Chapter 2) Moss, Pamela and Katherine Techtsoonian eds. (2008) Contesting Illness. Processes and Practices Toronto: University of Toronto Press. Payne, Sarah (2006). The Health of Men and Women. Cambridge: Polity Press. Sherwin, Susan (coordinator) (1998). The Politics of Women’s Health. Philadelphia: Temple University Press. Schulz, Amy J. and Leith Mullings (eds.) (2005). Gender, Race, Class and Health: Intersectional Approaches. New York: The CUNY Graduate Centre. Class # 5 Feb 4. Global Patterns in Illness and Health Across the world, women suffer more ill-health than men even though in many western countries women outlive men. What are the similarities and differences in world patterns in health and illness? Why are there differences and similarities? Adanu, R. <.K. and T.R.B. Johnson (2009) Migration and Women's Health International Journal of Gynecology and Obstetrics 106(2):179-181 Block, D., C. Butt and H. McMullen (2008) Critical Context: Understanding Women's Sexual and Reproductive Health and Rights Internationally International Women’s Health Program http://iwhp.sogc.org/ Bucio, A and H. McMullen (2008) International Women's Health Special Report 2008 Ottawa Society of Obstetricians and Gynecologists of Canada 4 Ellsberg, M. et al. (2008) Intimate partner violence and women's physical and mental health in the WHO multi-country study on women's health and domestic violence: an observational study The Lancet April 5-11, 371(9619):1165-1172. García-Moreno C; Jansen HA; Ellsberg M; Heise L; Watts C. (2005) Multi-country Study on Women’s Health and Domestic Violence against Women. Initial results on prevalence, health outcomes and women’s responses. Geneva, Switzerland, World Health Organization [WHO] Jaggar, Alison M. (2002) “Vulnerable Women and Neo-Liberal Globalization: Debt Burdens Undermine Women's Health in the Global South” Theoretical Medicine and Bioethics 23(6, November):425-440 Moss, Nancy (2002) “Gender equity and socioeconomic inequality: a framework for the patterning of women's health” Social Science & Medicine 54 (5, March) Pages 649-661 Pollack Petchesky, Rosalind (2003). Global Prescriptions Gendering Health and Human Rights. London: Zed Books. Sciarra, J. (2009) “Global issues in women's health”International Journal of Gynecology & Obstetrics, Volume 104, Issue 1, Pages 77-79. Shah, Anup. Global Health Overview. Nov. 12 2007 http://www.globalissues.org/health/overview/?p=1 World Health Organization (2009) Women and Health: Today's Evidence Tomorrow's Agenda http://www.who.int/gender/documents/9789241563857/en/index.htm Class # 6. Feb 11. The State of Women’s Health in Canada Here we’ll look at the evidence on women’s health and illness in Canada, always asking which women, where are they located and why their experiences with health and illness differ? Pat Armstrong and Jennifer Deadman, eds. (2008) Women’s Health. Intersections of Policy, Research, and Practice. Toronto: Women’s Press. Canadian Perinatal Health Report 2003. From the Public Health Agency of Canada CIHI Report (2004). Recent Immigrant Women Report Being Healthier Than Canadian-Born Women. October, 2004. 03 Dec. 2007. http://www.cihi.ca/cihiweb/dispPage.jsp?cw_page=media_27oct2004_e DesMeules, Marie, et.al (2003). Women’s Health Surveillance Report. Ottawa: CIHI. Dion Stout, Madeleine, Gregory D. Kipling and Roberta Stout (2001). Aboriginal Women’s Health Research Synthesis Project. www.cwhn.ca Leipert, B. and J. George (2008) Determinants of Rural Women’s Health A qualitative study in 5 Southwestern Ontario The Journal of Rural Health 24(2):210-218. Meadows, Lynn M., Wilfreda E. Thurston and Christina Melton (2001). “Immigrant women's health”. Social Science & Medicine. May, 2001, volume 52(9):1451-1458. 03 Dec. 2007. http://www.sciencedirect.com/science Messing, Karen (1998). One-Eyed Science Occupational Health and Women Workers. Philadelphia: Temple University Press. POWER Reports Project for Ontario Women’s Health Evidence-based Report (2009- 2011) Volumes 1 and 2, http://www.powerstudy.ca/thepower-report Savarese, Josephine (2003). Exploring the Intersections Between Women’s Health and Poverty, A Policy Paper for Prairie Women’s Health Centre of Excellence. Centres of Excellence for Women's Health Research Bulletin. 03 Dec. 2007. http://www.uwinnipeg.ca/admin/vh_external/pwhce/pdf/exploringIntersections.pdf Class #7. Feb 25 Health and Employment Paid work can promote health by engaging workers in meaningful activity. Such work can also undermine health. For women, the hazards they face at work often get dismissed as female complaints or remain invisible because it is assumed women’s work is safe. Here we will uncover both the hidden hazards in women’s work and the hidden assumptions in much of the research on workplace health hazards. Baines, Donna (2004). "'Case Studies in Women's Occupational Health in the New Labour Market: Social Services, Stress, Violence, and Workload." Canadian Woman Studies. Volume 23, 3: 157-164. Briar, Celia (2009) Hidden Hazards in Women’s Work Wellington: Dunmore Publishing di Martino, Vittorio (2003). Relationship between Work Stress and Workplace Violence in the Health Sector. Geneva, ILO Workplace Violence in the Health Sector.) 03 Dec. 07. http://www.ilo.org/public/english/dialogue/sector/papers/health/stress-violence.pdf European Agency for Safety and Health at Work (2003) Gender Issues in Safety and Health at Work Luxembourg: European Union Forastieri, Valentina (2000). Important Note on Women Workers and Gender Issues on Occupational Safety and Health. Geneva, ILO Safe Work. 03 Dec. 2007. http://www.ilo.org/public/english/protection/safework/gender/womenwk.htm Messing, Karen, Katherine Lippel, Diane L. Demers and Donna Mergler (2000). Equality and Difference in the Workplace: Physical Job Demands, Occupational Illnesses, and Sex Differences. NWSA Journal (National Women’s Studies Association) – fall, Volume 12, Number 3:21-49. 6 Wilkins, Kathryn (2007). “ Work stress among health care providers”. Health Reports (Statistics Canada, Catalogue 82-003); 18: 33-36. http://www.statcan.ca/english/freepub/82-003XIE/2006011/articles/10367-en.pdf Class # 8, March 4 Health Care Work Health care is women’s work. They account for four out of five of the paid and unpaid care providers. Although often rewarding, it is risky work. Here we explore the conditions and relations of care work and their consequences for women’s health. While homes can be havens in a heartless world, they can also be harmful to women’s health. Similarly, women’s unpaid work in the formal economy, and the relationship between paid and unpaid work can threaten women’s health. Armstrong, Pat, Hugh Armstrong and Krista Scott-Dixon (2008) Critical to Care The Invisible Women in Health Services Toronto: University of Toronto Press Armstrong, Pat Unpaid Health Care. An Indicator of Equity http://new.paho.org/hq/index.php?option=com_content&view=article&id=2680&Itemid=4017 Armstrong, Pat, Hugh Armstrong, Ivy Bourgault, Jacqueline Choiniere, Eric Mykhalovskiy and Jerry White (2000). Heal Thyself: Managing Health Care Reform. Toronto: Garamond. Armstrong, Pat, Hugh Armstrong, Jacqueline Choiniere, Eric Mykhalovskiy and Jerry White (1997). Medical Alert: New Work Organizations in Health Care. Toronto: Garamond. Armstrong, Pat, Hugh Armstrong, Jacqueline Choiniere, Gina Feldberg and Jerry White (1994). Take Care: Warning Signals For Canadian Health Care. Toronto: Garamond. Baines, Donna (2006). "Staying with People Who Slap Us Around: Gender, Juggling and Violence in Paid (and Unpaid) Care Work." Gender, Work and Organization. March 13(3): 129151. Baines, Donna (2004)"Caring for Nothing: Work Organization and Unwaged Labour in Social Services. Work, Employment and Society, 18(2):267-295. Bedford, Kate (2010) Harmonizing Global Care Policy? Care and the Commission on the Status of Women. Gender and Development Programme paper number 7, February. Geneva: United Nations Research Institute for Social Development. Brannen, Cyndi (2006). Women’s Unpaid Caregiving and Stress. Centres of Excellence for Women's Health Research Bulletin. Spring. FindArticles.com. 03 Dec. 2007. http://findarticles.com/p/articles/mi_qa4118/is_200604/ai_n17174924 Clarke, Juanne, Paula C. Fletcher and Margaret A. Schneider (2002). Mothers caring for children with cancer. Centres of Excellence for Women’s Health Research Bulletin, 3(1):6-8. Coburn D., S. Rappolt, I. Bourgeault and J.Angus (1999). Medicine, Nursing and the State. Toronto: Garamond. 7 Colin Caroline, Jacques and Chris Smith (2005). “Nursing in the home. Experiences from England and Quebec (Canada)”. Human Relations, 58 (1): 5-32. Denton M., I.Urla, S. Davies and J. Lian (2002). “Job Stress and Job Dissatisfaction of HomeCare Workers in the Context of Health Care Restructuring”. Work, Health and Quality of Life, 32 (2): 327-357. Duxbury, Linda, Christopher Higgins and Bonnie Shroeder (2009) Balancing Paid Work and Caregiving Responsibilities: A Closer Look at Family Caregivers in Canada Ottawa: Human Resources and Skills Development Canada Gahagan, Jacqueline (2005). A Healthy Balance: Women’s Paid and Unpaid Work in Nova Scotia. Centres of Excellence for Women's Health Research Bulletin. FindArticles.com. Spring. 03 Dec. 2007. http://findarticles.com/p/articles/mi_qa4118/is_200504/ai_n13510201 Grant, Karen R, Carol Amaratunga, Pat Armstrong, Madeline Bosco, Ann Pederson and Kay Willson (2004) Caring For/Caring About. Women, Home Care and Unpaid Caregiving Aurora: Garamond. Neysmith, Sheila (ed.) (2000). Restructuring Caring Labour. Toronto: Oxford. O’Brian Pallas, Linda and Andrea Baumann (2000). “Toward Evidence-based policy decisions: a case study of nursing health human resources in Ontario, Canada”. Nursing Inquiry 7 (4): 248257. O’Reilly, Patricia (2000). Health Care Practitioners. Toronto: University of Toronto Press. Pederson, Anne (2003). “Who Cares?. The Costs and Benefits of Caregiving”.Bulletin Spring. 03 Dec. 2007. http://www.cewh-cesf.ca/bulletin/v3n1/page1.html Rosenberg, Harriet (1990). “The Home is the Workplace”. Pp. 57-80 in Meg Luxton, Harriet Rosenberg and Sedef Arat Kroc, Through the Kitchen Window. Toronto: Garamond. Sioban Nelson and Suzanne Gordon (eds.) (2006). The Complexities of Care. Nursing Reconsidered. Ithica: Cornell University Press. Twohig, Peter L. (2005). Labour in the Medical Laboratory - Workers in the Maritimes 19001950. Montreal: McGill- Queen’s University Press. Zimmerman, Mary K., Jacquelyn S. Litt and Christine E. Bose (eds.) (2006). Global Dimensions of Gender and Carework. Stanford: Standford University Press. WHO World Health Organization (2006) Health Workers Geneva: WHO. Final Report of the Canadian Nursing Advisory Committee, (2002) Our Health, Our Future. Creating Quality Workplaces for Canadian Nurses. www.hc-sc.gc.ca. Class # 9, March 11, Health Services for Women Women not only deliver most of the health services. They also account for the majority of those who use them. In this class, we will look at the evidence on women’s access to and treatment in 8 using health care. Armstrong, Pat et al. eds. (2012) Thinking Women and Health Care Reform in Canada Toronto: Women’s Press Browne, Annette J. and Jo-Anne Fiske (2001) “First Nations Women’s Encounters with Mainstream Health Care Services” Western Journal of Nursing Research, 23 ( 2): 126147 Fowler, Robert et al. (2007). “Sex and Age Differences in the Delivery Outcomes of Critical Care”. CMAS Dec. 4, 177(12):1513-1521. Gray Gwen (1998) Access to Medical Care under Strain: New Pressures in Canada and Australia Journal of Health Politics, Policy and Law 1998 23(6):905-947 Jackson, Beth E. et al. “Gender-based Analysis and Wait Times: New Questions, New Knowledge” 15 pp.available at www.hc-sc.gc.ca 9 Devaney, Julie (2012) My Leaky Body Fredricton: Goose lane Press Kaul, Padma et al. (2007). “Differences in Admission Rates and Outcomes Between Men and Women Presenting to Emergency Departments with Coronary Syndromes. CMAS Nov. 6, 177(10): 1193-1199. Kermode-Scott Barbara (2004) “Canada accused of failing women patients” British Medical Journal 329:192 (24 July) Tannenbaum, Cara and Nancy Mayo (2003) “Women’s health priorities and perceptions of care: a survey to identify opportunities for improving preventative health care delivery for older women” Age and Ageing 32: 626-635 Class # 10. March 18.Women and Drug Gadalla, T. and N. Piran (2007) Eating Disorders and Substance Abuse in Canadian Men and Women: A National Study Eating Disorders 15(3): 189-203 DOI:10.1080/10640260701323458 Mintzes, B. (2002) Influence of direct to consumer pharmaceutical advertising and patients' requests on prescribing decisions: two site cross sectional survey British Medical Journal, Feb:324;278 Rochon Ford, Anne and Diane Saibil, eds. (2010) The Push to Prescribe. Women and Canadian Drug Companies Toronto: Women’s Press Spittal et al (2003) Surviving the sex trade: A comparison of HIV risk behaviours among street-involved women in two Canadian cities who inject drugs. AIDS Care 15(2):187195. Wen, S.W. et al. (2008) Patterns of pregnancy exposure to prescription FDA C, D and X drugs in a Canadian population Journal of Perinatology 28: 324–329; doi:10.1038/jp.2008.6; Class # 11, March 25. Maternity and Reproductive Health Now, finally, we look at what most people think of when they think of women’s health but we will try to look at these areas in ways that are far from common. Benoit, Cecilia (2006). “Social Determinants of Mental Health Disparities among New Mothers”. Centres of Excellence for Women's Health Research Bulletin. Spring 2006. 03 Dec. 2007. http://findarticles.com/p/articles/mi_qa4118/is_200604/ai_n17174925 Benoit, C, Zadoroznyj, M., Hallgrimsdottir, H.,Treloar, A. & Taylor, K. (2010). Medical dominance and neoliberalisation in maternal care provision: The evidence from Canada and Australia. Social Science & Medicine, 71: 475-481. Bernard, W.T. (2001). Including Black Women in Health and Social Policy and Development: 10 Winning over Addictions and Empowering Black mothers with Addictions. Halifax: Maritime Centre of Excellence for Women’s Health. Clow, Barbara and Ann Pederson (2006). Time to Deliver on Gender and HIV/AIDS. Centres of Excellence for Women’s Health Research Bulletin, Fall 2006. 03 Dec. 2007. http://findarticles.com/p/articles/mi_qa4118/is_200610/ai_n17196760 Kronelsen, Jude (ed.) (2001). Midwifery in Canada: Directions for Research. Proceedings from the National Invitational Workshop on Midwifery Research. May. British Columbia Centre of Excellence for Women’s Health. 03 Dec. 2007. http://www.cewhcesf.ca/PDF/bccewh/midwifery-in-canada-directions.pdf Mother and Child Reunion: Preventing Fetal Alcohol Spectrum Disorder by Promoting Women’s Health. British Colombia Centre of Excellence for Women’s Health. 03 Dec. 2007. http://www.cewh-cesf.ca/PDF/bccewh/FASbrief.pdf Pushing for Change: Challenges of Integrating Midwifery into the Health Care System. British Colombia Centre of Excellence for Women’s Health. 03 Dec. 2007. http://www.bccewh.bc.ca/publications-resources/documents/pushingforchange.pdf Bottorff, JL., C Kalaw, JL Johnson, M.Stewart, L.Greaves and J. Carey (2006). “Couple dynamics during women’s tobacco reduction in pregnancy and postpartum”. Nicotine and Tobacco Research. Vol 8, No 4, 499-509. British Columbia Centre of Excellence for Women’s Health. Devries K.M. and L. Greaves (2004). “Smoking cessation programs for pregnant women: Current Canadian programs and future development”. Canadian Journal of Public Health. 95(4): 278279. Greaves L. and N. Poole (2005). “Victimized or validated? Responses to substance-using pregnant women”. Canadian Women Studies. Vol 24, No 1: 87-95. Sutherns, Rebecca and Ivy Lynn Bourgeault (2003). “Finding Out About Birth Options in Rural Canada is Harder than You Might Think”. Network Magazine. Winter, Vol 5/6 No 4/1. Canadian Mothers Speak Out. Final Report, Baseline Consumer Focus Group Report, MCP2 Multidisciplinary Collaborative Primary Maternity Care Project (A joint initiative of the Association of Women’s Health Obstetric and NeoNatal Nurses (Canada); Canadian Association of Midwives; College of Family Physicians of Canada; The Society of Obstetricians and Gynaecologists of Canada; The Society of Rural Physicians of Canada). Lewis, Gwyneth (2004). Beyond the numbers: reviewing maternal deaths and complications to make pregnancy safer. World Health Organization. Geneva: WHO. Kronelsen, Jude (ed.) (2005).Rural women's experiences of maternity care: implications for policy and practice. Status of Women Canada, Ottawa. July. Public Health Agency of Canada. Special Report on Maternal Mortality and Severe Morbidity in Canada. Enhanced Surveillance: The Path to Prevention. Ottawa: Public Health Agency of Canada, 2004:13. 03 Dec. 2007. http://www.phac-aspc.gc.ca/rhs-ssg/srmm-rsmm 11 Best Start (2001). Workplace reproductive health: research & strategies. Best Start: Ontario's Maternal, Newborn and Early Child Development Resource Centre. Toronto. 03 Dec 2007. http://www.beststart.org/resources/wrkplc_health/pdf/WorkplaceDocum.pdf Moon M., L. Breitkreuz, C. Ellis and C. Hanson (1999). Midwifery Care: Women's Experiences, Hopes and Reflections. Prairie Women’s Health Centre of Excellence (PWHCE), June. Van Esterik, Penny Telling a New Story about Risk: Gender, Breastfeeding, and Broadening the Questions on Child Survival. Centres of Excellence for Women’s Health Research Bulletin. Fall 2006. 03 Dec. 2007 http://findarticles.com/p/articles/mi_qa4118/is_200610/ai_n17196756 Centres of Excellence for Women’s Health Research Bulletin (2006). Mental Health and Addictions in Women, Spring 2006. http://www.cewh-cesf.ca/PDF/RB/bulletin-vol5no1EN.pdf Battaglini, Alex, Sylvie Gravel, Carole Poulin, Jean-Marc Brodeur, Danielle Durand andSuzanne DeBlois (2001). “Immigration and Perinatal Risk”. Centre d’excellence pour la santé des femmes–Consortium Université de Montréal. What Makes Us Healthy, What Makes Us Sick?, Bulletin “Summer 2001. 03 Dec. 2007. http://www.cewhcesf.ca/bulletin/v2n2/bulletin_vol2no2_en.pdf Health Canada (1999). Women and Sexual and Reproductive Health. 03 Dec. 2007. http://www.hc-sc.gc.ca/hl-vs/pubs/women-femmes/sexu_e.html Class #12, April 1. Looking Ahead, Thinking Back The content of this last class will be determined by classroom discussions . 12