February 15, 2023

Putting your health first shouldn’t be hard. Skimm Well is here to break down the latest in health, and answer your burning wellness questions with science-backed insight from experts. Tell us what you need by submitting a question here.

The confusion around the abortion pill.

Here’s a question about half of US adults don’t know the answer to, according to a recent survey: Is medication abortion legal in my state right now? 

The Dobbs decision last year changed state and federal laws, causing confusion around when and where medication abortions (which account for more than half of abortions in the US) are legal. For example: Is it legal for someone who lives in a state that bans abortion to get the abortion pill out of state, and then return home? 

“That’s a gray area that even some of the top legal minds…haven’t been able to answer for us,” said Dr. Amy Addante, an OB-GYN in Illinois. Some abortion rights advocates say the confusion is intentional because the fear of legal repercussions can deter people from seeking abortions and docs from providing them. 

So is the abortion pill still legal or not?

This month, a federal judge in Texas could reverse the FDA’s approval of the first of two drugs that make up a medication abortion and take it off the market nationwide. That drug, mifepristone, aka “the abortion pill,” blocks the hormone progesterone needed to support a pregnancy. While the second drug, misoprostol, makes the uterus cramp to help pass the pregnancy. Medication abortions are considered safe and effective for ending a first-trimester pregnancy, and the drugs are also used to help manage miscarriages.

For now, access depends on where you live. There’s a near-total ban on abortions in 13 states, and the Guttmacher Institute, a research group that supports abortion rights, lists another 17 states that limit access to medication abortion — even though the Biden admin has argued that the US Postal Service could still deliver the pills in these states. For more info, check out the Kaiser Family Foundation’s legal tracker.

Are there any alternatives?

If mifepristone were banned, Dr. Addante said misoprostol alone would still be 75-95% effective at ending a pregnancy. But it could require higher doses and cause more side effects. “It's the difference between riding a bike versus driving a car," she said. "Driving a car, you're gonna get there a lot faster."

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Vague laws around abortion do nothing but make it more difficult for people to get health care. Although the Texas ruling could take the pill off the market, that decision wouldn't be the end-all — appeals could eventually take the case to the US Supreme Court.

What's gone off the rails...

An Ohio train — and its potentially hazardous contents. Earlier this month, 38 of 150 cars came off the tracks in East Palestine, Ohio, including at least 10 that had been carrying toxic chemicals. The incident sparked a days-long fire that forced officials to evacuate residents while they conducted a “controlled release” to avoid an explosion. The main chemical of concern: vinyl chloride, a known carcinogen linked to several cancers. Officials lifted the evacuation order last week, saying the air was safe to breathe based on EPA testing, despite the odor. Local residents, who’ve been advised to drink bottled water, have complained of headaches and other illnesses, and along with officials, reported fish dying in local streams. And the EPA said Friday that the chemicals carried on the train “continue to be released to the air, surface soils, and surface waters.” Efforts to clean up the “toxic soup” are ongoing, but answers to many outstanding questions are likely to come slowly as federal and local officials investigate the “complex environmental disaster.”

What’s getting an unexpected reaction…

The Lindsay Clancy case. After Clancy allegedly killed her three children and attempted to take her own life, her loved ones and fellow mothers on the internet have responded with notable empathy, revealing an understanding of how overpowering postpartum mental illness can be to those who’ve experienced or witnessed it. Clancy's exact diagnosis is unclear. But to some, her case reveals the need for better diagnosis and treatment of postpartum conditions. Meanwhile, prosecutors are seeking to remove questions of mental illness from the equation. 

If you or someone you know is struggling, call 988 for the Suicide and Crisis Lifeline or 1-833-943-5746 for the National Maternal Mental Health Hotline.

There’s a new type of vibrator…

For your colon. Vibrant, a new constipation treatment, is a drug-free pill that vibrates to stimulate the intestines, and it’s now available to people who experience chronic constipation. Another option for the millions of Americans (mostly women) who struggle to keep their bowel movements…moving.

While male birth control is inching closer to reality…

Male equipment may have gained some inches.

Do you have any advice for maintaining a vaginal pH? 

Dr. Suzanne Gilberg-Lenz, OB-GYN and author of “Menopause Bootcamp,” says: 

There are some cases in which you may want to work with a gynecologist to either preserve “good” vaginal bacteria or reintroduce it. But most of the time, the vagina is gonna do its own thing. You can use warm water regularly to rinse the vulva, and maybe even a mild soap if you’re not sensitive. But otherwise, most people won't need to do much. That said…

Don’t: put weird stuff in your vagina or sit in non-breathable leggings all day. 

Do: let things air out and wear loose cotton. 

This Q&A has been edited for length and clarity. You can read the full interview here.

“‘You Just Need to Lose Weight’ And 19 Other Myths About Fat People” by Aubrey Gordon

If you were ever under the impression that being fat is a choice or just a matter of calories in, calories out, Aubrey Gordon wants to clear up a few things. The co-host of the popular podcast “Maintenance Phase” draws on reams of research in her new book. She’ll get you thinking about the prevalent, under-researched health conditions (like PCOS) that impact traditional weight-loss methods, and all of the data that suggests dieting often leads to weight gain. Required reading for anyone who’s ever been tempted to give — or has gotten tired of receiving — weight loss advice.