En la zona metropolitana de Phoenix, el calor urbano está afectando la salud, la seguridad y la economía y se espera que estos impactos empeoren con el tiempo. Se prevé que el número de días por encima de 110˚F aumentará más del doble para el 2060. En mayo de 2017, The Nature Conservancy, el Departamento de Salud Pública del condado de Maricopa, Central Arizona Conservation Alliance, la Red de Investigación en Sostenibilidad sobre la Resiliencia Urbana a Eventos Extremos, el Centro de Investigación del Clima Urbano de Arizona State University y el Center for Whole Communities lanzaron un proceso participativo de planificación de acciones contra el calor para identificar tanto estrategias de mitigación como de adaptación a fin de reducir directamente el calor y mejorar la capacidad de los residentes para lidiar con el calor. Las organizaciones comunitarias con relaciones existentes en tres vecindarios seleccionados para la planificación de acciones contra el calor se unieron más tarde al equipo del proyecto: Phoenix Revitalization Corporation, RAILMesa y Puente Movement. Más allá de construir un plan de acción comunitario contra el calor y completar proyectos de demostración, este proceso participativo fue diseñado para desarrollar conciencia, iniciativa y cohesión social en las comunidades subrepresentadas. Asimismo el proceso de planificación de acciones contra el calor fue diseñado para servir como modelo para esfuerzos futuros de resiliencia al calor y crear una visión local, contextual y culturalmente apropiada de un futuro más seguro y saludable. El método iterativo de planificación y participación utilizado por el equipo del proyecto fortaleció las relaciones dentro y entre los vecindarios, las organizaciones comunitarias, los responsables de la toma de decisiones y el equipo núcleo, y combinó la sabiduría de la narración de historias y la evidencia científica para comprender mejor los desafíos actuales y futuros que enfrentan los residentes durante eventos de calor extremo. Como resultado de tres talleres en cada comunidad, los residentes presentaron ideas que quieren ver implementadas para aumentar su comodidad y seguridad térmica durante los días de calor extremo.

Como se muestra a continuación, las ideas de los residentes se interceptaron en torno a conceptos similares, pero las soluciones específicas variaron entre los vecindarios. Por ejemplo, a todos los vecindarios les gustaría agregar sombra a sus corredores peatonales, pero variaron las preferencias para la ubicación de las mejoras para dar sombra. Algunos vecindarios priorizaron las rutas de transporte público, otros priorizaron las rutas utilizadas por los niños en su camino a la escuela y otros quieren paradas de descanso con sombra en lugares clave. Surgieron cuatro temas estratégicos generales en los tres vecindarios: promover y educar; mejorar la comodidad/capacidad de afrontamiento; mejorar la seguridad; fortalecer la capacidad. Estos temas señalan que existen serios desafíos de seguridad contra el calor en la vida diaria de los residentes y que la comunidad, los negocios y los sectores responsables de la toma de decisión deben abordar esos desafíos.

Los elementos del plan de acción contra el calor están diseñados para incorporarse a otros esfuerzos para aliviar el calor, crear ciudades resilientes al clima y brindar salud y seguridad pública. Los socios de implementación del plan de acción contra el calor provienen de la región de la zona metropolitana de Phoenix, y se brindan recomendaciones para apoyar la transformación a una ciudad más fresca.

Para ampliar la escala de este enfoque, los miembros del equipo del proyecto recomiendan a) compromiso continuo e inversiones en estos vecindarios para implementar el cambio señalado como vital por los residentes, b) repetir el proceso de planificación de acción contra el calor con líderes comunitarios en otros vecindarios, y c) trabajar con las ciudades, los planificadores urbanos y otras partes interesadas para institucionalizar este proceso, apoyando las políticas y el uso de las métricas propuestas para crear comunidades más frescas.

The copper intrauterine device, or IUD, is a long-term, reversible contraceptive first introduced by Howard Tatum and Jamie Zipper in 1967. Health care providers place an IUD inside a woman’s uterus to prevent pregnancy. Copper IUDs are typically made of T-shaped plastic with some portion covered with exposed copper. Prior to the invention of the first IUDs, women had few long-term options for safe and reliable birth control. Those options mostly consisted of barrier methods and the oral birth control pill, which were only effective if used correctly and consistently. For women seeking to control their fertility, a copper IUD was one of the first forms of long-term birth control that was highly effective and did not require consistent and regular action on the woman’s part to remain effective.

In 2010, the Catholic Church excommunicated Margaret McBride, a nun and ethics board member at St. Joseph’s Hospital and Medical Center in Phoenix, Arizona. McBride was excommunicated latae sententiae, or automatically, for approving a therapeutic abortion, which is an abortion that is required to save a pregnant woman’s life. McBride approved an abortion for a woman who was twenty-seven years old, eleven weeks pregnant with her fifth child, and suffered from pulmonary hypertension, a life-threatening condition during pregnancy. Following McBride’s decision, St. Joseph’s lost its affiliation with the Catholic Church, which it had maintained since the late 1800s. Affiliation with the Catholic Church required that the hospital abide by Canon Law, which is the law of the Catholic Church. Under Canon Law, abortion is serious wrongdoing that could result in excommunication, as it did in the case of McBride. McBride’s excommunication illustrated the impact that affiliation of Catholicism with hospitals had on patients’ ability to receive comprehensive reproductive health care.

Carol Downer was a reproductive health and abortion rights activist in the twentieth and twenty-first centuries in the US and other countries. During the late 1960s, many women reported knowing little about female anatomy and receiving little information from their physicians. Downer advocated for women’s reproductive anatomy education and encouraged women to not rely on the intervention of a medical doctor for all reproductive issues. Downer demonstrated how to perform a vaginal self-examination to many women and taught women around the world how to provide safer in-home abortions when abortions were illegal. Downer helped start clinics throughout California which provided some of the first legal abortions in the US. With her reproductive health activism, Downer spread reproductive health self-help tactics throughout the US and the world, thereby improving women’s access to health information.

Misericordia et Misera (Mercy with Misery) was a letter written by Pope Francis and published in Rome, Italy, on 20 November 2016. Through the letter, Pope Francis gives priests the ability to grant forgiveness for abortion. Before Pope Francis’s letter, priests had some ability to grant forgiveness for the Catholic sin of abortion, but bishops had to grant that ability to the priests individually. Prior to the letter, the official rules of the Catholic Church did not state that priests could forgive abortion-related sins. The extension provided in the letter did not change the status of abortion as a grave sin that could result in excommunication. By extending that ability to priests, Pope Francis made forgiveness through the Catholic Church more accessible for women, doctors, and those who take part in an abortion, which started a discussion about the status of abortion in the Catholic Church in the twenty-first century.

In 1904, physician William Henry Walling published Sexology, a family medicine reference book. In his book, Walling proposed that his guidance would help people who were married or single and young or old, as well as anyone who wanted to conform to, what he claims are, gender expectations. Sexology discusses issues such as masturbation, abortion, pregnancy, labor, and marriage. Despite Walling’s limited scientific explanations and evidence for his medical claims, the Puritan Publishing Company printed and distributed the book, which received many positive reviews and endorsements from other physicians, college presidents, politicians, and religious leaders. However, in the twenty-first century, people may consider many of Walling’s claims to be sexist and oppressive toward women. Sexology provides readers with examples of historical medical misconceptions of male and female anatomy and provides context for the logic of reproductive medicine at the turn of the twentieth century.

By demonstrating the struggle for sound standard of care for non-medical reproductive health care providers during the nineteenth and early twentieth century, this project emphasizes what the standards of reproductive health care for abortion and contraception might be like if the organizations that made them so readily available, like Planned Parenthood, were defunded or criminalized in our modern setting.

In the early twentieth
century, birth control advocate Margaret Sanger published eight
issues of a feminist magazine called The Woman Rebel. During
this time, discussion of sex education, birth control, and
abortion were illegal. The magazine featured literary pieces on
topics like women’s rights, love and marriage, women in the
workplace, reproductive and sexual education, and contraception.
The Woman Rebel was one of the first magazines that discussed
issues that working class American women faced. Through the
magazine, Sanger sought to convince female readers to reject
their oppression and become what she called women rebels. The
Woman Rebel generated attention and controversy around the birth
control and feminist movements in the United States during the
twentieth century, advancing those movements and creating a
community of women with the common intent to rebel against
apparent injustice.

Barbara Seaman was a writer, investigator, and advocate for female healthcare rights during the twentieth century in the United States. Seaman’s work addressed the gendered prejudice she observed in the US healthcare system and argued that women of the 1960s lacked the proper tools to make informed decisions about pregnancy care, breastfeeding, childbirth, and contraception. Seaman wrote the book The Doctor’s Case Against the Pill in 1969 to expose the dangers in prescribing and consuming high doses of estrogen in the form of birth control. Seaman’s objective was to expose what she described as pharmaceutical companies’ drive for profit over safety. Her reporting helped provide a voice to many women who lacked proper health information and helped improve the standard of healthcare that women received in the US. Through her publications and activism, Seaman brought women’s healthcare to the public’s attention and contributed to the feminist and women’s healthcare movements of the twentieth century.

In 2013, Lois Uttley, Sheila Reynertson, Larraine Kenny, and Louise Melling published “Miscarriage of Medicine: The Growth of Catholic Hospitals and the Threat to Reproductive Health Care,” in which they analyzed the growth of Catholic hospitals in the United States from 2001 to 2011 and the impact those hospitals had on reproductive health care. In the US, Catholic hospitals are required to abide by the US Catholic Church's Ethical Guidelines for Health Care Providers, also called the Directives. The authors of the article argue that the Directives threaten reproductive health because of their limitations on contraception, sterilization, some infertility treatments, and abortion. The report demonstrated an increase in Catholic hospitals and an associated impact on reproductive health care, which formed the basis for lawsuits the American Civil Liberties Union brought against various Catholic hospitals and health care networks during the early 2000s.