women’s health

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Don’t Rush Your Delivery

Monday, August 27th, 2012

While being pregnant is a blessing, how you feel while pregnant is hardly ever comfortable or convenient.  As your delivery date approaches, this will become even more true.  That doesn’t mean it’s a good idea to rush your delivery though.  In fact, rushing your delivery could lead to serious problems that would make life after your pregnancy even more inconvenient.  Let me clarify the definition of a full-term pregnancy.  A full-term pregnancy is between 38 weeks, 0 days and 42 weeks, 6 days.  Yes, four weeks!  Mother Nature gives the baby four weeks to make up its mind to exit the padded “condo”.  With that said, recent neonatal literature (http://journals.lww.com/greenjournal/Abstract/2011/11000/Neonatal_Outcomes_After_Implementation_of.12.aspx) has concluded that babies who are delivered before the 39th week of gestation are significantly at risk for neurological deficits and respiratory problems.

Unfortunately, we have become a society of convenience.  Consequently, there has been an increase in the number of births by early induction of labor lately.  While it’s true that if there is medical reason to induce labor early, it can be a necessity, that does not mean it is safe or recommended for everyone.  In some cases, couples decide that they would like their baby to be born on a special date for future birthdays.  For others, it is because a father might be leaving for a while and would otherwise miss the birth of his child.  In still other cases, doctors actually recommend early induction simply because they are hoping to have the holiday off or don’t want to be called away from their vacation should delivery come later than the expected due date.  A study by the Agency for Healthcare Research and Quality concerning the results of elective induction once again confirm the dangers involved.  Inducing labor before your baby is ready, can cause serious problems that could harm his or her physical and mental development.  Those developmental issues could affect them for the rest of their life.  Also, babies born too early often have to stay in the hospital longer and sometimes must spend that time in intensive care.  The March of Dimes has supported this study and is now strongly opposing early elective delivery before 39 weeks.

Although you and your doctor might be itching to get that baby out and into the world, that is no reason to induce labor.  If it becomes medically necessary to do so, then it can be done safely, but the risks are still increased.  If your doctor urges you to induce labor without a medical reason, seek a second opinion.  If it’s just your impatience pulling you in that direction, be patient.  You’ll have plenty of time with your little one soon enough, and by waiting for your baby’s natural delivery date, the time you get with them will be of a much better quality.

 

– Yvonne S. Thornton, M. D., M. P. H.

Free Birth Control For All? Yes!

Friday, July 22nd, 2011

When you’re on a strict budget, out-of-pocket costs can convince a woman to forego birth control. But getting pregnant is a much more expensive proposition and comes with a lifelong commitment — one that many women are neither emotionally or financially ready to make.

The new health care law requires the Department of Health and Human Services to create a list of health services that new health insurance plans must provide without deductibles or co-pays. And the National Academy of Sciences’ Institute of Medicine (IOM) has prepared a report recommending that birth control be on that list.

…the Guttmacher Institute estimates that 98 percent of sexually active women will use contraception at some point during their reproductive years, and that cost concerns are frequently cited as a reason for inconsistent use or use of a less then optimal method.

 

In fact, Guttmacher said in testimony submitted to the IoM earlier this year, “Women citing cost concerns were twice as likely as other women to rely on condoms or less effective methods like withdrawal or periodic abstinence.”

Along with the recommendations concerning birth control, the IOM recommended a number of other preventive care services for women be made available without deductibles or co-pays:

…annual “well-woman” visits; screening of pregnant women for gestational diabetes; screening for sexually transmitted diseases, including HIV; more support for breast-feeding mothers; and counseling and screening for possible domestic violence.

I urge HHS Secretary Sibelius to accept the IOM recommendations. Women’s health issues have taken a backseat for too long.

– Yvonne S. Thornton, MD, MPH