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Archive for the ‘Cesarean’ Category

John Boehner

At this point, I assume you know that a new health care system is being implemented in this country.  If you don’t know this then…..well, there is no sense in reading this cause, honey, you are on another planet.

We’ve heard all the arguing and seen some of the commercials and watched the elections and all.  We’ve heard how the new Speaker of the House, John Boehner, has vowed to repeal the new law.  Well, that’s a total crock because while the House of Representatives will vote to repeal it, it’s unlikely that the Senate will do the same and, if by some chance they do repeal it, well, Obama-Man is sitting there with his ole veto pen.  End of story.

We’re gonna be living with this new law for some time.  That being the case, I thought I would regularly send you a short explanation of what all of this means to you to cut through all of the stuff that you see and don’t have time to sort out.

A number of the provisions of the law will not take effect for quite a while, but some things are already in effect.  So, right now, here’s the deal:

Any health plan that you get through your job or any new individual plan has to let any kids you have under 19 to have coverage.  In other words, they cannot be denied coverage if they are already sick or have some medical condition.

If your health insurance allows you to have coverage for your dependents, then they can be covered until they are 26 years old.  After that, you kick them out of the house and they’re on their own.

Insurance companies cannot drop you from their plans when you get sick just because you made a mistake on your coverage application.

Many insurance companies say that during your lifetime you can only be covered up to a certain point.  Today, there are no limits.

If your employer offers a health plan, you generally can’t be turned away or charged a higher premium because of your health status or disability.  This protection is called “nondiscrimination.”

If family members are eligible but are not currently enrolled under your health plan at work, you may be able to add them during a “special enrollment” opportunity outside of the usual “open enrollment” period.

Not too shabby, huh?

There’s so much more to come!  Stay tuned.

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vbacVaginal Birth after Cesarean Section (VBAC) has proven to be a safe method of delivery in a wide variety of pregnancies.  Sadly, with changes in insurance and malpractice laws, the threshold to allow such a health delivery, and circumvent unneeded additional Cesarean Sections is being sabotaoged by this environment.

Bottom line, mommies and babies suffer.

The literature continues to glean that all our sophisticated interventions seem to do much less than we expect.

Yes, Modern Obstetrics made tremendous strides over the past 80 years. Dropping maternal mortality rates from 1,200/100,000 to around 7/100,000.  But this was due primarily to control of hemmorhage, infection, and preeclampsia or toxemia of pregnancy.  Genetic screening has been a welcomed intervention as well.

Sadly we have not done what we expected for more.  Drop in preterm labor rates, decreased hypoxia or cerebral palsy,, or other diseases that we have just not been able to decrease despite our modern interventions.

There are more but beyond the scope of this note.

Back to VBACs.cesarean-vbac-rate-graph  

The graph shows it all.

What is going on here?

Doctor life style, poor management and timing of labor, premature amniotomies, poor epidural managemnt, and low tolerance to minimal risk of VBAC are partially to blame.  

Doctors are overworked and underpaid, and are unwilling to take the smallest risk of the right subset of patients.

VBAC when monitored, in the right setting (ie NOT a vertical incision on THE WOMB), when all the parameters have been looked is a safe and effective means of delivery.  There is no need to go back to the days of high section rates because we are afraid of a simple VBAC.

There should be a call to arms of advocacy.  Talk to your doctor. Show them the graph. Read up on this. This is a crime against women and babies that suffer higher levels of Transient Tachypnia of the Newborn as well as other phenomenon.

It is your body, make an informed choice.

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