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Posts Tagged ‘Vaginal Birth’

Teenagers

Okay, girls, it’s time for some basic info.

Let’s start with you youngsters.  Are you between the ages of 13 and 15?  Ah, God bless ya if you are!   I remember those days well.  I can remember cute little Tommy Kosky who sat in front of me in Algebra class.  To this day, I can still smell that cheap cologne that probably cost him $2.00 a gallon.  I remember asking him dumb questions just to get him to notice me…uh, I’m sorry, I’m digressing here.

Okay, earth to Pat.

As I was saying, if you are between the ages of 13 and 15, it’s time you picked up the phone and made your first appointment with an Obstetrician-Gynecologist, otherwise known as an Ob-Gyn.  Don’t know who to call?  Well, ask around, talk to your friends.  Don’t rely on the Google-meister.

The important thing is that this first visit will help you establish a relationship with the doctor of your choice and you’ll be able to talk candidly about your medical and sexual history (even if you have not had sexual intercourse.) This is a good time to ask questions about sexually transmitted diseases and contraceptives.   In many cases, this can become a life-long relationship.

If you are 21 years or older and have not yet had a pelvic exam or a Pap test, what the frig are you waiting for?   Get on your cell phone right now!

Ob-Gyn First Visit

If you have had these tests, then the question is how long has it been since your last Pap smear and pelvic exam? According to the American College of Ob-Gyns, women 21 to 29 should get a Pap smear every year, then every other year (or as often as your doctor recommends) from ages 30 to 64.

Meanwhile you should always see your gynecologist if you experience any bleeding between periods, bleeding after sexual intercourse or an unusual or constant vaginal discharge.

If you are over 30 years old, it is not necessary to get an annual Pap smear but you still should get an annual pelvic exam to check for any other changes or infections. If you’ve had an HPV test that was negative that doesn’t mean you don’t need to have a yearly pelvic exam. And remember that with each new sexual partner your risk of getting HPV increases by 15 percent. According to the ACOG guidelines for Pap testing women diagnosed with HIV or other diseases or conditions that lower immunity should continue having annual Pap smears after age 30.  Indeed, the greatest single reason for the occurrence of cervical cancer is not having Pap smears according to recommended guidelines.

Get with the program.  Don’t be a silly girl.  After all, it’s only your life.

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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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