My Blog Posts

Posted by on February 13, 2014 - 3:59pm

A recent report in Fertility & Sterility has indicated that among women between the ages of 18 and 40, there is a significant amount of misconception regarding fertility and becoming pregnant. Dr. Illuzzi, an OB/GYN at Yale University School of Medicine, led a study in which 1,000 women of various ages and backgrounds completed a survey about their knowledge of reproductive health. The results showed a lack of knowledge across the board, with higher educated women knowing only slightly more than less educated women.

Over one-third of the women surveyed believed that specific positions during intercourse, such as elevating the pelvis, increase the odds of conception, although there is no scientific evidence to back this up. Additionally, only 10 percent of women know when the best time of the month to conceive is. The majority of women thought that sex must take place after ovulation to become pregnant, while in reality, pregnancy is most optimal when intercourse occurs 1 to 2 days prior to ovulation.

Other notable findings in the study include women’s thoughts on what can decrease fertility and prevent conception. Around 25% of surveyed women were unaware that factors such as obesity, smoking, and a history of sexually transmitted disease can cause infertility. In fact, the number one factor women cited as causing infertility was stress. Stress can have many negative side-effects, but according to Dr. Illuzzi, research does not currently support that it leads to infertility. While most of the women surveyed were aware that conception becomes more difficult with age, many did not know that later pregnancies are also more likely to result in miscarriage and chromosomal defects.

If you are concerned about fertility, or have questions about becoming pregnant, it is best to talk to your doctor, but you can get more information on websites such as the American College of Obstetricians and Gynecologists.

Source: Doucleff, Michaeleen. “You’d Think We’d Have Baby-Making All Figured Out, But No.” NPR. 27 January 2014.

Posted by on January 16, 2014 - 12:56pm

Every year there are roughly 137 million births globally. Of these, about 10% may result in serious complications. Tragically, approximately 5.6 million babies are stillborn or pass away soon after, and around 260,000 women pass away every year in childbirth. These situations often occur in underdeveloped countries or rural areas where women do not have access to hospitals or procedures such as a cesarean section when undergoing an obstructed or prolonged labor. Currently, when situations like this arise, options to extract the baby include using forceps or a vacuum extractor, which can twist the baby’s spine, crush its head, or cause hemorrhaging. Despite these statistics and outdated technologies, there has been little to no technological advancement in this area for years.

However, Jorge Odón, a car mechanic from Argentina, recently came up with an idea for a new type of low cost device to help extract a baby from the birth canal. It consists of a plastic bag inside of a plastic sleeve. The bag is placed gently around the baby’s head and then inflated to grip it. When the sleeve is pulled, the baby emerges with it. This device is likely safer than using forceps or a vacuum extractor to assist in a difficult labor, and as there is less contact between the baby’s head and the birth canal, the risk of passing an infection such as HIV from mother to child may be diminished.

This birthing assistance device, known as the Odón Device, has been endorsed by the World Health Organization, which plans to increase testing from 30 Argentine women to 100 more women in China, India and South Africa to further determine its effectiveness and safety. The device has also received grants from donors, and has been licensed for production by an American company. If additional tests verify the claims that some doctors are making - that the device is safe to be used by midwives with minimal training - then the device may see clinical use in two to three years.

For more information on the Odón device, visit the WHO website here.

Sources:

Posted by on November 14, 2013 - 10:26am

According to the American College of Obstetricians and Gynecologists, around 85% of women who menstruate experience one or more premenstrual syndrome (PMS) symptoms such as irritability, depression, bloating, or muscle pain. A similar, but more severe condition is known as premenstrual dysphoric disorder, or PMDD, which is rare (affecting only about 1% of menstruating women), but can cause disabling emotional and physical symptoms in women during the weeks leading up to their periods.

There are three criteria that need to be met to diagnosis PMDD, as opposed to PMS or other conditions. To receive a PMDD diagnosis, a woman’s symptoms must correspond to her menstrual cycle for at least two successive months, and if symptoms include depression, this depression must only be present in the days prior to menstruation. Symptoms must also be disruptive to the point that a woman has difficulty completing her normal activities.

Until recently, psychiatrists did not technically consider PMDD to be a disorder, but the new Diagnostic and Statistical Manual (DSM-5) officially recognizes PMDD as a mental disorder. This decision has been praised by many, while met with reservations from others.

With PMDD now classified as a mental disorder, some believe that this will help women receive treatment for a condition that may have previously been overlooked. Some women diagnosed with PMDD feel positively about the classification, stating that the recognition helps them feel they are not alone. However, others are concerned that because PMDD only affects women, it may contribute to stereotypes or affect perceptions about women’s capabilities. For example, Dr. Sarah Gehlert of Washington University in St. Louis points out that if a woman is involved in a child custody case and is diagnosed with PMDD, the fact that she has a mental disorder may impact the outcome of the case. Gehlert is also concerned that due to potential financial opportunities, PMDD may be overdiagnosed in otherwise healthy women with normal hormone changes. While understanding more about the biology behind PMDD may help clarify its classification as a mental disorder, for now, women will have to live with the positive and negative outcomes of this new designation.

Source: Standen, Amy. “Should Severe Premenstrual Symptoms be a Mental Disorder?” NPR. 21 Oct. 2013.

Posted by on October 16, 2013 - 10:06am

When a woman goes through menopause before age 40, it’s considered early menopause. When this occurs naturally, due to genetics or chromosome defects, it is known as primary ovarian insufficiency and happens to about 1 in 100 women. Early menopause may also result from medical treatments, like chemotherapy or radiation. Researchers from the United States and Japan have recently reported on a new technique in which the ovaries of women who went through early menopause were successfully “reawakened.”

This study included 27 women around age 30 who were infertile with primary ovarian insufficiency. Prior to menopause, eggs in the ovaries begin as follicles and remain that way until some of them mature each month. After menopause, some follicles may remain, but in a dormant state. The researchers’ goal was to activate the remaining follicles in the ovaries of women with primary ovarian insufficiency. To “awaken” the follicles, researchers followed several steps. First, they removed the ovaries and cut them into pieces. Next, they introduced a chemical to spur egg development and replaced the ovary fragments at the top of the fallopian tubes. Finally, the women in the study underwent hormone therapy.

In 8 of the 27 women, the sleeping follicles began to develop and form eggs. At this point, the researchers took eggs for in vitro fertilization (IVF). Following this treatment, one woman successfully had a baby, and another is pregnant.

While this study did not yield high success rates, it is gathering significant traction in the medical world. With additional study and refinement, success rates may increase or lead researchers towards other techniques that will offer hope for women who experience early menopause and want a child.

Source: Gallagher, James. "Early Menopause: Baby born after ovaries 'reawakened.'" BBC News. 30 September 2013.

Written by guest blogger Sarah Henning.  To learn more about menopause visit:  www.menopausenu.org

 

 

Posted by on September 17, 2013 - 8:53am

The Guttmacher Institute, a non-profit organization that works to advance reproductive health, released a report in September on the state of unintended pregnancy in the United States. The organization estimates that currently, around 49% of all pregnancies in the U.S. are unintended. This is higher than the rate of unintended pregnancy in many other developed countries. For this study, an unintended pregnancy is considered a pregnancy that is either mistimed or unwanted.

While the rate of unintended pregnancy has remained more or less stable in the U.S. between 2001 and 2006, it has increased substantially among poor and low-income women while decreasing in higher-income populations. Between 1994 and 2006, the rate of unintended pregnancy in women whose income fell below the federal poverty line increased by 50%, while decreasing for women whose income was at 200% or more above the poverty line by 29%.

The report points out that access to and use of contraception has a significant impact on unintended pregnancy. Two-thirds of women that are at risk for an unintended pregnancy use contraception correctly and consistently. These women make up only 5% of all unintended pregnancies. 19% of at-risk women use contraception incorrectly or inconsistently, and account for 43% of unintended pregnancies, while 52% of unintended pregnancies come from from the 16% of at-risk women who do not use contraception at all for at least a month during the year.

While unintended pregnancies can cause hardships for the women and families they affect, they are also a public health issue. Research shows that unintended and closely spaced pregnancies are associated with negative health outcomes for both mothers and babies. For this reason, the U.S. Department of Health and Human Services has incorporated unintended pregnancy into their Healthy People 2020 campaign, and will attempt to reduce the rate of unintended pregnancy to 44% by 2020.

For more information and statistics, click the source link below.

Source: "Facts on Unintended Pregnancy in the United States." Guttmacher Institute. September 2013.

Posted by on August 21, 2013 - 2:56pm

According to the 2013 Breastfeeding Report Card released by the Centers for Disease Control (CDC) in July, a high rate of mothers are attempting to breastfeed their infants, and are breastfeeding their infants for longer. In 2010, around 75% of new mothers began breastfeeding.  Also in 2010, about 50% of babies were still being breastfed at 6 months old, and 27% at 1 year old. This is a significant increase from 2000, when these statistics were 35% and 16%, respectively. The American Academy of Pediatricians recommends mothers breastfeed their infants for 1 year, and the World Health Organization suggests that children be breastfed for 2 years.

These improvements are noteworthy, given the benefits children receive from being breastfed. Research shows that infants who are breastfed are less likely to experience ear infections and diarrhea than those that are not. Additionally, adults who were breastfed as babies are less likely to suffer from diabetes and obesity. However, these advantages are not always well publicized and some hospitals to do not promote breastfeeding.

In fact, about 25% of hospitals and birth centers provide formula to mothers whose babies are successfully breastfeeding, and around 75% of hospitals include formula in packs given to all new mothers. In addition to promoting breastfeeding, the CDC reports two specific actions hospitals can take to increase the number of women who breastfeed. The first is allowing new infants to “room in” with their mothers. In 2011, 37% of hospitals reported having babies stay in the hospital room with their mothers for 23 hours a day, which is up from 30% in 2000, but still leaves room for improvement. Hospitals should also ensure “skin to skin” contact between mothers and babies after birth, which help babies keep warm and successfully breastfeed. According to the CDC, about 54% of hospitals have infants skin-to-skin with mothers.

By taking the steps outlined above and increasing publicity about the benefits of breastfeeding, hospitals and public health officials can help increase the amount of women who breastfeed and the length that babies are breastfed for.

For more information and resources about breastfeeding from the U.S. Office on Women's Health, click here.

Source: Shute, Nancy. “More Moms Are Breast-Feeding, But Many Babies Still Miss Out.” NPR. 31 July 2013.

Posted by on July 11, 2013 - 2:10pm

The World Health Organization (WHO) recently released a report on the global prevalence and impact of violence against women, and found it to be a “global health problem of epidemic proportions.” The report includes data on violence against women by intimate partners and sexual violence against women by non-partners. The report also examines the effect violence has on other aspects of women’s health.

By studying data from across the world, WHO researchers found that about 35% of all women will experience violence in their lives from either intimate partners or non-partners. Violence inflicted by intimate partners is more prevalent worldwide, with 30% of women affected.

In addition to injury and death, violence against women results in other physical and mental problems. For example, women who have undergone partner violence are almost twice as likely to experience depression or have an alcohol-use problem than women who have not been subject to violence. Additionally, women who experience violence are more likely to acquire a sexually transmitted disease, have an unwanted pregnancy, and receive an abortion. Violence against women also affects the next generation, as studies show women who experience violence are 16% more likely to have a low birth-weight baby. Click here for additional statistics.

The report points out that steps need to be taken throughout the world to prevent future violence against women, but also improve the treatment of women who have already experienced violence. Dr Claudia Garcia-Moreno of the WHO states that “violence greatly increases women’s vulnerability to a range of short- and long-term health problems; [the report] highlights the need for the health sector to take violence against women more seriously,” and that many healthcare workers don’t know how to respond to cases of violence. However, to make a significant change, the social and cultural factors behind violence against women must be addressed.

Source: "WHO report highlights violence against women as 'global health problem of epidemic proportions." WHO Media Centre. 20 June 2013.

Posted by on May 27, 2013 - 9:06am

A significant number of parents are not allowing their daughters to receive the HPV (human papilloma virus) vaccine, despite an increase in doctors recommending it. The HPV vaccine is a series of three shots given to pre-teen and teen girls and boys over the course of six months to prevent HPV and related conditions, most notably, cervical cancer in women.

Between 2008 and 2010, the percentage of doctors recommending the HPV vaccine rose from 48% to 52%. However, the CDC reports that only around one-third of eligible girls have received the HPV vaccine. In a study of parents not planning on having their daughters receive the vaccine, the percentage of those concerned about its safety increased from 5% to 16% over the course of three years. Another 17% cited the lack of necessity of the vaccine as the reason their daughters won’t receive it.

In response to concerns over the safety of the HPV vaccine, Dr. Joseph Bocchini, a pediatrician on the CDC’s Advisory Committee on Immunization Practices has stated that “we have not identified a significant likelihood of serious adverse events following vaccine” and that it “is a very safe vaccine.” Claims that the vaccine is not necessary appear weak after identifying what results from HPV. Nearly all instances of cervical cancer are caused by HPV, and many cases of vulvar and vaginal cancer are linked to it. This doesn’t mean men are exempt from HPV. 95% of anal cancers and 60% of oropharyngeal cancers (cancers in back of the throat, base of the tongue and tonsils) are caused by HPV. Vaccinating both boys and girls significantly reduces the risk of them having several forms of cancer in the future.

Increasing education efforts may help increase the rate in which children receive the HPV vaccine. Currently, there is a strong correlation between receiving a doctor’s recommendation and receiving the vaccine. However, many teens do not see a primary care provider regularly in the years they can be vaccinated. Additionally, parents may not know about the vaccine, or feel they don’t know enough about it and how it can help their children. To tackle these problems, education programs that target the general public are necessary.

For more information on the HPV vaccine, click here.

 

Sources:

Hensley, Scott. "Worried Parents Balk at HPV Vaccine for Daughters." NPR. 18 March 2013.
"HPV and Cancer." Centers for Disease Control and Prevention. 5 February 2013. 

Posted by on April 25, 2013 - 11:50am

 A disturbing trend in many cases of domestic abuse, sexual assault, and rape against women is the tendency to blame the victim of the crime, rather than the perpetrator. Over the past several months, there have been a number of high profile cases of violence against women that highlight the victim-blaming culture we live in.This was seen in the aftermath of the recent Steubenville, Ohio trial in which two male high school football players were found guilty of raping a sixteen-year-old girl who was unable to consent to sexual activity after drinking alcohol at a party. Many individuals, both male and female, reacted to the trial and the guilty verdicts by harshly blaming the young woman for being raped, and declared the men’s innocence, despite the evidence against them. There has also been strong backlash against CNN’s reporting of the verdict, and its emphasis on the impact on the lives of the two men found guilty, rather than the victim. Reporter Poppy Harlow stated “These two young men that had such promising futures ... literally watched as they believed their life fell apart,” and Candy Crowley reported “What’s the lasting effect though on two young men being found guilty in juvenile court of rape essentially?” She failed to discuss what the lasting effect on the young woman who was raped might be (Shapiro).

Similar incidences can be seen throughout the world. In mid-March, a Swiss woman was gang raped by a group of men while camping overnight in India with her husband. The men robbed the couple, tied up and beat the man, and gang raped the woman. During the course of the investigation, local police claimed that the tourists were at least partially to blame, as they failed to tell the police where they were staying (Sieczkowski). While these are just a couple of cases that made headlines, women are victims of sexual and domestic violence every day, usually without any media attention.

Within this culture of victim blaming, women are told to change their own behavior in order to avoid being assaulted or raped. Women are told repeatedly to dress less provocatively, drink less alcohol, and not put themselves in risky situations. This proliferates the belief that women are at fault when they are attacked, and leads to a lack of accountability for men. Recently though, there has been a push to increase rape and assault prevention education for men. Zerlina Maxwell, a rape survivor who appeared on the Fox News show “Hannity” to discuss this issue, advocates rape prevention education for young boys and men, stating that “we need to teach them about consent and to hold themselves accountable.” This is significant because despite the common perception that rapists are usually violent strangers, women are often raped by men they trust and consider friends (Williams). This strategy was used in a 2011 Canadian ad campaign called “Don’t be that guy.”  One poster consisted of an image of a woman appeared to be passed out, surrounded by alcohol, along with a quote stating “Just because she isn’t saying no doesn’t mean she is saying yes.” After the launch of this campaign, rates of sexual assault in Vancouver dropped for the first time in years, by a rate of 10% (Matas).

While it’s important that women continue to be empowered and educated on how to prevent rape, this education needs to be extended to men as well. Men and women need to work together to change the culture of victim blaming, and help reduce violence against women.

For more information or help, visit the Violence Against Women page on womenshealth.gov.

 

Posted by on March 28, 2013 - 10:43am

Recently, emergency contraceptives have been at the center of the debate as to whether employers must cover contraception under their health insurance plans. Under the Affordable Care Act, which covers preventive care, non-exempt employers must cover the morning-after pill (Plan B) and the week-after pill (ella) for their employees. Some companies don’t want to follow this requirement because they claim that these drugs cause abortions. However, it seems that these claims are based on outdated information, because recent research now definitively proves that Plan B doesn't cause abortions, and that ella most likely doesn’t impact established pregnancies.

In the past, researchers knew that Plan B prevented pregnancy primarily by stopping ovulation, and therefore, fertilization. However, they were not certain whether it prevented fertilized eggs from implanting in the uterus. An abortifacient (abortion-causing drug) is something that interrupts an established pregnancy, which is typically considered to be when a fertilized egg implants in a woman’s uterus. By this definition, a drug that causes an unimplanted fertilized egg to leave a woman’s body is not considered an abortion, but it is still objectionable by some parties.

Recent studies, including one led by the International Federation of Gynecology and Obstetrics, have proven that these objections are unfounded by showing that Plan B only prevents ovulation and fertilization. It in no way stops a fertilized egg from implanting in a woman’s uterus, and does not cause abortions. This is also most likely the case with the week-after pill, known as ella, although the research is not as definitive. Ella is related to the abortion drug, RU-486 (Mifeprex), but unlike that drug which predominantly affects a woman’s endometrium, ella more strongly affects a woman’s ovaries, preventing ovulation. One study found that the rate of women who took ella after ovulation experienced pregnancy at the same rate as women who did not take it, indicating that the drug most likely does not prevent implantation.

While there is still stronger controversy when it comes to ella, individuals in the medical field opposed to abortion are starting to accept the fact that Plan B doesn't cause abortions, which is an important step in its increased acceptance as a contraceptive.

Source: Rovner, Julie. “Morning-After Pills Don’t Cause Abortion, Studies Say.” NPR. 4 February 2013.

For more information on the preventive services covered for women under the Affordable Care Act, click here.

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