Routine Pelvic Exam Should Be Discontinued, Physician Group Says
In a new practice recommendation issued last week, the American College of Physicians said the routine pelvic exam is not an effective way to detect gynecological cancers, venereal or pelvic inflammatory disease or bacterial infections. The annual procedure causes pain and discomfort to as many as 60% of women of childbearing age, prompting many to avoid regular visits to a gynecologist. And it is particularly likely to cause distress to women who have been sexually abused and those who are extremely overweight. Whether the recommendation will change the routine medical care of women is uncertain, as pelvic exams are most often performed by OB-GYNs who, citing "expert opinion," have defended their value. In a committee opinion drafted in 2012 and reaffirmed this year, the American College of Obstetricians and Gynecologists acknowledged that the case for the annual pelvic exam "lacks data to support a specific time frame or frequency." But the group nevertheless recommended annual pelvic exams for women over 21 without symptoms of possible illness, after a consultation between doctor and patient. Last week, ACOG said it "continues to firmly believe in the clinical value of pelvic exams."
Effect of Home Visiting by Nurses on Maternal and Child Mortality
A new study in the latest issue of JAMA Pediatrics finds that home visits from nurses may help lower the risk of maternal death. The study, revealed that in a group of 1,138 mothers at high risk for maternal death, those who received prenatal and infant and toddler nurse visits at home were significantly less likely to die than those who did not. The mothers were assigned to one of four different treatment groups, two of which included home visitation. After analyzing all cause maternal mortality and preventable-case mortality like sudden infant death syndrome, unintentional injury and homicide in children, researchers found that the average 21-year maternal all-cause mortality rate was significantly higher in the control groups without home visitation. Locally, Sarasota Memorial Hospital had a groundbreaking postpartum home visitation program that was defunded in 2012. The program included home visits from a lactation nurse to over 1100 families annually. We urge Sarasota Memorial to investigate funding sources to reinstate this program. In the meantime, support can be given to The Healthy Start Coalition of Sarasota County, who provides in-home and group support to women through all stages of pregnancy and the postpartum year. Visit healthystartsarasota.org for more information.
National Women's Law Center Launches CoverHer Hotline
In this week’s “Oh, Hobby Lobby” segment, we bring you some good news from our friend Sonia Fuentes, who tells us that the National Women's Law Center has launched a new hotline called “CoverHer” to help women who are having trouble getting access to women's preventive health services - especially contraception - at no cost to them. The user-friendly hotline provides personalized instructions on how to navigate the health insurance process to ensure that women get the coverage for preventive services they are guaranteed under the health care law. It also includes critical follow-up to track the results. The hotline number is (866) 745-5487. Visit www.CoverHer.org for more information.
Rest in Peace, Stephen Gaskin
And we have lost another champion of mother’s rights this week, as we say goodbye to Stephen Gaskin. Stephen was the founding father of the intentional community The Farm in Summertown, Tennessee, and the husband for 46 powerful years to midwifery pioneer Ina May Gaskin. Let’s listen to Ina May talk about the kind of man her husband was.
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Tonight's Epilogue:
On tonight's show, we welcomed back Hermine Hayes-Klein of the international organization Human Rights in Childbirth. Hermine expounded on the introduction to her organization she shared on our show two weeks ago, explaining how the motivation so many of us share through absorbing the negative birth experiences of our peers was transformed into the mobilization of multiple disciplines throughout several countries, all with a shared mission: to clarify and promote the fundamental human rights of pregnant people.
The fundamental human rights in childbirth that Hermine's organization works to raise awareness and preservation for are:
- Right to Informed Consent
- Right to Refuse Medical Treatment
- Right to Health
- Right to Equal Treatment
- Right to Privacy
- Right to Life
We talked about several recently publicized instances of human rights violations in childbirth, including forced cesarean sections, criminalization of homebirth midwifery, lack of VBAC access, shackling and sterilization of incarcerated pregnant women, and an overall obstetric climate that suggests that women are not autonomous, when we are, in fact, the captains of our ships.
Childbearing women are humans, and humans have basic fundamental rights. Human Rights in Childbirth is leading a global movement to restore and preserve these rights. If you would like to support their efforts, please visit their website, and go to their IndieGogo campaign to learn more. (You can score some sweet gifts, too.)
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