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Why Are Painkillers Dangerous For Pregnant Women?

A nurse recently asked a very important question that bears repeating: What effect does long-term use of pain pills have on pregnant women? She was concerned because of the increase in number of pregnant women who are taking pain pills on a long term basis based on previous surgeries, accidents or a history of chronic pain.

The most common “pain pills” prescribed are opiates which effectively eliminate or reduce pain but have a great tendency to be abused. Opioids are natural and synthetic type drugs that have the characteristics of morphine. It can only be obtained with a prescription and unfortunately physicians contribute to the problem of dependency and abuse through their lack of scrutiny regarding patient requests. My present home state of Florida has the unsavory distinction of being known as the country’s largest pill mill and it was reported that 80 percent of opiates were not dispensed by pharmacists but by physicians who dispense them from their offices. Consequently, the Florida legislators now prohibit physicians from dispensing opiates in their offices with rare exceptions.

Why are opiates or pain killers dangerous for pregnant women? Read more »

*This blog post was originally published at Dr. Linda Burke-Galloway*

Strokes Are Quite Common In Pregnant Women: How Can They Be Prevented?

According to CDC, there has been a 54 percent increase in the number of pregnant women who’ve had strokes in 1995 to 1996 and in 2005 to 2006. While this may surprise some researchers, it certainly would not surprise clinicians who take care of pregnant women who have risk factors such as obesity, chronic hypertension or a lack of prenatal care. Ten percent of strokes occur in the first trimester, 40 percent during the second trimester and more than fifty percent occur during the post partum period and after the patient has been discharged home. Hypertension was the cause of one-third of stroke victims during pregnancy and fifty percent in the post partum period. Hypertension accounted for one-third of stroke cases during pregnancy and fifty percent in the post partum period. Many stroke cases might be prevented if blood pressure problems were treated appropriately during pregnancy.

Pregnant women who have high blood pressure during the first trimester are treated with medication and are classified as having chronic hypertension. The problem occurs when Read more »

*This blog post was originally published at Dr. Linda Burke-Galloway*

Will Your Hospital’s Maternity Ward Close?

When our country starts closing obstetrical units in hospitals because they “cost too much” money to operate, pregnant women need to pay attention because their babies are in serious trouble. Such was the case of the most recent casualty, South Seminole Hospital, a 200-bed hospital, that’s located within 30 minutes of my neighborhood.

More than 20,000 babies were born in South Seminole Hospital during the past 18 years, and many of the babies were delivered by a local obstetrician who died approximately three years ago. I recall sitting in the emergency room of the hospital with a fractured ankle and listening to a chime that used to ring every time a baby was born. It was a soothing and humbling sound knowing that a new life was making its grand entrance each time that chime rang. Now, it will be replaced with silence.

Unfortunately, this phenomenon is not unique to Florida. In 1997 the closing of a North Philadelphia hospital (Northeastern) affected six additional hospitals in the community and their 23,570 annual births. In my hometown of Brooklyn, New York, Long Island Hospital had an annual delivery rate of 2,800 babies, but still closed its doors to the community and sold the hospital as prime real estate to the highest bidder, citing low reimbursement rates and high premiums for malpractice insurance as the culprit behind the decision. The Bedford Stuyvesant community of Brooklyn lost St. Mary’s Hospital, a delivery center of thousands of babies in 2005. Read more »

*This blog post was originally published at Dr. Linda Burke-Galloway*

Five Dead Babies: A Lesson In Prenatal Politics

When the Nebraska lawmakers voted to end Medicaid prenatal care for approximately 1,500 women, their unborn babies paid the ultimate price.

Any labor room hospitalist who is responsible for the care of unassigned pregnant women will tell you that it is far easier to take care of pregnant women who have had prenatal care than it is to take care of women who haven’t. The recent vigil of the Equality Nebraska Coalition in front of their state capitol to honor five dead babies whose death can be related to the lack of access to prenatal care speaks volumes.

On or about February of 2010, Nebraska expectant mothers received a “Dear John” letter from Nebraska’s Health and Human Services stating that their pregnancies were no longer covered under Medicaid. It appeared that the rationale for making such a drastic decision involved a resistance of state politicians to pay for medical services of “illegal immigrants.”

However, when one reads the comments on a popular website called Baby, the pregnant women who were affected were U.S. citizens who were college students, wives of husbands who had lost their medical insurance, and unemployed women. Eventually all the women were able to receive government-sponsored healthcare coverage, but the panic preceding their reinstatement was palpable. Read more »

*This blog post was originally published at Dr. Linda Burke-Galloway*

Prenatal Vitamins: Are They Necessary, Sufficient, Safe?

What is in a prenatal vitamin? Why do most doctors recommend them? Is there any evidence taking them is worthwhile? I decided recently that I would read through the ingredients of these vitamins, often touted as “essential vitamins and nutrients, crucial for the healthy development of your baby.” Hmmm. Does that mean eating traces of polyvinyl alcohol every day is beneficial?

The fine print ingredients of such brands as “One A Day”, “Centrum Materna”, “Rite Aid” and even the prescription only “Prenate Elite” are a confusing mess of milligrams, international units, RDA’s, and chemicals. As the makers of Centrum explain, “It is very challenging to formulate vitamins and minerals without the use of non-medicinal ingredients which serve to keep the product stable and to prevent the various ingredients from interacting.” They also find fault in the limited number of suppliers of the active ingredients in prenatal vitamins, and therefore claim substances like gelatin are difficult to avoid.

Let’s take a tour of the prenatal vitamin ingredient zoo. Read more »

*This blog post was originally published at The Examining Room of Dr. Charles*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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