It is said that sometimes you have to rock the boat in order to shift the course of progress. Well today pregnant women have reason to celebrate. The winds of change are apparent.
Bowing under pressure, K-V Pharmaceutical Company reduced the price of Makena from $1500 to $690. Makena is the trade name for hydroxyprogesterone caproate or 17OHP. It is a drug recently approved by the Federal Drug Administration (FDA) to reduce premature deliveries before 37 weeks if it is given before 21 weeks gestation. It has been used for years as an off-label drug and costs approximately $10 to $20 to make by compound pharmacists. When the FDA gave K-V an exclusive right to manufacture the drug, their integrity flew out the window. The pricing strategy of K-V is a case study of corporate greed. Most drug companies will use the “research and development” logic to explain their rationale for marking up the cost of a drug. In the case of Makena, that excuse is valid. The research and development of Makena had already been done by Squibb Pharmaceuticals who had sold the drug for years. Is it any wonder why U.S. citizens will cross geographic borders and purchase drugs from their Canadian and Mexican neighbors?
Kudos are in order to the American College of Obstetricians and Gynecologists (ACOG) who took the lead in questioning K‑V’s pricing strategies. Read more »
When we hear about maternal death, we immediately think of a third world country but in reality, 2 to 3 women die every day in the U.S. from pregnancy and childbirth. Unfortunately, African American women are affected disproportionately and are four times more likely to die than anyone else. The tragedy is that at least half of these deaths are preventable.
In her article, Special Report: Black Women Die Nearly Four Times the Rate of White Women From Pregnancy Complications, Rita Henley Jensen, describes the dilemma of the acting chief of the maternal and infant unit of CDC, Dr. William Callaghan. Callaghan can’t sleep at night because he wants to know why pregnancy is more dangerous for U.S. African American women.
During my residency training, I witnessed a maternal death. Read more »
Periodically, the FDA publishes drug warnings that should be shared with the public, especially if it affects pregnant women. Each year, over 4 million babies are born in the US and 43% will continue to be breast fed at 6 months. All of these moms will invariably use meds at some point after birth, so which meds are helpful and which are potentially harmful? These questions may now be answered by the Infant Risk Center, at the Texas Tech University Health Center, in Amarillo, Texas. This center provides up-to-date information regarding the safety of medications that are taken both during pregnancy and after birth.
Most drugs enter breast milk immediately after birth and during the first 4 to 10 days of life at a fairly fast rate based on the physiology of breast cells. New moms must therefore be careful of pain medications that are prescribed during the post partum period. Hydrocodone aka Vicodin is a potentially addictive opiate that is given for pain management. When it is processed by the body, it breaks down into a component called hydromorphone that is even more potent. The University of California at San Diego Medical Center performed a small study to determine how much of the drug is secreted into breast milk and what percentage is absorbed by newborns. 3 to 4% of hydromorphone was found in breast milk which is considered safe. As a rule of thumb, nonopioid medication should be prescribed first during the post partum period for pain relief. If the pain persists, no more than 6 Vicodin (hydrocodone) tablets or 30 mg should be prescribed in one day. Dosages greater than 40 mg should be avoided and the newborn should be monitored carefully for depressed behavior or inadequate breastfeeding.
Recently the FDA sent a drug warning to healthcare providers regarding the risks associated with the entire class of antipsychotic medications such as Haldol, Risperdal®, Risperdal® Consta®, Invega® and Invega®Sustenna, Clozaril, Zyprexa, Seroquel, Abilify, and Geodon. These medications are used to treat schizophrenia and bipolar disorders but are associated with abnormal muscle movements and withdrawal symptoms of newborns whose mothers took these medications during the third trimester. However it is recommended that patients should not abruptly stop taking these medications without speaking with their healthcare professional first. For further information, readers may go to the FDA website http://www.fda.gov/Drugs/Drug Safety/ucm243903.htm.
Remember, a healthy pregnancy doesn’t just happen. It takes a smart mother who knows what to do.
Art imitates life, and there’s nothing more hilarious than art imitating a woman in labor. I “stumbled” upon this incredible video and was in awe. Thea Monyee and her husband, GaKnew Rowel, are talented young poets who share their parenting experience at a Def Poetry session in Los Angeles.
What amazed me is the accuracy and clarity of Thea as she describes the laboring experience. Her comments regarding the labor-inducing medication Pitocin are both hilarious and laser-sharp and her description of the epidural placement were reminiscent of my days as an OB/GYN resident. Oh, would I get annoyed with the anesthesiology residents who couldn’t place the catheter correctly into a patient’s back on the first try.
Thea and her husband are a delight to watch. Have you had a similar experience while in labor? If so please share your stories, because as Thea and GaKnew so wisely state: “Nothing compares to having a baby.”
The holiday season is a time of both joy and sorrow. Tomorrow a childhood friend will be laid to rest — one of my favorite artists, Teena Marie, died unexpectedly two days ago and at least six other people have made their transitions as well. My own father died unexpectedly on Christmas Eve in 1981 leaving a great void in our family life. Why do people leave us during the holiday season? It has been said because they want to be remembered.
While I lamented about all the transitions that occurred in the past two weeks, one of my best friends announced that she had a new granddaughter that was born on Christmas Day. She stated that this was part of the “life cycle” or “circle of life.” Her comments gave me reason to pause and reflect. Read more »
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