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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 Center.com, 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*

Snoring During Pregnancy: A Risk For Gestational Diabetes?

A recent medical study reported a fairly unique finding:  Pregnant women who snore frequently are at an increased risk for developing gestational diabetes.

The Associated Professional Sleep Societies (TAPSS) reported that 24 percent of habitual snorers had an official diagnosis of gestational diabetes as opposed to 17 percent of nonsnorers. As gestational diabetes affects 4 to 6 percent of all pregnant women, this study is significant according to Louise O’Brien, Ph.D. who is associated with the department of neurology at the University of Michigan in Ann Arbor.

Snoring is nothing new among women but it becomes more pronounced with the onset of menopause or weight gain. Approximately one-third of all women in the U.S. are obese and at risk for snoring and sleep apnea. Being overweight can cause bulky throat tissue which then physically blocks air flow.

Up until the publication of the University of Michigan study, the health risks associated with snoring included greater than ten seconds of interruptions of breathing, frequent waking from sleep, potential strain on the heart which then results in hypertension, increased risk of heart attacks, and stroke. Now the tide has changed. Read more »

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

Pregnancy As A “Pre-Existing Condition”

Women who own individual healthcare policies, please take note. Should you become pregnant in the future, your individual healthcare policy might not cover your pregnancy.

A recent article in the Los Angeles Times by Michelle Andrews was revealing. Andrews described the plight of a North Carolina biology teacher who subsequently left teaching after the birth of her twins. She became a small business owner and was covered under individual health insurance policies. However, when she became pregnant again, she had a rude awakening. Despite paying an insurance premium of $400 per month, her pregnancy wasn’t covered unless she had paid for a special rider, prior to becoming pregnant. Since half of all pregnancies are “unplanned” how can you pay for coverage six months in advance of an unplanned event?

On October 12, 2010, the Committee on Energy and Commerce produced a dismal report that revealed a total disregard and absence of concern for pregnant women and their unborn babies by the insurance industry. The Committee’s chairmen, Congressmen Henry Waxman and Bart Stupak revealed the following: Read more »

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

Miscarriage? Don’t Wait To Get Pregnant Again

About 15 to 20 percent of women who know they are pregnant will have a miscarriage. The loss of a pregnancy before 20 weeks is considered a miscarriage. Many women suffer grief and shock after a miscarriage and fear there is something wrong with them or that they did something to cause it. But the reasons for miscarriage are usually not known. Women are often told to wait “a few months” to get pregnant again to let their bodies recover.

A new study published in the British Medical Journal looked at over 30,000 women who had a miscarriage in their first recorded pregnancy and subsequently became pregnant again. They found that women who conceived again within six months were less likely to have another miscarriage or problem pregnancy. They were even less likely to have a cesarean section, preterm delivery or infant of low birth weight. These women were more likely to have an induced labor.

The researchers wrote: “Women wanting to become pregnant soon after a miscarriage should not be discouraged.” These women had the best reproductive outcomes.

*This blog post was originally published at EverythingHealth*

Pregnant Women And Vitamin D

Vitamin DA new study in the American Journal of Obstetrics & Gynecology reports that low levels of vitamin D may be linked to early-onset preeclampsia in pregnant women.

The trial found that the average vitamin D level in 50 pregnant women with preeclampsia was 18 ng/mL, compared with 32 ng/mL in 100 women with healthy pregnancies. No casual relationship was proven, and the study’s lead author told Reuters Health that the recommended vitamin D intake in pregnant women hasn’t changed, but the study results raise yet more questions about this much-discussed nutrient.

ACP Internist covered the pros and cons of vitamin D in its November 2009 issue. (Reuters, ACP Internist)

*This blog post was originally published at ACP Internist*

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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