Women's Health Base

A look at women, the world and the web

Archive for July, 2009

Socialised medicine, obesity, the pill and guessing games

Posted by hannahflynn on July 17, 2009

Because it’s Friday, here’s a round up of a week in the blogosphere:

  • The American Medical Association endorsed Obama’s healthcare reform bill, marking the end to nearly a century of opposition to ‘socialised medicine in the United States. The White House Blog has a video of the speech Obama made explaining why reform is needed now.
  • Dr Kathryn Clancy, Assistant Professor of Anthropology at The University of Illinois, gives her opinion on the effects of the pill when considering the population as a whole in her three part series, What does this anthropologist think about hormonal contraception?.
  • Twitter fave, His Boys Can Swim are running a contest to see who can guess the time their baby will be born. ‘Jane’ is currently 39 weeks pregnant and has been providing an account of her pregnancy through Twitter since the beginning.

Send your news and round ups to the comments box.

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5 Reasons Health Forums are a Bad Idea

Posted by hannahflynn on July 15, 2009

1) It’s not medical advice – Obvious, but something which is often forgotten. People responding to your queries or the queries of others are offering an opinion, not medical knowledge. Plus, though some forums such as Yahoo! Answers has a system which allows medical experts to identify themselves, there are few ways of authenticating the claims of respondents.

2) It’s US dominated – Fair enough if you are living in the United States and have very comprehensive medical insurance, but many people don’t fall into this category. Therefore anybody without patient choice, i.e. most European individuals, are unlikely to be able to use a lot of the ‘get  a second opinion’ advice. The same goes for people without medical insurance in the United States.

3) The anecdote rules – Have you heard the one about the 44 year-old woman who had been trying to conceive through IVF for years and then after giving up, conceived healthy twins? Well it was a one-off and it’s probably not going to happen to you. These forums almost never quote statistics but provide you with stories about how one ‘cure’ worked for someone. Its worst on pregnancy forums too. Every single twinge, absence of twinge, weird feeling and bodily function is analysed within an inch of its life by expectant mothers. Useful for support perhaps, but dangerous if used in place of medical advice at such a vulnerable time.

4) The advice is narrow – As few of the respondents are likely to be medical experts the range of potential causes and complications being discussed is exceedingly narrow. Most threads come to the conclusion the subject is either pregnant or has endometriosis. Sometimes polycystic ovaries. And fften advice is given with only minimal background information provided. A doctor, nurse or midwife is indispensable when it comes to taking medical backgrounds and using them appropriately to diagnose rarer or more complicated problems.

5) It will tell you what you want to hear – Type ‘late period’ into Google and the world will tell you that you are undoubtably pregnant. No matter what your background or circumstances, that is what they will say. Why? Because the internet is dominated by pregnancy forums with women desperate to get pregnant. I recently found a forum where a women who had experienced cramps and bleeding (i.e. a period) was told this was a sign of early pregnancy by numerous women who had experienced the same thing when they were trying. This is confusing and simplified at best, and dismissive and dangerous at worst.

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Epidurals prevent bonding according to male midwife

Posted by hannahflynn on July 14, 2009

The Associate Professor in Midwifery at Nottingham University has caused a furore over the last few days by suggesting pain during childbirth is a rite of passage, helps strengthen the bond between mother and child and that women should forgoe epidurals as they increase the risk of intervention.

The Daily Mail quoted him saying, “A large number of women want to avoid pain, but more should be prepared to withstand it. Pain in labour is a purposeful, useful thing which has a number of benefits, such as preparing a mother for the responsibility of nurturing a newborn baby.” He also said, “emerging evidence shows that normal labour and birth prime the bonding areas of the mother’s brain more than Caesarean or pain-free birth.”

Much of the focus has been on the Associate Professor’s sex – Dr Denis Walsh is a midwife and a man – rather than the evidence behind his research. Published in Evidence Based Midwifery Dr Denis Walsh has claimed epidural rates are already too high and are rising.

His terminology has rightly been called into question by Maureen Freeley in Comment is Free in The Guardian. She has asked “Even if this man had a degree in anthropology, I’d want to question his terms. And what the hell does he know about Bonding with Baby?” She goes on to argue this most recent commentary on childbirth is typical, “As is so often the case in discussions about motherhood, it is laden with moral assumptions.”

The Times’ Alpha Mummy blog points out “his attitude that pain prepares women for motherhood sounds a bit old Testament to me.” The Alpha Mummy team go on to argue that yes, childbirth is a natural process, but so is infant mortality. They also make the interesting point the tables appear to have turned on the assumption The Man was trying to push interventionist approaches to childbirth on women, but now things are going in a different direction.

In the good old-fashioned name of balance the papers have been providing other expert opinions on the matter, many of which are surprisingly blunt in suggesting Dr Walsh’s analysis is lacking.”He’s exaggerating the risks of epidurals. They aren’t overused. In the main they’re a good thing and almost always necessary.” says Dr Justin Clark, an ObGyn based at Birmingham Women’s Hospital in The Telegraph.

Our very own Dr Maggie Blott, mother and head of the Royal College of Obstetricians warned the BBC, “Do not under-estimate the pain of having a baby – it is a very, very intense and painful experience. If it is happening hour after hour in a very prolonged labour it is very tiring and wears people down and I think epidurals are very useful in that situation.” She was backed up in her comments by Cathy Warwick, general secretary of the Royal College of Midwives who said, “At the moment it is very easy for most women to ask for an epidural, and if they want one they definitely should get one.”

For a more irreverent look at the realities of obtaining an epidural on the NHS, have a look at Zoe William’s brilliant Anti-Natal column in the Guardian here.

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The Buddy System

Posted by hannahflynn on July 4, 2009

Today, the wonderful Scarleteen website published an article on ‘The Buddy System’, explaining the benefits behind using two forms of contraception at a time. 

After a lot of statistical scribbles, the women behind this website have found that no combination leaves you with less than a 95 percent protection rate. The most effective form of contraception is the implant with condoms. 

They are careful to admit that adding a third contraceptive method makes such a slight statistical difference that it is not worth dealing with and some pairings are not suitable, for example two hormonal forms of contraception or the nuva ring and spermacide. 

In a time when the focus of contraceptive choice is being questioned, with more and more doctors recommending long term forms of contraception and the public appearing resistant to the suggestion, then ‘The Buddy System’ seems like a sensible half-way house. 

You can find the article and Scarleteen’s calculations of the rates of protection for various combinations here.

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