Category: Obstetrics & gynecology

Gentler new ACOG guidelines on water immersion during labor and delivery attempt to fix what wasn't broken in 2014 statement

The ACOG Releases Watered Down New Guidelines on Immersion During Labor and Delivery

In its new report, the ACOG remains clear on the lack of solid evidence in support of claimed benefits of water immersion during the first stage of labor. Inexplicably, though, it has inappropriately softened its stance on restricting underwater delivery to proper clinical trials.

/ December 16, 2016
Trump is OK with pseudoscience

“Donald Trump’s presidential election win stuns scientists”

Scientists in the U.S. and from around the world are weighing in on Donald Trump’s election as the next president of the most powerful country on earth: Trump will be the first anti-science president we have ever had . . . The consequences are going to be very, very severe. Michael Lubell, director of public affairs for the American Physical Society in...

/ November 10, 2016
Patients should get health information from doctors, not quacks.

Chiropractic Gynecologist Offers Dangerous Treatments and Misinformation

Over a year ago I wrote about escharotic treatments for cervical dysplasia. It is offered not by MD gynecologists but by chiropractors and naturopaths, along with inconsistent and unproven diet recommendations and supplements. A corrosive agent similar to “black salve” is applied repeatedly to the cervix; it works by destroying tissue. There are no controlled studies evaluating it for safety and effectiveness....

/ October 25, 2016

Efforts to Encourage Breastfeeding Like the Baby-Friendly Hospital Initiative (BFHI) May Have Unintended Consequences

“Breast is best,” but current efforts to increase the rate of breastfeeding may be misguided. A recent article in JAMA Pediatrics by pediatricians Joel Bass, Tina Gartley, and Ronald Kleinman is titled “Unintended Consequences of Current Breastfeeding Initiatives.” They criticize the Baby-Friendly Hospital Initiative (BFHI), saying “there is now emerging evidence that full compliance…may inadvertently be promoting potentially hazardous practices and/or having...

/ August 30, 2016

Does acetaminophen during pregnancy raise the risk of behaviour problems?

In my career as a pharmacist I’ve answered a lot of questions about medication use in pregnancy. Pharmacists are among the most accessible health professionals, and we’re usually found near a wall of medicines and supplements.  Many don’t trust Dr. Google, and for good reason: There are conflicting answers online. When it comes to medication use in pregnancy and effects on the...

/ August 18, 2016
Unsinkable rubber duck

Quackery: The 20 Million Dollar Duck

The publisher recently sent me a review copy of Quackery: The 20 Million Dollar Duck, by Tony Robertson. My first thought was “Do we really need another book on this subject? Don’t I know all this stuff already?” I was very pleasantly surprised. Robertson has ferreted out an impressive array of facts and details that I wasn’t aware of; and yes, we...

/ August 16, 2016

Hormone Replacement Therapy for Menopausal Symptoms: Setting the Record Straight

Whether you call them hot flashes or “power surges,” the symptoms of menopause can be very distressing. They were routinely treated with hormone replacement therapy (HRT) until the Women’s Health Initiative study in 2002 persuaded many patients and doctors to abandon that treatment. The results of that study were misunderstood by some and questioned by others, and there continues to be confusion...

/ May 17, 2016

Prenatal Multivitamins and Iron: Not Evidence-Based

When I was pregnant, I obediently took the iron pills and prenatal vitamins prescribed by my obstetrician. And I prescribed them for every pregnant patient I took care of as a family physician. I never questioned the practice. It seemed intuitively obvious that it was a good thing; we know pregnancy makes extra nutritional demands and depletes iron stores. It never occurred...

/ February 2, 2016

Vaginal Birth After C-Section: How Safe Is It?

Doctors used to insist “once a C-section, always a C-section.” Today it is standard practice to allow vaginal births after C-section (VBAC) for appropriately selected patients. The American Congress of Obstetricians and Gynecologists (ACOG) has issued a Practice Bulletin to guide obstetricians in determining which patients are appropriate candidates for VBAC. We frequently hear criticisms of practice guidelines like these. The doctors...

/ January 12, 2016

Home birth tragedies lead to changes in Oregon

Oregon Health Plan (OHP), the state’s Medicaid insurer, will no longer cover planned home and birth center births for women whose pregnancies aren’t classified as low risk, based on newly-established criteria. The Health Evidence Review Commission (HERC), a group of experts designated by the state, came up with criteria that will exclude women with a substantial list of conditions, such as high...

/ December 10, 2015