In the next few months, women in California and Oregon will be able to obtain hormonal contraceptives like pills, patches and rings by getting a prescription directly from the pharmacist, a more convenient and potentially less expensive option than going to the doctor.
By Jenny Gold
SAN FRANCISCO — Anne and Omar Shamiyeh first learned something was wrong with one of their twins during their 18-week ultrasound.
The technician was like, well there’s no visualization of his stomach,” said Anne. “And I was like, how does our baby have no stomach?”
It turned out that the baby’s esophagus was not connected to his stomach. He also had a heart defect. At the very least, he was likely to face surgeries and a long stay in intensive care. He might have lifelong disabilities.
This was only the start of an eight-month ordeal for the Shamiyeh family. Continue reading
By Michael Ollove
PORTLAND – Oregon—Matt cried at the birth of his son a couple of weeks ago. His husband, Sylvain, was outwardly more composed, but no less transfixed as his newborn blinked his eyes at a bright, unfamiliar world.
The woman who gave birth to the child was the calmest of the lot. She alone had been through this before—twice, in fact. Besides, this wasn’t even her baby.
A paid surrogate, she had had two fertilized eggs (from an egg donor) implanted in her uterus. She had carried the baby for nine months, lost its twin during the pregnancy, endured false contractions, and finally gritted her teeth through three hours of labor. And although she took a turn holding the baby and pumped breast milk for him, all her responsibilities toward him ended at birth, while Matt and Sylvain, French nationals recently transplanted to New York City, dove into the deep end of parenting. Continue reading
By Sandra G. Boodman
It’s the latest battle over screening: Should healthy women skip annual pelvic exams?
A controversial recommendation last year by the American College of Physicians, which represents the nation’s internists, strongly urged that doctors stop routinely performing the invasive exam on women without symptoms and who are not pregnant.
Citing 60 years of research, the ACP found no evidence that the screening, performed about 63 million times annually at a cost of approximately $2.6 billion, detects cancer or other serious conditions.
The exam, researchers reported, did cause harm: One-third of women reported discomfort, pain, embarrassment or anxiety — leading some to avoid care altogether.
For roughly 1 percent of women, a suspicious finding triggered a cascade of anxiety-provoking interventions — including tests and surgery, which carry a risk of complications for conditions that nearly always turned out to be benign.
The controversy underscores the difficulty of changing long-established clinical practice and raises questions about the role of payment in shaping physician behavior.
Patients expect it, the group said, and the screening builds trust, reassures women and encourages them to discuss sensitive matters such as sexual dysfunction. A decision about whether to undergo the exam should be made by doctors and patients, ACOG concluded.
These dueling recommendations leave women in the unenviable position of sorting out what to do. Continue reading
By Phil Galewitz
GREENVILLE, S.C. — Kristen Shorey gave birth to her second baby this summer in a marble-lined bathtub surrounded by LED candles and rested afterward on a queen-size mahogany bed. She received no pain killers, never saw a doctor and was home with her newborn son, Rowan, seven hours after birth.
It was nothing like the hospital experience where she had her first son two years ago, she said. In fact, the June birth wasn’t in a hospital at all but at the Greenville Midwifery Care & Birth Center. She delivered with help from a midwife instead of an obstetrician. Shorey, 25, labored in a water-filled tub rather than a small bed while hooked up to intravenous tubes and a fetal heart monitor — her 27-year-old husband, Taylor, by her side.
“This was the most empowering experience of my life,” she said. Continue reading
Clomiphene more effective than letrozole for achieving pregnancy, study finds
From the National Institutes of Health
Treatment with clomiphene, a standard therapy for couples with unexplained infertility, results in more live births than treatment with a potential alternative, letrozole, according to a study of more than 900 couples conducted by a National Institutes of Health research network.
The study authors undertook the comparison because earlier findings had suggested that letrozole might achieve as many live births as other treatments, but result in fewer multiple pregnancies.
Moreover, a 2014 study by the same network found that letrozole was more effective than clomiphene for achieving pregnancy in women with another infertility disorder, polycystic ovary syndrome. The study appears in the New England Journal of Medicine. Continue reading
By Roni Caryn Rabin
Kim Hudak was a young mother who was done having children when she volunteered for a clinical trial to an experimental birth control implant designed to make her sterile without tube tying surgery.
But soon after Hudak, 28 at the time, got the Essure implants in 2000, she said she developed health problems, including severe pelvic and lower back pain, difficult menstrual periods and pain during intercourse.
She complained to researchers at the Cleveland Clinic and was told her problems were not related to the implant. In an affidavit to the Food and Drug Administration, Hudak alleges that answers she gave researchers in response to questions about pain, adverse health effects and even whether her period was late had been altered on her medical record, without her knowledge. Those statements were part of the usual data collection for FDA approval of the device.
“I realized something could go wrong in a clinical trial, but I thought they would take care of me, and that if something wasn’t right, they’d fix it,” said Hudak, who eventually had a hysterectomy to remove the implants in 2013 and has filed a claim against Essure’s manufacturer for compensation for her injuries.
Hudak is one of several clinical trial participants who say that when they experienced complications with the implant, doctors and nurses ignored or belittled their symptoms, insisted they could not possibly have been caused by Essure, and referred them elsewhere for treatment. Continue reading