What You Need to Know About Home Births

Posted on May 13, 2013 by admin

The day your baby is born is hands-down one of the most important of your life. You’ll of course give major thought to everything that happens that day, from who’s in the room to where you deliver—in a hospital or at home. The American Academy of Pediatrics (AAP) recently published a policy statement with guidelines for the care of infants in home births.

Planned home births are uncommon—they comprise less than one percent of all births in the United States—but the amount of women choosing them has grown in recent years. In 2011, the American College of Obstetricians and Gynecologists (ACOG) released a committee opinion saying that while they believe that the safest place for a baby to be born is in a hospital or birthing center, they respect whatever medically informed decision a woman makes about where she gives birth. And the AAP echoes that ACOG opinion in their new statement. “Based on current evidence, we think that hospitals and birthing centers are safest for baby for being born,” explains Kristi Watterberg, MD, the lead author of the statement and a neonatologist and professor of pediatrics at the University of New Mexico. “But we recognize the right of the mom to make that choice. There are lots of reasons people might want to have a home birth, and those have validity, as well.”

In the AAP statement, the authors outline planned home birth recommendations for healthcare providers. These include making sure there are at least two people at the delivery—one whose main responsibility is caring for the baby and who has the skills and training to resuscitate the baby if that becomes necessary—and making sure that the phone is working and an arrangement has been made with a nearby hospital in case there’s an emergency. Many things must also be done for the baby once he or she is born, such as a detailed physical exam, several screenings, and Vitamin K injection. The AAP also agrees with ACOG when they say that moms should choose a midwife only from those who are certified by the American Midwifery Certification Board. Find the complete list of recommendations here.

Trying to figure out what the best plan is for you and your family? Watterberg advises all first-time moms (even ones who have already decided) to schedule a prenatal visit with their anticipated maternity care providers. “I think it’s really important to talk to your obstetrician, midwife, pediatrician about what you would like, why you would like it, and what your concerns are,” says Watterberg. Ask about the risks and benefits, in their view, of their approach.

And if you are thinking about giving birth at home, discuss whether or not you’re a good candidate with your healthcare provider. That includes being at term, not having any pre-existing medical conditions that put you at higher risk (like diabetes or high blood pressure), and having a baby that’s in vertex position (not breech) and not too big or too small. “You should have all of those things that make what would look to be a normal, happy, healthy delivery for both mom and baby before you decide to try an at home delivery,” says Watterberg.

photo: iStockphoto/Thinkstock

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Would You Want to Know Your Risk for Every Disease?

Posted on May 9, 2013 by admin

If your doctor had a way to peek into your health future and determine that you had a higher—but not definite—risk of developing cancer, heart disease, or any number of other scary illnesses, would you want to know?

It’s a question to start considering now that a procedure called genomic sequencing is set to become a standard part of your health-care routine in the not-too-distant future. Whole genome sequencing involves analyzing all of a person’s genes, obtained via a small blood sample, to find out which, if any, carry a predisposition to serious disease. For years, doctors have offered patients tests for specific genes that may cause illness—for example, the BRCA gene variants linked to a higher incidence of breast cancer. But genome sequencing looks at a person’s entire DNA and thus can uncover markers for a huge range of conditions.

On one side are groups such as the American College of Medical Genetics and Genomics (ACMG), which in March recommended that doctors tell patients about certain disease risk findings uncovered during genome sequencing—even if they were incidental findings discovered accidentally during testing for a different illness. The ACMG came up with a list of more than 20 medical conditions clinicians should look for (including specific cancers, retinal disease leading to blindness, and a genetic condition that causes high cholesterol)—whether a patient requests testing or not. The thinking is that if a predisposition for an illness is uncovered before symptoms show, the patient can get treatment or intervention early.

But a paper published today in the journal Trends in Biotechnology argues in response that doctors do not have the right to force patients to know their genetic disease risk for conditions they didn’t ask to be tested for. “The important point that we dispute is that the ACMG recommends that the patient or the patient’s parents should not have a choice about whether these extra tests are done and they receive the results,” explains Megan Allyse, PhD, a coauthor of the paper and fellow at the Stanford Center for Biomedical Ethics at Stanford University School of Medicine.

There are other issues to consider too, says Allyse. For starters, looking for so many genetic disease risks can be very costly, and if positive results are reported to your insurance company, it may affect your premiums. Also, knowing that you have a predisposition to a genetic disease can trigger anxiety and stress—especially in light of the fact that the disease may never actually develop, even without any intervention.

TELL US: Would you want your doctor to tell you about any disease risk your genomic profile points to, even if it’s an incidental finding—or would you prefer to not know? Share your thoughts in the comments!

photo: Wavebreak Media/Thinkstock

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Would You Know If You Had Lyme Disease?

Posted on May 9, 2013 by admin

Have a mysterious-looking bug bite or rash? Don’t write it off—especially if you’ve spent a lot of time outdoors recently. It could be Lyme disease, a bacterial infection that you get from tick bites. But here’s the thing: Lyme disease might not look like a typical tick bite, according to a new research letter published in the journal Emerging Infectious Diseases.

Lyme disease is what you get when you’re bitten by a tick infected with a dangerous bacterium called Borrelia burgdorferi, which then makes its way into your bloodstream. Early signs of the disease include a rash and flu-like symptoms like fever, chills, body aches, and fatigue. If left unchecked, it can wreak havoc on your nervous system, heart, and joints, says Steven E. Schutzer, MD, professor of medicine at the University of Medicine and Dentistry of New Jersey-New Jersey Medical School.

The famous telltale sign of the disease is a skin rash that looks like a bull’s-eye—a reddish ring within a ring. But as it turns out, this may not occur or be recognized in about 30 percent of Lyme-disease cases, according to the new letter. Researchers looked at 14 patients with symptoms of early Lyme disease, but only four had the classic target-like rash. The other 10 participants’ rashes resembled insect or spider bites, dermatitis, or other skin conditions.

Mistaking Lyme disease for something else can lead to inappropriate or delayed treatment. That’s a serious problem since catching Lyme disease (and treating it) early ensures the best odds for a successful recovery, says Schutzer.

If you suspect that you’ve been bitten by a tick, hightail it to your doctor, who will help you determine the best treatment options for your specific case.

If you don’t have any issues with your central nervous system or your heart, your physician will likely give you oral antibiotics, says Schutzer. If, however, there’s evidence of neurological disease, then he or she might recommend IV therapy.

Schutzer stresses that treatment really depends on your individual case: “It needs to be a decision between the doctor and the patient,” he says, “but that means that the patient has to go to the doctor, as opposed to not doing anything.”

Photo: iStockphoto/Thinkstock

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The Health Marker You Need to Know

Posted on April 26, 2013 by admin

A high heart rate on the treadmill is a good thing. But when you’re sitting on the couch? Not so much. People with high resting heart rates may face an increased risk of mortality, according to a new study published in the journal Heart.

Researchers started tracking the health of 6,125 men in 1971, but when they followed up in 2001, only 2,798 of the men were still alive. While the specific causes of death were unknown, researchers looked at the participants’ resting heart rates and found that, for every additional 10-22 beats per minute, mortality increased by 16 percent.

Even when physical activity level was controlled for, researchers determined that a high resting heart rate is an independent mortality factor.

To measure your resting heart rate, simply take your index and middle fingers and place them between your neck and jaw or the inside of your wrist. For 15 seconds, count the beats you feel and then multiply that number by four to get your resting beats per minute.

A normal resting heart rate is anywhere between 60-100 beats per minute, but don’t panic if you’re at the high end of the range; adopting a healthier diet or an exercise routine can help you lower it, says lead study author Magnus Jensen, MD.

If your resting heart rate is greater than 100 beats per minute, visit a doctor to figure out what may be causing the issue and what you should do to lower it, stat.

photo: iStockphoto/Thinkstock

More From Women’s Health:
The Truth About Your Heart Health
Heart Rate Monitors
Heart Health: The Mechanics

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Do You Know Your Diabetes Risk?

Posted on March 26, 2013 by admin

Have a couple of spare minutes today? Resist the urge to spend them on Cute Overload looking at puppy pics, and use them to find out your chances of developing type-2 diabetes instead. It’s the American Diabetes Association’s Alert Day, which was created to encourage people to take the ADA’s Diabetes Risk Test.

Diabetes affects almost 26 million people in the U.S., or 8.3 percent of the population, according to the Centers for Disease Control and Prevention. For adults in the U.S., it’s the leading cause of kidney failure, non-traumatic lower-limb amputations, and new cases of blindness. It’s also a major cause of heart disease and stroke.

In 2010, one in three people in the U.S. aged 20 or older had prediabetes, meaning that their blood glucose levels were abnormally high and that they faced a higher risk of getting diabetes. What’s worse: Only 11 percent of the people with prediabetes knew they had the condition, according to a new report from the CDC. In many cases, people with prediabetes don’t experience any symptoms. “That’s why we really advocate that people who are at risk get screening bloodwork done,” says Brandy Panunti, MD, chair of endocrinology at the Ochsner Medical Center in New Orleans.

People who are overweight and sedentary have a higher possibility of developing diabetes, as do African Americans, Hispanic people, Native Americans, Asian Americans, and Pacific Islanders. Having a family history of diabetes, having had gestational diabetes, or having given birth to a baby over nine pounds can also increase your risk.

Even if you are on your way to developing diabetes, you can make lifestyle changes to seriously turn things around, says Panunti. The key, of course, is knowing whether you’re at risk. Head to the American Diabetes Association’s website or Facebook page, or call 1-800-DIABETES (1-800-342-2383) to take the Diabetes Risk Test—a quick series of questions about you and your lifestyle—for free. “It’s easy to take,” says Lurelean B. Gaines, the ADA’s president of health care and education. “It’s a matter of minutes.”

You should also speak with a doctor about your odds of developing diabetes, especially if the test results indicate that you’re at risk.

Done with the test? OK, now you can check out those adorable animal pictures.

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6 Things You Need to Know About the Morning-After Pill

Posted on February 20, 2013 by admin

Whether you suffered from a condom mishap or a total lapse in judgment, having a backup plan is key when it comes to preventing unwanted pregnancy. And research shows that more women are taking advantage of that backup: Emergency contraception use rose from 4.2 percent of sexually-active women in the U.S. in 2002 to 11 percent in 2006-2010, according to a recent CDC report.

Plus, that number has probably continued to rise in the last few years, says Mary Jane Minkin, M.D., clinical professor at Yale University School of Medicine. “It’s wonderful for women to know that [emergency contraception] is out there and available to them, because we know accidents happen,” says Minkin. “But we also hope that people continue to use reliable contraception all the time.”

But about those accidents: Post-unprotected sex, your mind may be a total, anxious blur. So knowing a few key facts about your options before you need them will save you a ton of stress later on. Here, the six most important things to know about the morning-after pill:

There Is More Than One Option
You’ve probably heard of the most common pills on the market, Plan B and Plan B One-Step (the one-pill dose), which is available over-the-counter for women 17 and older. It’s a progestin-only pill that is effective at preventing pregnancy up to 72 hours after unprotected sex and works mainly by inhibiting ovulation. But there’s another med you should know about: Ella is a newer form of emergency contraception that can be taken up to five days after your oops moment, though it’s only available with a prescription. It also works by stopping or delaying ovulation, but it carries the same effectiveness for five days, says Minkin, rather than just 72 hours.

It Doesn’t Just Come in Pill Form
But the most foolproof method actually isn’t a pill at all—inserting a copper IUD up to five days after unprotected sex can also prevent pregnancy. “By far, the most effective emergency contraception is the insertion of a copper IUD,” says James Trussell, Ph.D., faculty associate at the Office of Population Research at Princeton University. Since this would include a doctor’s visit, a (potentially painful) insertion procedure, and a hefty upfront cost, it may not be viable option for women who weren’t already considering an IUD. This might be why the FDA doesn’t list the IUD as an approved method of emergency contraception. However, if you’re looking for a reliable birth control method anyway, this might be the time to talk to your doctor about the option.

You Have (a Little) Time
While 72 hours may sound like a long time—not to mention the five days you get with Ella—that doesn’t mean you should put off your trip to the drugstore. “You may have three days, but the sooner you take it, the better. If you can get to the pharmacy immediately, you should,” says Minkin. However, if you know you won’t make the 72-hour mark, you may want to call your doctor for a prescription for Ella to buy yourself some time.

The Pharmacist Could Shut You Down
This may sound crazy, but several states have laws that allow pharmacies or individual pharmacists to refuse to sell you emergency contraception, according to the Guttmacher Institute. “If this happens, they are supposed to direct you to someone who can get it for you,” says Minkin. Save yourself the trouble and call ahead. Dial up your nearest pharmacy (and a backup) to confirm that they have the pill in stock and that they have no qualms about dispensing it. If you’re having trouble locating a pharmacy with EC, call your local Planned Parenthood for help.

Your Period May Be Different
Don’t be shocked if your flow is a little off during the month that you take EC. Your period may be earlier, later or heavier than normal as a result of the medication, though it can also change due to stress (and who wouldn’t be anxious after a birth control failure!). However, if your cycle is more than a few days late, you may want to take a pregnancy test. “Emergency contraception isn’t 100 percent effective, but it’s better than nothing,” says Minkin.

It Shouldn’t Replace Birth Control
There’s a reason why this isn’t called Plan A—it’s not meant to be used as your regular birth control method. Instead, think of it like your emergency credit card: You’re not going to use it every day, but you might need to whip it out after a major slip-up. “It’s not dangerous to your health to take it several times, but there are a lot of great contraceptive methods out there,” says Minkin. “I do not recommend this for regular contraception, and I’m always encouraging people to use condoms no matter what.” That said, mistakes happen. And like your emergency plastic, it wouldn’t be a bad idea to keep one on hand in case of emergencies.

photo: Comstock/Thinkstock

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The Scary Stomach Bug You Need to Know About

Posted on January 28, 2013 by admin

Move over, major flu outbreak—there’s a nasty new bug in town. According to the U.S. Centers for Disease Control and Prevention, a new strain of norovirus from Australia is now the leading cause of norovirus outbreaks in the country, accounting for 58 percent of infection cases in December.

Called the GII.4 Sydney, the virus causes gastroenteritis–an illness that attacks the stomach and intestinal tract, leaving those affected with nausea, stomach cramps, and diarrhea (food poisoning is another example of gastroenteritis). The CDC estimates that noroviruses cause 21 million illnesses each year, contributing to 70,000 hospitalizations and 800 deaths in the U.S. The disease can be the most severe for young children, the elderly, and people with pre-existing health conditions.

“Every few years new strains come around. As far we know, it’s too early to tell if it’s going to be a worse norovirus than we see every year,” says Todd Reynolds, M.D., a family medicine practitioner at Prevea Health, says.

The virus spreads quickly from person to person, especially in closed crowded places such as schools, hotels, public transit vehicles, and daycare facilities. Gross fact alert: Contamination with norovirus means that the surface or area in question has been exposed to vomit or diarrhea particles, Reynolds says. These particles don’t have to be obvious or huge—microscropic particles left over on someone’s hands are enough to make you violently ill. Unfortunately, there’s no vaccine or medicine available to prevent or treat norovirus infections. On the plus side, these illnesses are short-lived, and often don’t last more than 72 hours, Reynolds says. That said, those 72 hours are sure to be miserable, and possibly life-threatening.

Even though there’s no way to prevent the virus entirely, there are precautions you can take. Adopt these four practices, STAT:

Wash your hands. Seriously.
Reynolds recommends spending a solid 30 seconds rinsing your hands with soap and water–water above body temperature often kills more bacteria. Alcohol-based hand sanitizers are useful if you’re on the go. And along these lines—stop touching your hair and face so much! Whatever you can do to minimize the chance of exposure to this virus, the better.

Scrub all contaminated surfaces
The CDC suggests using a chlorine bleach solution to rid infected areas. Wearing gloves can prevent your skin from feeling irritated and cracked, Reynolds advises. And if you don’t have any chlorine or bleach lying around, check out the Environmental Protection Agency’s list for other registered disinfectants proven effective against noroviruses.

Toss contaminated clothes in the laundry
Any piece of clothing you suspect has been contaminated with the virus should be cleaned ASAP. Wash them with detergent at the maximum cycle length and let them machine dry.

Wash and cook food properly
While this particular norovirus doesn’t come from infected food, it’s still good practice to wash and cook your meals appropriately. Noroviruses can sometimes survive temperatures up to 140 degrees Fahrenheit. Your best bet is to rinse foods well and cook meals thoroughly to decrease viral particles that could be left. Throw out any suspicious foods, and keep children away from anywhere you’re prepping food—kids are major culprits when it comes to spreading the virus.

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Everything You Need to Know About The New IUD

Posted on January 25, 2013 by admin

Want to prevent pregnancy for the next three years? There’s a new contraceptive to consider: The U.S. Food and Drug Administration (FDA) approved a new intrauterine device (IUD) that’s more than 99 percent effective in preventing pregnancy, according to statement released last week by the parent company Bayer HealthCare Pharmaceuticals, Inc.

The new hormonal IUD, called Skyla, is the first to hit the U.S. market in over a decade. Compared to Mirena, the other hormonal IUD on the market, this updated option delivers a lower dose of hormones, is slightly smaller, and lasts for up to three years, instead of five. Skyla’s size makes it a better option for women who haven’t had babies and don’t want one now–like college students or newlyweds–according to Laura Corio, M.D., a Manhattan-based gynecologist.

Intrigued? Here’s what you need to know:

HOW SKYLA WORKS
First, your gynecologist inserts a T-shaped IUD through the cervix and into your uterus. (The device itself is no longer or wider than a standard tampon, but yes, insertion can hurt a bit.) While non-hormonal IUDs are made from copper, which acts as a natural spermicide, hormonal IUDs such as Skyla gradually release small doses of the synthetic hormone levonorgestrel—the same stuff in emergency contraceptive pills. Both options thicken your cervical mucus, which creates a hostile environment for embryo implantation and prevents pregnancy, explains Corio. Based on a clinical trial of over 1,400 women, Skyla works well: fewer than 1 in 100 women got pregnant. Still, there’s no IUD that will protect you from sexually transmitted infections or HIV, so it’s smart for women who have one to use a condom during sex with a new partner.

SIDE EFFECTS
The good news: Skyla is over 99 percent effective at preventing pregnancy. And in some cases, the hormones from Skyla (and Mirena) can reduce cramps, lighten your flow, and even sometimes stop bleeding altogether. Now for the bad news: security comes with some strings attached. According to Bayer, the most common side effects include vulvovaginitis (vaginal inflammation or infection), pelvic pain, acne or seborrhea (itchy, flaky skin), ovarian cysts, headaches, menstrual cramps, breast pain, increased bleeding, and nausea.

COST
In many cases, an IUD is the most affordable method of long-term birth control, although it does cost the most upfront. Between a medical exam, the actual IUD, insertion, and follow-up visits with your doctor, getting an IUD can set you back between $ 500 to $ 1000, according to PlannedParenthood.org. The good news: It won’t cost you a penny more until you have it removed. (Unlike a tampon, you can’t do this yourself.) And if you leave your IUD in for its full lifespan–that’s three years for Skyla, five for Mirena, and 10 for a non-hormonal IUD–it will totally pay for itself.

HOW TO GET IT
According to Bayer, Skyla will be available by prescription the week of February 11—which leaves you plenty of time to do your research and talk to your doc about whether it’s right for you. And if you get an IUD, then decide to have a baby? You can go to your OBGYN to get it removed any time, and get pregnant as soon as it’s out.

Get more information about Skyla.

photo: Spike Mafford/Photodisc/Thinkstock

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Everything You Need to Know About The New IUD

Posted on January 15, 2013 by admin

Intrigued? Here’s what you need to know:

COST
In many cases, an IUD is the most affordable method of long-term birth control, although it does cost the most upfront. Between a medical exam, the actual IUD, insertion, and follow-up visits with your doctor, getting an IUD can set you back between $ 500 to $ 1000, according to PlannedParenthood.org. The good news: It won’t cost you a penny more until you have it removed. (Unlike a tampon, you can’t do this yourself.) And if you leave your IUD in for its full lifespan–that’s three years for Skyla, five for Mirena, and 12 for a non-hormonal IUD–it will totally pay for itself.

Get more information about Skyla.

photo: Spike Mafford/Photodisc/Thinkstock

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Everything You Need to Know About the Flu

Posted on January 10, 2013 by admin

Flu season: It’s officially scary. Yesterday, Boston declared a public health emergency after the virus killed more than a dozen people, according to CNN.

And Boston isn’t the only place affected by the virus. Twenty-nine states and New York City are reporting high levels of influenza-like-illness (ILI) and 41 states are reporting widespread geographic flu activity, according to the latest FluView update (which contains data from the last week of December) from the Center for Disease Control and Prevention.

Here, everything you need to protect yourself—and your loved ones—from the flu.

Flu Update from the CDC

Could This Be the Worst Flu Season EVER?

Should You Get the New Flu Shot?

5 Times You Should Call in Sick to Work

The Anti-Flu Drug That Might Not Work

Germ-Proof Your Office

6 Ways to Fight the Flu

What Causes the Flu?

Your Body On… The Flu

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