Posts Tagged ‘ gynecologist ’

Not Even Half of New Moms Keep Their Postpartum Appointments

Thursday, February 6th, 2014

Fewer than half of women keep the appointments their doctors recommend they make shortly after giving birth, according to a new study conducted by researchers at Johns Hopkins University.  Especially for women with complications like gestational diabetes or high blood pressure, those visits are important to future health, the researchers said.  More from the university:

The researchers found that women with pregnancy complications were more likely to see a doctor post-delivery, but overall, visit rates were low.

“Women need to understand the importance of a six-week visit to the obstetrician — not only to address concerns and healing after delivery, but also to follow up on possible future health risks, review the pregnancy and make the transition to primary care,” says Wendy Bennett, M.D., assistant professor of medicine and the lead researcher for the study, described online last week in the Journal of General Internal Medicine. “Women with pregnancy complications are at higher risk for some chronic diseases, such as diabetes, high blood pressure and heart disease, and these visits are an opportunity to assess risks and refer to primary care providers to work on long-term preventive care.”

Physician groups, such as the American College of Obstetrics and Gynecology, recommend women with complications like high blood pressure during pregnancy or gestational diabetes not only visit their obstetricians six weeks after a birth, but that they also see their primary care doctors within a year.

For the study, the researchers collected data from one commercial health insurance plan and multiple Medicaid insurance plans in Maryland. The aims were to determine different predictors of receiving post-delivery primary and obstetric care in women with and without pregnancy complications, including gestational or pregestational diabetes mellitus and hypertensive disorders, such as preeclampsia. Women with these conditions are much more likely to develop long-term health problems, such as type 2 diabetes and cardiovascular disease.

Among women with tax-supported Medicaid insurance, 56.6 percent of those with a complicated pregnancy and 51.7 percent of those without a complicated pregnancy visited a primary care doctor within a year. Among women with commercial health insurance, 60 percent of those with a complicated pregnancy and 49.6 percent of those without a complicated pregnancy did so.

White patients, older patients and patients with depression or preeclampsia were also more likely to visit their primary care doctor.

Of the women on Medicaid, 65 percent of those with complicated pregnancies and 61.5 percent of those without complicated pregnancies had a postpartum obstetric visit within three months. Numbers were slightly lower for those with commercial insurance, at 50.8 percent of those with complicated pregnancies and 44.6 percent of those without complicated pregnancies.

Bennett says providers need to develop creative ways to improve attendance at postpartum visits. A pilot project at Johns Hopkins Bayview Medical Center, for example, involves combined “mommy-baby” visits, she says. If the baby’s checkup is included in the mother’s visit, the mother may be more likely to keep the appointment, and thus would receive important education about improving health behaviors and the need for primary care follow-up. Other options are home visits and collaborations with day care centers, community centers and churches to make visits and health promotional activities more convenient.

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Postpartum Exercise: Tips For New Moms
Postpartum Exercise: Tips For New Moms
Postpartum Exercise: Tips For New Moms

Image: Doctor, via Shutterstock

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Doctors Broaching Fertility with Patients in Their 30s

Friday, June 7th, 2013

As fertility treatments continue to advance and women continue to pursue high-powered careers, the delicate question “when is it too late to try to have a child?” is becoming a routine part of annual gynecological exams for a growing number of doctors.  The Wall Street Journal reports:

It’s a touchy topic: broaching the issue of having children. But OB-GYNs say they are increasingly making it as routine as asking about contraception during annual visits. They are educating patients about fertility rates, which gradually begin to decline around age 32 and then rapidly decline after age 37. And they are discussing the risks of miscarriage and chromosomal abnormalities, which increase at age 35 and above.

About 20% of U.S. women—a growing share—wait until after age 35 to begin their families, according to data compiled by the American Congress of Obstetricians and Gynecologists. Even with significant advances in assisted-reproductive technology, or ART, a woman’s age can be a factor in getting pregnant. A healthy 30-year-old has about a 20% chance each month of getting pregnant, while a healthy 40-year-old has about a 5% chance each month—in many cases, even when using ART, the data show.

Doctors say advances in fertility treatments and media coverage of women conceiving in their 40s and even 50s have led some people to believe they can beat the biological clock. And though more women are pursuing fertility treatments, such as in vitro fertilization, using egg donors and freezing eggs and embryos, experts note that such procedures are expensive, rarely covered by insurance, and offer no guarantee for conception. Nationally, the mean age of first-time mothers was 25.4 years in 2010, up from 24.9 years a decade earlier, according to the latest data from the Centers for Disease Control and Prevention.

“I hear many people say 40 is the new 30. But not reproductively, it’s not the new 30,” says Cynthia Austin, medical director of in vitro fertilization at the Cleveland Clinic. “Our ovaries are aging at the same rate they did 50 years ago.”

Image: Doctor talking with female patient, via Shutterstock

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Panel Recommends Pap Tests Every 3 Years Rather Than Annually

Friday, October 21st, 2011

The United States Preventative Task Force, a group that’s comprised of government agencies, doctors, and major cancer groups, is recommending that women should receive pap smear tests every three years, rather than annually as has long been common practice.

Pap smear tests are still the best way to detect cervical cancer, a diagnosis some 12,000 American women receive each year, according to the Centers for Disease Control and Prevention.  But the task force says annual testing is not necessary, and in fact may be harmful for some women.

“If you test every year you find a lot of benign infections that would go away on their own,” Philip Castle of the American Society for Clinical Pathology told Reuters. “You end up overscreening, overmanaging and overtreating women who are not actually at risk of getting cervical cancer.”

The task force also recommended that women not receive pap smears until they are 21 years old, citing risks including vaginal bleeding, pain, infections,and psychological impacts of facing a possible cancer diagnosis.

This same group recently recommended that healthy men not receive regular prostate exams.

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