ACOG Statement on Mississippi's "Personhood Amendment" Proposition 26

The American Congress of Obstetricians and Gynecologists (ACOG) strongly believes that the autonomy of women to make personal health care decisions must be respected. As the nation's leading organization of women's health physicians, dedicated to all aspects of women's health, ACOG supports quality health care appropriate to every woman's needs throughout her life, including the full spectrum of clinical and reproductive services. Mississippi's "Personhood Amendment," Proposition 26, does not respect the autonomy of women and jeopardizes women's health. We urge the citizens of the State of Mississippi to reject this Proposition on November 8th. Proposition 26 substitutes ideology for science and represents a grave threat to women's health and reproductive rights that will have long-term negative outcomes for our patients and society.

Proposition 26 defines the term person to "include every human being from the moment of fertilization", which has wide-reaching implications that will impact access to women's health, including treatment for cancer, infertility treatment, birth control options, and pregnancy termination. This proposal unnecessarily exposes women to serious health risks and significantly undermines the relationship between physicians and our patients. The vague and overly broad terms in Proposition 26 will prevent physicians from providing the care vital to women's health.

Proposition 26 must be defeated in the best interest of women's health.

(link mine)

Depo-Provera and Bone Mineral Density News

Photo by ad-vantage

If your method of birth control is the Depo-Provera shot (depot medroxyprogesterone acetate; DMPA), or if you're considering using this method, make sure your physician is aware of the latest ACOG Committee Opinion, in particular:

1. Most of the DMPA bone loss is temporary and is similar to the BMD loss caused by pregnancy and breastfeeding [~3%-5% vs. 2%-8% and 3%-5%].

2. Its use should not be limited to 2 years.

3. Concurrent low-dose estrogen supplementation to slow DMPA bone loss is not recommended.

4. Implants and IUDs--effective, long-term methods of contraception that have no effect on bone density--should also be considered as first-line methods for adolescents.

5. The scientific basis for the 2004 Food and Drug Administration black box warning discouraging the use of DMPA for more than two consecutive years is caca*.

*Okay, that characterization is entirely mine. According to ACOG, the FDA's warning is based on intermediate effects on BMD which may or may not be relevant to increased risk of fracture (former adult DMPA users have BMD rates similar to nonusers) and, while low BMD is linked to an increased risk of fracture in older women, no studies have linked DMPA bone loss with increased rates of fracture in younger women with a low-fracture risk.

N.B. Speaking of Depo-Provera, don't forget you also have a lower-dose version, Depo-subQ, available.

ACOG ♥ the IUD

via

Ode to the Intrauterine device (IUD) at the annual ACOG meeting in New Orleans:


1. among the most effective contraceptives

2. treatment of heavy menstrual bleeding

3. treatment of endometriosis

4. associated with a 40 percent reduction in the risk of endometrial cancer

5. suitable for both women who've never given birth, as well as for those who have

If you are about to start using a birth control method, or are considering switching methods, I can not urge you strongly enough to give the IUD serious consideration.

After all, the IUD is the bestest, prettiest method of them all.

Government Says Women Must Get Belief-Based Medical Care

***UPDATED***

Photo by Anosmia

Health and Human Services Secretary Mike Leavitt calls on the American Board of Obstetrics and Gynecology to reject a new ACOG opinion (# 385) which states that physicians have a duty to refer patients in a timely manner to other providers if they're unable to provide evidenced-based reproductive care to their patients.

Leavitt frets about the conscience and other individual rights of health care providers and, correctly, points out that there are federal laws in place to protect Ob/Gyns who practice belief-based medicine and provide substandard care. He's also concerned about the serious economic harm [that might be caused] to good practitioners.

No word yet from the Health and Human Services Secretary on his concerns about the conscience and other individual rights of female patients and the serious physical and economical harm caused by being denied access to adequate medical care.

Not that the rights and quality of medical care of women of reproductive age should be any concern of the Health and Human Services Secretary. After all, unlike for any other class of people in this country, only for women with a certain anatomy and physiology is it considered acceptable public policy and public discourse to legislate and advocate for belief-based care and imminent danger of loss of limb or life as a condition of receiving medical care.

UPDATE:

The American Board of Obstetrics and Gynecology responds and assures Mike Leavitt that practicing evidence-based medicine and making sure patients have access to proper medical are in no way, shape or form factor[s] in the decision about board certification.

Not satisfied with this appalling lowering of standards, Health and Human Services Principal Deputy Assistant Secretary for Health Don Wright said that the Government still hope[s] that [ACOG] would revisit their position and give up altogether on the idea that belief-based medicine shouldn't be the standard of care for female patients of reproductive age.

I realize that in the current climate there are many issues--race relations, the war, etc.--competing for your attention. So all I'll ask you to do is to pause for a moment and image what would happen in this country if the Government and a medical specialty certification board came out and said that it is acceptable not to provide proper medical care to a segment of the population just because they are black, or they had their prostate removed, or are natural blonds. Inconceivable, no?

Reuters Mistakes ACOG Opinion For Entertainment

Same article, same news agency, different titles. Why?

ACOG's committee opinion on elective genital procedures is getting some press attention. (And some very good blog coverage, as well.)

On Medscape, we have this, from Reuters:

ACOG Advises Against Cosmetic Vaginal Surgery

On Yahoo! Health, the same Reuters article becomes:

U.S. gynecology group slams cosmetic vaginal surgery

Did Reuters decide to dumb it down for "the masses" by sensationalizing the title? If that's the case, shame on Reuters. The topic under discussion is complex enough as it is without a pipsqueak media organization having to go out of its way to muddle the waters.

Revised Guidelines for Women's Health Screenings

ACOG has issued updated recommendations for:

1) Down syndrome screening--All pregnant women, regardless of their age, should be offered screening for Down syndrome in their first trimester.

2) HIV Testing--Routine HIV testing should be offered to women ages 19 to 64 regardless of personal risk factors...and...adolescents who are or ever have been sexually active.

3) HPV Vaccine--HPV vaccination [should] be offered to all girls and women 9 to 26 who have not previously been vaccinated.

4) Tdap Vaccine--Adolescents should receive the Tetanus, Diptheria, Pertussis (Tdap) booster once between ages 11 and 16, then every 10 years thereafter up to age 64.

5) Meningococcal Vaccine--[A]dolescents not previously immunized [should] receive meningococcal conjugate vaccination before entry into high school. Older women at high risk also should receive the vaccine.

6) Colorectal Cancer Screening--Women age 50 and older should be screened for colorectal cancer using one of five recommended screening strategies....Single samples obtained by digital rectal examination in the ob-gyn's office are not adequate for colorectal cancer screening.

7) Preconception Care--[E]ncourage women of childbearing age to develop a reproductive health plan to help conscientiously assess the desire for a child or children or desire not to have children. The plan also should address the optimal number, timing, and spacing of children; determine the steps needed to prevent or plan for and optimize a pregnancy; and evaluate current health status and other issues relevant to the health of a pregnancy.