from the world's big
We Need Fewer C-Sections
Judy Norsigian: In the industrialized world we have a number of problems when it comes to reproductive health and I have to say we have to distinguish the United States from other countries because other countries are not as schizophrenic about say, the subject of abortion. Most industrialized countries have relatively reasonable access to abortion. It is an incredibly important part of reproductive healthcare. It’s not the only service, but there are some women who need access to abortion for a variety of reasons and that really ought to be available and it should be covered by any health plan. We have a huge problem there, which I won’t get into right now. We also have to make sure that women have better access to contraceptives even if they can’t afford some of the more expensive ones and they have access to good information and that we do a better job educating the public about the need for what we call dual protection, protection against unwanted pregnancy if that is what we want and protection against sexually transmissible infections, not just HIV AIDS, but a host of other things, Chlamydia infections, certainly want to prevent HPV infections and those are things we really need to do a better job on.
When it comes to maternity care we’ve actually slid backwards. In the United States it looks like our maternal mortality rate is starting to climb and certainly in some states we’ve demonstrated that. And the reasons are multi factorial, but the most important thing I want to underscore here is that this is an example where our high-tech inappropriately interventive approach has produced a downside. We’re doing way too many cesareans. It’s about one in three nationally, but we have many states and many communities where it is now 40, 50% cesarean section rate. I know in New Jersey there are hospitals that have 50 to 70% cesarean rates. This is unacceptable and of course it’s going to produce harm because cesarean section is a major abdominal surgery. Even if the surgery goes well you have all kinds of infections that occur in hospital settings. And we have an increase in MRSA, methicillin-resistant Staphylococcus aureus. MRSA infections are not often easily treatable with antibiotics and in fact some of our big guns like vancomycin aren’t doing such a good job and you need IV, intravenous antibiotics and long stays in hospitals sometimes to recover.
This can happen after a cesarean just like after any surgery. These are kinds of things women don’t appreciate, so we’re trying to educate women to think about what are best practices in maternity care. The best way to avoid an unnecessary cesarean section is to choose a midwife, whether it is a freestanding birth center or in a hospital setting where midwives can really practice midwifery or a homebirth setting and we’ve got good data that homebirths for low risk, uncomplicated pregnancies are as safe as hospital births. That data have been in for several years now and it’s really a turf problem that we’ve got where we see obstetricians scaring women into think this is risky tantamount to child abuse, ridiculous things when women suggest that it might be reasonable to have a homebirth or a freestanding birth center birth. These are actually wiser approaches and we have been involved in producing a 14 minute DVD largely designed for Massachusetts legislators who are considering a midwifery bill right now, but it is something we hope to have on YouTube soon so that the larger public can understand from the perspective of consumers and doctors. We have no midwives speaking in this DVD. It’s only physician couples who have used midwives and other couples who are very well-educated and physicians who understand the benefits of midwifery care speaking about the benefits of the midwifery model and it’s that kind of DVD or video that we want more of the public to see so they understand that what they’re getting from mainstream sources of information is not necessarily the best thing when it comes to how to go about having a baby in this country today.
Question: Does the recent Lancet study threaten commitments to women’s health?
Judy Norsigian: I was speaking at a conference of reproductive health providers just yesterday where we talked about the front page article in the New York Times describing the Lancet study, which gave us our first really good news that all the things we’ve been doing, many different interventions are finally having an impact on reducing maternal mortality in developing country settings. Now about 40 to 50% of the maternal mortality is created in 6 countries and one of them is India, which of course has nearly a billion people. They’ve done a really good job in recent decades in lowering the maternal mortality rate, so they have a big impact on the overall figure for maternal mortality worldwide. It’s a great thing the Lancet article came out. None of us at this meeting thought it would harm the investment and reduction of maternal mortality. In fact, finally we’ve got evidence that things we’ve been doing are being successful so that we should be pouring in more resource, investing more money in these approaches to reducing maternal mortality. It’s not about reducing our commitment. Now that we’ve shown this works we’re going to increase our commitment. And there are also some interesting things about this study we should not forget and that is that in places like Eastern and Sub Saharan Africa a big killer of pregnant women is HIV AIDS and so the solution is not getting women immediate obstetrical emergency coverage. It’s about getting antiretroviral to pregnant women because 60,000 deaths in that region were caused by HIV AIDS related problems. It wasn’t because a woman was in labor had obstructed labor, was hemorrhaging, had an infection and couldn’t get appropriate medical care. It was really the HIV AIDS problem. So it depends on where you are as to how you’re going to intervene in the problem of maternal mortality and pregnant women who are struggling with HIV AIDS have to really get that addressed in some cases first and foremost.
Question: What about when it comes to the developing world?
Judy Norsigian: Well in less industrialized countries there is no question that if we don’t support the health of women who are the mothers of children in future generations and very often they do double, triple duty. They’re working in the fields. They are taking care of the home. They are the ones who have to put food on the table. They don’t get access to education. We know now that the single most important thing we can do is make sure that young girls stay in school, that they get an education. That will more than anything else help them improve their own ability to be healthy, their ability to have healthy pregnancies, to be mothers who aren’t stranded with few resources and families they can’t feed. This would be the most important thing we could do and it means overcoming a lot of sexism, a lot of very negative attitudes about women and the need to put women in powerful positions in communities. Women are often not allowed leadership positions in government, community, state, national. These things have to change and when we see change there we see usually a trickledown effect in that women do better. The communities do better. Children do better. Overall health improves.
One in three babies is delivered via Caesarian section. "This is unacceptable and of course it’s going to produce harm."
Educators and administrators must build new supports for faculty and student success in a world where the classroom might become virtual in the blink of an eye.
- If you or someone you know is attending school remotely, you are more than likely learning through emergency remote instruction, which is not the same as online learning, write Rich DeMillo and Steve Harmon.
- Education institutions must properly define and understand the difference between a course that is designed from inception to be taught in an online format and a course that has been rapidly converted to be offered to remote students.
- In a future involving more online instruction than any of us ever imagined, it will be crucial to meticulously design factors like learner navigation, interactive recordings, feedback loops, exams and office hours in order to maximize learning potential within the virtual environment.
Placing science and religion at opposite ends of the belief spectrum is to ignore their unique purposes.
- Science and religion (fact versus faith) are often seen as two incongruous groups. When you consider the purpose of each and the questions that they seek to answer, the comparison becomes less black and white.
- This video features religious scholars, a primatologist, a neuroendocrinologist, a comedian, and other brilliant minds considering, among other things, the evolutionary function that religion serves, the power of symbols, and the human need to learn, explore, and know the world around us so that it becomes a less scary place.
- "I think most people are actually kind of comfortable with the idea that science is a reliable way to learn about nature, but it's not the whole story and there's a place also for religion, for faith, for theology, for philosophy," says Francis Collins, American geneticist and director of the National Institutes of Health (NIH). "But that harmony perspective doesn't get as much attention. Nobody is as interested in harmony as they are in conflict."
Studying voice recordings of infected but asymptomatic people reveals potential indicators of Covid-19.
A leading British space scientist thinks there is life under the ice sheets of Europa.
- A British scientist named Professor Monica Grady recently came out in support of extraterrestrial life on Europa.
- Europa, the sixth largest moon in the solar system, may have favorable conditions for life under its miles of ice.
- The moon is one of Jupiter's 79.
Neil deGrasse Tyson wants to go ice fishing on Europa<div class="rm-shortcode" data-media_id="GLGsRX7e" data-player_id="FvQKszTI" data-rm-shortcode-id="f4790eb8f0515e036b24c4195299df28"> <div id="botr_GLGsRX7e_FvQKszTI_div" class="jwplayer-media" data-jwplayer-video-src="https://content.jwplatform.com/players/GLGsRX7e-FvQKszTI.js"> <img src="https://cdn.jwplayer.com/thumbs/GLGsRX7e-1920.jpg" class="jwplayer-media-preview" /> </div> <script src="https://content.jwplatform.com/players/GLGsRX7e-FvQKszTI.js"></script> </div>
Water Vapor Above Europa’s Surface Deteced for First Time<span style="display:block;position:relative;padding-top:56.25%;" class="rm-shortcode" data-rm-shortcode-id="9c4abc8473e1b89170cc8941beeb1f2d"><iframe type="lazy-iframe" data-runner-src="https://www.youtube.com/embed/WQ-E1lnSOzc?rel=0" width="100%" height="auto" frameborder="0" scrolling="no" style="position:absolute;top:0;left:0;width:100%;height:100%;"></iframe></span>
A study finds people are more influenced by what the other party says than their own. What gives?
- A new study has found evidence suggesting that conservative climate skepticism is driven by reactions to liberal support for science.
- This was determined both by comparing polling data to records of cues given by leaders, and through a survey.
- The findings could lead to new methods of influencing public opinion.