Women’s Health

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Money May Be Motivating Doctors To Do More C-Sections

(Getty Images)

(Getty Images)

By Shankar Vedantam, NPR

Obstetricians perform more cesarean sections when there are financial incentives to do so, according to a new study that explores links between economic incentives and medical decision-making during childbirth.

About 1 in 3 babies born today is delivered via C-section, compared to 1 in 5 babies delivered via the surgical procedure in 1996. During the same time period, the annual medical costs of childbirth in the U.S. have grown by $3 billion annually. There are significant variations in the rate of cesarean deliveries in different parts of the country — in Louisiana, for example, the C-section rate is nearly twice as high as in Alaska.

Obstetricians in many medical settings are paid more for C-sections. In a new working paper published by the National Bureau of Economic Research, health care economists Erin Johnson and M. Marit Rehavi calculated that doctors might make a few hundred dollars more for a C-section compared to a vaginal delivery, and a hospital might make a few thousand dollars more. Continue reading

Binge Drinking on Rise in American Women

(Getty Images)

The Centers for Disease Control defines binge drinking in women as 4 or more drinks during one occasion. (Getty Images)

Over on Facebook, the group Moms Who Need Wine has more than 660,000 likes. While most of the posts there seem pretty darn cheerful, they point to a darker reality. Alcohol abuse in women is on the rise. And a specific problem for them is binge drinking, as the Centers for Disease Control reported earlier this year.

In the report, the CDC found that 1 in 8 women over age 18 — that’s 14 million women — binge drink about three times a month. Binge drinking is defined as four or more alcoholic beverages in a two to three hour period. One in 5 high school girls binge drink.

Dr. Bob Brewer who leads the Alcohol Program at the CDC’s National Center for Chronic Disease Prevention framed the public health costs of alcohol consumption for a KQED Forum audience recently. It’s the third leading cause of preventable death in the U.S., with an estimated 80,000 deaths and 2.3 million years of life lost every year linked to excess drinking, he said.

But within that excess drinking, it’s the binge drinking that is really taking a toll. “We know that binge drinking is by far the most common pattern of excessive drinking in the United States,” he said, responsible for half of those 80,000 deaths. Continue reading

Pap Tests for Cervical Cancer Are Too Often Overused

Healthy cervix cells, gathered during a Pap test, as seen under a microscope. (Euthman/Flickr)

Healthy cervix cells, gathered during a Pap test, as seen under a microscope. (Euthman/Flickr)

January is Cervical Health Awareness month, and the Centers for Disease Control is celebrating by highlighting just how poorly the US is doing at following established guidelines.

In dual reports today, the CDC finds that many women are being screened for cervical cancer way too often — while other women are not screened enough.

Let’s start with the guidelines themselves. In 2012, three different groups, the US Preventive Services Task Force, the American Cancer Society and the American College of Obstetricians and Gynecologists all came to agreement: Women ages 21 to 65 should receive a Pap test — the definitive screen for cervical cancer — once every three years. If you’re either under 21 — or 65 or older, you don’t need one, barring certain limitations. (Some women opt for an additional HPV test and can be screened with a Pap test every five years.)

In addition, the overwhelming number of women who have had a total hysterectomy (in which the cervix is also removed) do not need any more Pap tests. As Dr. David Chelmow, a professor of obstetrics and gynecology at Virginia Commonwealth University Medical Center, told Reuters, ”It’s tough to get cervical cancer without a cervix.”

The upshot from the CDC’s survey? Here are the numbers:

  • 41.5% of women ages 18 to 21 had a Pap test in the last year, despite the recommendations that they don’t need them Continue reading

Et Tu, Pelvic Exams?

Women can add pelvic exams to list of medical tests they may not need as often — or at all

(Maigh/Flickr)

(Maigh/Flickr)

First, let’s review. We’ve been getting a lot of updates to cancer screening tests lately.

Pap Smears, a screening test for cervical cancer, were recommended to be done annually, until a group of experts in prevention concluded that every three years was equally effective. Most medical groups, including the American Cancer Society, agree on this one.

Then there’s mammography. I think everyone knows the debate around that. Every year or every other year? Starting at 40? or 50? The evidence points to every two years after age 50, although many doctors maintain younger and more often is better.

Women get them annually, even though we “lack data” that they do much for us.

But this latest one — about pelvic exams — caught me by surprise. It turns out there’s really not a whole lot of evidence that doing an annual pelvic exam makes any difference to a healthy woman’s continuing good health. (Again, we’re stressing healthy women. Women having symptoms are definitely candidates for a pelvic exam).

Here’s what the American College of Obstetricians and Gynecologists (ACOG) says about the pelvic exam, after recommending it be done annually: Continue reading