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How Much Do You Know About the Benefits of Birds Nest?
Edible bird's nest is the nest made by the Swiftlet bird of Southeast Asia that is usually prepared as a soup and prized in Chinese culture as a healthful delicacy.
Professional Credentialing and Board Certification: An Ethical Faux Pas
Because of the Affordable Care Act, health care systems are coordinating care through accountable care organizations (ACOs) in order to reduce the cost of care and improve quality of care.
First Do No Harm?
There's no questioning the frightening nature of breast cancer, which strikes one in eight women in the U.S. – eclipsed only by skin cancer in terms of prevalence.
Reducing the Autogenic Inhibition Reflex: Making Weak Muscles Strong
The autogenic inhibition (AI) reflex is a sudden relaxation of a muscle in response to excess tension.
Animal Acupuncture: A Case Study in the Treatment of Traumatic Injury in the Equine
The rise of animal acupuncture in the U.S. began in the early 1970's as a result of the work by members of the National Acupuncture Association in Westwood, Calif.
5 Tips for Using Pinterest to Market Your Practice
Pinterest is a very popular, but often under-utilized, social media platform where people can bookmark, or "pin," fun and interesting things from all across the internet.
Integrating Art with Clinical Practice for Patients with PTSD: The Artemis Project
Are you restricted by those one-on-one clinic dynamics? Why not join colleagues and clients in experimental group settings? Three of us volunteered to do just that in Austin on behalf of women veteranss from all branches of the service.
Our Biggest Challenges to Compete in Wellness Care
In the first article in this four-article series [May 1 DC], I made the case that chiropractors should either embrace offering lifestyle wellness in their practices or face the possibility of losing their place in the wellness care marketplace.
The Tide is Rising in the Acupuncture Profession
Former President Ronald Regan said, "When the tide rises all boats float." The tide is rising for the acupuncture profession. Many forces outside the profession are helping the tides to rise.
A Poor Choice for Pain Relief
Acetaminophen is the most popular pain reliever in the U.S., accounting for an estimated 27 billion annual doses as of 2009. With 100,000-plus hospital visits a year by users, it's also the most likely to be taken inappropriately.
ACA or ICA: Which Best Represents You?
Last June, I was honored to represent Texas ICA members as their representative assemblyman at the ICA Annual Meeting in Kansas City.
The Challenges of Integrating Eastern and Western Medicine
My Masters thesis was titled, "The Challenges of Integrating Eastern and Western Medicine," which highlighted several reasons why it is hard for these two worlds to mix.
Rethinking Musculoskeletal Pain – A Public Health Perspective
The American Public Health Association (APHA) is the world's oldest and largest association of its kind, founded more than 140 years ago and boasting over 25,000 members.
The Acupuncturist's Problem
I want share with you some observations and insights into what seems to be the most common problem my colleagues in the acupuncture profession struggles with. If you also struggle with this problem, I hope you get a valuable "aha" moment from reading this.
Marijuana, Apathy and Chinese Medicine, Part 1
This article was written in response to the unheeded acceptance of marijuana as a harmless substance that potentially does good when used for the medical relief of pain.
We Get Letters & Email
A House Divided? (May 1 issue) provoked significant response from readers. Here are several of the surprisingly similar comments we received.
Giving Vets the Care They Deserve
The Department of Veterans Affairs (VA) administers the largest integrated health care system in the United States.
Green Tea Improves Cognitive Function in Elderly Subjects
Publishing their results in the journal Nutrients in May 2014, researchers showed that drinking the equivalent of 2-4 cups of brewed green tea (or bottled tea) daily improved cognitive function or reduced the progression of cognitive dysfunction in elderly subjects.
PCOM Granted Regional Accreditation
Pacific College of Oriental Medicine (PCOM) recently announce it has received regional accreditation from the Western Association of Schools and Colleges (WASC). This achievement reflects five years of hard work on the part of faculty, staff, and students.
5 Simple Steps to Create an Effective Marketing Calendar
In the educational experience of most healthcare practitioners, business and marketing are overlooked topics.
Spieth Thanks His Chiropractor After Historic Masters Win
Jordan Spieth didn't just capture the hearts of golf enthusiasts worldwide with his record-setting, wire-to-wire victory at the 79th Masters Tournament.
Medicine is Clumsy, Don't You Be
All medical systems have clumsiness in them. If the technique isn't, the practitioner is. Everyone in every form of medicine is striving to improve. That is why we call it practice.
May, 2005, Vol. 05, Issue 05
"V-Back" to the Dark Ages
By Elaine Stillerman, LMT
The popular belief that "once a Caesarean section, always a Caesarean section" came from a paper printed in 1916 called "Conservatism in Obstetrics," which cautioned doctors to avoid a primary C-section for fear that it would cause surgical deliveries in future births.At that time, the national C-section rate was two percent. Further support of avoiding C-sections and urging vaginal births after C-sections (VBACs - pronounced "vee-back) came during the 1980s when studies at large urban hospitals indicated that a vast majority - nearly 80 percent - of women had safe vaginal births after C-section(s).
While not every woman is a candidate for VBAC, eligible candidates were overwhelmingly sought to have vaginal births when given the option. In 1996 in the United States, vaginal births after C-sections went up from 19.9 percent to 28.3 percent, and in Europe to 50 percent in 1997. In this country, government health experts supported VBACs as a way to minimize and control rising C-section rates, which reached 24.4 percent in 2001. The report published in 2000 gave a goal of increasing VBAC rates to 37 percent of births by the year 2010.
But instead of following these guidelines, just the opposite occurred. The rates of VBACs dramatically dropped from 28.3 percent in 1999 to 10.6 percent in 2003. Today, at hundreds of small hospitals across the country, women are being told that they have no choice in the matter and must undergo a surgical delivery or be sent to larger medical centers, often miles away from their homes, families and doctors, to give birth vaginally. This even includes women who have already had successful VBACs. "Once a C-section, always a C-section" has come back to haunt us.
What went wrong? It seems that during the late 1990s, reports started coming in, particularly from rural settings, about women who had ruptured their uterus during labor without the presence of medical staff to deal with the emergencies. This caused widespread panic among doctors and hospitals and compelled the College of Obstetrics and Gynecology to revise their VBAC guidelines and stipulate that a doctor should be "immediately" available, rather than the previously worded "readily" available, in the event of an emergency. In other words, it required small, understaffed hospitals to have a medical team present at all times just in case of labor complications. Since many of these hospitals don't have that kind of medical staffing, they decided instead to ban the practice of VBAC altogether regardless of a woman's wishes. The other, and possibly more insidious reason, was the rampant fear of lawsuits.
In the majority of instances, the uterine scar from a previous C-section is very tough and able to withstand the contractions of an arduous labor. The rate of uterine rupture occurs less than two percent during a VBAC, the same degree as in repeated C-sections. None of this seems to impact the decision, however.
What doctors are failing to address is why the uterus might rupture in the first place. Some data (although inconclusive), suggests that the use of hormones to induce labor, or speed it up, such as prostaglandins and pitocin (synthetic oxytocin), increases the chances of rupture as much as 15 times. In midwifery practices, where labor augmentation is not used, VBACs are performed without any complications in the majority of cases. Uterine dehiscence (asymptomatic separations of the uterine scar) in a non-induced labor occurs in the same proportion as repeated C-sections, but some doctors and hospitals are still not willing to take the chance on a vaginal birth.
In third world and developing countries where sanitation is questionable, cephalopelvic disproportion (large fetal head size to small maternal pelvis size) is common, and access to medical care may be hours away, dehiscence of the scar may cause further uterine tearing and threaten the life of mother and child. But in the United States, which ranks 11th out of 117 in the world of the best countries to have a baby according to the 2003 survey "The Complete Mothers' Index and Country Rankings," published by Save the Children Foundation, serious rupturing is rarely a problem, particularly if labor-inducing and augmenting medications are not administered.
There are many reasons why women seek a VBAC. There is certainly less trauma to the body and a vaginal birth is easier to recover from than major abdominal surgery. The risks of surgical complications, including hysterectomy, increase with each C-section and the emotional satisfaction derived from a vaginal birth is unsurpassed. When a woman prefers a more family-centered, natural birth experience, she should be able to have one. The choice must belong to the women. Many women are more than willing to assume the risks and responsibilities of a vaginal birth after a C-section and believe that their decisions are being undermined by hospitals whose primary concern is the bottom line, a fear of lawsuits, and doctors who find surgical births more lucrative and easier to manage than vaginal births.
Little by little, women's reproductive rights are being whittled away by doctors who refuse to learn the necessary, life-saving medical procedure, D & C (dilation and curettage), because it can be used to perform abortions; by insurance companies who put birthing centers and dedicated doctors out of business as a result of their unaffordable malpractice premiums; by misogynistic extremists in Washington who use our bodies as legislative fodder to take away our reproductive choices; and by small-minded hospitals who force women to cede ownership of their bodies and dictate to them how to have their babies. We are indeed going back to the Dark Ages.
Click here for previous articles by Elaine Stillerman, LMT.
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