resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Specialized Pro-Resolving Mediators: 21st Century Inflammation Fighters
Specialized pro-resolving mediators, or SPMs, are a portion of the omega-3 fatty-acid spectrum that have been shown to have a powerful effect on reducing inflammation.
Health and Wellness Partnership
Yo San University of Traditional Chinese Medicine and The Wellness Center at the LAC + USC Historic General Hospital recently joined forces to extend care to the residents of Boyle Heights area of Los Angeles.
How Many of Your Patients Have Sarcopenia?
Figure 1 demonstrates the typical appearance of sarcopenia in the paravertebral muscles. Have you considered evaluating your patients for this problem? Sarcopenia is the progressive loss of skeletal muscle mass and function that affects the older population.
Filling the Gap: The Role of Alternative Practitioners in a Broken Health Care System
I have been asked many times what got me into alternative medicine. My answer is simple: I want to truly help and make a difference in people's health.
Identify & Adjust the Apex Posterior Sacrum
Low back pain involving an apex posterior sacrum (+θX-axis misalignment) typically presents with signs of lumbosacral joint impingement or facet syndrome.
Excited to Share the Science of Chiropractic: An Interview With Dr. Heidi Haavik
Dr. Heidi Haavik has become known in the circle of chiropractic researchers as not only a rising star, but also one willing to do research that can have a major impact in the scientific world and how chiropractic is perceived.
F4CP Launches New Social Media Campaign
The Foundation for Chiropractic Progress has launched a new service to help member doctors: a social media campaign called "Accelerator."
Let's Streamline Your Front Desk
Your front office can be your greatest source of efficiency or a constant bottleneck. Increasing the productivity of this area without sacrificing the quality of patient interaction can be a little tricky.
The Rest of the Patient Story
I've written previously about allowing a patient to tell you their story – about taking the time to listen and engage all the aspects of their case history, the injury in question, and the related issues.
Misconceptions & Opportunities With Medicare
As I speak around the country on how to properly document Medicare patient encounters, I get questions regarding opting out of Medicare. There are many misconceptions about opting out of Medicare, including just what it means to opt out.
Transparency is Key at ASA First Annual Meeting
On March 4th and 5th the American Society of Acupuncturists (ASA) held a successful first annual meeting in Albuquerque, New Mexico.
Designing a Fitness Plan (Part 4): Blending Pain Relief With Healthy Aging
Pain relief is still the No. 1 reason patients come to my office. However, most of my patients have other goals as well, such as: "I want to lose 10 to 20 pounds"; "I feel old and want to slow down the aging process"; "My doctor says I am becoming a diabetic and need to exercise"; or "I'm tired and want more energy."
An Interview with Amanda Shayle
JW: Can you share with us some of your history and how you became an acupuncturist? What did you do prior to becoming an acupuncturist? Where did you go to school?
NCCAOM Launches New Membership Organization
The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) recently launched a new national membership organization, the NCCAOM Academy of Diplomates.
Roots in the Community, Branches Far Beyond
The Jung Tao School of Classical Chinese Medicine (JTS) was founded in 1998 by Sean Christian Marshall in Sugar Grove, North Carolina, a small community near Boone in the state's westernmost mountains.
An Alarming Lack of Accountability
Accountability seems to be a lost quality today. The simple act of taking responsibility and doing the right thing just doesn't happen as often as it should. Maybe it is the litigious nature of our society.
Constructing Our Reality: The Primary Channels and Perception, Part 1
My favorite topic of discussion within Chinese medicine is the acupuncture channel systems. First of all, each of us have them. They are part of our bodies; not something external to us. To learn about the acupuncture channels is to learn about ourselves.
Energy: For Life and For Death
Energy is a deep topic in Traditional Chinese Medicine. Qi is understood to underlie all of existence, animated or not, and the qi of the living is studied with special attention.
The Value of Melatonin in Breast Cancer Prevention and Adjunctive Treatment
Although melatonin (MLT) is best known for its sleep-aid properties and as a natural remedy to prevent jet lag, extensive experimental studies suggest it possesses anticancer activity through several biological mechanisms.
Building Relationships and Referral Networks with Allopathic Practitioners
Dr. Doug, an orthopedist of 20 years, had heard stories from patients who tried acupuncture. While he was able to address many of their complaints effectively, some appeared to gain additional benefit when their care included TCM.
News in Brief
Northwestern Student Honored for Addressing Concussions Head-On; Northwestern Announces New CFO; Life U. to Provide Unique Opportunity.
The Art of Listening
One of the most important clinical concepts for me was voiced by the legendary physician William Osler. "Listen to your patient, he/she is telling you the diagnosis." After treating literally thousands of patients, it can become almost second nature to quickly discover clues which reveal the underlying diagnosis.
Asking Patients the Right Questions
When was the last time you asked a patient a question? Maybe 30 seconds ago? But, are you asking the right questions to elicit valuable and useful information? As a healthcare provider, you've likely spent hundreds of hours learning to ask the right questions to gather critical health information from your patients.
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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