Many women assume that they are unable to get pregnant
directly after giving birth, especially if they are breastfeeding. Although
breastfeeding generally suppresses ovulation, a new report in Obstetrics and
Gynecology reminds new mothers to start using some form of contraception as
soon as three weeks postpartum.
The authors acknowledge that it’s unlikely to conceive while
breastfeeding and even women who aren’t breastfeeding don’t typically begin
ovulating until six weeks after delivery. However, they stress that it is still
possible. In some studies reviewed in the journal, women began ovulating again
45-94 days after giving birth. Two other studies found women ovulating as early
as 25 and 27 days after giving birth. Although, the studies also revealed that
the first ovulatory cycles were unlikely to result in pregnancy.
The report is mostly directed at women who are not
exclusively breastfeeding their babies. Nursing mothers are not advised to use
common forms of hormonal birth control because the estrogen could affect their
baby’s growth. For women who are not frequently breastfeeding, the World Health
Organization recommends using hormonal contraceptives as early as six weeks
after giving birth.
The real purpose of the review was to make sure that women
and their doctors are making plans for their future fertility, even when
contraception may be the last thing on a new mother’s mind.
Do you have plans for
contraception after you give birth?
Many women choose to give birth a little early whether
through an elective C-section or induction. There are many reasons cited for
doing it and most babies end up being born healthy. Some babies, however, are
being born too early and winding up in the Neonatal Intensive Care Unit (NICU). It's these babies that Texas legislators are targeting in an effort to cut
costs as they face a budget deficit.
On the surface, the debate looks like a low-blow, but
legislators are looking into unusually high preterm birth and C-section rates
that are well-known in the United States. Some studies have found that early
birth rates are directly correlated with for-profit hospitals and the concern
that doctors are pushing more intensive medical procedures to make more money
is not new. It costs Medicaid $2,500 for a routine delivery and $45,000 for an
NICU stay. Since the decision to put some babies in the NICU can be subjective,
doctors looking to make more money can easily be biased in that direction.
Legislators estimate that they could save $36.5 million in
Medicaid over the course of two years by better managing the NICU, limiting
“convenience” C-sections and refusing to finance elective inductions before 39
weeks. State health officials say that
137 Medicaid-covered babies experienced complications in 2009 that were born
through elective inductions.
Many hospital workers don’t agree with legislators on the
cause of so many babies filling Texas NICUs. They point out figures unique to
Texas: a high birth rate, few people with health insurance, and limited
prenatal care. Plus, the rise of infertility services has increased the number
of multiple births and births to older women. Regardless of the cause of increased
preterm births, at the end of this debate, legislators could take a step that
would limit the choices of mothers on Medicaid.
What do you think of
limiting elective cesareans and inductions?
In Search of Cuts, Health Officials Question NICU Overuse [NyTimes]
Hasidic Jewish families are experiencing a shortage of an
imported kosher baby formula. Materna imports to the United States from Israel
are apparently being restricted and it is one of the few milk-based baby
formulas that conform to Hasidic religious laws.
Orthodox Jewish families have a selection of kosher formulas
available to them, but Hasidic Jews follow a stricter kosher standard known as cholov yisroel. To meet these standards, the milk is watched by a
kosher supervisor from the time it leaves the cow. The only other formula that
follows these practices is one made by Similac that is more expensive and only
available in powder form.
Materna made a statement regarding the shortage and said
they are “working around the clock to resolve this,” an issue which they say is
out of their hands. Mystery surrounds the actual cause of the shortage, but
store owners are being told by suppliers that it will return to the shelves