When I had my first baby, one of my friends coordinated a meal train where coworkers could sign up to bring our new family a dinner every other night. Those first few weeks of motherhood were such a chaotic blur that I do not even remember how many weeks this meal delivery went on for except to say that it was both long enough and over too quickly. There was ...

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“One can dream.” That’s often a quote we hear when we talk about winning the lottery or landing a job that lets us do something great like being a taster of new ice cream flavors for a living (I wish). However, what’s sad is that many American moms utter those same words when they think about life after baby. A year of paid maternity leave. Access to a good lactation consultant. Family members who ...

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Decisions about how many children to have (if any) or what type of contraception to use are complex. For patients who are not health care providers, the doctor-patient relationship remains a critical relationship by which these sometimes difficult decisions are navigated. As a practicing gynecologist for 13 years, I continue to be mystified at how many women report to me a nearly complete lack of counseling prior to being prescribed ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 32-year-old woman is evaluated for anticoagulation management after an uncomplicated vaginal delivery of a healthy newborn. She was diagnosed with a bilateral pulmonary embolism at 25 weeks' gestation and was treated with therapeutic low-molecular-weight heparin (LMWH). The LMWH was discontinued at the onset of labor and was restarted 6 hours after ...

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The debate over the safety of giving birth at home, both for the mother and for the infant, has been debated for years. I’ve written about the issue myself. From time immemorial until about 75 years ago or so most babies were born at home. Now it’s around 1 percent in the U.S., although it’s much higher than that in many Western European countries. The shift to hospital births ...

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There have been many times when I have struggled to empathize with the patient. There are certain health care issues, and certain patients, that I have found consistently frustrating over the years. I've written about this, and been pretty well chastised by readers. I don't mind, because I know that 99 percent of physicians have their kryptonite issues, and just don't talk about it. I'll take the heat for being honest. My ...

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Though I am two years into my residency, I still experience flashbacks to my time as a medical student on the wards. The adrenaline of arriving at the hospital 2 hours before rounds, scrambling to see my patients, constructing a note that no one would ever look at, and preparing a hastily-constructed presentation to deliver in a half-performance, half-examination outside of our patient’s room. I remember being the object of a ...

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Foria wants you to know they are selling vaginal suppositories of THC (tetrahydrocannabinol) and CBD (cannabidiol) called Fiora Relief for menstrual cramps. Each suppository contains 60 mg of THC and 10 mg of CBD. Foria claims they can treat the pain of menstrual cramps and endometriosis. Is this possible? THC and cannabidiol (CBD) are compounds found in marijuana. The psychoactive (i.e., high) from marijuana is believed to be due to the ...

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Quick: Which U.S. state has the highest rate of unintended pregnancy? I’ll reveal below, but I learned the answer and several other surprising facts in an interview with Mark Edwards, the co-founder of Upstream USA, a non-profit advocacy organization that provides technical assistance to health enterprises (medical practices, clinics, public health departments) in the use of long-acting, reversible contraceptives (known in the trade as LARC). LARC consists of two options: ...

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I know we all bemoan the chief complaint of vaginal bleeding when it pops up on the board. Your heart sinks even more when it is followed by the dreaded home pregnancy test. No ED provider is going to love seeing patients with first trimester bleeding. More than anything, I loathe the drag it takes on my time and productivity. Labs, urine, moving them to the appropriate room for the ...

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