In an effort to reduce the spread of HIV, public health officials are considering the promotion of “universal circumcision” for all baby boys born in the United States.
The move comes after officials analyzed the results of several studies that show in African countries hit hard by HIV, men who were circumcised reduced their infection risk by half, the New York Times reported. However, those studies focused on heterosexual men who are at risk of getting HIV from infected female partners. The main issue in the U.S. is men who have sex with men.
In 2008, the CDC estimated that more than 56,000 people were newly infected with HIV in 2006 (the most recent year that data are available). Over half of those new infections occurred in gay and bisexual men.
Click here for more facts on circumcision from the CDC.
Meanwhile, critics of the recommendation said it subjects newborn boys to “medically unnecessary” surgery without their consent.
But Dr. Peter Kilmarx, chief of epidemiology for the division of HIV/AIDS prevention at the CDC, told the Times that any step that could stop the spread of HIV must be given “serious consideration.”
“We have a significant HIV epidemic in this country, and we really need to look carefully at any potential intervention that could be another tool in the toolbox we use to address the epidemic,” Kilmarx told the newspaper. “What we’ve heard from our consultants is that there would be a benefit for infants from infant circumcision, and that the benefits outweigh the risks.”
An official draft of the proposed recommendations by the CDC is due out by the end of the year. In the meantime, the CDC is hosting its National HIV Prevention Conference in Atlanta this week.
Fact:
Clinical trials in Kenya, South Africa and Uganda found that heterosexual men who were circumcised were up to 60 percent less likely to become infected with H.I.V. over the course of the trials than those who were not circumcised.
Fact:
79 percent of adult American men are already circumcised
Fact:
The American Academy of Pediatrics is revising its guidelines, stating that circumcision has health benefits even beyond H.I.V. prevention, like reducing urinary tract infections for baby boys, said Dr. Michael Brady, a consultant to the American Academy of Pediatrics.
Fact:
Circumcision is believed to protect men from infection with H.I.V. because the mucosal tissue of the foreskin is more susceptible to H.I.V. and can be an entry portal for the virus. Observational studies have found that uncircumcised men have higher rates of other sexually transmitted diseases like herpes and syphilis, and a recent study in Baltimore found that heterosexual men were less likely to have become infected with H.I.V. from infected partners if they were circumcised.
Click here to read more from the New York Times.
Click here to read more about why Jews Circumcise from a religious perspective.
Monday, August 24, 2009
Monday, August 3, 2009
How To Pick Your Practitioner/Location For Delivery
I promised on this blog to push the envelop so I'll pull no punches on this topic.
Working in the birth community I've learned that most pregnant parents don't realize the importance of this subject until it's almost too late to do anything about it.
We as a society often spend more time researching the flat screen television we want to buy than the way we will give birth.
The history of birth in the United States is so varied over the last hundred year but most never realize this.
Every 20 years or so the "experts" decide upon a new way that is the correct way to birth. In the early part of the last century most babies were born at home. Today that information is manipulated to make homebirth sound archaic.
Homebirth's statistically have an incredibly lower c-section rate and have been shown to have no difference in infant mortality or the safety and life of the mother compared to hospital births.
But homebirth gets a bum rap. We have visions of mother's dying in childbirth or sick babies. But this could not be further from the truth.
In the begining of the last century the problem with medicine in general and with those who delivered babies was not the location but the doctors themselves. Hygiene caused a lot of infections. And today the problem is STILL the doctors themselves.
Obviously we've come very far with our understanding of germs, health, & proper cleanliness and birthing and delivering babies at home shows to statistically be safer with less c-sections.
Currently your chances of having a c-section nationally is 37.5%. The World Health Organization says that the c-section rate should not be more than 10%.
Ina May, who runs The Farm and has been a Midwife for about 38 years has a c-section rate around 2% for that entire period of time.
Women come to her location in Tennessee to experience a safe place to have an unmedicated labor and delivery. This is a great option for those who do not live close to a hospital but want a natural and unmedicated birth of their baby.
Home birth is not for everyone. There's a few main things to consider:
Your location
Your pain tolerance
Your partners support of this wish
To have a homebirth you must live in a state where this is legal. A midwife will be the practitioner to provide all your prental care and deliver your baby when the time comes.
The midwife will need to meet with you and get a full medical history to determine if you are a good candidate for homebirth. Medically, not every woman is a proper candidate. If you have high risk medical issues such as diabetes, high blood pressure or pre-eclampsia you're most likely going to be what we call "risked out".
However age is not a risk factor in home birth. Age is something you will hear from OB's as a risk factor however there is no medical evidence to support that tale.
Homebirth midwives come to your labor and delivery with everything that a hospital would need to provide in an emergency situation. Oxygen, Ambu bags, needles, syringes, pitocin, methergen, cytotec, lines for hydration etc..
It's important to note that another factor in the safety of homebirth is your location. Statistically emergencies that require some transfer of either the baby or the mother or both are very low, around 2%, however they do happen. So those who wish to achieve a homebirth should live in a city or metropolitan area.
Birthing Centers are the next best option for those who do not live close enough to have a homebirth. These locations are a place where women can come to receive care in a more natural-focused location outside the home. Again they provide all the necessities for resuscitating a baby or mother or to give medications to help stop hemmoraging and are close to a hospital in case an emergency transfer is necessary.
And then of course there are hospitals and OB's.
What baffles me is how these hosptials do their tours and sell their locations to the parents. Parents are told about the amazing rooms and luxuries they provide, such as the size of the beds, the televisions, the furniture and some even go as far as to tout the room service.
All of those things are fine and dandy, however, none of them address the standard of care, your wishes or the allowance of how you want your labor to proceed. You will be seen as a person on an assembly line. Because of the volume you will be pushed into timelines, and procedures that are just nonsense to make it easier for them to finish their work for the day. In short you are forced into the cookie cutter version of birth. And I can promise you, no matter what you are told, in the end, if your body doesn't respond to their clock, you're going to end up having a c-section.
More on hospital births in a post coming soon.
Working in the birth community I've learned that most pregnant parents don't realize the importance of this subject until it's almost too late to do anything about it.
We as a society often spend more time researching the flat screen television we want to buy than the way we will give birth.
The history of birth in the United States is so varied over the last hundred year but most never realize this.
Every 20 years or so the "experts" decide upon a new way that is the correct way to birth. In the early part of the last century most babies were born at home. Today that information is manipulated to make homebirth sound archaic.
Homebirth's statistically have an incredibly lower c-section rate and have been shown to have no difference in infant mortality or the safety and life of the mother compared to hospital births.
But homebirth gets a bum rap. We have visions of mother's dying in childbirth or sick babies. But this could not be further from the truth.
In the begining of the last century the problem with medicine in general and with those who delivered babies was not the location but the doctors themselves. Hygiene caused a lot of infections. And today the problem is STILL the doctors themselves.
Obviously we've come very far with our understanding of germs, health, & proper cleanliness and birthing and delivering babies at home shows to statistically be safer with less c-sections.
Currently your chances of having a c-section nationally is 37.5%. The World Health Organization says that the c-section rate should not be more than 10%.
Ina May, who runs The Farm and has been a Midwife for about 38 years has a c-section rate around 2% for that entire period of time.
Women come to her location in Tennessee to experience a safe place to have an unmedicated labor and delivery. This is a great option for those who do not live close to a hospital but want a natural and unmedicated birth of their baby.
Home birth is not for everyone. There's a few main things to consider:
Your location
Your pain tolerance
Your partners support of this wish
To have a homebirth you must live in a state where this is legal. A midwife will be the practitioner to provide all your prental care and deliver your baby when the time comes.
The midwife will need to meet with you and get a full medical history to determine if you are a good candidate for homebirth. Medically, not every woman is a proper candidate. If you have high risk medical issues such as diabetes, high blood pressure or pre-eclampsia you're most likely going to be what we call "risked out".
However age is not a risk factor in home birth. Age is something you will hear from OB's as a risk factor however there is no medical evidence to support that tale.
Homebirth midwives come to your labor and delivery with everything that a hospital would need to provide in an emergency situation. Oxygen, Ambu bags, needles, syringes, pitocin, methergen, cytotec, lines for hydration etc..
It's important to note that another factor in the safety of homebirth is your location. Statistically emergencies that require some transfer of either the baby or the mother or both are very low, around 2%, however they do happen. So those who wish to achieve a homebirth should live in a city or metropolitan area.
Birthing Centers are the next best option for those who do not live close enough to have a homebirth. These locations are a place where women can come to receive care in a more natural-focused location outside the home. Again they provide all the necessities for resuscitating a baby or mother or to give medications to help stop hemmoraging and are close to a hospital in case an emergency transfer is necessary.
And then of course there are hospitals and OB's.
What baffles me is how these hosptials do their tours and sell their locations to the parents. Parents are told about the amazing rooms and luxuries they provide, such as the size of the beds, the televisions, the furniture and some even go as far as to tout the room service.
All of those things are fine and dandy, however, none of them address the standard of care, your wishes or the allowance of how you want your labor to proceed. You will be seen as a person on an assembly line. Because of the volume you will be pushed into timelines, and procedures that are just nonsense to make it easier for them to finish their work for the day. In short you are forced into the cookie cutter version of birth. And I can promise you, no matter what you are told, in the end, if your body doesn't respond to their clock, you're going to end up having a c-section.
More on hospital births in a post coming soon.
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