408-854-1883 starts at $30 per hr home care

Affordable in home care | starts at $28 per hr

Maternal and newborn outcomes in planned home birth vs planned hospital births

We included English-language peer-reviewed publications from developed Western nations reporting maternal and newborn outcomes by planned delivery location. Outcomes’ summary odds ratios with 95% confidence intervals were calculated.

Results

Planned home births were associated with fewer maternal interventions including epidural analgesia, electronic fetal heart rate monitoring, episiotomy, and operative delivery. These women were less likely to experience lacerations, hemorrhage, and infections. Neonatal outcomes of planned home births revealed less frequent prematurity, low birthweight, and assisted newborn ventilation. Although planned home and hospital births exhibited similar perinatal mortality rates, planned home births were associated with significantly elevated neonatal mortality rates.

http://www.ajog.org/article/S0002-9378%2810%2900671-X/fulltext?refissn=0002-9378&refuid=S0002-9378(12)01074-5


Connie’s comments: To reduce neonatal risks, moms should not take drugs during pregnancy (and maintain a healthy pregnancy of whole foods and exercise and monthly prenatals with OBs/CNMs) and homebirth CNMs/midwives should risk out mothers (high risks) for homebirths based on monthly prenatals.

 

Why do we give birth in hospitals when our ancestors didn’t have to?

My answer to Why do we give birth in hospitals when our ancestors didn't have to?

Answer by Connie b. Dellobuono:

From a woman’s perspective, we give birth to hospitals because after World War II, women are heralded to hospitals to birth their babies to ensure that we can use the newest technology possible when needed but hospital is not for all women (with normal birth, cared for by midwives). During that time, after the doctor touches the dead bodies, they then touch the laboring women without gloves and many died during childbirth.

Currently, complications arise because some women used drugs/OTC meds/alcohol during pregnancy (blue babies) or labor and delivery related complications.

For profit purpose, we have to spend $6000 for C-section in the hospital even when not warranted. Because of our lifestyle of sitting all day and not walking a mile a day (with sugar consumption and other drugs), some of us are at high-risk to birth at home. There are only few nurse midwives (CNM) who can do homebirth because the govt/health insurance companies only allows/pays CNMs and not homebirth midwives.

Why do we give birth in hospitals when our ancestors didn't have to?

Gaps in women’s health insurance

The study, by researchers at the National Women’s Law Center, an advocacy group based in Washington, D.C., examined health coverage exclusions in marketplace plans offered by 109 insurers in 16 states in 2014 and 2015.

The health law requires insurers to provide a general summary of benefits and coverage for every plan that states whether the plan excludes coverage of 13 specific services, including acupuncture, bariatric surgery and infertility treatment.

These coverage summaries, which are no longer than eight pages, are easy to read and available online or in paper form. But other services that aren’t in the summary documents may be excluded as well, although they may be hard for consumers to find because they appear in the detailed plan coverage materials. Health plans must provide a link from the online summary to those documents, which can be quite technical and run dozens of pages.

Reviewing these detailed documents, researchers identified six types of excluded services that could have a disproportionate impact on women’s health care, although many of them also apply to men. The excluded services included:

  • Treatment for conditions that result from non-covered services, for example, if you get an infection following cosmetic surgery (42 percent of plans).
  • Maintenance therapy for a chronic disease or other care that prevents regression of a stable condition (27 percent of plans).
  • Genetic testing, except as required by law (15 percent).
  • Fetal reduction surgery, which is sometimes recommended when a woman is carrying multiple fetuses, to protect the woman’s health or improve the odds a pregnancy will be successful (14 percent).
  • Treatment for self-inflicted conditions, such as a suicide attempt or eating disorder (11 percent).
  • Preventive services not required by law (10 percent).

“We wanted to highlight issues that would have a particular impact on women as well as show how broad some of the exclusions are,” said Dania Palanker, who co-authored the study and is now an assistant research professor at Georgetown University’s Center on Health Insurance Reforms.

It’s not uncommon for women who have a family history of breast or ovarian cancer to run into this type of road block when they need genetic testing or preventive services, said Lisa Schlager, vice president of community affairs and public policy at Force, an advocacy group for people affected by hereditary breast, ovarian and related cancers.

The health law requires insurers to cover services that are recommended by the U.S. Preventive Services Task Force, an independent panel of medical experts, without requiring consumers to pay anything out of pocket. The task force recommends that women with a family history of breast or ovarian cancers receive genetic counseling and, if necessary, testing for a mutation in the BRCA1 or BRCA2 genes that are known to increase the risk of developing those cancers.

However, insurers aren’t required to cover testing for the 40 or so other genetic mutations that are also recognized as increasing women’s risk of breast or ovarian cancer, Schlager said, and many don’t.

http://www.nbcnews.com/health/health-care/hidden-plan-exclusions-may-leave-gaps-women-s-care-n632161

breast



Connie’s comments: We must be vigilant and proactive to ask our health insurance companies what is our right as consumers. I asked my insurance company before to pay for my nurse midwife since they only covered one third of the cost of homebirth. I argued that I saved them $3000 by having a homebirth with a CNM. So the next day, they mailed the remaining balance, paying 100% of the $2700 homebirth expense.

Consumers will lead the way to true health care system

true health care

Only in the USA that you can go bankrupt if you get a heart surgery from a heart attack. This happened to my co-worker who has medical insurance. Sitting on his desk 8-hrs a day and eating a western diet did not help him.  He is in his 50s.

Many of us are now empowered to take control of our health as we hit the gym to go for cross-fit training or run around our neighborhood to burn some calories and sweat out.

We flock to Trader Joes, farmer’s market and/or Whole Foods to avoid toxins in our foods. Many food delivery companies and fitness apps were created. Our children are now more informed compared to the Sandwich generation.

But the high cost of housing in the bay area makes us work past 65 yrs of age and work two jobs.  We only hope that we will not be stressed by the workload and lifestyle we are in.

As consumers, we can still control our health care delivery system. Be alert, be informed and be proactive with our health. This is the only way we can cut cost and reserve the hospital only for emergencies.

Connie


From: http://www.foxnews.com/health/2016/09/01/online-tools-help-people-improve-their-health-but-need-more-study.html

Afshin’s team also found that web-based programs to help people become more physically active were highly effective, with 88 percent helping people exercise more.

Among web-based programs for quitting smoking, 77 percent increased people’s success. Mobile texting programs were less helpful, and only two out of seven helped people stop smoking for at least one week.

Among web-based programs to cut down alcohol use, about 83 percent were shown to be helpful.

“Programs that have components such as goal-setting and self-monitoring and use multiple modes of communication and tailored messages tended to be more effective,” Afshin said.

Brie Turner-McGrievy, a behavioral researcher at the University of South Carolina in Columbia, noted that participants in many traditional, in-person interventions may not have much support in between meetings.

With technology, however, real-time feedback is possible, she said by email. “We are able to adapt our interventions as participants are engaging in healthy or unhealthy behaviors throughout the day.”

Though traditional methods may still have some advantages, this is changing as technology changes, said Turner-McGrievy, who was not involved in the new study.

Afshin noted that tech interventions can be combined with in-person care as well. “Clinicians . . . can use such programs to help their patients improve their lifestyle behaviors and reduce the risk of chronic disease such as cardiovascular disease and diabetes,” he said.

Mobile health application acceptance statistics

Only 16% of healthcare professionals currently use mobile applicationswith their patients, but 46% plan to do so in the next five years, according to a 2015 survey of 500 professionals by Research Now, a Plano, Texas-based market research firm. Even so, 86% of the professionals surveyed said they believe mobile apps will increase their knowledge of their patients’ conditions, while 46% said the apps will improve their relationships with patients.

Research Now also surveyed consumers who use medical apps and found that 96% said they believe the devices help them improve the quality of their lives. Sixty percent use them to monitor their activity and their workouts, 49% to count their calories and 42% to monitor weight loss.

“I have patients asking me all the time about health-related apps,” said Dr. Mike Sevilla, a family physician who belongs to a six-physician group practice in Salem, Ohio. “It’s really a great way for me to talk to my patients and make them accountable” for managing their own health.

http://www.modernhealthcare.com/article/20151128/MAGAZINE/311289981

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http://www.mhealthshare.com/mfactsheet.htm


Connie’s comments: Consumers will define the future of mobile health application. The apps should benefit the communities and demographics they serve. The app should facilitate communication and delivery of health care. It should not be used as a diagnosis but as monitoring and patient-centered tool.

USA Rich and poor tax payers, 2010

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Middle income and families

Middle income and couples contributed more in taxes compared to other income groups. Free education, housing support, child care support, health care access and other family-centered and middle-income centered benefits should be given more to this income group.

From these income groups, more than half of the monthly income goes to housing expense.