Let’s begin with this. I am thankful for all the blessings that you are thankful for. I am especially thankful for scientific medicine that saved my life. I would have been dead 33 years ago from large cell lymphoma without it. I will spend Thanksgiving with my two sons and their families. I have seen them develop successful careers. I have taken my grandsons fishing. The truth, facts, and scientific medicine made that possible.
I am not a cancer specialist, but I am especially grateful that I still have the freedom to write about the facts and the truth about medicine in this country. I am not an oncologist. I cannot exactly return the favor, but I have helped others live longer with heart disease and other conditions like diabetes. The facts and the truth are especially critical in how we think about our healthcare system and policy. It is a fact that we could have better health at lower cost in this country by making substantial changes in the way that we address chronic diseases. It is also a fact that winners in our current system are a barrier to patient-centered care and progress. Financial considerations are blocking the way forward.
Nevertheless, we can still discuss the truth and the facts, and we can try to work through our disagreements. The promise of scientific medicine has never been greater. Modern scientific medicine has advanced as dramatically as communications science, but you are not reaping the benefits you could receive. New science and new systems mean you could live a longer healthier life for much less money. It is the truth, and it is a fact to the best of my ability to determine it. I will be even more thankful when we have a healthcare system that is truly patient-centered and delivers on it. Let’s take the rest of this week off and I will put up another post on Monday after the holiday.
Medicine is a life-or-death pursuit. It is serious business. There is no room here for lies, hysteria or manipulation and we see those far too often. Women’s health is a great example. We have the highest infant and maternal mortality of any other developed country in the world. It is about to get worse because of hysteria and disinformation about abortion. Maternal mortality in the United States is 24 per 100,000 live births. That is a massive outlier compared with other developed countries. Some states are even worse. Alabama, Arkansas, and Mississippi have a maternal mortality rate over 40 per 100,000. In the Netherlands, it is one per 100,000. In Denmark, Austria, and Australia it is 2 per 100,000. Our national maternal mortality is ten times the rate in Poland, Japan, and Israel. Some states have a maternal mortality rate that is 40 times the rate in the Netherlands.
Eclampsia is a leading cause of death in pregnant women. Preeclampsia-eclampsia is defined as new-onset high blood pressure with new-onset protein in the urine or chronic hypertension with new-onset protein in the urine after 20 weeks of gestation. These conditions are dangerous. They affect 5% to 7% of all pregnant women and are responsible for over 70 000 maternal deaths and 500 000 fetal deaths worldwide every year. In the United States, they are a leading cause of maternal death, severe maternal complications, maternal intensive care admissions, cesarean section, and prematurity.
Some risk factors for preeclampsia and eclampsia are impressive. If you had a problem with this condition in a prior pregnancy, your chance of developing it in your current pregnancy is 8 times the average risk in a pregnant woman. If you just have high blood pressure, your risk is increased 5 times. If you have diabetes prior to becoming pregnant, your risk is nearly 4 times as great. Eclamptic seizures are a medical emergency and require immediate treatment to prevent death in both the mother and fetus The definitive treatment for eclampsia is delivery or abortion to end the pregnancy.
An infant is full term at thirty-seven to forty weeks. This potentially deadly disease can begin by definition at 20 weeks. The fetus cannot survive outside the womb at that point and removing the fetus is the treatment for this condition. The question of fetal viability becomes extremely important, and the American College of Gynecology says that some individuals frequently misrepresent or misinterpret this concept based on ideological principles. “This perpetuates incorrect and unscientific understandings of medical terms and leads to interference in the practice of medicine” That is not medicine based on truth or fact and our women and children are paying the price.
So, what are the facts? If the pregnancy is beyond 25 weeks the health of the mother must be balanced against the health of a delivered infant. “Rates of neonatal survival to discharge at this time range dramatically from 23% to 27% for births at 23 weeks, 42% to 59% for births at 24 weeks, and 67% to 76% for births at 25 weeks of gestation. The consensus also notes that deliveries before 23 weeks have a 5–6% survival rate and that significant morbidity is universal (98–100%) among the rare survivors.” There are women with preeclampsia and eclampsia that fall into the gap between 20 and 24 weeks when half of the babies can survive. “As a proportion of all deliveries including stillbirths, virtually no babies born at 22 weeks survive. And among only the live births at this very early stage, just 7.3 percent of babies survive. But survival rates surge to 24 percent for the subset of these babies who can be admitted to neonatal intensive care units (NICUs). In contrast, 82 percent of all babies delivered at 27 weeks live, with the survival odds rising to 90 percent for those admitted to NICUs, the study team reports in Pediatrics… More time in the womb also increases babies' odds of survival without severe impairments: at 22 weeks, just 1.2 percent of babies born alive are free of major impairments, but this rises to 64 percent of infants who arrive at 27 weeks…Most major impairments, i.e. cerebral palsy, severe sensory (vision, hearing) impairment and mental retardation are discovered at 3 years of age," …But we know that less severe mental and physical impairments, such as significant learning, behavioral and attention difficulties and clumsiness that are not detected at 3 years are common among school children born very and extremely preterm, and again, in particular when approaching the limit of viability.” Eclampsia may occur between 20 and 27 weeks. That presents mothers and their clinicians with some extremely difficult decisions. Tubal pregnancies are never viable and must be terminated.
The consequences of preeclampsia are not confined to the time of pregnancy and immediately after. Women who have preeclampsia or eclampsia are twice as likely to have a heart attack or a stoke later in life. They are four times as likely to have high blood pressure and they are more likely to develop diabetes.
Do abortion statistics match up with these realities? These data are collected by the Centers for Disease control, and they originate in the states, the District of Columbia, and New York City. In 2016, almost two-thirds (65.5%) of abortions were performed at less than 8 weeks’ gestation, and nearly all (91.0%) were performed before 13 weeks into pregnancy. Fewer abortions were performed between 14 and 20 weeks of pregnancy (7.7%) or at 21 weeks or more of pregnancy (1.2%). 98.7% were performed before 20 weeks when no fetus is viable. Only 1.2 percent of abortions are done at 21 weeks or later.
This is what Kaiser Health News had to say on the topic. “Abortions occurring at or after 21 weeks gestational age are rare. They are often difficult to obtain, as they are typically costly, time-intensive and only performed by a small subset of abortion providers. Yet these abortions receive a disproportionate amount of attention in the news, policy and the law, and discussions on this topic are often fraught with misinformation; for example, intense public discussions have been sparked after several policymakers have theorized about abortions occurring “moments before birth” or even “after birth.” In reality, these scenarios do not occur, nor are they legal.”
Given these facts, these new anti-abortion laws represent a death sentence for young mothers in several states. Arkansas’ bans, Idaho’s total ban, Mississippi’s total ban, Oklahoma’s bans, South Dakota’s ban, and Wisconsin’s ban don’t contain a health exception for mothers. It is straightforward. More young mothers will die in these states. Arkansas and Mississippi have some of the highest maternal mortality rates already. These laws will only aggravate that problem.
Maternal mortality, infant mortality, and abortion are all related. These are complicated medical topics, and they are emotional issues. Some politicians are fanning the emotional flames and demonizing those who disagree with them. Heightened emotions make reasonable solutions impossible. Women’s health should not be a political issue beyond using reason, facts, evidence, and the truth to improve it. I am thankful that I can still write about this important topic and other health matters where the truth and the facts make such a difference. Warning clouds are on the horizon though. A prominent antiabortion politician recently said this about people like me who disagree with his policies: He promised to "root out the communists, Marxists, fascists and the radical-left thugs that live like vermin within the confines of our country, that lie and steal and cheat on elections.” He and those like him have made a medical issue political. I will do all I can to avoid being rooted out.
It is not the science that is the problem. The problem is the people who have no interest in the morality of their actions. They gaslight the public and plunder their wealth. Just recently, I encountered a mother and her three year old daughter, both survived preeclampsia. The daughter was born premature and suffers from severe “undetectable cardiac symptoms”, she turns blue with frequent onsets of pneumonia; and they were told that these cardiac conditions are permanent without treatment or cure; she will die young! Also, the desperate mother has weight gain and severe depression issues. It tuned out that their Multifunction Cardiogram (MCG) tests were nearly identical indicating metabolic heart dysfunctions except the difference in degrees of functional severity. To the mother’s extreme surprise, these dysfunctions are reversible and the three year-old will have her heart healed with simply but robust lifestyle adjustments. The same goes for the mother! The mother was in tears hearing my explanation of why they are suffering. Imagine that?
Pregnancy induced metabolic disorder is preventable starting in pre pregnancy, lifestyle optimization is the only way to go. Maternal fetal metabolic health can be improved dramatically during pregnancy, simple MCG testing can detect and monitor the effects of pregnancy and the lifestyle changes to ensure safe pregnancy and effective delivery without premature birth or deaths of both mothers and babies. These are preventable tragedies. Facts! We can really help!
Slippery slope though. Look at how all culture has changed and not for the better I might add. It’s hard to fight liberals who think everything is morally relative. I would argue that is why we are where we are right now! I think abortion is evil and I think a number of women now use it as a method of birth control. I would argue that if people were healthier in general we would see a lot fewer maternal and fetal problems. How about making things simpler and better? Use birth control!