Policy & Practice


ACOG Revisits Cord Blood Banking

If a patient requests information on umbilical cord blood banking, physicians should provide “balanced and accurate” information that explains the pros and cons of public versus private banking, according to the American College of Obstetricians and Gynecologists. In a recent opinion from ACOG's Committee on Obstetric Practice and the Committee on Genetics, ACOG also urges physicians to disclose any financial interests they may have when recruiting pregnant women for a for-profit cord blood bank. The committee opinion, which replaces an earlier opinion from 1997, advises physicians that there is no accurate estimate of the likelihood of using an autologous unit of umbilical cord blood. Some estimates put the chances at 1 in 2,700, while others say the rate could be lower. “Patients need to be aware that the chances are remote that the stem cells from their baby's banked cord blood will be used to treat that same child—or another family member—in the future,” Dr. Anthony R. Gregg, chair of ACOG's Committee on Genetics, said in a statement.

Abortion Rate on the Decline

Both the number and rate of abortions in the United States fell between 2000 and 2005, according to an analysis from the Guttmacher Institute. The number of abortions declined from 1.31 million in 2000 to 1.21 million in 2005, a drop of about 8%. And abortion rate dropped from 21 per 1,000 women aged 15–44 to 19.4 per 1,000 women, the lowest rate since 1974. The analysis, which will be published in the March issue of Perspective on Sexual and Reproductive Health, is based on the Guttmacher Institute's 14th survey of all known abortion providers in the United State. The Guttmacher Institute researchers cited a range of factors contributing to the decline in abortions including better contraceptive use, lower levels of unintended pregnancy, more women carrying unintended pregnancies to term, and difficulty accessing abortion services in some areas of the country. The National Right to Life Committee, however, credited women's right-to-know laws, parental consent laws, and so-called partial birth abortion bans with the decrease in abortions.

Prisoners' Abortion Rights Upheld

A federal appeals court in Missouri recently upheld the right of female prisoners in the state to be transported off-site to access abortions. In Roe v. Crawford et al., lawyers for the American Civil Liberties Union argued that pregnant women who are incarcerated do not lose their constitutional rights to obtain an abortion. The case first arose in 2005 when the ACLU went to court on behalf of a pregnant Missouri prisoner who wanted to obtain an abortion. At the time, the court ruled that the prison must transport the woman to a local health care facility to receive the abortion. Following that court victory, the ACLU had the case certified as a class action on behalf of all pregnant prisoners in Missouri. The U.S. District Court for the Western District of Missouri ruled in favor of the ACLU in July 2006, and last month the 8th U.S. Circuit Court of Appeals upheld that ruling.

Gender Plays Role in Depression Dx

Male and female physicians may have slightly different beliefs about when women are at greatest risk for depression, according to a survey of primary care physicians commissioned by the Society for Women's Health Research. While male and female physicians largely agree on the risks of depression, women doctors were more likely than men to say that women are at risk for depression during puberty and perimenopause. About 68% of female physicians cited puberty as a time when women with especially vulnerable to depression, compared with 48% of male physicians. The difference was more pronounced in perimenopause, where 93% of female physicians cited an increased risk, versus 68% of male physicians. The telephone survey included 417 male and 83 female physicians. The physician surveyed included family physicians, general practitioners, and internists. The survey, which was conducted by International Communications Research, was funded through an educational grant from Novartis.

Blue Cross/Blue Shield Sets Campaign

The Blue Cross and Blue Shield Association last month unveiled a 5-point plan for building on the current employer-based health insurance system to improve quality, rein in costs, and provide universal coverage. The plan would create an independent institute to support research comparing the relative effectiveness of different medical treatments; change incentives so that providers are rewarded for delivering high-quality, coordinated care, especially for those with chronic illnesses; empower consumers and providers with personal health records and cost data on medical services; promote healthy lifestyles to prevent and manage chronic illness; and foster public-private solutions to cover the uninsured.

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