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Surgeon General: Breast Is Best

In a “Call to Action,” U.S. Surgeon General Regina Benjamin identified ways that physicians and others can help new mothers stick with breastfeeding. For example, clinicians can get training in how to care for breastfeeding mothers and babies and then give mothers proper how-to advice. About 75% of mothers breastfeed their babies initially, but that number falls to 43% at the end of 6 months, according to 2010 data from the Centers for Disease Control and Prevention. “Many barriers exist for mothers who want to breastfeed,” Dr. Benjamin said in a statement accompanying the report. “They shouldn't have to go it alone. Whether you're a clinician, a family member, a friend, or an employer, you can play an important part in helping mothers who want to breastfeed.” But Dr. Benjamin said that breastfeeding is a personal decision and that women shouldn't be made to feel guilty if they choose not to.

Law Eased Medicaid Expansions

The Affordable Care Act made it easier for states to expand their Medicaid family planning services, according to the Guttmacher Institute. Previously, that could be done only through a waiver process that typically took 2 years to complete, according to the Guttmacher report. But under the health reform law, states have the authority to expand Medicaid without a waiver. 'A strong body of research demonstrates the significant impact of these programs in enabling women to avoid unintended pregnancies and the abortions and births that follow,” said Adam Sonfield, the report's lead author, in a statement. New York, for example, could save $1.6 million a year by avoiding some unintended births, according to the report. The research was supported by a grant from the Centers for Disease Control and Prevention.

New Laws Restrict Abortion

State laws passed in 2010 were far more restrictive of abortion than in favor of abortion rights or access to contraception, according to NARAL Pro-Choice America. Last year, 16 states passed 34 measures that NARAL deemed “antichoice,” the organization reported. For example, Arizona, Louisiana, Mississippi, Missouri, and Tennessee enacted laws that ban abortion coverage in the state-based insurance exchanges set to launch in 2014 under the Affordable Care Act. In contrast, nine states enacted measures that NARAL categorized as “prochoice.” California, for instance, increased protections for the confidentiality of reproductive-health professionals and patients. NARAL President Nancy Keenan said she is concerned that more abortion restrictions will emerge in the coming years because many abortion opponents were elected to Congress, state legislatures, and governorships last fall.

Medicaid Hospital Admissions Rise

Medicaid hospital admissions rose 30% from 1997 to 2008, while admissions of privately insured patients rose only 5%, the Agency for Healthcare Research and Quality found in another analysis. By 2008, Medicaid paid for 18% of the nearly 40 million hospital stays by U.S. patients, with maternity-related and newborn care accounting for about half of the Medicaid-financed hospitalizations. In that year, the public insurance program spent $51 billion on hospital care, compared with $117 billion paid by private insurers and a cost of $15 billion for the care of uninsured patients.

Federal Abortion Law Introduced

Abortion opponents in the House have introduced the “No Taxpayer Funding for Abortion Act” (H.R. 3) to both further restrict abortion funding and outlaw discrimination against providers who refuse to perform abortions. The bill states that no federal funding can go to any health-benefits plan that includes abortion coverage and that federal tax credits can't be claimed for a health plan that covers abortion, except in cases of rape, incest, and where the life of the mother is in danger. But abortion-rights supporters say the legislation goes too far. Nancy Northrop, president of the Center for Reproductive Rights, said the legislation would create “new tax penalties” aimed at making abortion coverage unavailable even under private health insurance.

AMA Issues Social Media Policy

Physicians using social media sites such as Facebook and Twitter should carefully guard patient privacy while monitoring their own Internet presence in order to make sure it is accurate and appropriate, the American Medical Association said in a new policy statement. During its semiannual policy meeting in San Diego, the association called for physicians to “recognize that actions online and content posted can negatively affect their reputations among patients and colleagues, and may even have consequences for their medical careers.” The AMA urges physicians to set privacy settings on Web sites at their highest levels, maintain appropriate boundaries when interacting with patients online, and consider separating personal and professional content online.

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