So, you've decided that you don't want any more children. It's final, and there's no chance you'll ever want a baby again. You've done your share of "populating the world" and your husband is too chicken to get his "tubes" cut.
You come into the gynecologists office to get your tubes tied and he/she tells you about this new procedure called Essure that is now available for permanent birth control. Do you want to go with something new, or would you rather stick with the "tried and true" old method of cutting or tying the tubes.
This is a common question, and you should consider several questions before you make your decision. There are several factors which make the Essure procedure better than a tubal ligation. You do not need general anesthesia, you will not need any incisions in your abdomen and the surgical risk is much less.
So, if you are a poor candidate for surgery, for example if you are obese, if you have had many abdominal surgeries, or if you have medical problems that make surgery risky, it should be a no-brainer - Essure is the way to go!
However, there are some disadvantages as well. You need to use another form of birth control for three months until you have a special type of X-ray called an HSG which will confirm that they are in place. If this bothers you, although it is usually not a big deal, then maybe you should go with the tubal.
Also, if you have had surgery on your tubes, such as for an ectopic pregnancy, or if you have a rare allergy to nickel, you may not be a good candidate for the Essure. In such cases the tubal ligation might be right for you.
Of course, a good discussion with your doctor would be the way to go. Every woman has unique issues and concerns, and you should discuss these with your doctor to decide what is right for you.
Screening for postpartum depression, a controversy?
January
01 ,
2008
Time magazine has a whole report about a "debate" regarding postpartum depression (PPD) screening.
Excuse me for putting in my two cents, but I have been screening for PPD for years, and so have just about every obgyn that I know. The postpartum visit is a perfect time to ask women about their mood symptoms, and I have personally been able to help numerous women through this very serious problem. Many of these women would never have sought help had I not asked.
I can't believe that anyone could possibly object to this. A few simple questions could really save someone from serious harm. I am appalled that some people suggest that this is some sort of ploy by the drug companies. For starters, so many SSRIs (the most common medications given for postpartum depression) are generic anyway, like sertraline and fluoxetine. Furthermore, if the screen confirms the disease, and the drug prescription is appropriate, why shouldn't the drug company make the sale? Isn't that what happens every time we prescribe a medicine for someone who needs it?
Any doctor who fails to ask about PPD is clearly neglecting his/her responsibility to his/her patients. It is no different than taking someones blood pressure. Are we to stop taking blood pressure because the drug companies might make a few dollars selling blood pressure medications? Please, get a life.
