Surprising news about female sterilization

Or “permanent contraception” (the new term): It was huge news in 1996 when a large study (CREST) was published and we learned that female sterilization, or having your tubes tied, failed much more often than we had thought. Now, a large new study reports even higher failure rates (although the study is retrospective—not the strongest study type). Examining Medicaid claims data, the authors report a 4.7% pregnancy rate after hysteroscopic sterilization (Essure, no longer on the market) and a 5.57% after laparoscopic sterilization. They did not study the rates after a postpartum procedure commonly done within 1-2 days of delivery.

Female sterilization is the most common contraceptive method used in the U.S. (and worldwide), and users are often counseled that the risk of pregnancy is ~ 1%. For comparison, both IUDs and implants have lower reported failure rates and are reversible.


Eat your prunes!

Not only do they have fiber to keep you regular, but two recent studies found that eating prunes prevents bone loss in postmenopausal women with osteoporosis. Luckily, they had groups assigned to different amounts of prunes—and the beneficial impact on bone density was obtained by eating just six prunes a day. This is good to know because 41% of subjects assigned to eating 12 prunes a day dropped out of the study (not surprising). Six prunes have 137 calories and are rich in antioxidants – helpful for reducing inflammation and protecting your cells from damage by free radicals. Prunes don’t only protect against bone loss, but may also help reduce heart disease and diabetes.

The FDA issued a warning about some popular prenatal genetic tests -These noninvasive prenatal tests, used by over one third of pregnant women, are not regulated or approved by the FDA, and use a simple blood draw from the mother to screen for fetal genetic problems. The tests are more reliable when they report that there is no problem, but the warning came because some people are interpreting a positive result as definitive evidence there is a problem with the pregnancy. Instead, these tests are meant to be used as a screening test, or an indication for additional diagnostic testing such as ultrasound examination, chorionic villus sampling, or amniocentesis.

C-Section News

Despite trying to reduce high rates of C-Sections for decades, they continue, especially in the US south.

  • • C-sections are often necessary and can be lifesaving, but they are performed more often than necessary for many reasons including convenience (for the family and the doctor) and fear of lawsuits that something may go wrong during birth
  • • In 2020 the reported overall rate of births by C-sections in the U.S. was 31.8%
  • • In Mississippi, the state with the highest rate, it was close to 40%
  • • C-sections are considered major abdominal surgery, that can lead to short and long-term complications – such as internal scar tissue
  • • One way to decrease rates is to publicize a hospital’s and a doctor’s personal rates. In New Jersey, this led to a drop in rates for first-time, low-risk mothers, from 33.1% in 2013 to 26.7% six-years later

Sadly, C-sections “can still be a taboo topic” for many U.S. women*

  • Many women report feeling judged that they had to have a C-section
  • We must support mothers through situations where they often feel judged, or like they failed in some way
  • These common situations include miscarriage, infertility, having an unplanned Cesarean section, and challenges with breastfeeding
  • One way to support women is to talk more openly about these experiences
  • Birthing a human in any way is an incredible process and whether someone has a Cesarean or uses an epidural does not make them any less worthy. The goal is a safe and healthy delivery.\