Since the U.S. Supreme Court's Roe v. Wade decision in 1973, nearly thirty million legal abortions have been performed in the United States. Every year hundreds of thousands of women choose to have abortions. Yet a veil of secrecy is drawn across abortion sites, disturbed only by protest demonstrations and violence outside clinics. For years the antichoice movement has loudly condemned the abortion procedure. Opponents use such words as "baby-killing", "murder", and "blood-dripping abortionists" to describe what goes on in an abortion clinic - highly charged words that are intended to frighten women who are facing one of the most important decisions of their lives. What does - and does not - go on inside an abortion clinic? Why do women seek this procedure? Why would a physician specialize in this service? Why I Am An Abortion Doctor provides a unique, firsthand look at the life and work of a leading abortion provider. With compassion and courage Dr. Suzanne T. Poppema shares the intimate details of her private and professional struggle - including a view from the abortion clinic operating room as well as a recollection of her own fifth-month abortion - to promote better understanding of the reality of abortion and the violent forces that threaten a woman's right to choose. Dr. Poppema's journey has led her from a Catholic upbringing in rural New Hampshire to professional training at Harvard Medical School, where she made a critical career decision to forgo the fame and fortune awaiting those who enter lucrative medical specialties in favor of becoming a family physician. She has traveled to some of the poorest places on earth, where she observed the expendability of human life and thesubjugation of women. Dr. Poppema's work has brought her a world-wide reputation as an authority on abortion. She served as a member of an international panel in Paris to discuss the French abortion pill, RU 486. Her own clinic was chosen as one of the few U.S. test sites for this controversial drug. Why I Am An Abortion Doctor is a compelling, informative book for readers on both sides of the controversy. It is a groud-breaking work that puts a human face on abortion and tells precisely what the procedure involves, who it helps, and why women seek to terminate their pregnancies.

The prevalence of hypertension is almost three times as high as that of diabetes mellitus type 2, with both conditions being major risk factors for stroke, ischemic heart disease, cardiac arrhythmias, and heart failure. The exact prevalence of hypertension related to hormonal derangements (endocrine hypertension) is not known but estimated to affect less than 15% of hypertensive patients. Recent scientific discoveries have increased the understanding of the pathophysiologic mechanisms of hypertension. In Endocrine Hypertension, a renowned panel of experts provides a comprehensive, state-of-the-art overview of this disorder, discussing when to assign an endocrine cause in one of many conditions that may present with hypertension. The first part of Endocrine Hypertension is dedicated to adrenal causes. The second part of the volume concerns potential nonadrenal causes of hypertension, such as growth hormone excess or deficiency, primary hyperparathyroidism, vitamin D deficiency, testosterone deficiency, insulin resistance, obesity-associated hypertension, and the role of central mineralocorticoid receptors and cardiovascular disease. An important contribution to the literature, Endocrine Hypertension is an indispensable reference not only for endocrinologists, diabetologists, and adrenal investigators, but also for translational scientists and clinicians from cardiology, internal medicine, pediatrics, family medicine, geriatrics, urology, and reproductive medicine / gynecology.

Part of the recognised Infertility Management Series, this handbook is a complete guide to ovarian stimulation. Beginning with an overview of the physiology of gonadotropins, the following chapters discuss ways in which clinicians may better predict ovarian response to stimulation and how to select and tailor appropriate protocols. The book covers both oral and injectable agents for stimulation, and protocols for IVF and IUI, egg donors, oncofertility patients, and for low ovarian response. The final chapter details complications in ovarian stimulation, and their prevention and management. Other titles in the series include: Investigating Infertility, Intrauterine Insemination, Practical Management of Male Infertility, and Polycystic Ovarian Syndrome. Key points Part of Infertility Management Series providing complete guide to ovarian stimulation Helps clinicians better predict ovarian response and select appropriate treatment protocols Covers oral and injectable agents for different patient groups Edited by recognised team of experts in reproductive medicine

Progestogens are a class of steroid hormones that bind to and activate the progesterone receptor. This book is a guide to the use of progestogens for clinicians. Beginning with an overview of structure, biochemistry and classification, the following chapters discuss methods of administration, pharmacokinetics, metabolism and the physiological actions of progesterone. The remaining sections of the book cover clinical usage guidelines for progestogens, their role in contraception, side effects and contraindications. The book concludes with a chapter offering guidance on prescription writing and detailed references. Key points Guide to progestogens for obstetricians and gynaecologists Provides step by step detail on structure, classification, and pharmacokinetics Includes clinical usage guidelines, side effects and contraindications Features chapter on prescription writing

A mother's narcotics abuse can have profound effects on her pregnancy and the health of her child, both inside and outside the womb. Spontaneous abortion, premature birth, labor difficulties, increased perinatal and neonatal mortality, respiratory distress, low birth weight, and passed on addiction are just some of the possibilities. Ernest Abel's Narcotics and Reproduction: A Bibliography is the first comprehensive listing of the scholarly research literature produced on this subject. Arranged alphabetically by author, the book lists materials dealing with the effects of the use of heroin, morphine, methadone, and related drugs on sexual function, reproduction, and the fetus.

Practicing specialists in pathology, laboratory medicine, and obstetrics comprehensively summarize the latest scientific findings and their experiences in the use and interpretation of laboratory testing in patients who are pregnant or experiencing recurrent pregnancy loss. Topics of interest include the effects of normal physiological changes on test results, test selection for diagnosis, changes in reference ranges, monitoring the pregnant patient, new technologies, and the limitations of laboratory testing. The authors not only clearly explain currently used test methods and technologies for the nontechnical reader, but also provide comprehensive details for laboratory professionals. The comprehensive appendix that compiles published normal reference ranges by first, second, and third trimester consttitutes an excellent resource for professionals caring for pregnant women.

Einzigartig umfassender evidenzbasierter Leitfaden fur Geburtshilfe und Gynakologie. Evidence-based Obstetrics and Gynecology richtet sich an Geburtshelfer, Gynakologen und angehende Facharzte. Der Schwerpunkt liegt auf der klinischen Praxis in den Bereichen Diagnostik, Untersuchung und Management. Der erste Abschnitt behandelt die evidenzbasierten medizinischen Verfahren fur beide Fachrichtungen. Im zweiten und dritten Abschnitt werden die wesentlichen Erkrankungen erlautert. Dabei beleuchtet jedes Kapitel die besten verfugbaren Behandlungsoptionen nach evidenzbasierten Kriterien. Die Kapitel folgen im Aufbau der EBM-Methodik, nach der sich die relevanten klinischen Fragen aus dem jeweiligen Fall ergeben. Evidence-based Obstetrics and Gynecology beschreibt ausfuhrlich abnorme Vaginalblutungen, Eileiterschwangerschaften, Unterleibsschmerzen, Infektionen des unteren Genitaltrakts, Verhutung und Sterilisation, Erkrankungen der Brust, urogynakologische und endokrinologische Erkrankungen, Unfruchtbarkeit, Pubertat und vorzeitige Pubertat, zervikale Dysplasie und Infektionen mit HPV, Gebarmutterhals-, Vaginal-, Gebarmutter- und Eileiterkrebs, Behandlungsverfahren vor einer Empfangnis, pranatale Behandlung und Diagnostik, Medikamente und deren Dosierung wahrend der Schwangerschaft, Komplikationen bei Schwangeren, chronische Hypertonie, Diabetes mellitus, Schilddrusenerkrankungen, neurologische Erkrankungen, psychische Erkrankungen, UEbertragung in der Schwangerschaft, Komplikationen beim Foetus, Praeklampsie u.v.m. - Das erste Fachbuch, das sich evidenzbasiert mit Geburtshilfe und Gynakologie in der klinischen Praxis beschaftigt. - Die evidenzbasierte Medizin ist ein uberzeugender Ansatz fur dieses mit vielen Risiken verbundene Fachgebiet. - Herausgeber ist ein fuhrender Experte aus den USA, der sich fur die evidenzbasierte Medizin engagiert.

The Part 3 MRCOG is a clinical assessment of knowledge, skills, attitudes and competencies. Passing the Part 3 exam leads to the award of the Membership of the Royal College of Obstetricians and Gynaecologists (MRCOG) and remains the essential waypoint for UK trainees to pass from core training to higher training. Trainees must have passed MRCOG Parts 1 and 2 before they can sit the Part 3 exam (Royal College of Obstetricians and Gynaecologists). This book is a complete revision guide for students preparing for the MRCOG Part 3 examination. Beginning with an overview of training in obstetrics and gynaecology in the UK and basics of the exam, the following chapters provide step by step tips and advice on aspects of the exam, patient safety, communication with patients and colleagues, information gathering, application of knowledge, and clinical governance. The book features nearly 50 OSCE scenarios with variations that may be encountered in the exam, as well as clinical problems and their solutions. Related specialties such as anatomy, genetics, immunology, endocrinology, and psychology, are also discussed. Key points Complete revision guide for students preparing for the MRCOG Part 3 examination Features nearly 50 OSCE scenarios that may be encountered in the exam Includes clinical problems and their solutions Discusses structure of the UK National Health Service and the role of midwives in the care of pregnant women

Anyone working to improve the childbearing experience and help women avoid unnecessary intervention has encountered numerous obstetric myths or old doctors' tales. And while the evidence in the medical literature may be solidly, often unequivocably, against whatever the doctor said, without access to that evidence, the pregnant woman is quite reasonably going to follow her doctor. This book is an attempt to make the medical literature on a variety of key obstetric issues accessible to people who lack the time, expertise, access, or proximity to a medical library to research concerns on their own. This compact, accurate, yet understandable reference is designed for people without medical training and organized for easy access.

After an introductory chapter giving basic information about the different types of medical studies, how to evaluate them, and some basic statistical concepts, Goer provides chapters on cesarean issues, pregnancy and labor management, and a review of alternative approaches. Each chapter begins with a stated myth, followed by an examination of the reality. Goer then analyzes the mainstream belief, pointing out its fallacies. Then comes a list of significant points gleaned from the studies and keyed to her abstracts. Next is the outline by which the abstracts are grouped. Finally come the numbered abstracts of relevant articles published, in most cases, after 1980. The book concludes with a glossary of medical terms and an index. This compact, accurate, and understandable reference tool is designed for people without medical training as well as care givers.

Medical imaging has been transformed over the past 30 years by the advent of computerized tomography (CT), magnetic resonance imaging (MRI), and various advances in x-ray and ultrasonic techniques. An enabling force behind this progress has been the (so far) exponentially increasing power of computers, which has made it practical to explore fundamentally new approaches. In particular, what our group terms "model-based" modalities-which produce tissue property images from data using nonlinear, iterative numerical modeling techniques-have become increasingly feasible.

Alternative Breast Imaging: Four Model-Based Approaches explores our research on four such modalities, particularly with regard to imaging of the breast: (1) MR elastography (MRE), (2) electrical impedance spectroscopy (EIS), (3) microwave imaging spectroscopy (MIS), and (4) near infrared spectroscopic imaging (NIS). Chapter 1 introduces the present state of breast imaging and discusses how our alternative modalities can contribute to the field. Chapter 2 looks at the computational common ground shared by all four modalities. Chapters 2 through 10 are devoted to the four modalities, with each modality being discussed first in a theory chapter and then in an implementation-and-results chapter. The eleventh and final chapter discusses statistical methods for image analysis in the context of these four alternative imaging modalities.

Imaging for the detection of breast cancer is a particularly interesting and relevant application of the four imaging modalities discussed in this book. Breast cancer is an extremely common health problem for women; the National Cancer Institute estimates that one in eight US women will develop breast cancer at least once in her lifetime. Yet the efficacy of the standard (and notoriously uncomfortable) early-detection test, the x-ray mammogram, has been disputed of late, especially for younger women. Conditions are thus ripe for the development of affordable techniques that replace or complement mammography. The breast is both anatomically accessible and small enough that the computing power required to model it, is affordable.

This book reveals how giving birth is an inherently safe, relatively painless process that is best performed without the assistance of doctors or midwives, and how confidence and a positive attitude reduces fear-and therefore the pain-of labor. According to Laura Kaplan Shanley, a renowned leader in the natural-birth movement, human birth is inherently safe and relatively painless-provided we refrain from physical or psychological interference. The problems often associated with birth can be traced to three main factors: poverty, unnecessary medical intervention, and fear. When these causes are eliminated, most women can give birth either alone or with the help of a partner, friends, or family. This second edition of Unassisted Childbirth leads with a history of childbirth and then describes how most deliveries occur today, detailing why these processes don't serve mothers or babies. The information in this unique book gives women yet another legitimate choice in childbirth that doesn't rely on doctors and technology, and allows parents, birth professionals, and general readers to reexamine their most basic ideas about birth and learn to think in new ways. A bibliography of unassisted childbirth resources

The Interfaces of Perinatal Addiction Ira J ChasnofT In the last few years, problems associated with drug use in pregnancy have become endemic. As cocaine has become the drug of choice for millions of Americans, including pregnant women, as AIDS has become more commonly recognized in women and infants, and as legal cases have begun to raise the question of fetal abuse, no professional group has come forward to serve as advocate for this special population of substance abusers. Meanwhile, however, physicians, nurses, social service agencies and public health officials have all been faced with increasing numbers of infants showing the detrimental effects of their mothers' drug use. Although problems of substance abuse in pregnancy have received increasing attention in the medical literature since the early 1970s, there has recently been a very rapid increase in the number of articles published related to this field. The reasons for this new interest are easily understood when current statistics from the National Institute on Drug Abuse are reviewed 1. Although patterns of abuse of alcohol, marijuana, heroin and other substances by women of childbearing age have changed very little over the last ten years, the incidence of cocaine use in this special population has been rising rapidly, a reflection of cocaine's increasing popularity among the general population of the United States.

In June 1998 the Fourth International Workshop on Digital Mammography was held in Nijmegen, The Netherlands, where it was hosted by the department of Radiology of the University Hospital Nijmegen. This series of meetings was initiated at the 1993 SPIE Biomedical Image Processing Conference in San Jose, USA, where a number of sessions were entirely devoted to mammographic image analysis. At very successful subsequent workshops held in York, UK (1994) and Chicago, USA (1996), the scope of the conference was broadened, establishing a platform for presentation and discussion of new developments in digital mammog raphy. Topics that are addressed at these meetings are computer-aided diagnosis, image processing, detector development, system design, observer performance and clinical evaluation. The goal is to bring researchers from universities, breast cancer experts, and engineers together, to exchange information and present new scientific developments in this rapidly evolving field. This book contains all the scientific papers and posters presented at the work shop in Nijmegen. Contributions came from as many as 20 different countries and 190 participants attended the meeting. At a technical exhibit companies demon strated new products and work in progress. Abstracts of all papers were reviewed by members of the scientific committee. Many of the accepted papers had excellent quality, but due to limited space not all of them could be included as full papers in these proceedings. Papers that were rated high by the reviewers are included as long or short papers, others appear as extended abstracts in the last chapter."

This book presenting the latest thinking on Reproductive Endocrinology and Infertility is truly international as the authors hail from no less than four different continents (North America, Europe, Australia and Asia). The idea for this book was conceived during the XII World Congress On Fertility and Sterility where the unique confluence of our distinguished authors occurred in Singapore in October 1986. The authors were involved in the Pre And Post Congress Scientific Programmes which we organised. The overwhelming success of the Congress and the Pre And Post Congress Scientific Programmes prompted this book so that those unable to attend the meeting will still be able to benefit from the vast range of topics covered. This book will be a valuable addition to the knowledge in Reproductive Endocrinology and Infertility and will be useful reading for those wishing to pursue this subspecialty. The authors are indebted to Lee Foundation (Singapore) for help in the publication of this book. We would also like to thank Miss Jam Siew Fong and Miss Tang May Mey for their excellent secretarial assistance. Singapore, January 1988 Charles SANg F H Maurine Tsakok S LTan K H Chan ix 1 Hypothalamic and Pituitary Disorders in Reproduction ROGER J PEPPERELL 1 HYPOTHALAMIC AND PrruITARY DISORDERS Disorders of ovulation are present in 15 to 25% of couples with infertility.

This book is a practical guide to latest procedures and diagnostic guidelines for use of sonography in gynaecology. Beginning with an introduction to the role of ultrasound and patient preparation, the following chapters cover common pathologies, uterocervical abnormalities, colour flow mapping, and duplex Doppler. All the latest advances have been included to ensure clinicians are fully up to date in their field. The book features nearly 500 2D, 3D and 4D ultrasound images, with a corresponding image for most of the pathologies described in the text. Key Points Practical guide to latest procedures and diagnostic guidelines for gynaecologic sonography Provides overview of role of ultrasound and patient preparation Covers common pathologies, abnormalities, and different types of ultrasound Includes nearly 500 2D, 3D and 4D ultrasound images

Recent years have seen important advances in the technology and techniques available to surgeons performing gynecologic surgery as well as reconstructive of clinical pelvic procedures. These developments took place in a wide variety settings from regional teaching centers to private clinical facilities. In 1996, the leading investigators from around the world gathered to discuss the present status of pelvic surgery and adhesion prevention with a look toward the future of patient care. This volume contains the proceedings of that meeting: the Third Interna tional Congress on Pelvic Surgery and Adhesion Prevention. Each chapter in cludes the material presented at the congress as well as a timely update of the authors' latest research and clinical thinking. Presentation integrating basic and clinical science provide the basis for con sidering peritoneal repair after surgery including the interaction of growth factors and other biochemical messengers. Research has increased the understanding of mesothelial reepithelialization and has led to new surgical technologies to reduce adhesion fonnation. A state-of-the-art review of emerging surgical adjuvants for adhesion prevention is provided, including discussion of barriers, gels, and poly mers as well as "designer" drugs effective at modifying the peritoneal response to injury. Assessment of clinical outcome in a wide variety of gynecologic surgical procedures brings into focus the benefits available as a result of these new tech nologies."

Vulval diseases are managed by dermatologists and by ObGyns and while expert referral centres do exist, the majority of patients are treated by non-specialists. These conditions are relatively common (approximately 15% of a gynaecologist's caseload) and can be difficult to diagnose. Gynecologic Dermatology is a practical, highly illustrated guide written with the needs of the general dermatologist or gynaecologist in mind. The book begins with chapters on normal anatomy; history taking and examination of the vulva; biopsy taking and general management options. Next, symptom-based chapters describe presenting problems such as pruritus, broken skin and scarring, using flowcharts to help the physician work through to a diagnosis. Finally, chapters devoted to key conditions (lichen sclerosus, lichen planus, etc) describe the pathogenesis, clinical presentation, differential diagnosis and management of the disease in question. Abundantly illustrated and written in a practical, clinically oriented style, Gynecologic Dermatology is an indispensable reference for non-specialists that bridges the gap between dermatology and gynaecology. Symptom-based section reflects how patients present in real life and provides algorithms/flowcharts to help with diagnosis Includes second-line treatment options to help physician when standard treatment is unsuccessful Lavishly illustrated with over 500 photos, diagrams, tables and boxes

Oncofertility integrates the two previously distinct fields of cancer treatment and fertility research and aims to explore and expand the reproductive future of cancer survivors. In order to achieve the goal of fertility preservation, the Oncofertility community must focus on communication and the way data is provided and received. Concomitant with the rapidly changing technology of Oncofertility, there have been radical shifts and advances in the way health educators and clinicians can produce and share information.As success rates of reproductive techniques such as egg freezing and banking continue to rise, providing increasing opportunities for young cancer patients to preserve their fertility prior to the onset of cancer treatments, communication among professionals in oncology, reproductive medicine, and psychosocial work, among others, becomes crucial, and clinical demand for Oncofertility information is expected to rise considerably.

"Oncofertility Communication" describes and addresses the myriad channels through which the multiple audiences involved in Oncofertility can be served with appropriate and accurate information about cancer-related fertility issues. The text answers frequently asked questions and provides invaluable insights to scientific and health care professionals about communication among the diverse Oncofertility audiences. It incorporates timely discussions about traditional and emerging electronic communication tools and discusses the impact of health care policy changes on the Oncofertility field. "

With infertility statistics soaring, a growing number of women are embracing natural approaches to enhance fertility and de-stress during rigorous, emotionally draining treatments. Traditional Chinese Medicine (TCM) is powerful in supporting fertility because it treats body, mind, and spirit - all must be strong to conceive. "The Tao of Fertility" is the first book combining a practical plan for conceiving using TCM with empowering Taoist principles that can carry the reader not just through pregnancy and birth, but through life in general. Readers learn to boost their chances of conception as Dr. Dao shares the dietary plans, recipes, herbal supplements, meditative exercises, and self-applied acupressure he uses so successfully with his patients. The methods are inexpensive and accessible. A detailed questionnaire helps women discover their personal fertility profile, followed by methods to calm and strengthen the body to receive and nourish new life.Enriched by powerful stories of women who became pregnant using TCM, this is a compassionate, comprehensive handbook. It includes: a questionnaire assessing fertility potential; a 28-Day fertility enhancement program synchronized to the menstrual cycle; fertility-enhancing herbs; simple meditations and acupressure points to improve reproductive circulation and relaxation; how to map your fertility using Chinese methods of diagnosis; eating plans for pregnancy, postpartum, and while breastfeeding. Chapters on specific fertility challenges, with stories from women who became pregnant by incorporating Dr. Dao's methods into their treatment; the Taoist perspective on pregnancy loss, adoption, surrogacy, egg donors, and living without children.

Obesity epidemic is a global problem of the 21th century for women in reproductive age and also the obstetricians and pediatricians. There are influences of mother's prepragnancy and antepartal obesity, at delivery, for fetal programming and for maternal and fetal lifelong metabolism. The epidemiological results are important, but for the health care providers the skills for prevention of mother's obesity with all consequences are essential. Evaluated programms in nutrition and physical activity will be discussed.