Women's Health Snapshots

A study in Canada compared the care received by women from nurse-midwives to the care from obstetricians or family physicians. The results showed that the nurse-midwife group had a cesarean delivery rate of 4% compared with 15.1% in the physician group. The episiotomy rates, excluding Cesarean deliveries, were 15.5% for the nurse-midwife group and 32.9% for the physician group. The rates for epidural anesthesia for pain relief were 12.9% for the nurse-midwife group and 23.7% for the physician group.
"A Randomized, Controlled Trial of Nurse-Midwifery Care." Birth, vol. 23, no. 3, September 1996.

Within the group of healthy, mostly white nurses who agreed to participate in the Nurses Health Study, there have been almost 3 times as many cases of breast cancer as heart attacks up to age 71. (Heart disease is eventually the leading cause of death, which occurs at an average age of 79.
Journal of Women's Health, February, 1997, pp. 49-62.

Women of color with abnormal screening mammograms have later follow-up tests than white women. Researchers found that women of color who participated in a San Francisco screening program had follow-up tests on average one week later than white women with similar circumstances. A delay of one week cannot explain worse survival rates seen in women of color, but researchers speculate that delays may be much longer in other settings where a comprehensive program is not in place.
Cancer October 1, 1996, pp. 1395-1402.

Childbirth activists attribute the U.S.'s unusually high rate of Cesarean sections to several factors—the overuse of unnecessary drugs and technologies which interfere with normal labor, caregivers' impatience with slow labors, fear of lawsuits, and payment schedules which favor C-sections. A recent study found that equalizing payments for Cesarean and vaginal deliveries had no effect on the rate of Cesareans. At the same time, another group of researchers found that time of day had an important effect on Cesarean rates—C-sections were significantly more common between 9 p.m. and 3 a.m. Both studies were funded by the Agency for Health Care Policy Research.
Medical Care Research and Review, December, 1996, pp. 465471. The Journal of Family Practice, November, 1996, pp. 461-467.

A group of African American and white women taking part in a long-term study of risk factors for cardiovascular disease reported on their experience of anti-gay discrimination. 7% of the African American women and 14% of the white women reported at least one same-sex sexual partner. Among these women 33% and 52% respectively reported experiencing discrimination based on sexual orientation. Other types of discrimination have been shown to have direct negative health effects, including high blood pressure, and the researchers call for more attention to the public health implications of discrimination based on sexual orientation.
International Journal of Health Services, 1997, pp. 157-176.

For the first time, a study has shown a connection between smoking and breast cancer. Using blood samples from white women with breast cancer and similar women without cancer, researchers found that those women who had a weakened form of an enzyme important in detoxifying carcinogens and who started smoking at young ages were more likely to develop postmenopausal breast cancer. The weakened enzyme (N-actyltransferase) is found in about half of all whites, 35% of African Americans, and 10-20% of Asians. More studies will be needed to confirm these findings and determine if the same relationship is found in women of color.
Journal of the American Medical Association, November 12, 1996.