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Women’s Health, Defined

Me & My OBGMarch 10, 2015Uncategorized

If you don’t know what women’s health terms like “Perinatal,” “Ectopic Pregnancy,” “LARC,” or “Emergency Contraception” mean, you’re not alone. Most Texas women probably don’t understand all the basic health care terminology, which could be a disadvantage when deciding their course of care. What’s more, state lawmakers who may know the “39 weeks law” or the “Sonogram Bill,” are not all so well-versed on many women’s health conditions and procedures.

WomensHealthBannerTo take some of the mystery away, District XI of the American Congress of Obstetricians and Gynecologists (ACOG) – Texas has published a Women’s Health Glossary.  The glossary will be an essential resource for legislators and women’s health advocates during policy discussions this legislative session.

The terms and definition included in the new glossary are below.

Breast and Cervical Cancer Services (BCCS): This Texas Department of State Health Services program helps fund clinics that provide low-income women with affordable breast and cervical cancer screenings and diagnostic services in order to catch breast and cervical cancer as early as
possible.

Children’s Health Insurance Program (CHIP) Perinatal Program: Overseen by the Texas Health and Human Services Commission, this program provides limited prenatal care services to low-income women ineligible for Medicaid and benefits to the child for up to twelve months after birth.

Contraception: Also known as birth or fertility control, contraception is the intentional use of artificial methods to prevent pregnancy as a result of sexual intercourse. A few familiar contraceptives include hormone pills, intrauterine devices, and male or female surgical sterilization.

C-section: Short for Cesarean delivery, a c-section is a surgical procedure in which a baby is delivered through an incision on the mother’s abdomen and uterus. It may be planned or necessitated by pregnancy or delivery complications.

Depo-Provera: The birth control shot is well known by this brand name, though it may also be referred to by the name of the medicine in the shot, DMPA. This birth control method uses an injection of the hormone progestin into a woman’s arm or buttocks to prevent pregnancy for about three months. Depo-Provera does not protect against STDs.

Ectopic Pregnancy: This is an abnormal pregnancy in which the fertilized egg attaches itself somewhere other than inside the mother’s uterus, most commonly in the fallopian tube. Ectopic pregnancy must be treated, as the uterus is the only area suited to support a growing embryo. Common causes of ectopic pregnancies include blockage in the fallopian tube caused by inflammation or scar tissue. Symptoms of ectopic pregnancy may include vaginal bleeding or pain in the abdomen, pelvis, or shoulder.

Emergency Contraception: Sometimes called “the morning after pill,” emergency contraception is a form of birth control that lessens the chance of pregnancy when taken up to five days after unprotected sexual intercourse. Emergency contraception may be used in cases where contraceptives
used prior to or during sex are believed to have failed or in cases of nonconsensual sex.

Expanded Primary Health Care (EPHC): The Texas Legislature established this program in 2013, following severe budget cuts to the women’s health infrastructure in 2011. Under the Texas Department of State Health Services, the EPHC program provides primary care, screening, and preventive services to women, targeting women 18 and older who are at or below 200 percent of federal poverty and lack access to healthcare. Through participating providers located across the state, EPHC aims to reduce hospitalizations due to hypertension and diabetes, bolster early detection of breast and cervical cancers, and lessen the number of preterm births.

Family planning: By this practice, couples or individuals control the number of children they have and/or the spacing of births. Family planning may be rendered through artificial contraception or natural means, such as abstinence.

Fetal anomaly: Mid-pregnancy ultrasound scans or other screening methods are typically conducted on an expectant mother between her 18th and 20th week of pregnancy to check for fetal anomalies. During the scan, a sonographer will examine the fetus in search of birth defects, such as brain malformations, cleft lip, unequal heart chambers, or spinal defects. Screening for abnormalities allows parents to properly prepare for the birth of their child, as parents may want to consider treatment in utero, immediate post-delivery surgery or pregnancy termination in extreme cases.

Gestation: Through this process, the fetus grows and develops within a mother’s uterus from the time of conception until birth. The average human gestation period is 280 days from the first day of the last menstrual period (LMP) until delivery.

Gestational Diabetes: Gestational diabetes is diabetes that develops in women for the first time during pregnancy. Some women found to have gestational diabetes actually may have had mild diabetes before pregnancy that was not diagnosed. Gestational diabetes is caused by a change in the way a woman’s body responds to insulin during pregnancy. Gestational diabetes increases the chance of having a very large baby (a condition called macrosomia) and possible cesarean birth. High blood pressure and preeclampsia are more common in women with gestational diabetes.

Gynecologist: a physician specializing in gynecology, the branch of medical science that deals with the health maintenance and diseases of women, especially of the reproductive organs.

High Risk Pregnancy: This sort of pregnancy involves increased challenges before, during, or after delivery for the mother or her baby. The chances of a high-risk pregnancy may increase as a result of preexisting conditions (i.e. advanced maternal age, diabetes, or heart disease) or pregnancy complications (i.e. increased amniotic fluid levels). Mothers carrying twins or higher order multiples of children are considered a high-risk pregnancy.

Hypertension: Blood pressure is the pressure of the blood against the blood vessel walls each time the heart contracts (squeezes) to pump the blood through your body. High blood pressure is also called hypertension. Hypertension can lead to health problems. Hypertension tends to develop over an extended period of time so a patient suffering from high blood pressure may not experience symptoms for many years. Once detected, hypertension can be controlled with lifestyle changes and/or medication. During pregnancy, severe or uncontrolled hypertension can cause complications for mother and baby.

Human Papillomavirus (HPV): HPV is the most common sexually transmitted infection (STI) in the United States and may lead to certain types of cancer. HPV is spread by direct skin to skin contact, most commonly by having vaginal, anal, or oral sex with someone who has the virus. Some types of HPV cause genital warts, but for other women symptoms may not appear for years after one has the infection. The HPV vaccine helps reduce the effects of HPV.

Inter-conception care: Women of reproductive age may choose to receive inter-conception care, which is simply care delivered between pregnancies. Inter-conception care aims to mitigate problems encountered in previous pregnancies from occurring in future ones.

Induction: Labor induction is the use of medications or other methods to bring on (induce) labor. Labor is induced to stimulate contractions of the uterus in an effort to have a vaginal birth. Labor induction may be recommended if the health of the mother or fetus is at risk. Elective (without a medical reason) induction should not occur before 39 weeks of pregnancy.

Intrauterine Device (IUD): An intrauterine device is a small device inserted into a woman’s uterus by a medical professional. There are two types of IUDs which are used as birth control: the hormonal IUD and the copper IUD. Both types of IUDs work mainly by preventing fertilization of the egg by the sperm. The hormonal IUD also thickens cervical mucus, which makes it harder for sperm to enter the uterus and fertilize the egg.

In Vitro Fertilization (IVF): This form of assisted reproduction involves the manual combination of a woman’s egg and a man’s sperm outside of the body in a laboratory. A catheter is then used to place the embryo in the woman’s womb, where pregnancy will result if the embryo implants in the woman’s uterus. IVF may be an alternative to artificial insemination or fertility drugs if fertility problems persist.

Long Acting Reversible Contraception (LARC): LARC birth control methods are effective for an extended period without user action but are not permanent. Examples of LARC include intrauterine devices (IUDs) and sub-dermal implants.

Maternal-Fetal Medicine (MFM) Specialist: These specialized physicians are experts in high-risk pregnancies, representing a subset of obstetricians/gynecologists who have completed an extra 2-3 years of training to develop the knowledge and skill set specific to the health needs of women who experience high risk pregnancies. MFM physicians typically partner with other health care providers to meet the mother’s needs.

Maternal morbidity: Maternal morbidity is any physiological or psychological medical complication that a mother experiences as a result of pregnancy, labor, or delivery. Complications range in severity from fever to severe bleeding, which may result in death.

Maternal mortality: Maternal mortality is the death of a woman as a result of pregnancy or childbirth complications. The rate has been rising in Texas and African American women are much more likely to die than are Caucasian or Hispanic women. The most common causes of maternal mortality in Texas are heart problems and high blood pressure. Many maternal deaths may be
preventable.

Menopause: Menopause is the time in a woman’s life when she stops having menstrual periods. The years leading up to this point are called perimenopause, or “around menopause.” Menopause marks the end of the reproductive years that began in puberty. This biological process ends a
woman’s fertility, meaning that she can no longer become pregnant. Menopause typically occurs between the ages of 40 and 60. Hot flashes, emotional swings, and unusual sleep patterns may signal the onset of menopause. Treatments such as hormone therapy or lifestyle changes may be used to mitigate these symptoms.

Neonatal intensive care unit (NICU): Also known as an intensive care nursery, a NICU is a specialized intensive-care unit dedicated to the care of ill or premature newborn infants. Here, neonatologists and nurses provide around the clock care to newborn babies not yet stable enough to
leave the hospital.

Obstetrician: A physician qualified to practice in obstetrics, the branch of medical science concerned with childbirth and caring for and treating women in or in connection with childbirth. Papanicolaou (Pap) test: Also known as a Pap smear, this test assesses a sample of cells taken from a woman’s cervix or vagina to look for signs of cervical cancer, which is highly treatable when detected early. Pap tests are recommended every few years for women between the ages of 21 and 65 years.

Pelvic Exam: During this special exam, a medical professional visually and manually examines a woman’s reproductive organs, either as part of a regular physical checkup or to address unusual symptoms. Pelvic exams may include a Pap test, which screens for cervical cancer.

Perinatal: Perinatal refers to the time period immediately preceding and following a birth. Though there is some discrepancy as to its exact range, the perinatal period is typically thought to begin between the 20th and 28th week of pregnancy and ends 1-4 weeks after delivery.

Post-partum: Also known as the postnatal period, the post-partum period is that period of time immediately following a baby’s birth and is typically considered to last for 6-8 weeks.

Preconception Care: Preconception care is care that a woman receives in planning for a future pregnancy. The goal of preconception care is to address health issues and needs that could affect a pregnancy. Identifying these factors before pregnancy allows women to take steps to increase the
chances of having a healthy pregnancy and a healthy baby.

Preeclampsia: A disorder that can occur during pregnancy or after childbirth in which there is high blood pressure and other signs of organ injury, such as an abnormal amount of protein in the urine, a low number of platelets, abnormal kidney or liver function, pain over the upper abdomen, fluid in the lungs, a severe headache, or changes in vision.

Prenatal Care: Prenatal care is the specialized health care a woman receives during pregnancy. It includes medical care, education, and counseling. The earlier women receive prenatal care, the better the chances are for a healthy pregnancy and baby.

Pregnancy Medical Home Model: This special model is a health care setting that facilitates partnerships between individual patients, their physicians, and, when appropriate, the patients’ families. The model aims to improve pregnancy and newborn outcomes, enhance the experience of patients and reduce the overall costs of care by increasing access to care and emphasizing preventive services.

Sonogram Bill: By this bill, Section 171.012 of Texas’ Health and Safety Code was amended during the 2011 legislative session to stipulate that women seeking abortions must receive a sonogram, including both images and heartbeat audio, from the doctor or agent who is to carry out the abortion before the procedure is performed. Exceptions include cases where the pregnancy resulted from sexual assault or the fetus has a serious, irreversible abnormality.

Sexually Transmitted Infections (STI): Sexually transmitted infections (STI), also known as sexually transmitted diseases (STD), are infections that may be contracted by intimate sexual contact. Examples of STI’s include Chlamydia, Gonorrhea, Syphilis, and HIV/AIDS.

Texas House Bill 2 (2013: 2nd Special Session): This legislation adds regulatory measures for abortion procedures, providers, and facilities. HB 2 requires that abortion doctors have admitting privileges at a hospital within 30 miles of the abortion clinic, prohibits abortions in pregnancies that have progressed past 20 weeks minus severe health complications for the mother or severe abnormalities of the fetus, and creates additional requirements for how and when abortion-inducing drugs may be given.

Title X: This portion of the Public Health Service Act allows the federal government to determine family planning policy and establishes flexible grant funds that subsidize reproductive health services to ensure that family planning centers are available to local communities. Title X-supported sites provide contraceptives and/or health screenings.

Texas Women’s Health Program (TWHP): This program provides reproductive health services such as screenings and contraceptives to Texas women of low-income who are between the ages of 18 and 44.

Tubal Ligation and Implants: Colloquially known as “having your tubes tied,” this surgical procedure blocks, ties, or cuts a woman’s fallopian tubes and prevents future egg fertilization. The nonsurgical alternative to tubal ligation is tubal implantation, in which scar tissue grows around small metal springs placed in each fallopian tube, eventually blocking the tubes. These procedures are considered permanent birth control methods and are typically carried out by an obstetrician/gynecologist.

Well-woman visit: Health care providers, such as OBGYN’s, conduct well-woman visits to screen women for potential reproductive health problems. This visit typically includes questions about family and medical history, counseling about healthy behaviors, a general physical, administration of vaccinations, a breast exam, and may include a pelvic exam with a pap smear.

1115 Waiver: Also known as the Medicaid Transformation Waiver, the 1115 waiver changes the way health care is delivered and funded in Texas. Texas’ Health and Human Services Commission received federal approval for the current waiver in December 2011. It is set to expire September 30, 2016, unless renewed. The 1115 Waiver allows for a statewide expansion of Medicaid managed care, increases funding for hospitals that treat large numbers of uninsured patients, and establishes incentive payments for health care improvements.

17-alpha-hydoxyprogesterone caproate (17P): Intramuscular injections of this type of progesterone have been shown to reduce the chance of recurring preterm birth, which is the leading cause of infant morbidity and mortality.

39 weeks law – HB 1983 (2011): Established by House Bill 1983, this legislation requires Texas Medicaid programs to take cost-cutting measures aimed at reducing non-medically indicated Medicaid deliveries at less than 39 weeks of pregnancy.

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