Pregnant women are usually told how many pounds they should gain during pregnancy but I suggest the nutritional needs of the baby may not by these weight recommendations for mothers in my latest Substack post. ruraldocalan.substack.com/p/…

Preeclampsia is considered a woman's disease, but little attention is paid to the evidence that fathers contribue to the risk for eclampsia, something I have posted about on Substack. ruraldocalan.substack.com/p/…

I have added another new printable to my Etsy site: Postpartum Depression Can Be Prevented.  A new baby changes everything. In my experience, postpartum depression is reactive. In other words, it is a reaction to the many changes a new baby brings into a household when there hasn't been enough thought given in advance as to how to adapt to the inevitable changes. etsy.com/listing/4497975941/…

I have added a new printable to my Etsy site: The Hormone Cascade in Labor and Delivery. Learn how your hormones in labor and delivery can vary depending upon whether or not you have an induction. Check it out! etsy.com/listing/4494064368/…

What is a Kick Test? I have an Etsy page with a number of printables for pregnant women and their families. I just posted my latest printable on the importance of monitoring your baby's movements during your last trimester of pregnancy with a home kick test. Check it out! etsy.com/listing/4484301807/…

Pregnancy Your Way Application Update My “proof of concept” web site which provides a preview of the pregnancy application I am seeking funding to develop is now live. My Pregnancy Your Way application (an extension and expansion of the information in my book, Pregnancy Your Way) will contain my pregnancy advice gained from 50 years of experience. Please stop by and let me know what you think! #pregnancy #choices #healthare open.substack.com/pub/rurald…

Will No Longer Be Posting Weekly Women can choose the kind of pregnancy they want 95 percent of the time, but most women do not know this. My pregnancy application will provide them with the information they need to make safe choices in their pregnancy and choices for the kind of pregnancy and delivery they would like. #pregnancy #access #choice open.substack.com/pub/rurald…

Penny Wise and Dollar Foolish I have written ad nauseam about how to really decrease the healthcare budgetwithout hurting the average consumer or provider. In the first place, decisions about cutting the healthcare budget require looking at where the money in the healthcare budget currently goes. It strikes me that there are probably some really good reasons that nobody at the Centers for Medicare and Medicaid Services (CMS) wants the public to know that only 7 percent of the healthcare budget actually goes to direct patient care. In other words, CMS is directing 90 percent of their attempts at controlling the healthcare dollar at the 7 percent who actually provide the healthcare. #healthcare #Obamacare #insurance open.substack.com/pub/rurald…

Pregnant and Afraid Postpartum depression and other mental health problems are recognized as the number one complication in having children, but our healthcare system fails miserably in addressing this problem. In fact, our healthcare system fails miserably in even looking for mental health problems in prenatal care, much less recognizing the problems after the birth of a baby. Maternal mental health issues are now recognized as being central to the well-being of mothers and their families globally. The Centers for Disease Control and Prevention (CDC) notes that up to 20 percent of mothers experience postpartum mental health issues, the leading cause of maternal mortality. #postpartumdepression #fragmentation #healthcareaccess open.substack.com/pub/rurald…

Ineffective Fragmented Care Solutions CMS recognizes the added costs of fragmented care but is unable to recognize why independent practices are more successful at reducing the costs of fragmented care. That would require recognition that independent physicians understand the inherent value of the patient-physician relationship and how that relationship plays a critical role in quality care. Years ago, we physicians owned our care. Our patients were not considered our property—until corporate medicine began to consider patients property. #fragmentedcare #qualityhealthcare #CMS ruraldocalan.substack.com/p/…

Nursing Homes Old and New Articles about long-term care will describe various kinds of regulations for assisted living. But I have never seen any articles about long-term care in an acute hospital. Long-term care in hospitals are essentially nursing homes but somehow have escaped nursing home regulations so they are monitored very differently. #nursinghomes #longtermcare #Medicine ruraldocalan.substack.com/p/…

The Ivory Tower and Poisoned Wells The internet has made it possible for the Ivory Tower crowd to commune with the rest of us in the everyday world. So now every research paper in existence is blasted from the Ivory Tower as being the truth and everything else is misinformation. Doesn’t matter that the research studies may contradict each other. Yet we all know that research studies give various results for many reasons, and indeed, some research results relied upon for years are overturned by later studies. #science #research #medicine open.substack.com/pub/rurald…

The primary care physician is fast disappearing from our healthcare landscape. This Substack post by Paula Demasco does a wonderful job of describing what a primary care physician does and what we have lost. #primarycare #medicine #healthcare sensible-med.com/p/the-unive…

I will now be publishing a newsletter on Patreon about Pregnancy Your Way and how to choose the kind of pregnancy you want 95 percent of the time. patreon.com/cw/pregnancyyour…

Due Process Here and There, by @RuralDocAlan I’ve talked about the sacrificial lamb in medical practice many times, in particular, with regard to punishing one physician for the faults of many. As I have indicated many times previously, a problem like this does not arise suddenly from nothing. I have also discussed the public harm caused by the political nature of board decisions which protect their friends. open.substack.com/pub/rurald…

Tylenol Is In The News Anapyrexia is the term for a very serious infection which has no fever. This is a condition commonly seen in the very vulnerable, which include the very young and the very old. Years ago, before we started taking Group B strep infections seriously, many newborns became ill with Group B. They do not get a fever. They simply become sluggish and unresponsive, and finally, they go to sleep and die. So, it is easy for nurses, doctors, and parents to think that their babies don’t cry much and are well behaved. These vulnerable patients with these conditions without fevers are extremely high risk and subsequently caretakers, including nurses, and doctors need to have a high index of suspicion, to recognize, treat and save those seriously ill patients without fevers. #acetaminophen #fevers #antiobioticresistance open.substack.com/pub/rurald…

We All Need Access to Good Healthcare Unfortunately, it is also true that healthcare financing is in an extreme crisis and there is absolutely nobody in our legislature looking realistically at the causes or genuinely exploring any kind of long-term solution. ruraldocalan.substack.com/p/…