Chlamydia: an infection we should care about!

Chlamydia is the most common sexually transmitted infection in Canada and the US, particularly among men and women under 25 years of age, although it can affect anyone who is not in a monogamous relationship.  That includes anyone in a  sexual relationship with a new (to them....) partner.

Unfortunately, most women who carry chlamydia do not even know that they are infected.  You can have the infection without any visible symptoms, but the disease can cause long term inflammation of the pelvis leading to scarring and chronic pain, Pelvic Inflammatory Disease (PID) and infertility.  

Fortunately diagnosing and treating chlamydia is easy.  Chlamydia can be detected using a urine test, or with a swab taken during a pelvic exam.  Treatment is with a single dose of the antibiotic azithromycin, which is both safe and effective (98% cure rate).  However it is important that your sexual partner(s) are also treated at the same time, otherwise you will develop a "ping-pong" infection, passing the infection back and forth.  Consider informing any partners you have had in the past two months so that they can also get treated if necessary.

If you have been treated for chlamydia, we recommended getting retested in three months to make sure that there is no reinfection.  Also, if you are pregnant and plan to proceed with your pregnancy, then it is important to have follow-up testing  as chlamydia can infect a newborn during labour and delivery with possible serious consequences.

At Bloor West Village Women's Clinic we routinely test all women for chlamydia before your abortion procedure or D&C. We will contact you if your test is positive and provide treatment; all communication is confidential.

For more information about chlamydia and your health please see:

https://www.cdc.gov/std/tg2015/chlamydia.htm

 

 

 

Abortion and the Illusion of Choice

When I was going through medical school many years ago, I became passionate about reproductive justice: a woman's right to control her own body, to make her own reproductive choices, and ultimately to have an abortion if and when she wanted to without any interference from others.  I felt a strong sense of justice because women throughout history have borne the consequences of society making choices about their bodies: when they could have sex and with whom, when and who they would marry, how many children they could have, or not have.  A woman's control of her reproductive choices is about taking back control of her life.

I still believe in these same fundamental principles, but having worked at an abortion clinic for several years now I realize that the idea of "choice" is far more complex than it seems at first.  No woman chooses to come to our clinic to have an abortion in the real sense of the word.  Who wouldn't rather be somewhere else?  Working?  Shopping?  At the dentist even?!  While many women are eager and even happy to be able to come to our clinic, I wouldn't necessarily call it a "choice".  

Most women come to our clinic because they find themselves in a situation not of their choosing. The reasons that women end up unintentionally pregnant, or pregnant at the wrong time, or unable to bear a child are myriad, and I don't need to go into them here.  The key point is that for many women having an abortion or a D&C isn't a real choice, it is their best response to an unhappy, or nerve-wracking, or even devastating situation.  

However the idea of choice is not unimportant.  Having an abortion may be the most viable option under difficult circumstances for many women, but at least in Canada abortion is legal, and it is safe.  In many other countries abortion may also be the only choice a woman has, but there she must put her own health and safety, and even her own life at risk to get the service she needs.  Where there is often little space for real choice for women, it is society that dictates how dangerous her journey will be.

The Abortion Pill is now free for Women in Ontario

On August 3, 2017 the government of Ontario announced that medication Mifegymiso, also known as the "Abortion Pill" will be made free to all women across the province.  This means that women will now have affordable access to medical abortion as well as surgical abortion in Ontario.  Qualified physicians and nurse practitioners will now be able to prescribe Mifegymiso, which can be picked up at participating pharmacies.  

A medical abortion involves taking a set of pills over a period of days, and causing miscarriage of the pregnancy.  The miscarriage will happen in the privacy of your home, which some women find more convenient than have a surgical procedure.   Medical abortion with Mifegymiso is suitable for women up to nine weeks of pregnancy.  A woman who is having a medical abortion should have ready access to a health centre or hospital during her miscarriage in case of heavy bleeding.  If you are planning on travelling outside of the country or to a remote area, the medical abortion may not be the right choice for you.  

At Bloor West Village Women's Clinic we prescribe Mifegymiso, as well as providing surgical abortions.  Please review the section on Medical Abortion on our website to determine if this is a good option for you.  You can also call our clinic at 416-849-4595 and speak with one of our staff about your abortion choices.

Abortion Access Increasingly Restricted in the United States

Recent political changes in the United States threaten the access of women there to safe and affordable abortion, particularly if the federal government succeeds in defunding Planned Parenthood.  However the access of American women to abortion care has been gradually eroding even before the current administration.  Dozens of laws across the country have made it more expensive, more time-consuming and more difficult for women to access abortion services.  Laws in Texas that require abortion providers to have privileges at local hospitals have forced the closure of most of that state's abortion clinics.  Other states require women to return to the clinic for multiple visits, to look at the ultrasound of the pregnancy, or for doctors to provide false, negative information about the long term risks of abortion.

When legal access is no longer possible, women are often desperate and turn to dangerous, self-induced abortions.  Data from internet search-engines shows that more women are trying to find out how to do a home abortion, and those women overwhelmingly live in states with poor access to legal, safe abortion care.

Luckily in Canada abortion is fully legal, and there are no requirements such as forcing a women to come back for a second visit, forcing her to look at her ultrasound, or providing her with misleading or false information about the risks of abortion.  Most abortion services in Canada are concentrated in the large towns and cities, making access difficult for women in rural communities.  However at least they do not face unreasonable and unfair barriers created by layers of government that do not have women's best interests or health in mind.

To learn more about restricted access to abortion in the United States read the following article:

The Return of the D.I.Y. Abortion - The New York Times

 

Miscarriage of pregnancy - what are your options?

The miscarriage of a pregnancy can be an upsetting and frightening experience.  Sometimes the miscarriage is the first sign that you were pregnant.  Other times it is the painful end of a much wanted pregnancy.  In any case you will ask yourself what the next steps should be.

If you are bleeding, have strong abdominal or pelvic pain, or a fever, then you should seek immediate medical help.  Once you know that you are having a miscarriage then the process might take hours, days or even weeks.  Make sure that you are under the care of a medical professional.  You may be given medication to speed the miscarriage, or you may be offered a D&C (dilatation and curettage), or you may suggest an expectant management approach, without any intervention.

If you are experiencing discomfort with the miscarriage then you may benefit from rest; a hot water bottle over the lower abdomen can relieve symptoms of cramping.  Over the counter pain medication can also provide relief.

If you would like more information about the management of miscarriage please read this link below from the Society of Obstetricians and Gynaecologists of Canada: 

Miscarriage and stillbirth - Pregnancy SOGC

At Bloor West Village Women's Clinic we offer definitive management of miscarriage through surgical D&C.  Please feel free to get in touch if you would like to speak with one of our staff.

Zika: Worse than Thalidomide?

In early 2016 Brazilian authorities noted an alarming spike in the number of cases of microcephaly in some parts of the country. Microcephaly is the medical term for "small head", meaning that the baby's brain did not develop normally during pregnancy. The symptoms of microcephaly can include intellectual deficits, deafness, blindness, seizures and death. Usually microcephaly is extremely rare, but Brazil was seeing many times the number of cases expected. The reason? The condition was being caused by Zika, a formerly little-known virus transmitted by mosquitoes. Women who were infected during pregnancy, or even before pregnancy, transmitted the virus to the developing baby, with devastating consequences.

Since the outbreak was first identified we have learned a lot about Zika, none of it good. The virus can also be transferred to a woman through her partner's semen, so even if she isn't infected by a mosquito bite, she could still get infected and pass the virus on to her fetus. Also, the geographic range of Zika is now known to extend throughout South and Central America and Mexico, and is even in the southern United States. Because a Zika infection often doesn't have symptoms for the woman, she may be carrying the Zika virus without knowing it.

This is a public health disaster, but there seems to be little that the affected countries are able - or willing - to do. "Don't get pregnant" is the advice from health ministers. This is very difficult for women to do in countries where birth control expensive and hard to access, and where abortion is often illegal. Many women are left with few options to ensure a healthy pregnancy and a healthy child.

 

For more information on Zika and its effects on the brain please see the article below:

Zika: Worse Than Thalidomide?

Mifegymiso, the abortion pill, is now available in Canada

Here's what you need to know.

One year after Health Canada first approved Mifegymiso, the drug is finally available , but only through physicians certified to prescribe it.

 

What it is

Included among the World Health Organization’s list of “essential medicines,” the combination of mifepristone (also known as RU-486) and misoprostol is used in medical abortions, ending pregnancy in its first trimester. Previously unavailable here, the drug received approval from Health Canada last July. Its brand name will be Mifegymiso.

How it works

Mifepristone blocks the production of progesterone, a hormone that prepares the uterine lining for pregnancy. A day or two later, a woman then takes the drug misoprostol, which causes contractions. Together, the drugs essentially induce a miscarriage at home.

Where it’s used

Mifepristone first became available in France and China in 1988, in the United Kingdom in 1991 and in most European countries by 1999. In 2000, it was approved in the United States, and in Australia in 2012. The drug is now used in roughly 60 percent of abortions in some European countries and about 20 percent in the U.S.

The risks

A 2012 review of more than 45,000 abortions using mifepristone found that fewer than five percent of women required surgery to complete the abortion and 0.4 percent experienced serious complications. The review, published in the medical journal Contraception, concluded that “[e]arly medical abortion with mifepristone 200 mg followed by misoprostol is highly effective and safe.”

The delay

In October 2011, the European drug company Linepharma International submitted an application to Health Canada for approval of its 200-mg mifepristone tablet. The company resubmitted an application the following year, but Health Canada held off making its decision until now.

Medical abortion in Canada today

Until recently fewer than four percent of abortions in Canada are performed medically. Currently, women take methotrexate, a chemotherapy drug administered orally or by injection, then follow with misoprostol after five to seven days. In addition to the longer wait time, the drug is less predictable than mifepristone, sometimes requiring several weeks to complete, additional appointments with practitioners and surgery.

by Danielle Groen, published 20 Apr 2016

SOURCE

"Phony abortion clinics in Canada are scaring women with lies" ~VICE

Here's an informative article by Tamara Khandakar from VICE Canada, about fake abortion clinics -- or rather, religious organizations that attempt to convince women to change their mind.

"They'll have innocuous-sounding names, like “Aid to Women” or “Pregnancy Care Centre,” and to the untrained eye, they won't look like they're being run by lying nut jobs.

When I call Aid to Women, a Toronto crisis pregnancy centre, to schedule a pregnancy options consultation, I speak with Enza Rattenni, the executive director. She seems friendly enough at first, but it's not long before what should be a pretty simple phone call starts feeling like an interrogation.

Full disclosure: none of what I tell Enza on the phone is true: I'm not six weeks pregnant, I don't have a boyfriend, and I don't need options counselling. But I've heard a ton of horror stories about crisis pregnancy centres."

...

"She tells me if I'm only able to come in after hours, it's fine and that she knows how important it is to have these conversations. Sometimes, she tells me, girls walk out of abortion clinics and find out they've been LIED to, and she doesn't want this to happen to me. It made me wonder how the women who mistakenly stumble into the clinic Enza is working out of must feel when they realize they’ve been misled, given how little these clinics do to distinguish themselves as anti-abortion organizations."

At any genuine abortion clinic, counseling must always be unbiased. All counsellors are trained to help ensure each patient is making a decision based on what she wants. Women's decisions are respected. Moreover, these fake clinics attempt not only to pass themselves off as unbiased, but give the impression of being medical in nature - they are neither, of course. These centers are unregulated, have their own personal agenda, and use deception, fear and intimidation to acoomplish their own selfish goals.

Additionally, they use fear mongering and blatant falsehoods that are not medically supported to scare people away from a very common, safe and legal procedure performed many thousands of times each year in Toronto alone. Unlike Canadian abortion clinics, these centers aren't accountable to anyone and lure women under false pretenses.

"Many women are presumably being coerced by these clinics into keeping children they’re not ready for—and with a significant lack of attention placed on these phony abortion centres—this is an issue Canada should become more aware of as soon as possible."

SOURCE