Women's health

Despite inherent challenges, high-quality antenatal health care is provided in immigration detention centres

Mark Parrish FRACGP, MHA, FRACMA · Anthony Renshaw MRCS(Ed), MFMLM, MD(Res) · Gregory J Duncombe CSCT(FMP), FRANZCOG, CMFM · Paul J Bretz MB BS, FRANZCOG · William J Milford MB BS(Hon), FRANZCOG

Strategies to reverse the decline in GP obstetricians

Wendy E Brodribb MB BS, FABM, PhD

A supported and empowering learning environment engenders competence and confidence

Alison M Campbell BA · James Brown FRACGP, FACRRM, MFM(Clin) · David R Simon FRANZCOG, FRACGP, MPH · Sari Young BNSc(Hons), AdDipNaturopathy, AdDipNutritionalScience · Leigh Kinsman BHSc, MHSc, PhD

A story inspired by many trips to western New South Wales as a visiting doctor

David C Shelley Jones MB BS, FRCOG, FRANZCOG

Research consistently finds there is no association between abortion and risk of breast cancer

Kelly-Anne Phillips · Fiona J Bruinsma · Roger L Milne

This effective form of contraception has less uptake among the more disadvantaged

Philip Goldstone MB BS(Hons) · Yachna H Mehta MB BS · Kevin McGeechan MBiostat, PhD · Katherine Francis BE(Electrical), MB BS · Kirsten I Black MB BS, FRANZCOG, PhD

There is a need to protect against risks considered unacceptable in Australian practice

Martyn A Stafford-Bell MB BS, FRCOG, FRANZCOG · Sam G Everingham BSc, MA, MPH · Karin Hammarberg RN, BSc, PhD

Through gynaecological cancer prevention and treatment, assisted reproduction and good pregnancy care

Tania Janusic

Assisted reproductive technology has come a long way in 40 years

Gabor T Kovacs MD, FRANZCOG, CREI

Vaccinated women need to be screened

Annabelle Farnsworth MB BS(Hons), FRCPA, FIAC

This much maligned galactagogue may carry no direct risk to breastfeeding women

Luke E Grzeskowiak PhD, BPharm(Hons), GradCertClinEpid · Lisa H Amir MB BS, MMed, PhD

Concerns that women may not continue to participate in screening appear to be warranted

Alison C Budd PhD · Julia M L Brotherton BMed(Hons), MPH(Hons), FAFPHM · Dorota M Gertig MB BS(Hons), ScD, FAFPHM · Theresa Chau BPsychSc · Kelly T Drennan BHlthSc, PGCertCommDev · Marion Saville MB ChB, FIAC, GradDipMed(ClinEpi)

Reasons behind geographic and socioeconomic differences in survival warrant further investigation

Satyamurthy Anuradha MB BS, FRCS, PhD · Penelope M Webb MA, DPhil · Penny Blomfield MB BS, FRANZCOG, CGO · Alison H Brand MD, FRANZCOG, CGO · Michael Friedlander FRACP · Yee Leung MB BS, FRANZCOG, CGO · Andreas Obermair MD, FRANZCOG, CGO · Martin K Oehler MD, FRANZCOG, CGO · Michael Quinn MB ChB, FRANZCOG, CGO · Christopher Steer MB BS, FRACP · Susan J Jordan MB BS, FRACGP, PhD

A high standard of pregnancy care should be provided for all women

Caroline M de Costa PhD, MPH, FRANZCOG

Up to 50% of women diagnosed under the new criteria do not meet the agreed risk threshold

Michael C d’Emden MB BS, PhD, FRACP

Objectives: To investigate the characteristics of parents and intended parents and their current and planned behaviour in relation to surrogacy arrangements. Design, setting and participants: Members of two Australian parenting support forums who were considering surrogacy or were currently or previously in a surrogacy arrangement were invited to complete an online survey during July 2013. Main outcome measures: Sociodemographic characteristics; proportions engaging in domestic uncompensated and overseas compensated arrangements; countries used; costs incurred; and impact on behaviour of state laws criminalising compensated surrogacy. Results: Of 1135 potential participants, 312 (27%) commenced the survey. Of these, 24 did not fulfil inclusion criteria and 29 did not complete the survey. Eighty-nine respondents were considering surrogacy and 170 had commenced or completed surrogacy. Many respondents (53%) considered both overseas and domestic surrogacy. Among those who only considered one option, overseas surrogacy was considered significantly more often than domestic surrogacy (92% v 8%; P < 0.05). Only 22 respondents (8%) commenced with a surrogate in Australia. The most common countries used for compensated surrogacy were India and the United States, and average total estimated costs were $69 212 for India and $172 347 for the US. Barriers discouraging domestic surrogacy included concern that the surrogate might keep the child (75%), belief that it was too long and complicated a process (68%) and having no one of the right age or life stage to ask (61%). Few intended parents (9%) were deterred by state laws criminalising compensated surrogacy. Conclusions: Most Australian intended parents via surrogacy consider or use overseas compensated arrangements. Laws banning compensated surrogacy do not appear to deter those seeking surrogacy arrangements.

Sam G Everingham BSc, MA, MPH · Martyn A Stafford-Bell MB BS, FRCOG, FRANZCOG · Karin Hammarberg RN, BSc, PhD

MSF reflects on the emergency medical response in the wake of a disaster

Daniel Martinez Garcia MD · Alexandra L Brown BA

There is still no consensus about the VTE risk with newer contraceptive pills

Therese M Foran MB BS, MClinEd, FAChSHM

More attention to treating women is needed to prevent FASD

Lucy Burns · Courtney Breen · Adrian J Dunlop

Fewer women receive information and counselling about emergency contraception from their GP

Danielle Mazza MD, FRACGP · Christopher M Harrison BPsych(Hons), MSocHlth · Angela J Taft BA, MPH, PhD · Helena C Britt BA, PhD · Melissa Hobbs RN, MPH, PhD · Kay Stewart BPharm(Hons), PhD · Safeera Hussainy BPharm(Hons), PhD, GCHE · Bianca R Brijnath BA(Hons), PhD

The potential for unwarranted terminations being contemplated is concerning

Ronald P Batagol

Complex matters of health care demand considered, holistic and compassionate responses

Diana McKay

Better facility-based outcomes for mothers and newborns are within reach

Myrto M Schaefer MD, MSc · Alexandra L Brown BA

Non-invasive prenatal testing heralds a new era in antenatal care

Stefan C Kane MB BS, BMedSc, FRANZCOG · Fabricio Da Silva Costa PhD, FRANZCOG, COGU · Shaun P Brennecke MB BS, DPhil, FRANZCOG

To the Editor: Lee and colleagues assessed the hospital caesarean section (CS) rates among hospitals in New South Wales according to the Robson 10-group classification. They identified the 20th centile CS rate for each group.1 These data could be used in Australian maternity services to reduce CS rates and potentially increase the quality of care. Monitoring the quality of care in maternity services has been difficult ...

Rick J Fielke