Obstetrician Gynecologist New Orleans Louisiana La

Abortion bill moves to House floor; would modify 'conscience protection' for ...

Rep. Frank Hoffman , R-West Monroe, has titled House Bill 586 the "Forced Abortion Prevention Sign Act," pitching the requirement for a new state website and the posting of new signs at reproductive services clinics as a way to help women make "informed decisions" about how to handle a pregnancy.

But a lesser debated provision of the 17-page proposal could substantially alter Louisiana's existing "conscience protection" statute that governs when physicians, nurses and other health-care professionals can refuse services and tasks based on their personal beliefs.

Current law states that, "Any person has the right not to participate in, and no person shall be required to participate in any health care service that violates his conscience to the extent that patient access to health care is not compromised." Hoffman's bill, which has the backing of Gov. Bobby Jindal and abortion-rights opponents, would end that sentence at the word "conscience," thus eliminating the qualifier that a medical professional's decision cannot threaten patients' right to care. It would also define the health-care services covered by the provision to include "the destruction of any living human embryo."

The legislative digest, prepared by House analysts, explains it this way: "Proposed law provides unconditionally that a person shall not be required to participate in any health care service that violates his conscience."

Conscience protection clauses have become a flash point in state legislatures in recent years as they debate the regulation of abortion and scientific research involving stem cells.

While the bulk of Hoffman's measure would apply narrowly to seven clinics that are the exclusive providers of elective abortions in Louisiana, the conscience protection statute applies broadly to all medical providers and researchers, including public and private hospitals. Hospitals in Louisiana are barred from providing elective abortions, meaning the only pregnancy termination procedures in those facilities are deemed medically necessary by a physician.

The conscience protection change did not come up in debate until Julie Mickelberry of Planned Parenthood noted it among her many objections to the bill. "Basically we're saying that the doctor's right to refuse services is more important than the woman's right to health care," she said. Planned Parenthood is a national organization whose reproductive services include abortion, though the group's Louisiana offices do not offer the procedure.

Women's Health Screenings: What You Should Know - living new orleans

Most of us know the obstetrician/gynecologist as the person who deals with reproductive health issues and promotes optimal wellness for women. The American Congress of Obstetricians and Gynecologists is the nonprofit organization of women’s health-care physicians that advocates for the highest standards of practice and sets forth the rules that govern the field.

ACOG’s goal is to catch problems early through screening tests like Pap smears. “(Patients) are getting screened for high-risk viruses, which helps define a population of people who may be at high risk for developing problems as time goes on,” says Dr. Stephen Champlin, obstetrician/gynecologist at East Jefferson General Hospital in Metairie.

These are the patients who need more screening or observation, including those with signs of osteoporosis. “We have good technology and machines to pick up bone density and osteoporosis years in advance of it actually turning into osteoporosis,” says Champlin, “so those women can get started on medication so their bones get stronger, and [will] never have to deal with an osteoporotic fracture or deformed posture.”

The quick, non-invasive DEXA scan measures bone mineral density and is analogous to getting an X–ray. “Women lie on their backs, put their calves up on a foam block, and it is a combination of ultrasound technology and X–ray radiation, which in low dose looks at the hips, back and tells where the weak areas may be,” Champlin says. Unless a woman has a family history of osteoporosis, ACOG now recommends DEXA scans begin around the age of menopause. Follow-up exams are based on the initial results.

ACOG has also changed its recommendation for Pap smears. “Previously, it had been [at] 18 years old or three years after the first sexual encounter, but we now start at [age] 21,” says Dr. Veronica Gillispie, obstetrician/gynecologist at Ochsner Health System in New Orleans. The frequency recommendation has changed as well. “Patients with normal Pap smears can go every two years,” says Gillispie.

For some patients, it is easier to do the Pap smear annually because it can be hard to remember. “The American Congress of Obstetricians and Gynecologists and the American Cancer Society say that you can stop at [ages] 65 to70, but if patients are coming in and still have a cervix, I screen them into their mid-70s,” says Gillispie.

Patients have a better understanding of the purpose of the test. “The goal of the Pap smear is to diagnose pre-cancerous changes of the cervix such that we can treat it in both an aggressive yet conservative manner, in order to salvage reproductive capacity,” says Dr. William von Almen, obstetrician/gynecologist at Touro Infirmary Hospital in New Orleans. When something is caught in an early—versus later—stage, it may mean the difference between freezing or lasering, and a hysterectomy.

Transactions of the Southern Surgical and Gynecological Association

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Transactions of the Southern Surgical Association

New Orleans medical and surgical journal

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