Perspectives: Hospitals Must Adopt Reforms To Reduce Maternal Mortality; Yes, Hate Speech Does Lead To Violence Against Others

New England Journal of Medicine: What We Can Do About Maternal Mortality — And How To Do It Quickly 
Most Americans take for granted that giving birth in a U.S. hospital will be a safe experience resulting in a healthy mother and baby. However, recent reports in the lay media — an NPR special series called “Lost Mothers: Maternal Mortality in the U.S.”; a New York Times article on closures of rural maternal services; and a USA Today series, “Deadly Deliveries” — discuss increasing maternal mortality in the United States and the significant concern it presents for childbearing women and their families. Women in the United States are more likely to die from childbirth- or pregnancy-related causes than women in any other high-income country, and black women die at a rate three to four times that of white women. Increasing maternal mortality is a tragedy, and though multiple factors contribute to the risk of maternal death, national and state reviews have identified the most preventable contributors. (Susan Mann, Lisa M. Hollier, Kimberlee McKay and Haywood Brown, 11/1)

New England Journal of Medicine: Postpartum Care In The United States — New Policies For A New Paradigm
In April 2018, the American College of Obstetricians and Gynecologists (ACOG) called for a new paradigm for postpartum care in the United States. According to the ACOG committee opinion, postpartum care should be an ongoing, individualized, and woman-centered process, rather than being limited to the “arbitrary 6-week check” that constitutes care for most women today. We believe that such a shift is critical to improving postpartum care and outcomes. More than half of pregnancy-related deaths occur during the year after delivery, and many women have postpartum complications such as pain and bleeding, high blood pressure, lactation difficulties, and pelvic-floor dysfunction. (Mara E. Murray Horwitz, Rose L. Molina and Jonathan M. Snowden, 11/1)

The New York Times: The Neuroscience Of Hate Speech
You don’t need to be a psychiatrist to understand that the kind of hate and fear-mongering that is the stock-in-trade of Mr. Trump and his enablers can goad deranged people to action. But psychology and neuroscience can give us some important insights into the power of powerful people’s words. We know that repeated exposure to hate speech can increase prejudice, as a series of Polish studies confirmed last year. It can also desensitize individuals to verbal aggression, in part because it normalizes what is usually socially condemned behavior. (Richard A. Friedman, 10/31)

The Hill: Violence Against Women Act Diminishes The Seriousness Of Domestic Violence 
Domestic Violence (DV) will be redefined if the Violence Against Women Act (VAWA) (H.R. 6545)  is reauthorized in its revised form. VAWA is the federal touchstone for how DV is addressed nationwide. Passed in 1994, the act has been reauthorized in 2000, 2005 and 2013, with additions attached each time. The 2018 reauthorization is no exception. The pending bill would expand the definition of DV in a way that could harm abused women and other innocent people. (Wendy McElroy, 10/31)

Stat: Medicine Must Make Resilience Part Of The Curriculum 
During a recent run-in with burnout, my co-resident at a large teaching hospital in Boston proposed several small but tangible changes that would significantly improve her life as a physician, things like getting help with retrieving outside hospital records, securing prior authorizations for certain medications, and scheduling follow-up appointments at discharge. She was instead reminded that “these things are a part of our job, and we need to explore why everyone else is doing them fine and you are getting burned out because of them. For any line of work, you have to learn to cope with the negatives.”She would feel better, she was told, if she could “be more resilient in difficult situations.” (Rich Joseph, 11/1)

Bloomberg: Save The Climate, Eat Less Red Meat 
Ultimately, if people worldwide who heavily rely on meat switch to a more plant-based diet, they could potentially decrease food-related greenhouse-gas emissions by almost half by 2050. People reluctant to cut back might find it persuasive to learn that eating less meat, especially less red meat, could help them live longer. Red and processed meat-heavy diets are associated with certain kinds of cancer and with health problems such as obesity, diabetes and high blood pressure. Consider the findings from one of Springmann’s earlier studies: If everyone in world became vegetarian, annual deaths would fall by 7.3 million. (Jessica Fanzo and Shreya Das, 10/31)

New England Journal of Medicine: Health Regulation For The Digital Age — Correcting The Mismatch 
Does it make sense that Alexa can remind me when I need to purchase more cereal but not when I need to take my insulin? Rather than applying ill-fitting old laws to new digital medicine interventions, we could tailor a new regulatory regime to new technologies. (Barak Richman, 11/1)