Ashley's Story

When a pregnant woman enters a hospital to give birth, she expects that she will leave there with her baby in her arms, and her uterus in her body. While most women do leave the hospital with their baby, many leave without their womb.

The mixture of joy when she looks at her healthy infant, and the pain and suffering of the loss of her reproductive sex organ, is irreconcilable. Well meaning family and friends try to be kind and comforting when they tell her how lucky she is to have a healthy baby, especially if she has other children. And because her loss is not visible, family and friends may not know or understand the profound physical and life altering changes she is experiencing. It is often lonely and isolating. It would help to listen when she talks about how she feels, and to validate her experience by telling her that you’re sorry this was done to her. The usual platitudes, “you’ll be okay”, or “you’re so lucky the baby is healthy” or “you’re lucky to be alive” are a denial of what she’s going through.

The following is the experience of Ashley Shewman, a woman who believes that if she had had better medical treatment during her pregnancy, and a C-section delivery, her uterus would still be where it belongs, in her body.

Ashley Shewman’s Story

Deciding to have another child was a hard decision for me, and my husband. At that time we had a very challenging four-year-old, and although the pregnancy was perfect, I hemorrhaged after labor and required a blood transfusion and a Dilation and Curettage (D&C).  I remember the doctors telling me if the surgery didn’t work that they would have to give me a hysterectomy.  My eyes filled with tears and within seconds I was sleeping – and undergoing surgery. I did not know if I would wake up with my husband telling me that we can not have anymore children or if the D&C was a successful treatment.

That time it was. 

When we decided to have another child things were a little different. I was 29 years old. At the beginning of my pregnancy I started to bleed. I thought I was having a miscarriage and was ordered to bed rest for a week. My next doctor’s visit went fine and I heard a strong heartbeat.

Throughout my pregnancy I bled often and changed my OB to a high risk doctor. They found out that I had a condition called Placenta Praevia, where the placenta is attached to the uterine wall, close to or covering the cervix, which can cause massive bleeding during a vaginal delivery. It sometimes occurs in the latter part of the first trimester, but usually during the second or third. I visited the doctor more often than normal and was told that if it didn’t improve, I would need a c-section.  During the second trimester everything seemed fine and I was back to normal.
 
I wasn’t even eight months pregnant and went into labor.  I was seven weeks early - in the hospital dilating - and there was nothing they could do to stop or slow down the contractions. Ella May was born vaginally,on May 4, 2008 at 2:47 am and went straight to the NICU. The doctors decided to give me a D&C after birth just to be sure there was no more placenta. I remember feeling really sluggish and tired after going home. I thought that after a few days I would feel better physically but I never did.
 
Ella was a month old when I hemorrhaged again. Blood was everywhere and I remember thinking, “Does this happen to someone twice? Am I going to die? Is this it?”

I was rushed to the hospital by ambulance. That was the longest night of my life. In the emergency room I sat in the bed bleeding on and off, speaking to doctors, and worrying onlyabout my baby because I was breast feeding. After waiting a few hours, a woman doctor came in to speak about my options.  She suggested we perform another D&C. As I sat on the cold hospital bed I asked her if I would have to have a hysterectomy if the D&C does not work. She said (and I still can remember her voice and every wordwas she matter of fact? Cold? Distant? Confident and assured so that you believed her?She seemed very confident about her decision to perform the D&C. “We will not have to go down that road.” With both of my children I heard the word hysterectomy and my heart went numb. I didn’t even know what to think.  

The procedure was only supposed to take 10 minutes. After over an hour of the most annoying and exhausting surgery (I had a spinal, so I was awake). I was told it would take ten minutes and after more than an hour I was very annoyed and uncomfortable.  the doctor came up to me and said, “We can’t get the entire placenta out. We will have to give you a hysterectomy.”  By then I was so tired I think after she told me that I passed out from the surgery.
 
I woke up in the most excruciating pain I have ever felt in my life. My husband was at home resting at the time. I sent him home because I thought I was getting another D&C and when I was done I would call him. He didn’t even know I had a hysterectomy. We didn’t have the time to talk about this. I didn’t have the option. I had to have my mother call him and tell him what happened. No one else was with me at the time of the surgery. The recovery was very difficult and long.  My husband and I didn’t get a chance to discuss my surgery until almost a year after. He thought I would be fine and things would go back to normal, little did he know.  I was a monster.  I didn’t like who I was, I just thought I was crazy.  After numerous breakdowns and fights, I decided to talk to someone to get help.  My husband decided to attend a support group so he was able to understand what I was going through.  I recommend that to any husband or significant other. 
I don’t’ feel I was examined correctly. I had a doctor that was supposed to be one of the best in the city, but he rushed through every scheduled visit with me. He said I was fine, but I believe that if I would have had the c-section I would have not had to have the hysterectomy. My doctor was pretty confident everything was going smoothly, but it didn’t. I went to see him on a Friday because I was leaking fluids.  I thought my water broke but when he examined me, he said I was fine and to go home.  He also said I was not going to go in labor that weekend.  I started having contractions on Saturday night and had my daughter Sunday morning.  My doctor was “out of town” that weekend so I didn’t even know who was going to deliver me.  I am grateful to have had both my girls vaginally but after what I went through I would have wanted a C Section to save my cervix and uterus.

I was not well educated about what would happen physically, emotionally, and mentally after hysterectomy, and I experience this every day since  the surgery. I have two beautiful girls and I am so grateful I am alive, but having the hysterectomy changed my life. I just hope that one day I will get over the fact that I cannot have any more children -- we wanted, or hoped for a son.
 
It’s been a year since the surgery and I still struggle every day.

The only advice I have for women with Placenta Praevia is if you have any doubts about anything, get a second, third and fourth opinion.  Go online, read and educate yourself on everything you should know about this subject. It might change your life.

She almost died, but the College of Physicians and Surgeons ruled no negligence

The rate of hysterectomies is five times greater in the south in the U.S. and in Newfoundland than in the rest of North America. And, as it is in the U.S., the fox is guarding the hen house in Newfoundland.

On September 21, 2009 just four days after Sharon Virginelli’s court victory (Click on the link on the right under Previous Posts) of a $5M award for an “unnecessary” hysterectomy, it was ruled that a gynecologist in Gander, New Foundland, was not negligent in performing a hysterectomy that left a woman with a colostomy, put in intensive care for a month, and in the hospital for two months.

But Annie Ralph has not yet had her day in court. The no negligence finding was by Newfoundland and Labrador’s medical watchdog, the College of Physicians and Surgeons. Annie has filed a lawsuit (called a statement of claim in Newfoundland), against Dr. Doug Torraville and The Central Health Authority.

Annie entered the hospital for a hysterectomy three years ago, in October of 2006, expecting to be home in a few days. She was in intensive care for 28 days and in the hospital for two months. On the day of the surgery it was evident there were complications. Three days later she became very ill, and exploratory surgery revealed that her colon had been perforated. She has since undergone three surgeries in attempts to repair the damage to her colon and reverse a colostomy.

When the College of Physicians and Surgeons investigated her complaint against Torraville they determined that he was not negligent. The College said Ralph was warned that colon damage could be a complication during a hysterectomy. However being warned of a possible risk does not make acceptable the damage that Torraville inflicted on her by perforating her colon, not repairing it during the surgery, and putting her life at risk by not responding timely to her symptoms. Furthermore, did Torraville inform her of the life long, permanent consequences of hysterectomy? Did he inform her that her sex life would never be the same? That her vagina would be shortened? That hysterectomy would increase three-fold her risk of heart disease? It is unlikely those consequences of hysterectomy will even be mentioned when she gets her day in court, because they are losses women are not usually compensated for. You cannot see them. Unlike the infection that almost killed Annie Ralph, and unlike her colostomy bag, they are not documented in the medical record, and the damage is not visible. The defense’s expert’s witnesses in hysterectomy medical malpractice cases usually say “She making it up, it’s all in her head”.

Gynecologists get away with performing hysterectomies by not admitting that it is a damaging surgery. Because the female organs are internal, it is easy to deny what is not visible to the eye.

HERS will be monitoring and reporting the outcome of her case. If you were involved in a medical malpractice lawsuit, please share your experience. We all know how difficult it is to bring legal action against a doctor, particularly when in hysterectomy cases. Please post a comment to let Annie know you support her bringing this action against Doug Torraville and The Central Health Authority.

Twenty-two Million Strong

There have been several recent comments on HERS blog arguing for financial compensation, or reparations, from the government for the damage caused by hysterectomy and castration.

Reparations do not become a consideration until the public at large acknowledges that harm was done to a select group of people, and the acts that caused harm are stopped. That group and their supporters, then form a coalition to press for compensation from governments that either participated in the wrong doing that caused harm, or failed to stop it.

Let’s pull together to educate the public about the damage caused by hysterectomy, and to support passage of a law that will compel doctors to provide HERS video, “Female Anatomy: the Functions of the Female Organs”, to every woman before she is told to sign a form consenting to hysterectomy or castration. HERS video is a powerful educational tool that has been viewed by close to a million people. Women scheduled for hysterectomies who watch the video cancel their surgeries and when they are told they need the surgery but doctors have not informed them of the information in HERS video, many fire the doctor and walk out.

Everyone’s voice and point of view is important and deserves to be heard. It’s imperative that our common cause brings us together in a positive way to accomplish our common goal of stopping hysterectomy and castration from being performed on women who have not been given the information requisite to informed consent. Please tell us what you think needs to be done, offer wise insightful criticism, and what you are prepared to do to help expedite changing the law. Email HERS at hersfdn@earthlink.net and tell us how you want to be involved in educating the public and supporting legislation. Tell us what you can and want to do:

• Write letters to the editor of your local and syndicated newspapers
• Call talk show hosts or their producers to tell them about the issues and the recently published book THE H WORD
• Ask them to interview Rick Schweikert and Nora W. Coffey
• Use Facebook and Twitter to tell people to watch the video and read the book
• Hand out HERS Hysterectomy Pamphlet to people on the street and put them in the waiting rooms of doctor's offices and hospital's waiting rooms
• Get people to sign the petition
• Send THE H WORD to friends and family
• Let HERS know when you have sent THE H WORD to gynecologists so that we can add their name to the growing list on HERS website of doctors who can never again say "I didn't know."
  

Donate whatever you can to help HERS with the challenging, time intensive, hard work required to change the law, and encourage others to support the growing movement to change the law. It requires dedication, commitment, and perseverance, and the funds to pay for printing, postage, travel to meet with legislators, research, writing, continuous updating of the website and blog, and more.

There are 22 million living women in the U.S. who have been hysterectomized, and 73% of them were castrated. We have all been hurt- primarily women who have been hysterectomized, and by extension their family and friends. Though many women have supportive family and friends, others do not. Each woman lives alone with the far reaching consequences of the surgery, coping the best she can, struggling with problems others have difficulty comprehending. Although each woman is alone in a profound way as she tries to find strategies to cope with a plethora of unsolvable hysterectomy caused problems, collectively we are powerful, 22 million strong. Hand in hand we can circle our legislators, and demand our government work with us and for us, and by working together we can accomplish our common goal of stopping this from being done to the next generation of women and girls.

Woman Awarded $5M After 'Unnecessary' Hysterectomy

What's a uterus worth if it's valued as a reproductive organ?

Verdict: $5 million dollars.

What's a uterus worth if it's valued as a hormone responsive sex organ that supports the bladder and bowel, and provides cardiovascular protection?

Verdict: $0.

A decade after 31 years old Sharon Virginelli was unnecessarily hysterectomized, she was awarded $5 million Wednesday by a Cook County jury against the doctor who performed an unnecessary hysterectomy after the delivery of Virginelli's first child.

Kudos to Sharon Virginelli and her lawyer, Keith Hebeisen of Clifford Law Offices, for waging this courageous court battle, where it is rare for unnecessary hysterectomy lawsuits to be brought, and even more rare for them to be won.

A Cook County jury deliberated for about four hours before reaching its verdict following a one-week trial in Cook County Circuit Court.

Sharon Virginelli, underwent a C-section in May 1999 at Northwestern Memorial Hospital. Her obstetrician, Dr. Pamela Lui, performed the surgery and determined a hysterectomy was necessary due to post-operative bleeding.

Experts testified that her bleeding was slowing down and that less drastic surgical techniques could have been performed to avoid the hysterectomy.

Press releases and articles have focused on the fact that she is now unable to have children. Unfortunately the many other critically important, life long functions of the uterus as a hormone responsive sex organ that provides structural support and cardiovascular protection, appear to have been ignored.

Unquestionably, this is a legal victory. But as all hysterectomized women know only too well, no amount of money can compensate for the loss of their health, sex, sexuality, and vitality.

New study shows link between female castration and lung cancer

Ovary Removal May Play a

Role in Lung Cancer

A new Canadian study reports that castration (removal of the female gonads, the ovaries) almost doubles a younger woman's risk for developing lung cancer. "It's possible that vulnerability to lung cancer is caused by early and sudden decrease in estrogen levels or potentially long-term use of hormone replacement therapy, and further research is needed to explore these hypotheses." said study co-author Jack Siemiatycki, a professor at the University of Montreal's Department of Social and Preventive Medicine.

The report was published online in the International Journal of Cancer in May 2009. It is based on a study of 999 patients from hospitals in Montreal including 422 women with lung cancer. "A major strength of this study was the detailed smoking information which we obtained from all study participants," said study co-author Anita Koushik. "This is important because of the role of smoking in lung cancer and because smokers generally have lower estrogen levels than non-smokers."

"Although smoking is the dominant cause of lung cancer, we know other factors can play an important role in enhancing the impact of tobacco carcinogens." Koushik added "This research suggests that, in women, hormonal factors may play such a role."

________________

A note from Nora W. Coffey

This important discovery should alert every woman and man to the fact that removal of the female organs creates a higher risk of life threatening health problems including but not limited to heart disease, stroke, dementia and lung cancer. Although not considered a "health" or life threatening problem, the loss of sexual feeling and loss of vitality associated with sexual energy are serious adverse effects of hysterectomy and/or castration. There are many more permanent consequences that have either not been discovered, or if known, they have been denied or not reported.

Hysterectomy? Slow down!

Hysterectomy: Putting On

The Brakes

The highest risk factor for hysterectomy is not the presence of disease. Women with intact female organs who have "routine" medical exams and public or private medical insurance are most at risk for hysterectomy.

When hysterectomy is recommended, most women respond by telling the doctor that removing their uterus is too drastic for the reason given for the operation. A small number of women think it would be freeing to not have menstrual cramps, bleeding, and PMS, but most women want to put on the brakes and slow down the rush toward surgery. Nonetheless, one out of every three women undergo hysterectomy by the age of 60, without the information required for informed consent.

The reason so many women are hysterectomized without informed consent is remarkably simple...as is the solution.

Many of the functions of the female organs - such as cardiovascular protection, pelvic support, and uterine orgasm to name a few - are not visible. On the other hand, because the male organs are visible, as are many of their functions, men would never consider the amputation of their male organs to be freeing. The solution to preventing unnecessary hysterectomy, then, is providing women with information about female anatomy and the functions of the female organs.

THE H WORD, the book co-authored by Nora W. Coffey and Rick Schweikert, tells the story of how and why the HERS video "Female Anatomy: the Functions of the Female Organs" was produced, and why it is at the heart of a legislative solution to end unwarranted hysterectomy and female castration. The video, vetted by gynecologists and an anatomy professor, includes the anatomical facts every woman requires to be fully informed. 98% of the women HERS has referred to board certified gynecologists after being told they needed hysterectomies discovered that, in fact, they did not need the surgery. With this video, women come to understand the information needed to put the brakes on the doctor's rush toward surgery, or to understand why they feel the way they do after the surgery.

The "Female Anatomy" video is an essential, low-cost, highly successful educational model that provides the information women need to make an informed decision about hysterectomy and castration. It is available for free on the HERS website and has been viewed by more than a million women and men.

It also represents the turning point in THE H WORD, where education meets political action. And as Lee Rothberg said in her review, "THE H WORD is the beginning of the end...the silence is over!"

HERS Honored With Women's Way Award

Amid the applause of 1,100 guests, the Women's Way 32nd Annual Powerful Voice Awards were presented in Philadelphia on May 6, 2009. The awards honored the accomplishments of Women Organized Against Rape (WOAR) Director Teresa White, community organizer and HIV/AIDS awareness advocate Waheedah Shabazz-El, and women's rights advocate and activist, Hysterectomy Educational Resources and Services (HERS) Foundation President Nora W. Coffey.

Women's Way Executive Director Melissa Weiler Gerber says of the award, it "serves as a call to action to women everywhere, encouraging us to increase women's influence in the media and make a difference in the community."

Women's Way is the first major women's organization to publicly acknowledge the importance of educating women about the damaging effects of hysterectomy and the lifelong functions of the female organs. The award is recognition that hysterectomy is one of the most serious health issues facing women today. As demonstrated in Nora's book THE H WORD, co-authored by Rick Schweikert, the hysterectomy rate is on the rise, and every woman with a uterus is at risk.

Women's Way presented HERS with an excellent opportunity to talk about the issues, but the award presenter was a pharmaceutical company representative. Nora's first thought was, "I can't accept an award presented by someone from the industry." HERS is an independent women's health education organization with a policy of not accepting support from the medical industry.

"Because there was no opportunity to address this issue publicly at the banquet," Nora said, "in keeping with HERS' mandate of education, I presented a copy of THE H WORD to the pharmaceutical rep as she handed me the award. That way, she could educate herself and her pharma colleagues about these issues."

Since 1977, Women's Way has been the country's oldest and largest women's funding federation. This award brings into focus the imperative to provide women with the information required for hysterectomy informed consent.

We welcome any ideas you might have about getting exposure for HERS and THE H WORD. Each time someone reads the book, it's another person who has been educated about these issues and someone who may educate others and join us in changing the law. Each time the book is in the media, in a bookstore, on a blog, or on a library shelf, the number of people who have access to this vital information is magnified many times over.

This is an opportunity to put hysterectomy information into the hands of those who need it...to save a girl, to save a woman, to save a family. To prevent hysterectomy from becoming the legacy of another generation of women and girls.

Fraud and Hysterectomy

Fraud in the inducement is a legal term used to describe a scenario where one person has tricked or deceived another into a harmful situation they would not have entered into if they had known they would be harmed.

In the example of hysterectomy, a woman is induced into signing a consent form under the guise that she needs the surgery, there are no alternatives to hysterectomy, and she may die without it. But that is rarely the case. She is also induced into signing the consent form by being told she will be "better than ever after the surgery," or that she will be a "new woman." She is then drugged, strapped to a table, and her female organs are removed, because of erroneous information supplied by the inducers. 

No woman is unharmed or undamaged by the removal of her female organs, but that is really not the point. The point is, women who are provided with the information required for informed consent, such as the information provided in the HERS video "Female Anatomy: the Functions of the Female Organs," decide against undergoing hysterectomy. 

As we make clear in our book The H Word: What gynecology doesn't want you to know about 100 years of hysterectomy and female castration in America, whether the surgery might be one of the 2% that are lifesaving or not is irrelevant. It's every woman's right to know the information that is requisite to informed consent prior to being asked to sign a hysterectomy consent form, whether she has a mere annoyance or a true health problem.

Fraud in the inducement for hysterectomy requires proof that 1) a false statement of material fact was made, 2) the doctor/hospital knew or should have known the material fact was false, 3) the false statement induced the woman into signing the consent form, and 4) the hysterectomy caused injury to the woman who relied on the misrepresentation as fact. 

False statements of material fact on medical websites are more the standard than the exception. A survey of doctor, government health agency, and hospital websites demonstrates that not only do doctors remove sex organs without providing the information required for informed consent, the information they do provide is often erroneous and unsupported by anatomical fact, as was confirmed on the blog post, "Hysterectomy and Female Castration: the Enablers Part II." Most of the false statements are authored by doctors and hospitals that claim to be sources of medical expertise, who should know that the information they publish runs contrary to anatomical fact. Women are encouraged to use this information to make a decision about hysterectomy. The adverse effects then cause injury to more than 621,000 women in the U.S. each year. 

For more on this subject, see the article "Sanctioned Violence Against Women," published in The Women's International Perspective (The Wip).  

We are interested to hear how your experience with hysterectomy fits the four requirements above for fraud in the inducement. Would you take part in a class action lawsuit against doctors and "patient education" institutions that supplied the erroneous information used to induce you to sign a hysterectomy consent form?

Please be brief in your comments about how your experience fits the four legal requirements of fraud in the inducement. 

Hysterectomy Causes Heart Disease

The American Heart Disassociation     

Heart disease was once thought to be less of a problem for women than for men. Research now indicates that heart disease is the No. 1 cause of death among women in the US (Centers for Disease Control and Prevention, Heart Disease Facts and Statistics, 2008), while confirming that women with an intact uterus have a lower incidence of heart disease because they benefit from the uterine advantage.

     In his article, "Prostacyclin From The Uterus And Woman's Cardiovascular Advantage," James D. Shelton writes, "Prostacyclin emanating from the uterus is proposed as a major contributor to the reduced risk of coronary disease among women." He refers to the uterus as a "systemically active organ whose removal significantly increases subsequent risk of myocardial infarction" (Prostaglandins Leukotrienes and medicine, 1982). 

     The American Heart Association reports that in 2006 there were 16.8 million cases of coronary heart disease in the US. About one in 18 Americans suffers from heart disease. This number would be much lower, if not for hysterectomy.

     Studies reveal that premenopausal removal of the uterus is associated with a three-times-greater incidence and prevalence of heart disease (Brandon S. Centerwall, "Premenopausal Hysterectomy and Cardiovascular Disease," American Journal of Obstetrics and Gynecology, 1981) and that women who undergo a bilateral oophorectomy (surgical removal of the ovaries, castration) have a 5.5 times greater cardiovascular risk (Jacqueline C.M. Witteman et al, "Increased Risk of Atherosclerosis in Women After The Menopause," British Medical Journal, 1989). Other studies demonstrate that women who are castrated before age 35 are hospitalized for myocardial infarction 7.2 times more often than women with intact uterus and ovaries (Lynn Rosenberg et al, "Early Menopause and the Risk of Myocardial Infarction," American Journal of Obstetrics and Gynecology, 1981).

     Hysterectomy is the most commonly performed non-obstetric surgery in the US, and there is general consensus even among the medical community that a majority of hysterectomies are unnecessary. Hysterectomy rates are subject to variations that do not necessarily correlate with health factors. Statistics from the Centers for Disease Control and Prevention (CDC), for example, tell us that women in the South are 50 percent more likely to be hysterectomized than in the Northeast. And the hysterectomy rate among black women is 20 percent higher than among white women.

     Some researchers and medical writers attempt to explain the higher incidence of hysterectomy and removal of the ovaries in black women by demonstrating that they have a higher incidence of fibroids. As the Hysterectomy Educational Resources and Services (HERS) Foundation makes clear in the online educational video, "Female Anatomy: the Functions of the Female Organs," fibroids are benign growths that rarely cause symptoms or problems, until a doctor spots them incidentally during a routine exam.

     Although less than 1 percent of fibroids are cancer (William Parker et al, Obstetrics and Gynecology, 1994), fibroids are the leading reason doctors perform hysterectomy. But women who are told they need a hysterectomy for fibroids may merely have the wrong doctor. Not surprisingly, not only are black women more likely to be hysterectomized, heart disease is the No. 1 cause of death among black women.

     The CDC's Division for Heart Disease and Stroke Prevention reports that 870,000 people died in 2008 - 2,400 each day - from heart disease. "The cost of heart disease and stroke in the United States," the CDC concluded, "is projected to be more than $448 billion in 2008, including health care expenditures and lost productivity from death and disability." The financial burden and tragedy of heart disease as a result of hysterectomy is largely avoidable.

     According to the US Department of Health and Human Services, one of every three women is hysterectomized before the age of 60, while the American Heart Association reports that nearly one out of every three women dies of heart disease.

     Visitors to the "Go Red For Women" web site are encouraged to tell the American Heart Association "about the choices you've made to improve your well being." Women can avoid much of the risk of heart disease by retaining their uterine advantage - cardiovascular well-being that depends in large part on the lifelong functions of the uterus.''     

     Drastically reducing cardiovascular risk, circumventing much of the staggering cost of heart disease charged to medicaid and Medicare, and avoiding the tragic toll of thousands of strokes and deaths may be achieved by helping women avoid hysterectomy.

Published February 16, 2009 in Truthout.

     

PAYING FOR THE BAILOUT

As we tighten our belts at home and abroad, we are all accountable for the burden of national debt we pass along to future generations. Local and international relief efforts for the poor are also feeling the pinch, which makes the search for ways to heal our broken economy a humanitarian effort.

Although medical profits continue to soar, there have been rumblings lately that the next "industry" to show up in Washington hat-in-hand will be medicine ("Disappearing Credit Forces Hospitals to Delay Improvements," Reed Abelson, New York Times, October 14, 2008). Meanwhile, evidence abounds that an increasing portion of our tax dollars that fund Medicare and Medicaid are the most lucrative revenue stream for the medical industry, and a large portion of those expenditures are going toward unnecessary, even harmful surgeries, not unquestionably-needed emergency care.

Any savings to be realized, without causing more people to become disadvantaged, must be embraced immediately. So-called port barrel federal expenses, and those that can be revealed to cause more damage than good, must be the first to go.

A staggering number of surgeries have been proven in study after study to be medically unwarranted and cause more harm than good. Rob Stein of The Washington Post reports, "One of the most common surgical procedures performed in the United States - arthroscopy to treat arthritis in the knee - is useless, researchers reported yesterday." So let's take a look at the two most over-utilized, most commonly performed surgeries in America - cesarean sections and hysterectomies.

When a doctor and a hospital get involved in the natural process of childbirth, time is money. "Spontaneous deliveries," as they are often referred to (where there is no surgical intervention), are time-consuming for doctors. In rare instances, such as when the placenta happens to block its own exit by attaching to the uterine wall close to or covering the cervix (placenta previa), C-section may be lifesaving for both baby and mother. Also, when the placenta does not detach from the uterine wall (placenta accreta), sometimes a hysterectomy is the only way of saving the mother's life. But placenta previa can often be managed conservatively and occurs in only 1 in 200 pregnancies. Placenta accreta occurs in only 1 in 2,500 pregnancies. Combined, they account for only one half of one percent of C-sections, which means that as many as 99% of C-sections may be medically unwarranted.

A study published in the New England Journal of Medicine reports that nearly 1/3 of all births in the U.S. are surgical, with up to a four-times higher risk of complications ("Caesarean Section Before 39th Week Poses Extra Risk, Study Finds," January 7, 2009.) Judith Reichman of NBC News reports that more than 30% of the 4.3 million U.S. births each year are surgical deliveries. However, Dr. Mayer Eisenstein, an ardent advocate of home birth and the founder of Homefirst Health Services in Chicago, reports that Homefirst's C-section rate is only 4.1%.

Depending on the severity of C-section complications, each surgical delivery taxes Americans anywhere between $2,000 and $200,000, in addition to the cost of an in-hospital birth. As reported by Rita Rubin in the January 7, 2007 USA Today, "The average initial hospital cost of a planned C-section for a first-time mother was 76% higher than that for a planned vaginal birth." A conservative estimate of C-section expenses burdening American families would top $3 billion each year for additional doctor and hospital charges alone.

As for hysterectomy, Ashley Montagu wrote in his book The Natural Superiority of Women about a House of Representatives subcommittee investigating the incidence of unnecessary hysterectomy. "Various sources," he writes, "put the percentage of unnecessary hysterectomies anywhere between 24 and 88 percent." Findings from more than 850,000 counseling sessions at the HERS Foundation in Philadelphia puts the percentage of hysterectomies that could be avoided with conservative treatment (or no treatment at all), at about 98%.

The Centers for Disease Control and Prevention (CDC) report that more than 1/3 of American women have their female organs removed by the age of 60. The CDC also reports that the incidence of cancer in the female organs and the male organs is virtually identical, while the incidence of male organ removal is statistically insignificant.

"'We have four times the hysterectomy rate of any industrialized nation, in this country,'" said [Ernst] Bartsich, a clinical associate professor at Weill Cornell Medical College. At age 60, one out of every three women has had a hysterectomy; and at age 65, one out of two women have had a hysterectomy. And 85 percent are not necessary" (Newsday, May 2004, Roni Rabin).

In a September 5, 2007 article published in Health Insurance Underwriter's magazine, Rick Schweikert reports that more than $17 billion each year is spent on direct doctor and hospital charges for hysterectomy. In 2007, the HERS Foundation released an educational female anatomy video on its website that was vetted by gynecologists and other medical and legal experts. Ninety-eight percent of the women who watch the video and call the HERS Foundation do not proceed with the doctor's recommendations for hysterectomy after learning about the unavoidable and irreversible consequences of removal of the female organs - facts that women are not informed of by doctors. The long-term cost of treatment and subsequent surgeries, and a lifetime of harmful drugs and treatments for the problems caused by hysterectomy and ovary removal, could easily top the $17 billion paid for the initial surgery.

According to their 2008 SEC filings, the largest hospital chain in the U.S., the Hospital Corporation of America (HCA) - founded by the family of former Senator and Majority Leader Bill Frist - reports that in 2008 about 49% of their revenues and 59% of their hospital admissions were Medicare and Medicaid "related." In 2007, HCA reported revenues of $26.9 billion, approximately $16 billion of which (according to HCA) was paid for by American taxpayers.

What most people may not know is that HCA "plead guilty to 14 felonies" and was hit with a $1.7B fine - far-and-away the largest such fine in history - for Medicare fraud, as reported by Kurt Eichenwald in the December 18, 2002 New York Times. These fines, it seems, were a minor bump in the road for HCA, on their way to grabbing hundreds of billions of American taxpayer dollars in the years to come. Doctors and hospitals reap the financial benefit of surgeries, whether they are warranted or not. American taxpayers, both in terms of Medicare/Medicaid payouts and higher insurance premiums, pay the price.

No mother or father whose child has a medical emergency should be required to answer any questions or demonstrate any ability to pay for medical services when they arrive at an emergency room seeking care. But as our government strategizes how to spend hundreds of billions of dollars in its economic stimulus package, we owe it to future generations to unshackle ourselves from doctors and hospitals performing medically unwarranted surgeries.

In a December 2, 2007 article titled "National Debt Grows at a Million Dollars a Minute," (published long before any talk of "bailout" packages), the Associated Press reports that, "retirement and health benefit programs now make up the largest component of federal spending. Defense is next. And moving up fast in third place is interest on the national debt."

Each million dollars saved today could save future generations tens of millions of dollars in interest on the national debt. As President Obama said in his inaugural address, "Our health care is too costly." In these trying times, Americans are not in a position to leave $17B a year of unnecessary medical expenses on the table. Especially when it will keep hundreds of thousands of American women off the operating table, with their female organs intact.

Published February 4, 2009 in The Women's International Perspective.