In just a couple of months, I'm going to become a mother. So, of course, the personalized ads that follow me around the internet and social media are now entirely devoted to profiting from my many fears. I get ads for swaddles and high-tech baby gadgets that promise to buy me just a little more sleep, for creams to fight stretch marks, for breast pumps that are supposed to make the process marginally less inconvenient. (By the way, be sure to read my colleague Tara Bannow's follow-up to her blockbuster First Opinion on the locked lactation room at JPM.) And then there are the cord blood banking ads, which are the most alarming of all. They tell me that I need to pay to bank my baby's cord blood in case of some mysterious future emergency. They make it sound so reasonable — as though if I don't bank her cord blood, I'm already failing my daughter.
So a First Opinion I published this week from Judith S. Mercer has made a difference in my life. "When I became a certified nurse-midwife in 1974, inspired by the work of French obstetrician Frederick Leboyer, I began advocating for a gentle transition for the newborn," she writes. "I would put the baby on its mother's abdomen and allow the cord to remain attached until it stopped pulsating and the placenta was ready to deliver." Then, almost 20 years ago, she began conducting research on the value of delayed cord clamping; she and her colleagues have found it offers immense benefits. But banking cord blood means you can't delay cord clamping too much, or you get nothing to bank for the future.
The tension here captures a tricky dynamic: Is it better to use those "precious life-giving substances" immediately, or save them in case of a catastrophic health emergency in the future? The odds of needing that banked cord blood in the future are small, but small does not mean nonexistent. But I've decided I can't worry about the unlikely right now, when the benefits of delayed cord clamping are so clear.
So now, thanks to Mercer, I'm going to ignore those cord blood banking ads and focus instead on something more important: stressing about whether I should buy a used Snoo.
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In First Opinion this week, Christopher M. Worsham and Anupam B. Jena write that road-blocking protests can cost ambulances, and patients, precious time. Christopher Palatucci, who works for a life sciences executive search firm, offers an optimistic take on the industry job market in 2024. Unless you're Mayo or Cleveland, elite multispecialty medical groups are in trouble. Interoperability in medical data is still far behind where it should be. Cord blood banking is popular with influencers, but not good for babies, writes Judith S. Mercer. And BMI cutoffs for orthopedic surgery don't lead to better patient outcomes.
Recommendation of the week: In each season of the Slate podcast "One Year," the show looks at a handful of major stories from, well, a particular year. The recently concluded 1990 season included an absolute powerhouse of an episode titled "The Angry Death of Kimberly Bergalis," about a young woman who apparently contracted HIV from her dentist and the national conversation her story provoked. It's a must-listen if you're interested in the history of HIV.
Got questions about writing for First Opinion? On Tuesday, Jan. 30, at 2 p.m. Eastern, I'll be holding "office hours" on STAT+ Connect, our subscriber-only platform. Join me!
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