A Woman’s Health Options
June 25, 2008
By Dr. John Spangler
Dr. John Spangler
OB/GYN
How long have you been practicing? Since 1966.
How long have you been practicing in Hawaii? Since 1972.
What do you think has been the biggest change in OB/GYN since you started?
Well, of course, abortion. That was against the law when I started. So that’s changed in the past 25 to 30 years. That’s kind of a big thing. There’s been new drugs and new procedures, but we still have the same body. We also can detect whether someone has a venereal disease when we do the Pap smears now. That’s something brand new in the last couple years, whereas before we would have to do cultures and things. So that’s an improvement.
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Does the controversial morning-after pill work?
It works sometimes. It depends how it’s taken and when it’s taken. It’s hard to find statistics because they can buy the pill over the counter. I really haven’t seen anyone who has come in who has said that it hasn’t worked. I keep waiting for someone to tell me that it didn’t work, so it must be pretty successful.
How much of your practice is with pregnancy, labor and post-delivery?
Right now it’s only about 10 percent, but it used to be 25 to 30 percent. As you get older you get less OB. I think it’s more fun delivering a baby than anything else.
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Is it often hard to convince women stay healthy while they’re pregnant?
It is very hard. They go to Burger King and eat ice cream and drink beer. You try because they are providing an environment in their body for this baby and the most important thing is to keep it healthy. Even after the baby is born, though, they shouldn’t be smoking around the baby.
When should someone start seeing an OB/GYN and how often?
It varies depending on who you talk to, but I usually recommend before she goes off to college. Or if they become sexually active they should be seen at that time. I suggest once a year for women.
How do you feel about those four-dimensional ultra-sounds where you can see the baby in detail?
The trouble is that we don’t know the effect of the ultra-sound on the baby. It’s a sound wave, so it’s an energy that you’re putting into the uterus. Although they don’t think there’s any harm to the fetus, doing all these extra-lengthy ultrasounds probably isn’t good. The American College says that it shouldn’t be done.
I hear it’s becoming more common for women to choose having a Cesarean section rather than going through labor. Is that something you’re noticing in your practice?
Oh, yeah, we do that. We never used to do that, but the C-section rate in this town is now 1 out of 4. If they don’t want to have labor, they can choose to have a C-section. But the date has to be a week of their due date. In Brazil, the C-section rate is 85 to 90 percent because the women don’t want their vagina stretched. But everyone is different and everyone sees things differently.
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What are the biggest on-the job challenges for you?
Trying to get people to not get pregnant, unless they want to. That’s a big challenge and a real concern for all of us. These people aren’t using anything, then they get pregnant and want an abortion. It would be nice if people would be more responsible and understand what they’re doing and have some consideration for their own body. For some reason, some people are not mature enough to know what they’re doing. Even things like smoking. I go by high schools and there’s a bunch of kids out front smoking. Maybe these people don’t understand that smoking is one of the worst things that you can do to your body. More people die every day from smoking than anything else all put together. But people don’t understand that. My father was a doctor, and many, many years ago almost all doctors smoked. But then once the statistics began to come in, well, there are very few doctors now who smoke. If we could just get young people not to smoke that would be wonderful.
What is the most common STD that you see?
Usually vaginitis or yeast infection. With that said, STDs are a very serious thing and using condoms is very important. I am surprised how many people aren’t using anything.
What female disorder do you commonly see?
Irregular bleeding. That’s the most common complaint that I see. Then there’s a small group who are trying to get pregnant, but can’t get pregnant. And then there’s people who have pelvic pains.
Are there any new methods of birth control?
Nothing exciting. There’s IUDs, implants, pills, condoms, sponges. But there’s no perfect thing, just like there’s no perfect medicine in the world. All medicines have side effects and aren’t perfect. I don’t know why people get so upset when things sometimes don’t work or makes them sick. To think that there’s a perfect medicine, that does not exist.