Hi Pat,

There are more birth defects in both the Ultra-Orthodox and
Arab/Beduin/Druze
communities due to a number of factors:  large families where mothers
give birth just about till ovulation stops;
a lot of marrying within the community; reluctance in some cases to seek
OB/GYN care which may seem "embarrasing or immodest" (that's why these
groups have had a low rate of breast exams/mammography.)  Within the
non- secular population, screening techniques such as amnio are not
widely accepted.

I have the say that the health funds are making an effort to get these
women into clinics for breast examinations and mammograms.  Women are
sent personal invitations to come in for a check-up.  They are assured
that only female medical staff will be present. But there's not enough
being done in the area of birth control.  Probably not too many are
willing to get into a sensitive issue including religious
sensitivities.  Most of the religious families I have worked with choose
to have large families, even if it means economic hardship.  In the
breastfeeding courses run by the Israel Childbirth Education Center, we
bring in an OB/GYN to educate nurses about LAM.

Best wishes,

Susan Nachman-Srebrnik, IBCLC
Ra'anana, Israel

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