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Exclusion of Pregnant Women From Industry-Sponsored Clinical Trials

December 20, 2016

OBJECTIVE: The lack of human data available to inform evidence-based treatment for illness during pregnancy has led to calls for greater inclusion of pregnant women in research, but the extent of their current representation is poorly characterized. Our objective was to measure the current exclusion of pregnant women from industry-sponsored clinical trials as a baseline … Read more

Ethics and “Normal Birth”

December 20, 2016

The concept of “normal birth” has been promoted as ideal by several international organizations, although debate about its meaning is ongoing. In this article, I examine the concept of normalcy to explore its ethical implications and raise a trio of concerns. First, in its emphasis on nonuse of technology as a goal, the concept of … Read more

The Language of Birth

December 20, 2016

Our language both reflects and influences our attitudes and behavior. This Roundtable Discussion explores the language used in obstetrics and in the interactions between caregivers and women or their families: What do practitioners say to mothers and families during labor? At birth? In consultations? To describe what is happening? To encourage a woman’s efforts? To … Read more

Obstetrician-Gynecologists’ Objections to and Willingness to Help Patients Obtain an Abortion

December 20, 2016

OBJECTIVE: To describe obstetrician-gynecologists’ (ob-gyns’) views and willingness to help women seeking abortion in a variety of clinical scenarios. METHODS: We conducted a mailed survey of 1,800 U.S. ob-gyns. We presented seven scenarios in which patients sought abortions. For each, respondents indicated if they morally objected to abortion and if they would help patients obtain … Read more

“Therapeutic” Bed Rest in Pregnancy

December 20, 2016

“Therapeutic” bed rest continues to be used widely, despite evidence of no benefit and known harms. In this commentary, we summarize the Cochrane reviews of bed rest and propose an ethical argument for discontinuing this practice. Cochrane systematic reviews do not support “therapeutic” bed rest for threatened abortion, hypertension, preeclampsia, preterm birth, multiple gestations, or … Read more

Fertility Patients’ Views About Frozen Embryo Disposition

December 20, 2016

OBJECTIVE: To describe fertility patients’ preferences for disposition of cryopreserved embryos and determine factors important to these preferences. DESIGN: Cross-sectional survey conducted between June 2006 and July 2007. SETTING: Nine geographically diverse U.S. fertility clinics. PATIENT(S): 1020 fertility patients with cryopreserved embryos. INTERVENTION(S): Self-administered questionnaire. MAIN OUTCOME MEASURE(S): Likelihood of selecting each of five conventional … Read more

Marking the Fine Line

December 20, 2016

On July 25, 1978 in England, Louise Brown became the first baby born by in vitro fertilization (IVF). Three years later, Elizabeth Carr followed suit as the first “test tube baby” born in the United States. Since then, much has changed in the field of human reproduction. Once reported “with a fervor not seen since … Read more