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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 … Continued

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 … Continued

“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 … Continued

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 … Continued

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 … Continued

Ethical Dilemmas in Women’s Health in Under-Resourced Settings

December 20, 2016

Ethical decision making in women’s health presents a series of unique challenges that are exacerbated considerably in under-resourced settings. Severe constraints on both autonomy and resources highlight limitations of principle-based ethics for addressing ethical dilemmas. Other useful ethical “tools” are considered in the context of 2 cases that emphasize the challenges to ethical decision making … Continued

Decisional Conflict and the Disposition of Frozen Embryos

December 20, 2016

BACKGROUND: Fertility patients often struggle with decisions about disposition of embryos remaining after fertility treatment. We aimed to identify predictors and correlates of decisional conflict among patients facing these decisions. METHODS: We analyzed results from a survey of 2210 patients from nine geographically diverse US fertility clinics. The main outcome measure was decisional conflict about … Continued

Moving Forward With Research Involving Pregnant Women

December 20, 2016

Each year, hundreds of thousands of women in the United States confront significant medical illness while pregnant: Hypertension, diabetes, serious psychiatric illnesses, autoimmune diseases such as arthritis and lupus, and even cancers complicate pregnancies. Yet we face a critical dearth of information about how to treat them. Little is known about how drugs work in … Continued