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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

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 … Read more

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 … Read more

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 … Read more

The Meaning of “Control” for Childbearing Women in the US

December 20, 2016

Childbearing women, healthcare providers, and commentators on birth broadly identify control as an important issue during childbirth; however, control is rarely defined in literature on the topic. Here we seek to deconstruct the term control as used by childbearing women to better understand the issues and concepts underpinning it. Based on qualitative interviews with 101 … Read more

Consequences of Smoking During Pregnancy on Maternal Health

December 20, 2016

OBJECTIVE: To estimate the incidence of maternal cardiovascular and pulmonary events and the prevalence of other comorbid conditions among pregnant smokers. METHODS: We queried the Nationwide Inpatient Sample (NIS) from the Healthcare Cost and Utilization Project (HCUP) of the Agency for Healthcare Research and Quality (AHRQ) for pregnancy-related discharge codes for the years 2000-2004. The … Read more

“Doctor, What Would You Do?”

December 20, 2016

Patients making difficult choices among therapeutic options often ask their physicians what they would do if they were in the same situation. When faced with that question, physicians might be concerned that a direct answer could infringe on a patient’s autonomy by substituting the physician’s unique worldview or experience for their patients’. However, refusing to … Read more

Toward an Ethically Responsible Approach to Vaginal Birth After Cesarean

December 20, 2016

Determining approach to delivery after a previous cesarean is among the most contentious areas of obstetrics. We present a framework for ethically responsible guidelines and practice regarding vaginal birth after cesarean. We describe ethical complexities of 3 key issues that mark the debate: the cesarean delivery rate, safety, and patient autonomy. We then describe a … Read more