Among the most controversial of medical issues is the resuscitation of newborns that are unlikely to survive. The Born-Alive Infants Protection Act (BAIPA), enacted in 2002, and the enforcement guidelines later issued by the United State’s Department of Health and Human Services (DHS) outlined clinical procedures to be used in the resuscitation and care of infants born between 20 and 24 weeks gestation. (A normal, full-term pregnancy is 37 to 42 weeks of gestation.) This act has gained remarkably limited attention, and many neonatologists are not familiar with the act or DHS guidelines concerning its enforcement. A recent study published in Pediatrics suggested that most neonatologists surveyed did not agree with the legislation, but that it did have the power to change medical practice if it was enforced. Read more →

Emergency contraception (EC) has been available in the United States for almost a decade. It is a safe and effective contraceptive choice when other methods have failed or have not been used and a pregnancy is not desired. Still, many barriers exist to the prompt and reliable provision of EC to appropriate patients. While the ethical battle concerning EC will likely never cease, these concerns do not represent the greatest barriers to appropriate EC access. Read more →

Diabetes in pregnancy is associated with increased morbidity for the mother and the infant. Complications of pregnancy-related diabetes include birth defects, congenital abnormalities, shoulder dislocation during delivery, cesarean delivery, excessive fetal weight and head size, and hypertension. Risk factors for gestational diabetes, or glucose intolerance first diagnosed in pregnancy, include advanced maternal age, overweight or obesity prior to pregnancy, family history of diabetes, and belonging to an ethnic group with a high prevalence of diabetes (African American, Native American, Hispanic, South or East Asian, or Pacific Islander.) A new study published in the Journal of the American Medical Association finds that in addition to the well-known complications of diabetes during pregnancy, women with gestational diabetes are more likely to experience depression during and after pregnancy. Read more →

Like many of you, I have watched as the world has been captivated by the birth of the octuplets to Nadya Suleman. To say that this case has opened heated debates on the ethical and psychological issues related to in vitro fertilization (IVF) would be a gross understatement. What makes this case especially newsworthy is the fact that Ms. Suleman not only has a total of 14 children, all with the help of IVF, but is also single and unemployed.

This is not the first octuplet birth to rock the medical community worldwide. In London 12 years ago the The Lancet produced an editorial on the story of Mandy Allwood. That case was also interesting for its many ethical questions: Ms. Allwood was secretly taking fertility drugs without medical supervision or informing her significant other. Read more →

Most people know the “typical” eating disorder patient: adolescent girl, over-achiever, perfectionist. This is an accurate description, since most patients with diagnosed eating disorders and patterns of disordered eating are females between the ages of 10 and 20. Currently, it is estimated that 1% of adolescent girls have anorexia. Nearly 30% of adolescent girls have disordered eating attitudes and behaviors, while not meeting the criteria for diagnosis of an eating disorder. Read more →

It has been known for years that babies in utero (womb) suffer ill effects from their mothers’ exposure to tobacco, drugs and alcohol. A new study funded by the National Institute on Drug Abuse and performed by Michael Rivkin of Children’s Hospital Boston showed that children exposed to these toxins may suffer effects well into early adolescence.

Using MRI technology, the study looked into the long term effects of prenatal exposure to drugs, alcohol, tobacco or a combination of the three on the brain structure of preteens. The study found that these kids have thinner cortical grey matter than subjects who did not suffer exposure to toxins in utero. This study also showed a reduction in brain volume directly tied to this exposure. Read more →