Each year, hundreds of thousands of pregnant women in the US face
significant medical illness during their pregnancies. Diabetes and
hypertension complicate 40,000+ pregnancies; psychiatric illness
complicates an estimated 500,000; cancer and autoimmune diseases are not
uncommon, and yet we have surprisingly little data about how to safely
and effectively treat these conditions. The pregnant body can
substantially change the ways in which drugs are metabolized; and
concerns about the safety of taking medication must be balanced against
the medical risks—to woman and fetus alike—of undertreating
significant medical disease.
In April of 2009, scholars from Georgetown, Johns Hopkins, and Duke held
a two-day Second Wave workshop to make progress in this challenging area.
Participation included leaders from the NIH, FDA, as well as from
leading academic medical centers. Supported by a
Reflective Engagement from Georgetown, the outcome of the workshop identified barriers,
articulated the costs of ignorance, and proposed consensus proposals
that can immediately begin to make a difference in pregnant women's
health. We also worked over the summer of 2009 with
with Congresswoman Nita Lowey of New York's 18th District
to raise awareness of the issue and resulting in supportive language in the House Committee
Report accompanying the Fiscal 2010 Appropriations for the Departments
of Labor, Health and Human Services and Education.
Resources:
- Second Wave Conference
- Op Ed: Lyerly, A., F. Faden, M. Little, A Custom Drug, New York Times, May 2, 2009
- Lyerly, A., M. Little, F. Faden,Pregnancy Is No Time to Refuse a Flu Shot, New York Times, Sept., 29, 2009
- Little, M., A. Lyerly, R. Faden,Pregnant Women and Medical Research: A Moral Imperative, Bioethica Forum, Vol. 2, no. 2, pp. 60-65.
A few years ago, Annie Lyerly -- an Ob-Gyn and fellow bioethicist -- and I were having yet
another conversation about the
odd ways society deals with the risks associated with reproduction.
These discussions led to formation of The Ob-Gyn Risk Research Group.
The group brings together experts
from medical epidemiology, obstetrics & gynecology, philosophy,
bioethics, gender theory, and the medical humanities, to assess
what is known about risk in women's reproductive lives, and how risks
are communicated and perceived in public policymaking, medical
decisionmaking, and individual choice. This research encompasses a
wide variety of issues, including contraception, prenatal genetic
testing, health management in pregnancy, decisions in delivery, and
breastfeeding.
Working from a perspective that is science-based and
woman-centered, the mission of the group is to bring to light
distortions in perceptions of risk, and to provide a framework for development of medical guidelines.
Members:
- Betsy Armstrong, Ph.D., Department of Sociology, Princeton University.
- Miriam Kupperman, Ph.D. Associate Professor, Primary Dept., Obstetrics, Gynecology and Repro. Sciences, UCSF Medical.
- Rebecca Kukla, Ph.D., Associate Professor of Political Science and Philosophy, Carlton University.
- Maggie Little. That's me.
- Anne Drapkin Lyerly, M.D., Assistant Professor of Obstetrics and Gynecology, Duke University Medical Center.
- Lisa Mitchell, Ph.D., Assistant Professor, Dept. of Anthropology, University of Victoria, British Columbia.
- Lisa Harris, M.D., Lecturer, Division of Maternal-Fetal Medicine, University of Michigan.
In 2001, the faculty senate of Georgetown convened a
task force to explore possibilities for more adequate family
leave for faculty. I served on the committee, chairing it from
2002-2004, as we navigated our way through the complex moral,
political, financial, and legal issues surrounding parental leave. With
the support of the Provost's office, the Main Campus ultimately adopted
a policy providing for paid parental leave for
ordinary—tenure-track and tenured—faculty.
The links below include the Georgetown policy and some
other materials that might be of interest.
