Double Dose: Pregnant Drug Users Arrested in Alabama; New Book on Global Birth Control; A Real Conversation on the CDC Study on STIs; Most Competitive Medical Residencies Are ...

By Christine Cupaiuolo — March 23, 2008

Alabama’s Response to Pregnant Drug Users: “Two worlds are colliding in this piney woods backcountry in southern Alabama: casual drug use and a local district attorney unsettled that children or fetuses might be affected by it. The result is an unusual burst of prosecutions in which young women using drugs are shocked to find themselves in the cross hairs for harming their children, even before giving birth,” reports The New York Times. The story continues:

Over an 18-month period, at least eight women have been prosecuted for using drugs while pregnant in this rural jurisdiction of barely 37,000, a tally without any recent parallel that women’s advocates have been able to find. The district attorney, Greg L. Gambril, acknowledges the number puts him at the “forefront,” at least among Alabama prosecutors. Similar cases have come up elsewhere, usually with limited success. But Alabama, and in particular this hilly, remote terrain just above the Florida Panhandle, is pursuing these cases with special vigor.

The National Advocates for Pregnant Women has published an excellent, comprehensive response that begins: “We were pleased that it did not use such stigmatizing and scientifically baseless terms as ‘crack’ and ‘meth’ baby. We were disappointed though that the story did not quote any experts in the field.”

Birth Control for Others: In a review of Matthew Connelly’s new book, “Fatal Misconception: The Struggle to Control World Population,” Nicholas Kristof writes that Connelly, an associate professor of history at Columbia University “carefully assembles a century’s worth of mistakes, arrogance, racism, sexism and incompetence in what the jacket copy calls a ‘withering critique’ of ‘a humanitarian movement gone terribly awry.'”

Kristof adds:

Critics of family planning programs will seize gleefully upon this book, and that’s unfortunate, because two propositions are both correct: first, population planners have made grievous mistakes and were inexcusably quiet for too long about forced sterilization in countries like India and China; and second, those same planners have learned from past mistakes and today are fighting poverty and saving vast numbers of lives in developing countries.

“Fatal Misconception” is to population policy what William Easterly’s “White Man’s Burden: Why the West’s Efforts to Aid the Rest Have Done So Much Ill and So Little Good” (2006) was to foreign aid: a useful, important but ultimately unbalanced corrective to smug self-satisfaction among humanitarians. Connelly scrupulously displays a hundred years of family planners’ dirty laundry, but without adequately emphasizing that we are far better off for their efforts. One could write a withering history of medicine, focusing on doctors’ infecting patients when they weren’t bleeding them, but doctors are pretty handy people to have around today. And so are family planners.

An Epidemic No One Wants to Talk About: “A much-publicized study from the Centers for Disease Control and Prevention this month highlighted the high rates of sexually transmitted diseases among teenage Americans. But for those of us who work in public health, this ‘news’ is already old,” begins this Washington Post op-ed by three medical experts who argue convincingly for discussions that address race and poverty and other social conditions underpinning high rates of HIV and STIs in some communities.

For one thing, women in poor African American communities who engage in the lowest levels of risk behavior are dramatically more likely to acquire STDs than higher-risk women in communities with low background rates of infection. Where you live and choose sexual partners has an enormous impact on your risk, particularly if it is in a community with high incarceration rates. Imprisonment changes community male-female ratios, and these unbalanced numbers contribute to low marriage rates, a reluctance to negotiate “safe sex,” formation of concurrent partnerships and the maintenance of STDs within the networks in which members choose partners.

Simply put, we will never rid the United States of HIV and other STDs if our only weapon is medical treatment. And if we are unable to engage in a national dialogue about the sexual health of our youths and the social dynamics that drive STDs, this epidemic will go largely ignored, and many more lives will be lost.

The CDC study is covered here. Read the full op-ed at the Washington Post.

HHS Challenges ACOG Ethics Opinion: Daily Women’s Health Policy Report has a nice round-up of information concerning an NPR report on the Bush administration’s criticism of an ethics opinion released last year by the American College of Obstetricians and Gynecologists that calls on physicians to provide referrals for patients seeking abortions, emergency contraception or other procedures if they are opposed to providing the service themselves.

NPR’s “Morning Edition” covered the issue in two parts last week.

Voices from the Sidelines: “To begin with, both those of us who oppose and those who support legal abortion agree that there’s unbearably little nuance in the public conversation on reproductive rights,” writes Anna Clark at RH Reality Check. “But that’s only the beginning of our common ground. While not one national anti-choice organization supports contraception or science-based sexuality education, many individuals who oppose legal abortion are making the connections on their own: birth control and education reduce the rate of unintended pregnancy and abortions.”

Targeting Health Disparities: What’s the connection between living in disadvantaged neighborhoods and early onset breast cancer? University of Chicago researchers are trying to find out. According to a release, “researchers are studying 230 black women with newly diagnosed breast cancers living in predominantly black Chicago neighborhoods to learn about environmental factors, such as neighborhood features that might lead to social isolation.”

Who Wants to Work in an Attractive Field?: “As thousands of medical students await word this week on residency programs, two specialties concerned with physical appearance — dermatology and plastic surgery — are among the most competitive,” reports The New York Times. “The vogue for such specialties is part of a migration of a top tier of American medical students from branches of health care that manage major diseases toward specialties that improve the life of patients — and the lives of physicians, with better pay, more autonomy and more-controllable hours.”

A Plea for Reading the Original Sources: Or, a manual to ending poorly researched stories about the differences between men and women’s brains. Mark Liberman has the breakdown. Via Feminist Law Professors.

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