Tag: birth weight

Bioethics Blogs

In the Journals–March 2017, Part I by Julia Kowalski

Here is Part I of our March article round-up.

American Anthropologist

A Dog’s Life: Suffering Humanitarianism in Port-au-Prince, Haiti

Greg Beckett

In the Bel Air neighborhood of Port-au-Prince, Haiti, most residents are dependent on humanitarian and foreign assistance for food, services, aid, and jobs. Yet, some residents feel that the conditions under which such aid is provided actively blocks their ability to live a life they find meaningful. In this article, I explore how some Haitians theorize this humanitarian condition through the figure of the dog, an animal that exemplifies, for Haitians, the deep history of violence, dehumanization, and degradation associated with foreign rule. I then contrast this with how foreign aid workers invoke the figure of the dog to illustrate their compassionate care for suffering others. Drawing on research among Bel Air residents and foreign aid workers in the years after a devastating earthquake destroyed much of Port-au-Prince, I show how the figure of the dog is central both to Haitian critiques of humanitarian aid and to the international humanitarian imaginary that responds to forms of suffering it deems cruel.

Biosocieties

“Let’s pull these technologies out of the ivory tower”: The politics, ethos, and ironies of participant-driven genomic research

Michelle L. McGowan, Suparna Choudhury, Eric T. Juengst, Marcie Lambrix, Richard A. Settersten Jr., Jennifer R. Fishman

This paper investigates how groups of ‘citizen scientists’ in non-traditional settings and primarily online networks claim to be challenging conventional genomic research processes and norms. Although these groups are highly diverse, they all distinguish their efforts from traditional university- or industry-based genomic research as being ‘participant-driven’ in one way or another.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Contraception and Reproductive Ethics: Constitutional Right vs. Right for the Country

Sophia Yin won the Reproductive Ethics category for our 2016 Bioethics Essay contest.  Our panel of judges thought Sophia’s essay presented a rigorous and clarifying analysis of a contentious and ongoing debate about reproductive rights.  We are pleased to publish Sophia’s essay, below. — The Editors

by Sophia Yin

Though the male condom seems almost ubiquitous in current American society, female contraceptive methods constantly seem to be the subject of controversy. While debates in the twentieth century centered on the legalization of contraception, the discussion now is over who should be required to pay for contraception. This question of funding may seem less pressing than the question of legality, however, ability to pay is directly tied to access: women who cannot afford contraception cannot freely use it. Though many supporters frame their case in terms of an infringement of women’s rights, this argument is inherently weak. Women should have open access to contraception regardless of whether they have the right to it. The issue of women’s access to contraception is most often viewed through a legal lens, but it should be discussed in terms of its benefits to public health.

Supporters of access to contraception argue that women have a right to contraception. This argument is based upon the rulings of Griswold v. Connecticut, in which the Supreme Court ruled that states cannot outlaw the use of contraception by married couples because of “the zone of privacy created by several fundamental constitutional guarantees.” Though the ruling did not directly state that women had a right to contraception, it did create a right to privacy in reproductive matters for married couples, which allowed them the freedom to decide, without state interference, whether they would like to use contraception.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

In the Journals – December 2016, Part I by Livia Garofalo

Here is the first part of our December article roundup. Three journals have special issues this month (abstracts in the post below):

Enjoy reading (and what’s left of the holidays)!

American Anthropologist

The Contingency of Humanitarianism: Moral Authority in an African HIV Clinic

Betsey Behr Brada

One consequence of the recent expansion of anthropological interest in humanitarianism is the seeming obviousness and conceptual stability of “humanitarianism” itself. In this article, I argue that, rather than being a stable concept and easily recognizable phenomenon, humanitarianism only becomes apparent in relation to other categories. In short, humanitarianism is contingent: it depends on circumstance and varies from one context to another. Furthermore, its perceptibility rests on individuals’ capacity to mobilize categorical similarities and distinctions. One cannot call a thing or person “humanitarian” without denying the humanitarian character of someone or something else. Drawing on research conducted in clinical spaces where Botswana’s national HIV treatment program and private US institutions overlapped, I examine the processes by which individuals claimed people, spaces, and practices as humanitarian, the contrasts they drew to make these claims, and the moral positions they attempted to occupy in the process. More than questions of mere terminology, these processes of categorization and contradistinction serve as crucibles for the larger struggles over sovereignty, inequality, and the legacies of colonialism that haunt US-driven global health interventions.

Scripting Dissent: US Abortion Laws, State Power, and the Politics of Scripted Speech

Mara Buchbinder

Abortion laws offer a point of entry for “the state” to intervene in intimate clinical matters.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

For IVF Embryos, Lab Chemicals Can Have Lasting Effects

August 25, 2016

(STAT News) – The different types of goop that embryos are grown in during in vitro fertilization could play a part in how well the process works — and how babies conceived through IVF fare after birth, too. A new study — the first to randomly assign embryos to culture media — finds that the substrate used could affect the number of viable embryos created, pregnancy rates, and birth weight. There are around 20 different substrates used in clinics around the world. Fertility experts now say they want companies who make those compounds to clearly label the ingredients so scientists can parse out the differences.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

Are Babies Born via ART More Likely to Have Birth Defects?

June 21, 2016

(Medscape) – The authors studied the frequency of birth defects among liveborn infants in three states over a 10-year period and evaluated the impact of ART use. Various linked databases were used for data collection. The prevalence of chromosomal (chromosomes 13, 18, and 21) and nonchromosomal birth defects of specific organ systems were compared. Maternal age, race, education, parity, history of diabetes, hypertension, smoking status, plurality of pregnancy, infant sex, birth weight, and gestational age at delivery were adjusted for during the analysis. Subgroup analysis was carried out for types of ART procedures.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Technologies of Care: Administering Donated Breast Milk in a South African Neonatal Intensive Care Unit by Miriam Waltz

This is the third installment of the series from the University of Cape Town’s First Thousand Day Research Group. My research traces out the pathways of donated milk from donor to recipient in a state neonatal unit in South Africa (Waltz 2015), to show how care and technologies are interwoven in complex and sometimes surprising ways.

Breastfeeding is widely seen as the best infant feeding option for mother and baby. The dominant discourse in both the public and the medical realm presents breastfeeding as a natural behaviour, best for babies, best for mums. In a recent series, The Lancet claims that increasing breastfeeding worldwide could prevent over 800,000 child deaths every year (Victora et al. 2016). This position is reflected in state policy and official declarations of the World Health Organisation (WHO) and UNICEF. In South Africa, after a decade of promoting the use of formula milk to offset possible vertical (mother to child) HIV transmission, the state re-committed to facilitating breastfeeding in the Tshwane declaration of August 2011 (see also Doherty et al. 2010 for the revised WHO guidelines on breastfeeding). Breast milk is even more important in the case of premature or low birth weight babies, who are highly susceptible to necrotising enterocolitis, (a serious gastrointestinal condition) if fed on formula milk (Neu and Walker 2011). Here, breast milk is critical in securing life; ‘breast is best’ (Murphy 1999). Where the birth mother’s breast milk is not available, donated breast milk is the best alternative.

My research on the milk’s trajectories was wide-ranging. I interviewed donor mothers; members of milk banks associated with the collection, testing, packaging and distribution of donated milk; hospital staff responsible for its prescription and distribution; and mothers whose infants were receiving donated milk.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Largest Study Yet Shows Mother’s Smoking Changes Baby’s Epigenome

Credit: Daniel Berehulak/Getty Images

Despite years of public health campaigns warning of the dangers of smoking when pregnant, many women are unaware of the risk or find themselves unable to quit. As a result, far too many babies are still being exposed in the womb to toxins that enter their mothers’ bloodstreams when they inhale cigarette smoke. Among the many infant and child health problems that have been linked to maternal smoking are premature birth, low birth weight, asthma, reduced lung function, sudden infant death syndrome (SIDS), and cleft lip and/or palate.

Now, a large international study involving NIH-supported researchers provides a biological mechanism that may explain how exposure to cigarette toxins during fetal development can produce these health problems [1]. That evidence centers on the impact of the toxins on the epigenome of the infant’s body tissues. The epigenome refers to chemical modifications of DNA (particularly methylation of cytosines), as well as proteins that bind to DNA and affect its function. The genome of an individual is the same in all cells of their body, but the epigenome determines whether genes are turned on or off in particular cells. The study found significant differences between the epigenetic patterns of babies born to women who smoked during pregnancy and those born to non-smokers, with many of the differences affecting genes known to play key roles in the development of the lungs, face, and nervous system.

In recent years, several smaller studies have provided evidence that maternal smoking can have epigenetic effects on an unborn child [2, 3, 4].

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Introduction: The First Thousand Days of Life by Michelle Pentecost

(On behalf of the First Thousand Days Research Group (University of Cape Town))

“Good nutrition in the first 1000 days between a woman’s pregnancy and her child’s second birthday sets the foundation for all the days that follow.”

– ThousandDays.org

“The First 1,000 Days of being a parent are now accepted to be the most significant in a child’s development.”

– National Childbirth Trust, UK

“Researchers have identified the first 1,000 days of a child’s life—from pregnancy through a child’s 2nd birthday—as a critical window of time that sets the stage for a person’s intellectual development and lifelong health.”

– Lucy Sullivan, National Healthy Mothers, Healthy Babies Coalition

 

The focus of this series is the “the first thousand days”, a new field of enquiry that is radically reshaping understandings of health and heredity, with material consequences for policy, publics and concepts of life. The thousand days between conception and a child’s second birthday is presented in contemporary epidemiology and public media, shaped by new knowledge in neuroscience, epigenetics and Developmental Origins of Health and Disease (DoHaD) research, as a critical period that determines future health and potential. This imaginary – as captured by the excerpts from non-governmental organizations above – has been the object of study for The First Thousand Days Research Group at the University of Cape Town, chaired by Professor Fiona Ross, since mid-2013. Under the rubric of “the first thousand days”, we have conducted ethnographic research across a set of inter-related themes to interrogate the logics and implications of this imaginary. The sites of our research include antenatal clinics, soup kitchens, laboratories of reproductive technologies, places of worship, neonatal units, breast milk banks, middle class settings and informal settlements.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

IVF twins. Monochorionic twins higher risks

Approximately 7.2% of pregnancies achieved through in-vitro fertilisation (IVF twins) are monochorionic twins pregnancies. Since these type of embryos have a higher risk of preterm birth and low birth weight in particular (Fertility and Sterility 104; 629-632, 2015), there seems little doubt that they should try to reduce their number, perhaps by promoting single embryo transfer in each procedure.

La entrada IVF twins. Monochorionic twins higher risks aparece primero en Observatorio de Bioética, UCV.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

The Ethics of Human Milk Exchange and Sale

Robyn Lee critiques the inequalities and social injustices that surround human milk exchange practices.

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Public milk banks provide human milk for premature infants because compared to formula feeding it is associated with lower rates of serious intestinal disease, a leading cause of illness and death. While public milk banks are very common in some countries, such as Brazil, there are only four currently operating in Canada. These are in Vancouver, Calgary, Toronto, and Montreal.

Public milk banks in Canada and the United States, are undersupplied and unable to meet high demand. As a consequence of widespread awareness of the benefits of human milk, some parents are trying to source human milk online through informal exchanges http://www.onlythebreast.com/; http://www.eatsonfeets.org/; http://hm4hb.net/. Public health agencies in Canada and the U.S. (along with national pediatric associations in those countries) have taken a strong position against any human milk exchange outside of milk banks, warning parents of the risks posed by transmission of pathogens and chemical residues. Nevertheless, the practice of human milk exchange is growing in popularity.

While some human milk exchange online forums such as “Human Milk for Human Babies” are based on sharing, others like “Only the Breast” also involve the sale of breast milk. Human milk has been described as “liquid gold” and costing “more than sushi” in media accounts because of its scarcity and high value. Human milk is becoming commodified and the high cost of obtaining milk may mean that access will be determined by socioeconomic status.

American biotech companies such as Prolacta Bioscience and Medolac have been processing human milk in order to create consumer products.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.