Reproductive Rights Prof Blog

Researchers Closer to Predicting Pregnancy from IVF

San Jose Mercury News: Predicting pregnancy odds, by Vianna Davila:

Stanford University researchers said they are one step closer to accurately predicting if in vitro fertilization will result in pregnancy, according to a study released Tuesday.

The study, published in the Public Library of Science journal, identifies factors that will indicate with 70 percent accuracy the chances of pregnancy after a single round of in vitro fertilization, or IVF.

How Not to Get Teens to Take Pregnancy Seriously

ABC Family seems to have come up with a very lame response to recent concerns about teenage pregnancy.  And, as in every American movie of late to confront unintended pregnancy, abortion continues to be the big shameful "a-word" that must not be uttered....  (from the review: "[The pregnant teen's] friends tell her she has options, but abortion is apparently not one of them; that choice is dismissed right away in horrified tones.") (more on that topic here).

NY Times: A Teenage Pregnancy, Packaged as a Prime-Time Cautionary Tale, by Alessandra Stanley:

No one seems to know for sure whether all those high school girls in Gloucester, Mass., had a secret pregnancy pact. But “The Secret Life of the American Teenager” must surely be the collective effort of an anti-pregnancy cabal....

At a time when hit movies like “Juno” and “Knocked Up” celebrate the lighter side of unprotected sex and the celebrity press has recently been filled with belly shots of Jamie Lynn Spears, it’s not surprising that purveyors of pop culture feel compelled to send a corrective message to young viewers. NBC is doing its part with a reality show, “Baby Borrowers,” that assigns teenage couples babies to raise by themselves full time to discover what parenthood is really like. ABC Family chose a more traditional drama format and then promptly forgot who its audience is.

NY Times Magazine Examines Declining Population in Europe

NY Times Magazine cover story: No Babies?, by Russell Shorto:

...In the 1990s, European demographers began noticing a downward trend in population across the Continent and behind it a sharply falling birthrate. Non-number-crunchers largely ignored the information until a 2002 study by Italian, German and Spanish social scientists focused the data and gave policy makers across the European Union something to ponder. The figure of 2.1 is widely considered to be the “replacement rate” — the average number of births per woman that will maintain a country’s current population level. At various times in modern history — during war or famine — birthrates have fallen below the replacement rate, to “low” or “very low” levels. But Hans-Peter Kohler, José Antonio Ortega and Francesco Billari — the authors of the 2002 report — saw something new in the data. For the first time on record, birthrates in southern and Eastern Europe had dropped below 1.3. For the demographers, this number had a special mathematical portent. At that rate, a country’s population would be cut in half in 45 years, creating a falling-off-a-cliff effect from which it would be nearly impossible to recover. Kohler and his colleagues invented an ominous new term for the phenomenon: “lowest-low fertility.”...

Supreme Court to Consider Pregnancy Leave Case

Wash. Post: High Court to Take Up Pregnancy Leave Case, by Christopher Twarowski:

Noreen Hulteen gave birth to a daughter, Rachael, in 1968, when she was 34. While on maternity leave, she required surgery and wound up missing 240 days of work. Hulteen, 74, contends that her employer, Pacific Bell -- now AT&T -- did not properly weigh her pregnancy leave into her retirement and other benefits. Yesterday, the U.S. Supreme Court agreed to review the issue in a case that could affect thousands of women who are near or at retirement age.

Gloucester Mayor Denies Teen "Pregnancy Pact"

Reuters: Mayor in Massachusetts city denies pregnancy "pact", by Jason Szep:

The mayor of a Massachusetts city that drew attention for a spike in teenage pregnancies denied on Monday a media report that a group of girls entered a pact to become pregnant.

Experts Concerned By Recent Spate of Teen Pregnancies

Baltimore Sun: Babies As Something Fun, by Susan Reimer:

The head of the National Campaign to Prevent Teen and Unplanned Pregnancy is outraged that for many teens,'having a baby is ... about the same as getting a tattoo'

June 22, 2008

Teen pregnancy news has gone from the mundane to the sensational.

Recent data show that the declines in teen sex and improvements in contraceptive use have leveled off and that the teen birth rate is on the rise for the first time in 15 years.

Unfortunately, that news generated not much more than yawns.

See also this statement by the National Campaign on Jamie Lynn Spears' becoming a teenage mother. 

MTV Newsroom also has a recent article on teen pregnancies: Jamie Lynn Spears Birth, Teen Pregnancy Increase Concern Experts: ‘Babies Need And Deserve Adult Parents’

The Skyrocketing Cost of Care for Preemies

BusinessWeek: Million-Dollar Babies, by Spencer Ante:

The cost of care for preemies is sky-high—some 15 times the expense of full-term infants and rising. Is there such a thing as too young?

...Preemies are a quickly expanding class of patients in the U.S., Britain, and other advanced nations. And the costs and technical challenges of caring for them are a growing source of controversy. Nearly 13% of all babies in the U.S. are preemies, a 20% increase since 1990. A 2006 report by the National Academy of Sciences found that the 550,000 preemies born each year in the U.S. run up about $26 billion in annual costs, mostly related to care in NICUs. That represents about half of all the money hospitals spend on newborns. But the number, large as it is, may understate the bill. Norman J. Waitzman, a professor of economics at the University of Utah who worked on the National Academy report, says the study considered just the first five years of the preemies' lives. Factor in the cost of treating all of the possible lifelong disabilities and the years of lost productivity for the caregivers, and the real tab may top $50 billion, Waitzman says.

...Does this relentless push to care for ever younger infants serve the interests of the babies, their parents, or society? Critics of the trend note that about one-third of preemies suffer from severe disabilities such as cerebral palsy, chronic lung disease, and blindness. A 2006 report from the Nuffield Council on Bioethics, an independent British group, recommended that preemies struggling for their lives after 22 weeks of gestation should not be given intensive care.

Gloucester, MA: "Pregnancy Pact" Explains Startling Increase in Pregnant Teens

TIME: Pregnancy Boom at Gloucester High, by Kathleen Kingsbury:

As summer vacation begins, 17 girls at Gloucester High School are expecting babies—more than four times the number of pregnancies the 1,200-student school had last year. Some adults dismissed the statistic as a blip. Others blamed hit movies like Juno and Knocked Up for glamorizing young unwed mothers. But principal Joseph Sullivan knows at least part of the reason there's been such a spike in teen pregnancies in this Massachusetts fishing town. School officials started looking into the matter as early as October after an unusual number of girls began filing into the school clinic to find out if they were pregnant. By May, several students had returned multiple times to get pregnancy tests, and on hearing the results, "some girls seemed more upset when they weren't pregnant than when they were," Sullivan says. All it took was a few simple questions before nearly half the expecting students, none older than 16, confessed to making a pact to get pregnant and raise their babies together. Then the story got worse. "We found out one of the fathers is a 24-year-old homeless guy," the principal says, shaking his head.

Rare pregnancy of weedy sea dragon at Georgia aquarium

Yes, this blog usually focuses on human reproduction.  But I do love the weedy sea dragon.  Plus, isn't it cool that male sea dragons (and seahorses) are the ones who give birth? 

Associated Press: Rare pregnancy of weedy sea dragon at US aquarium:

ATLANTA: The Georgia Aquarium is celebrating a rare occurrence: a weedy sea dragon at the aquarium is pregnant.

It is only the third time ever that such a creature has been pregnant at a U.S. aquarium, aquarium officials said.

Sea dragons are one of the very few species — along with sea horses and pipe fish — in which the male carries the eggs, said Kerry Gladish, a biologist at the aquarium.

Gloucester stymied by rise in teen pregnancy

Boston Globe: Gloucester stymied by rise in teen pregnancy, by Tania deLuzuriaga:

Kim Daly sensed something was amiss in this seaside community during the first month of school last fall after several girls came to the school health clinic she runs at Gloucester High School asking for pregnancy tests.

Each time, Daly stood in her lab with her eyes closed, little white wand in hand waiting for the results to appear. When they were negative, she breathed a sigh of relief. When they were positive, she braced herself for the unpredictable emotional response that comes with telling a teenager she's going to be a mother. Some girls broke down in tears. Others broke into smiles. One exclaimed, "Sweet!"

By October, Daly had delivered positive results to as many girls as she typically does in an average year. By May, she knew of 17 girls who were pregnant, more than four times the number the 1,162-student school had the year before.

The spike has shocked and baffled education and health officials here and reignited a fierce debate about contraception in schools. But most alarming to education and health officials is the fact that a significant portion of the pregnancies are occurring in girls 16 and younger and that some seem to be intentional.

Past Cesarean Can Mean Higher Health Insurance Premiums

NY Times: After Caesareans, Some Women See Higher Insurance Cost, by Denise Grady:

When the Golden Rule Insurance Company rejected her application for health coverage last year, Peggy Robertson was mystified.

“It made no sense,” said Ms. Robertson, 39, who lives in Centennial, Colo. “I’m in perfect health.”

She was turned down because she had given birth by Caesarean section. Having the operation once increases the odds that it will be performed again, and if she became pregnant and needed another Caesarean, Golden Rule did not want to pay for it. A letter from the company explained that if she had been sterilized after the Caesarean, or if she were over 40 and had given birth two or more years before applying, she might have qualified....

With individual insurance, unlike the group coverage usually sponsored by employers, insurance companies in many states are free to pick and choose the people and conditions they cover, and base the price on a person’s medical history. Sometimes, a past Caesarean means higher premiums.

Woman Carries Ectopic Pregnancy to Term

BBC News:  Ovary baby survives against odds:

A woman in Australia has given birth to a healthy baby girl after a rare full-term ectopic pregnancy.

Against all odds, baby Durga survived despite developing in her mother's ovary instead of her uterus. 

Her mother Meera Thangarajah, 34, had shown no signs of abnormality and doctors only realised when they performed a Caesarean section. 

Most ectopic pregnancies end in miscarriage or are terminated early because of the risk to the mother.

With an ectopic pregnancy, the embryo can rupture the fallopian tube, leading to massive internal bleeding - and possibly death - for the mother.

FDA Proposes Drug Label Changes Related to Pregnancy

Wash. Post/HealthDay News: FDA Proposes New Drug Labels for Pregnant Women, by Steven Reinberg:

WEDNESDAY, May 28 (HealthDay News) -- U.S. health officials proposed Wednesday changes to the labels on prescription drugs that would detail potential health effects for pregnant and breast-feeding women, their fetuses or their newborns.

If enacted, the new system, proposed by the U.S. Food and Drug Administration, would provide doctors and pharmacists with more comprehensive information to guide them in their prescribing practices....

The proposed system would replace the current system that relies on letter designations to describe the risks of a drug when taken during pregnancy or breast-feeding. This system was deemed confusing and incomplete.

The Importance of Contraception in Humanitarian Emergencies

United Nations Population Fund: Contraception Can Save Lives in Humanitarian Emergencies, by Shannon Egan:

In Afghanistan, where fertility and maternal death rates are among the highest in the world, restricted access to certain conflict areas makes it nearly impossible to deliver contraceptives to woman who would like to have fewer and safer pregnancies. After natural disasters, supply chains are often disrupted. And in Darfur women and young people trying to locate family planning services and information may wind up as survivors of sexual violence or worse: dead.

Stress During Pregnancy May Increase Babies' Risk of Asthma, Allergy

Wash. Post/HealthDay: Mom's Stress in Pregnancy May Up Baby's Asthma and Allergy Risk, by Serena Gordon:

If an expectant mother is exposed to high levels of stress, her baby may be more likely to develop asthma or allergies later in life, new research suggests.

Babies born to mothers experiencing high levels of stress had more IgE in their blood at birth than did babies born to less-stressed moms. IgE is an antibody involved in allergic and asthmatic reactions.

"Moms who had elevated levels of stress had children who seemed to be more reactive to allergens, even when exposed to low levels of allergens," said study co-author Dr. Rosalind Wright, an assistant professor of medicine at Brigham and Women's Hospital and Harvard Medical School in Boston.

Victory in the Regina McKnight Case

Via the ACLU Blog:

Earlier this week, the South Carolina Supreme Court unanimously ruled that Regina McKnight, a woman convicted in 2001 of homicide after suffering a stillbirth and admitting to cocaine usage, did not have a fair trial. In so doing, the court recognized that McKnight's counsel failed to make use of existing evidence that could have shown that factors other than McKnight's drug use could have caused the stillbirth.

The court's ruling has significant import for the dozens of pregnant women in the United States each year that, like McKnight, are criminally charged for continuing their pregnancies to term despite their struggles with drug addition. (A recent New York Times article profiles several such women and their prosecutions in Alabama.)

While courts in other states have routinely rejected prosecutions of pregnant, drug-using women, they have not addressed the question of whether pre-natal exposure to substances causes harm to the fetus.

S.C. Supreme Court Overturns Mother's Homicide Conviction for Drug Use During Pregnancy

MyrtleBeachOnline: High court overturns mother's conviction, by Kelly Marshall Fuller and Janelle Frost:

The S.C. Supreme Court on Monday overturned a conviction that sent a Conway woman to prison for 12 years.

The court ruled that Regina McKnight, who was convicted in 2001 of homicide by child abuse after being accused of killing her unborn child with cocaine, must be granted a new trial.

McKnight gave birth to a stillborn, 5-pound girl May 15, 1999. The baby's age was estimated at between 34 and 37 weeks.

McKnight's first trial, in January 2001, ended in a mistrial. Four months later, a jury convicted her.

Monday's decision means that case will be remitted to the 15th Circuit Solicitor's office within 30 days, Solicitor Greg Hembree said....

In January 2003, the S.C. Supreme Court upheld McKnight's conviction. The U.S. Supreme Court then refused to hear her case.

Read the decision. 

Students Experience Simulated Pregnancy and Parenting

Atlanta Journal-Constitution: Playing at pregnancy: Students get parenting lesson, by Aileen Dodd:

Other students whispered and stared as Dacula High School senior Lindsay Holbrook waddled down the hall with a round belly peeking through a cotton maternity shirt.

Pregnant before graduation? What a shame.

"A lot of people in the hallway thought it was real," Holbrook said. "They were like, 'Are you pregnant?' And I was like 'No, it's for a class project.' "

The "Responsible Parenting" class aims to prevent teenage pregnancy by giving students a "real-life" parenting experience.

Students – girls and guys – don a 30-pound pregnancy "empathy belly" containing metal balls floating in water to simulate the movement of a baby in amniotic fluid. They also walk around with a pouch of sand pressing down on their bladders like a real growing fetus would....

After lessons on labor, delivery and child care, students face the ultimate challenge – they take a newborn baby home overnight or for a weekend stay.

Gene Linked to Preeclampsia

ScienceDaily: Clues Into How Preeclampsia May Surface In Some Pregnancies:

The COMT gene -- known already for its role in schizophrenia -- has been found to play a role in preeclampsia, according to a report in today's advance on-line issue of Nature.

Led by researchers at Beth Israel Deaconess Medical Center (BIDMC), the study further suggests that a steroid molecule, 2-ME, may serve as both a diagnostic marker and therapeutic supplement for the treatment of this dangerous pregnancy disorder.

Characterized by hypertension, proteinuria, and edema, preeclampsia affects approximately 5 percent of all pregnancies worldwide, and is a leading cause of maternal and neonatal morbidity. Knowing that placental hypoxia, or oxygen shortage, associated with vascular dysfunction, is a hallmark of the condition, senior author Raghu Kalluri, PhD and his colleagues began by screening for genes that regulate hypoxia.

South Sudan Has World's Highest Maternal Mortality Rate

Not a happy mother's day story.  Reuters: Battling to take death out of birth in Africa, by Skye Wheeler:

JUBA, Sudan, May 11 (Reuters) - Lying on a sagging mattress and wincing slightly, Anna Lado laughs at the idea that she should have been afraid of giving birth to her first child, now lying in a crib near her in a hospital in south Sudan.

"It's natural," she smiles.

But in fact, she received a life-saving caesarean in the capital Juba's teaching hospital: a relatively rare operation in south Sudan where one in 50 women die in childbirth, the world's highest maternal mortality rate.

Special Schools for Pregnant Teens

Christian Science Monitor: Special schools for pregnant girls?, by Ben Arnoldy (4/30):                        

Boise, Idaho - Soon after getting pregnant, high school sophomore Alicia Mattocks worried that bullies might purposely slam her into a locker and that a teacher's rules wouldn't allow frequent bathroom runs.       

But it was the thought of not having to go to school quite so early, when she felt her worst, that pushed her to transfer to the Marian Pritchett School, an alternative public school in Boise for pregnant and parenting students. That decision, she says, saved her from dropping out.

A senior now, she plasters her binders with photos of her son, Ryder. This June, she'll mark another milestone: On her head will be a tasseled square cap.       

Pritchett school, however, faces a funding shortfall because state grants that fund it have dried up. Separate schools for pregnant teens have dwindled in recent years because of concern for educational equality, budget constraints, and changing social mores.

See also this post regarding the closing last year of special schools for pregnant teenagers in New York.  One reader asked whether such schools pose a Title IX problem.  Here's the response I posted (regarding the New York schools):

That's a good question. As the article points out, "Title IX of the Education Amendments of 1972 stated that schools were allowed to create separate educational programs for pregnant students but that they must be of comparable quality to standard high schools."

While these schools were formed in the '60s when pregnant girls were being forced out of ordinary schools, obviously Title IX made that practice illegal, although the schools could still provide alternative education for pregnant girls who chose it. It seems that given the inferior education the schools were providing, however, they were not complying with the spirit of Title IX.

Pregnant girls have continued to face discrimination in New York and elsewhere, including exclusion from programs like the National Honor Society, and it is important for pregnant students and their families to understand that this is illegal.

UPDATE/CORRECTION (5/13):  Apologies for a prior link to an NYCLU publication on pregnant and parenting teens that no longer worked.  The following publications from the NYCLU Reproductive Rights Project are available online:

• Booklet: The Rights Of Pregnant And Parenting Teens (2006)
• Palm Card: Your Rights As A Pregnant Or Parenting Teen (2007) (also available in Spanish)

Thanks to Southern Students for Choice - Emory for providing the links to these publications.

Government Survey Shows Early Breast-Feeding at All-Time High

New York Times: More Mothers Breast-Feed, in First Months at Least, by Gardiner Harris:

About 77 percent of new mothers breast-feed their infants at least briefly, the highest rate seen in the United States in more than a decade, according to a government survey released on Wednesday.

In 1993 and 1994, just 60 percent of new mothers breast-fed their babies, but rates have been gradually rising ever since, according to regular surveys by the Centers for Disease Control and Prevention.

“The report shows that the initiation of breast-feeding is at an all-time high,” said Karen Hunter of the disease centers.

Breast-feeding experts said that they were cheered by the report’s numbers but noted that rates of breast-feeding at 6 months of age have remained unchanged and are significantly lower than goals set by government agencies. The most recent C.D.C. survey did not report breast-feeding rates at 6 months because of a lack of data.

I. Glenn Cohen on Rights Not To Procreate

I. Glenn Cohen (Harvard Law School) has posted The Constitution and the Rights Not to Procreate on SSRN.  Here is the abstract:

Does the Federal Constitution protect a right not to procreate, and what does that mean? Modern reproductive technology has made this question both more salient and more problematic. For example, a number of courts and commentators have assumed the existence of a federal constitutional right not to procreate and relied on it to resolve disputes over stored frozen preembryos that couples have fertilized in the course of in vitro fertilization (IVF).

In this Article, I challenge that assumption. I argue that these authorities err by relying on a monolithic conception of the right not to procreate. I instead contend that the right is best conceived as a bundle of rights containing three possible sticks: the right not to be a genetic parent, the right not to be a legal parent, and the right not to be a gestational parent. Using this framework, I show that while the Supreme Court's jurisprudence unquestionably protects a right not to be a gestational parent as a fundamental right, it does not compel recognizing a right not to be a genetic parent, when genetic parenthood is unbundled from the obligations of legal and gestational parenthood. I also examine three other challenges to the Court's and commentators' constitutional claim. First, I suggest that even if there is a fundamental right not to be a genetic parent, infringement thereof might survive constitutional scrutiny under the appropriate standard of review. Second, I argue that there is no state action in preembryo disputes and others like them, such that the Constitution is not implicated at all. And finally, I argue that the asserted constitutional right not to be a genetic parent may be subject to advance waiver, as are many other constitutional rights.

Pre-Pregnancy Health for Men

HealthDay News: Health Tip: Pre-Pregnancy Health for Men:

When trying to conceive, good health is important for both moms- and dads-to-be. Future fathers can help a couple's chances of having a healthy baby.

Here are a few pre-pregnancy suggestions for would-be dads, courtesy of the American Pregnancy Association:

• Visit your doctor for a general checkup.
• Talk to your doctor about any medications you are taking, to determine if any of them may affect fertility.
• Get plenty of sleep, and maintain a healthy diet. Be sure to get plenty of zinc and vitamin E.
• Stop drinking alcohol and smoking, and never use illegal drugs.
• Practice good testicular health. Avoid immersion in hot water (hot tubs or spas), long hot showers, or wearing briefs or tight pants.
• Avoid bicycling.

Study Shows Rise in Diabetes Among Women Starting Pregnancy

Wash. Post/HealthDay News: Pre-Pregnancy Diabetes Rates Have Doubled, by Serena Gordon:

The number of women starting their pregnancies with type 1 or type 2 diabetes has doubled since 1999, but rates of gestational diabetes have stayed the same, new research finds.

In some age groups, the results were even worse. Researchers from Kaiser Permanente found that the number of teenagers who had diabetes before birth jumped fivefold....

Past research has focused on the number of women who develop diabetes during pregnancy, which is called gestational diabetes, and generally disappears after the baby is born.

The new study, which included 175,249 women who gave birth from 1999 to 2005, also included women with type 1 and type 2 diabetes. All of the women in the study were treated at one of 11 Kaiser Permanente hospitals in southern California. Fifty-two percent of the women were Hispanic, 26 percent were white, 11 percent were Asian/Pacific Islanders, and 10 percent were black, according to the study.

Preexisting diabetes -- type 1 or type 2 -- was found in 1.3 percent of all pregnancies. In 1999, the rate of preexisting diabetes was 0.81 per 100 births; by 2005, that number had jumped to 1.82 per 100 births.

But, during that six-year period, gestational diabetes rates remained nearly unchanged. In 1999, 7.5 women per 100 births had gestational diabetes; in 2005, it was 7.4 women per 100 births.

More Evidence of Benefits of Chocolate for Pregnant Women

Reuters: Chocolate may reduce pregnancy complication risk:

NEW YORK (Reuters Health) - Indulging in chocolate during pregnancy could help ward off a serious complication known as preeclampsia, new research suggests.

Chocolate, especially dark chocolate, is rich in a chemical called theobromine, which stimulates the heart, relaxes smooth muscle and dilates blood vessels, and has been used to treat chest pain, high blood pressure, and hardening of the arteries, Dr. Elizabeth W. Triche of Yale University in New Haven, Connecticut and colleagues write.

Preeclampsia, in which blood pressure spikes during pregnancy while excess protein is released into the urine, has many features in common with heart disease, the researchers add.

Lucinda Marshall on "The Abortion Conversation We Should Be Having"

Lucinda Marshall writes on AlterNet:                                                                                                    

Abortion is not an isolated issue of choice, but part of a complex set of issues that reproductive rights advocates need to address holistically.

Far too often, I have the nagging feeling that we're having the wrong discussion. About what? Pretty much darned near everything but none more so than the endless pro-life vs. pro-choice debate.

During a recent community conversation in Louisville, KY, Loretta Ross, the National Coordinator of SisterSong Women of Color Reproductive Health Collective offered what I think is a far more productive framework for discussing the abortion issue. Ross posits that abortion is only part of the issue of reproductive health and rights, which she points out include not only the right not to have a child but also the right to have a child.

New ME law allows midwives to buy some medications

Bangor Daily News: New law allows midwives to buy some medications, by Meg Haskell:

AUGUSTA, Maine  - Gv. John Baldacci on Wednesday signed into law a measure that authorizes Maine pharmacists to provide certain medications to certified professional midwives for administration to mothers and newborns during home births.

Certified midwives — sometimes referred to as "lay" midwives to distinguish them from registered nurses with additional midwifery credentials — typically help women deliver their babies safely at home rather than in a hospital or other medical setting.

The medications specified in the new law include drugs that induce labor, injectable vitamin K to control bleeding, antibiotic eye drops for newborns, numbing agents to reduce discomfort when repairing skin tears after delivery, and oxygen. Midwives often obtain these medications from pharmacies through "friendly" doctors who write prescriptions for them or other means. The new law is intended to grant them the autonomy of purchasing the drugs independently.

Surrogacy Sees Increased Media Coverage

Wall Street Journal: Outsourcing Childbirth, by Cheryl Miller:

"Katie is coming out of the mommy closet," Caroline (Maura Tierney) teases her sister Kate (Tina Fey) in the film "Baby Mama," out in theaters today. Kate, a hard-charging executive at a Whole Foods-like grocery chain, seems to have the perfect life -- except, oops, she forgot to have a baby. Cursed with a misshapen uterus, she turns to a surrogate agency, which assigns a wacky South Philadelphia girl, Angie Ostrowiski (Amy Poehler), to carry her baby.

Surrogacy itself seems to have come out of the mommy closet, to judge from recent media coverage. The New York Times and the Boston Globe have both reported on the practice of outsourcing wombs to poor Indian women. On a recent cover of Newsweek, the abdomen of a pregnant woman appeared with the words "Womb for Rent" emblazoned upon it. The issue's lead story, "The Curious Lives of Surrogates," ignited a small media frenzy with its sensationalistic revelations about military wives cashing in as surrogates -- in part by bilking their government-provided health plans.

Teen Pregnancy Rate versus Teen Birth Rate

Our Bodies Our Blog: What's the Truth About Teen Pregnancy?

You may have seen recent headlines such as "US teen pregnancy rate near historic low" and been somewhat confused (I certainly was). After all, didn't the CDC just announce that teen pregnancy rates were going up? A Dec 7, 2007 CDC press release entitled "Teen Birth Rate Rises for First Time in 14 Years" stated that "The teen birth rate in the United States rose in 2006 for the first time since 1991, and unmarried childbearing also rose significantly, according to preliminary birth statistics."

The two reports focus on slightly different things - teen pregnancies vs. teen births. The new report notes that the teen pregnancy rate was 72.2 per 1,000 ages 15-19 in 2004. The 2006 report indicates that the teen birth rate has increased to 41.9 births per 1,000, but doesn't provide an overall teen pregnancy rate. These are difficult to compare easily, as not all pregnancies result in births. We know, then, that births to teenagers increased in 2006, but not how the actual pregnancy rate changed. The teen pregnancy report shows a historic trend of both birth and abortion rates declining alongside pregnancy rates.

 

Student Scholarship: Procreative Rights, and Child Welfare and Future Persons

Carter Dillard (LLM candidate, NYU) has posted two articles on SSRN.  Here are the abstracts:

Rethinking the Procreative Right:

Few principles are as universally accepted in legal scholarship today, but based on such scant support, as the fundamental nature and broad scope of the right to procreate. What is perceived as a vague but nonetheless justified legal and moral interest to procreate freely without regard to others is, upon closer examination, based on little more than misconstrued or inapposite case precedent and blurry statements in non-binding sources of international law. By relying on this authority, conflating procreation with conceptually distinguishable behaviors, presuming its intrinsic value, and ignoring competing rights and duties, lawyers have largely overlooked procreation and its legal and normative limits. Interpreting U.S. constitutional and international law sources, and finally employing Locke's model of natural rights, this Article redefines the right in law and practice as satiable and narrow, acknowledging the competing rights and duties that both qualify and justify the right. It posits that the procreative right, properly stated, includes at least the act of replacing oneself and at most procreation up to a point that optimizes the public good.

Child Welfare and Future Persons:

While ethicists have delved deep into the rights and wrongs inherent in procreating, lawyers have had little to say about the matter, stymied by practical concerns, the tendency of the law to ignore future persons and their interests, and the misperception of a fundamental rights boundary that absolutely forbids state intervention. But recently a small door has opened in the wall between law and ethics, as some courts faced with having to constantly remove abused and neglected children from parents adjudged unfit have issued temporary no-procreation orders. As precedent slowly begins to form and the possibility of ex ante regulation of procreation and parenthood begins to grow, a moral and legal debate is beginning over what duties prospective parents owe their future children and the society with which they will interact, the resolution of which will in part define the actual constituency of the future state. This Article is the first to cut through the debate, which is a muddle of conflicting state and constitutional law, uncovering the essential principle at its core, and arguing for codification of that principle. It posits, largely through deductive reasoning, that there is a moral and legal duty on a prospective parent to be fit when he or she has a child, one arising from or creating correlative claim-rights shared by the state and prospective children, and a prospective parent has no liberty to have a child until he or she is fit. It argues for codification of this principle to be applied in cases of recurring abuse and neglect, taking courts out of the sea of confusion where they have been left by politically sensitive legislatures, and allowing them to best protect the various interests involved and avoid irreparable harm.

On-Line Resource Helps Determine "Extremely Preterm Birth Outcome Data"

NY Times: New Calculator Factors Chances for Very Premature Infants, by Denise Grady:

Researchers are reporting that they have developed a new way to help doctors and parents make some of the most agonizing decisions in medicine, about how much treatment to give tiny, extremely premature infants.

These are infants at the edge of viability, weighing less than 2.2 pounds and born after 22 to 25 weeks of pregnancy, far ahead of the normal 40 weeks. About 40,000 babies a year are born at this very early stage in the United States.

The new method uses an online calculator developed for such cases factoring in traits like birth weight and sex and generating statistics on chances of the baby’s survival and the likelihood of disabilities.

The calculator is available here.

See also:  Wall Street Journal: Weighing Which Babies Get a Costly Drug, by Laura Landro:

In the mounting debate about how best to spend scarce health-care dollars, pediatric experts are wrestling with an emotionally fraught issue: whether to let some babies at risk for a potentially serious respiratory virus take their chances with the disease or to preventively administer an expensive drug that may or may not work.

Respiratory syncytial virus, or RSV, may be the most prevalent disease parents have never heard of: It is the leading cause of hospitalization for infants and children. It will infect nearly all children at least once before they reach the age of two, and while it usually doesn't cause serious problems, the risks are higher for the growing number of premature babies and for those with lung and heart problems.

CDC Study Shows Dramatic Decline in US Teen Pregnancy Rate

AFP: US teen pregnancy rate near historic low: study:

CHICAGO (AFP) — The teen pregnancy rate in the United States has fallen to historic lows, abortion rates have declined dramatically and more women are having children out of wedlock, a study published Monday said.

The teen pregnancy rate dropped 38 percent from 1990 to 2004, with abortion rates down by half and birth rates down by more than a third, the Centers for Disease Control and Prevention Study said.

However, pregnancy rates among Hispanic and black teens and young women were more than double that of their white counterparts.

Research has revealed a similar trend in Canada.  Ottowa Citizen: A Healthy Trend:

...The U.S. numbers echo the Canadian trendline. Research released last year found that the teen pregnancy rate in Canada was at an all-time low. There has also been a corresponding drop in the abortion rate in Canada. "What we're seeing," said Alex McKay, author of a study published in the Canadian Journal of Human Sexuality, "is that fewer young women are becoming pregnant in the first place."

And that is a good thing, since teenage mothers face more challenges and the outcomes for them and their children are often worse than for older mothers and their children.