Hostname: page-component-848d4c4894-x24gv Total loading time: 0 Render date: 2024-05-19T08:52:24.129Z Has data issue: false hasContentIssue false
  • English
  • Français

Finding Common Ground: The Necessity of an Integrated Agenda for Women's and Children's Health

Published online by Cambridge University Press:  01 January 2021

Wendy Chavkin ,
Vicki Breitbart  and
Paul H. Wise
Get access Rights & Permissions [Opens in a new window]

Extract

During the past decade, a new term has entered the medical/legal lexicon : maternal-fetal conflict. Implicit in the terminology is the assumption that a pregnant woman and her fetus have separate and competing rights. This concept has stimulated extensive legal and ethical debate, primarily in the context of medical interventions (cesarean sections and blood transfusions) forced on unwilling pregnant women, and in corporate efforts to bar fertile women from hazardous jobs. On one side of the debate are the proponents of the future child's right to be born of sound mind and body, and society's interest in the delivery of healthy newborns. On the other side, are advocates of a woman's right to reproductive autonomy, bodily integrity, due process, confidential medical treatment, and freedom from gender discrimination. Neither side has challenged the formulation of the problem, or has examined its permeation into public health policy.

Type
Article
Information
Journal of Law, Medicine & Ethics , Volume 22 , Issue 3 , Fall 1994 , pp. 262 - 269
Copyright
Copyright © American Society of Law, Medicine and Ethics 1994

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Nelson, L.J. Milliken, N.M., “Compelled Medical Treatment of Pregnant Women,” JAMA, 25 (1988): 1060–66; and Williams, W.W., “Firing the Woman to Protect the Fetus: The Reconciliation of Fetal Protection with Employment Opportunity Goals Under Title VII Williams,” Georgetown Law Journal, 69, no. 3 (1991): 641-704.CrossRefGoogle Scholar
Title VII of the Civil Rights Act of 1964, as amended, 42 U.S.C. § 2000e, et seq.; and Pregnancy Discrimination Act, 42 U.S.C. § 2000e(k).Google Scholar
Webster v. Reproductive Health Services, Blackmun, J., dissenting, 109 U.S. 3040, 3049 (1989).Google Scholar
Institute of Medicine, Prenatal Care (Washington, D.C.: National Academy Press, 1988).Google Scholar
Breitbart, V. Chavkin, W. Wise, P., “Finding Common Ground: Developing a New Agenda for Maternal-Child Health,” presentation to American Public Health Association (1993).Google Scholar
Kempe, A. Wise, P.H. Barkan, S.E. et al., “Clinical Determinants of the Racial Disparity in Very Low Birthweight,” New England Journal of Medicine, 327 (1992): 969–73.CrossRefGoogle Scholar
Haas, J.S. Udvarhely, S. Morris, C.N. Epstein, A.M., “The Effect of Providing Health Coverage to Poor Uninsured Pregnant Women in Massachusetts,” JAMA, 269 (1993): 87–91.CrossRefGoogle Scholar
Barno, Y. Higginson, G. Longchamp, E. et al., “Infant Deaths in Central Harlem,” presentation to American Public Health Association (1988).Google Scholar
Coustan, D.R. Carpenter, M.W. Sullivan, P.S. et al., “Gestational Diabetes: Predictors of Subsequent Disordered Glucose Metabolism,” American Journal of Obstetrics and Gynecology, 168 (1993): 1139–45.CrossRefGoogle Scholar
Committee to Study the Prevention of Low Birthweight, Preventing Low Birthweight (Washington, D.C.: National Academy Press, 1985).Google Scholar
Jamesen, D.J. Buescher, P.A., “The Effect of Family Planning Participation on Prenatal Care Use and Low Birthweight,” Family Planning Perspectives, 24 (1992): 214–18.CrossRefGoogle Scholar
Corman, H. Grossman, M., “Determinants of Neonatal Mortality Rates in the US: A Reduced Form Model,” Journal of Health Economics, 15 (1985): 235–48; and Miller, M.K. Stokes, C.S. Warland, R.M., “The Effect of Legalization and Public Funding of Abortion on Neonatal Mortality: An Intervention Analysis,” Population Research Policy Review, (1988): 79-92.Google Scholar
Kaunitz, A.M. Brewer, J.L. Paryani, S.G. et al., “Prenatal Care and HIV Screening,” JAMA, 258 (1987): 2693.CrossRefGoogle Scholar
Grimes, D.H., “The CDC and Abortion in HIV Positive Women,” JAMA, 299 (1988): 217.CrossRefGoogle Scholar
Minkoff, H.L. Landesman, S.H., “The Case for Routinely Offering Prenatal Testing for Human Immunodeficiency Virus,” American Journal of Obstetrics and Gynecology, 159 (1988): 793–96.CrossRefGoogle Scholar
Rutherford, G.W. Oliva, G.E. Grossman, M. et al., “Pregnancy Outcome in Women with HIV Infection in Puerto Rico,” Montreal, 5th International Conference on AIDS, Abstract No. MBP 27, June 1989).Google Scholar
Krasinski, K. Burkowsky, W. Bebenroth, D. et al., “Failure of Voluntary Testing for HIV to Identify Infected Parturient Women in a High Risk Population,” New England Journal of Medicine, 318 (1988): 185–89.Google Scholar
Women, AIDS, and Public Health Policies (Washington D.C.: National Women's Health Network, 1990).Google Scholar
Pearl, M. Bahzhaf, M. Leger, A. Long, I., “Women in U.S. Government Clinical Trials,” Amsterdam, 8th International Conference on AIDS, Abstract No. PUB 3866, July 1992.Google Scholar
Centers for Disease Control, “Guidelines for Prophylaxis Against Pneumocystis Carinii Pneumonia for Persons Infected with Human Immunodeficiency Virus,” Morbidity and Mortality Weekly Report, 28, 5, Supp. (1989): 1–9.Google Scholar
Food and Drug Administration, “Guidelines for the Study and Evaluation of Gender Differences in the Clinical Evaluation of Drugs,” Federal Register, 58, no. 139 (1993): 39406–16.Google Scholar
Bill A6747, New York State Assembly, 1993–1994 sess. (March 30, 1993).CrossRefGoogle Scholar
Chavkin, W., Letter to Editor: “Pneumocysitis Carinii Pneumonia in Children with Perinatally Acquired HIV Infection,” JAMA, 271, no. 2 (1994): 102–03.CrossRefGoogle Scholar
Gelber, R.D. Kiselev, P., Executive Summary of ACTG 076: A Phase III Randomized, Placebo-Controlled Trial to Evaluate the Efficacy, Safety and Tolerance of Zidovudine (ZDV) for The Prevention of Maternal-Fetal HIV Transmission (Boston: Statistical and Data Analysis Center, Harvard University, February 17, 1994).Google Scholar
Moye, J., “Brief Review of Current Clinical Trials that May Resolve Uncertainties About the Reduction of Vertical Transmission of HIV,” Department of Health and Human Services, National Institutes of Health Memo (Bethesda: DHHS, April 6, 1994).Google Scholar
U.S. Department of Health and Human Services, “The 1993 Sexually Transmitted Diseases Treatment Guidelines,” Morbidity and Mortality Weekly Report, 16, no. RR-14 (1993): 16.Google Scholar
“Recommendations of the U.S. Public Health Service Task Force on the Use of Zidovudine to Reduce Perinatal Transmission of Human Immunodeficiency Virus,” Morbidity and Mortality Weekly Report, 43, no. RR-11 (1994): 1–20.Google Scholar
Paltrow, L., Overview of Opinion and Orders of Criminal Cases Based on Prenatal Conduct and Sentencing Based on Pregnancy Status (New York: The Center for Reproductive Law and Policy, November 1992).Google Scholar
American College of Obstetricians and Gynecologists, Fact Sheet: State Laws on Pregnant Women and Substance Abuse (Washington D.C.: Government Relations Department, 1991); and Marshall, A.B., “Update: Perinatal Addiction Research and Education,” 1992 Legislative Review (October 1992).Google Scholar
Chavkin, W., “Drug Addiction and Pregnancy: Policy Crossroads,” American Journal of Public Health, 45 (1990): 55–57.Google Scholar
See American College of Obstetricians and Gynecologists, supra note 29.Google Scholar
Chasnoff, I.J. Landress, H. Barett, M., “The Prevalence of illicit-Drug or Alcohol Use During Pregnancy and Discrepancies in Mandatory Reporting in Pinellas County, Florida,” New England Journal of Medicine, 320 (1989): 762–68.Google Scholar
Drug-Exposed Infants: A Generation at Risk. Report to the Chairman Committee on Finance, U.S. Senate (Washington, D.C.: United States General Accounting Office, June 1990).Google Scholar
Mayes, L.C. Granger, R.H. Bornstein, M.H. Zuckerman, B., “The Problem of Prenatal Cocaine Exposure: A Rush to Judgement,” JAMA, 267 (1992): 406–08; and Robins, L.N. Mills, J.L. (eds.), “Effects of In Utero Exposure to Street Drugs,” American Journal of Public Health, 83 supp. (1993).CrossRefGoogle Scholar
Ibid.Google Scholar
Chavkin, W. Paone, D. Freidman, P. Wilets, I., “Reframing the Debate: Toward Effective Treatment for Inner City Drug-Abusing Mothers,” Bulletin of the New York Academy of Medicine, 70, no. 1 (1993): 50–68.Google Scholar
Paone, D. Chavkin, W. Willets, I. Friedman, P. DesJarlais, D., “The Impact of Sexual Abuse: Implications for Drug Treatment,” Journal of Women's Health, 1 (1992): 149–53.CrossRefGoogle Scholar
Newberger, E.H. Barkan, S.E. Leiberman, E.S. et al., “Abuse of Pregnant Women and Adverse Birth Outcome: Current Knowledge and Implications for Practice,” JAMA, 267, no. 17 (1992): 2370–72.CrossRefGoogle Scholar
McNulty, M., “Pregnancy Police: The Health Policy and Legal Implications of Punishing Pregnant Women for Harm to Their Fetuses,” Review of Law and Social Change, XVI, no. 227 (1987–1988).Google Scholar
In re A.C., 533 A.2d 611 (D.C. 1987), vacated 539 A.2d 203 (D.C. 1988), vacated and remanded 573 A.2d 1235 (D.C. 1990).Google Scholar
International Union, U.A.W. v. Johnson Controls, 499 U.S. 187, 11 S. Ct. 1196, 113 L.Ed.2d 158 (1991).Google Scholar
Roberts, R.H., Memorandum to Central Detectives: Operation Guidelines (Charleston: City of Charleston, South Carolina, October 12, 1989).Google Scholar
See American College of Obstetricians and Gynecologists, supra note 29; see Marshall, , supra note 29; and see Chasnoff, et al., supra note 32.Google Scholar
Balisy, S., “Maternal Substance Abuse: The Need to Provide Legal Protection for the Fetus,” South California Law Review, 60 (1987): 1209; and Dougherty, C.J., “The Right to Begin Life with Sound Body and Mind: Fetal Patients and Conflicts with Their Mothers,” University of Detroit Law Review, 63 (1985): 89.Google Scholar
Johnsen, D., “The Creation of Fetal Rights: Conflicts with Women's Constitutional Rights to Liberty, Privacy, and Equal Protection,” Yale Law Journal, 95 (1986): 599; and Moss, K., “Substance Abuse During Pregnancy,” Harvard Women's Law Journal, 13 (1990): 278-99.CrossRefGoogle Scholar
Roe v. Wade, 410 U.S. 113 (1973).Google Scholar
Child Welfare League of America, Children at the Front: A Different View of the War on Drugs (Washington, D.C.: North American Commission on Chemical Dependency and Child Welfare, 1992).Google Scholar
Florida v. Jennifer Johnson, No. E89-890-CFA, motion for rehearsing and sentencing (18th Cir. 1989).Google Scholar
See Chavkin, , supra note 23.Google Scholar
Rochin v. California, 342 U.S. 165, 172 (1952); Winston v. Lee, 105 S. Ct. 1611 (1985); and Schmerber v. California, 384 U.S. 757 (1966).Google Scholar
See Chavkin, , supra note 30.Google Scholar
See Moss, , supra note 45.Google Scholar
See Chavkin, , supra note 30.Google Scholar
Roberts, D.E., “Punishing Drug Addicts Who Have Babies: Women of Color, Equality, and the Right of Privacy,” Harvard Law Review, 104, no. 7 (1991): 1419–82.CrossRefGoogle Scholar
Committee on Bioethics of the American Academy of Pediatrics, “Fetal Therapy: Ethical Considerations,” Women's Health Issues, 1, no. 1 (1990): 16–17; Committee of Ethics of the American College of Obstetricians and Gynecologists, “Patient Choice: Maternal-Fetal Conflict,” Women's Health Issues, 1, no. 1 (1990): 13-15; Board of Trustees of the American Medical Association, “Legal Interventions During Pregnancy: Court-Ordered Medical Treatments and Legal Penalties for Potentially Harmful Behavior by Pregnant Women,” JAMA, 264, no. 20 (1990): 2663-70; “Policy Statement No. 9020: Illicit Drug Use by Pregnant Women,” Public Policy Statements of the American Public Health Association: 1948–1991 Collection (Washington, D.C.: American Public Health Association, 1992), pp. 466–67; and Committee on Adolescence, Committee on Bioethics, and Provisional Committee on Substance Abuse, “Screening for Drugs Abuse in Children and Adolescents,” Pediatrics, 84, no. 2 (1989): 396-87.CrossRefGoogle Scholar
Chavkin, W. St. Clair, D., “Beyond Prenatal Care: A Comprehensive Vision of Reproductive Health,” JAMA, 45 (1990): 223–25; and Wise, P.H., “Confronting Racial Disparities in Infant Mortality: Reconciling Science and Politics,” American Journal of Preventative Medicine, 9 (1993): 7-16.Google Scholar