This Women’s History Month, let’s stop ignoring pregnancy
March is National Woman’s History Month in the United States. Congress designated March to be a month where we focused on the contributions of women to our country in 1987, and it remains in effect today.
That is why it is so timely to discuss how women—pregnant women especially—have been mostly left out of scientific studies and trials, and how this needs to change if we want to do anything about the maternal morbidity and mortality crisis that we are experiencing in our country.
An article in the Washington Post highlighted this issue recently. The problem boils down to this: because of the concern for pregnant women and their fetuses, coupled with a focus on liability and lack of understanding for how pregnancy complications can affect a women for the rest of her life, many scientists and drug companies do not enroll pregnant or lactating women in their studies.
The result? That we know very little about how certain medications, disease processes, and complications can affect women who give birth. One simple example is that even though it is 2019, we still aren’t completely sure about why or how a woman goes into labor.
And the placenta—in my opinion the most amazing organ in the body in that it grows for 40 weeks and then just detaches when it is doing being useful—is basically a mystery to us.
Many scientists and doctors do want to include pregnant women in their clinical trials, but regulations have made this difficult. The intent was good, given the thalidomide scare from the 1960s, but it ended up having far-reaching and rather negative effects.
Since pregnant women have historically been left out of drug trials, we know little on the safety of many drugs for a developing baby, as well as how a pregnant woman might metabolize them differently from her non-pregnant counterparts.
Women with disabilities who are pregnant or want to become pregnant are also affected, as they too have been left out of most studies. Because there is so little information on how certain diseases or disabilities might affect conception or pregnancy, many disabled women are left to navigate on their own and often turn to consulting online support groups. They deserve better.
As recently as this past January, a federal policy was changed so that pregnant women are no longer lumped in the same category as children or mentally disabled adults. Pregnancy used to also be a condition under which women were considered “vulnerable to coercion,” and this has also been changed.
It has taken until 2019 for these changes to happen, which means it is going to take many more years for studies to be developed, funded, implemented, and interpreted.
Even though March is National Woman’s History Month, we still have a long way to go in this country when it comes to treating pregnant women with the autonomy and respect that they—and all women—deserve.