Policy & Practice


Frist Pledges Stem Cell Support

Senate Majority Leader Bill Frist (R-Tenn.) has shifted his support to legislation to expand federal funding for human embryonic stem cell research. Sen. Frist, a physician, previously backed President Bush's policy of limiting federal funding to stem cell lines derived before Aug. 9, 2001. In a speech on the Senate floor this summer, Sen. Frist said that although the Stem Cell Research Enhancement Act (H.R. 810), which was passed by the House in May, has “significant shortcomings,” he will support it. The bill would allow federal funding for embryonic stem cell research for cells derived from human embryos that were created for the purpose of fertility treatment and otherwise would be discarded. Sen. Frist's support is expected to increase the chances of Senate passage of legislation to expand funding to all stem cell lines derived within ethical guidelines. President Bush has vowed to veto the bill.

The State of Pregnancy

Women having unplanned pregnancies are less likely to seek prenatal care and make other healthy choices during their first trimester, according to a recent survey sponsored by First Response. Of women who have had a planned pregnancy, 99% reported visiting the doctor regularly, versus 80% of women whose pregnancy was unplanned. Women who had an unplanned pregnancy were also less likely to take prenatal multivitamins (94% versus 72%) and to reduce alcohol consumption (58% versus 48%). Of the women who reported that they had been pregnant, 55% said their pregnancy was unplanned. The online survey, conducted by Harris Interactive, included more than 1,200 women aged 18–44; of these, 723 have been pregnant.

Caring for Homeless Women

Ob.gyns. should provide care to homeless women in their individual practices without bias but should also work to implement programs for the homeless with their local hospitals and clinics, according to a recent policy statement from the American College of Obstetricians and Gynecologists. The ACOG Committee Opinion, issued last month by the ACOG Committee on Health Care for Underserved Women, recommends that homeless women receive prenatal care that is coordinated with social services, rehabilitation programs, and programs to help women who live in homeless shelters during pregnancy (Obstet. Gynecol. 2005;106:429–34). “Even though individual obstetrician-gynecologists can and do provide services to homeless patients in their practices, it may be more beneficial for communities to develop organized services targeted specifically to this population that can better provide both health care and support services,” the committee wrote. The committee recommended that ob.gyns. advocate for professional liability protections for physicians who volunteer to provide care to the homeless.

Environmental Exposure

An advocacy organization is calling on the Centers for Disease Control and Prevention to begin testing the umbilical cord blood of newborns, citing the results of its own tests of 10 cord blood samples. The Environmental Working Group (EWG) commissioned tests of 10 cord blood samples and found that the babies averaged 200 contaminants in their blood. The group found the presence of mercury, fire retardants, pesticides, and the Teflon chemical perfluorooctanoic acid. “Chemical exposures during childhood can be far more harmful than those later in life,” EWG's vice president for research Jane Houlihan said in a statement. “Our cord blood findings above all raise the need for testing that ensures the safety of the widespread exposures we've documented that begin even before birth.” The group recommended changes to the federal Toxic Substances Control Act that would require chemical manufacturers to demonstrate that the chemicals they sell are safe for the entire population, including a fetus. The report is available at

Heart Trials and Women

More women should be recruited to participate in clinical trials of heart disease to have “statistically sufficient power” to identify whether women respond differently to treatment than men, according to a study published in August in the European Heart Journal (2005;26:1585–95). The study analyzed the literature on female-specific aspects in the pharmacotherapy of chronic cardiovascular diseases. The authors recommended that researchers analyze data on hormonal aspects, such as concomitant hormone therapy, gender differences in pharmacodynamics and in complication rates. “It is essential that trials are designed to provide the necessary data so that researchers know from the outset that they will be able to analyze factors that could contribute to different outcomes for men and women,” Verena Stangl, M.D., a cardiologist in Berlin and senior author of the study said in a statement.

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