Policy & practice


Abstinence Education

The federal government is awarding $37 million to 63 abstinence education grantees, the Department of Health and Human Services' Administration for Children and Families announced. The awards, from the Community-Based Abstinence Education program, are designed to encourage youth to remain abstinent until marriage. “The only way to be 100% certain that kids avoid pregnancy and sexually transmitted diseases is to stay abstinent until marriage,” said Wade F. Horn, Ph.D., assistant secretary for Children and Families. “By focusing on this clear message, the Bush administration is ensuring youth have the information they need to make the healthiest decision.” In a policy statement issued earlier this year, the American Academy of Pediatrics didn't specifically encourage abstinence until marriage, but instead stated that physicians should encourage adolescents to postpone early sexual activity.

ART and Multiple Births

The American College of Obstetricians and Gynecologists endorsed efforts to lower the risk of multiple births with assisted reproductive technology (ART) in a new committee opinion, “Perinatal Risks Associated With Assisted Reproductive Technology.” The most important health effect of ART to the offspring is iatrogenic multiple fetal pregnancy, the committee opinion said. The opinion advises physicians to tell patients about the risks and the socioeconomic burdens of multiple births and to counsel them in advance about the option of fetal reduction to decrease perinatal risks in the case of a high-order pregnancy. The American Society for Reproductive Medicine and the Society for Assisted Reproductive Technology have developed updated recommendations on the number of embryos per transfer to reduce the risk of multiple gestation.

Resident Work Hours

Resident work hour restrictions have improved residents' satisfaction with their personal lives but not with their work, according to a study published online in the September issue of the Journal of Reproductive Medicine. Researchers surveyed a total of 10 current and 25 graduated ob.gyn. residents at a Cleveland medical center that implemented resident work hour changes a full year before the requirement went into effect in 2003. Current and former residents reported that their sleep while not on call did not change with the reforms, suggesting that residents were spending the extra 6 hours each week on other outside activities. In addition, residents reported sleeping an average of 1 hour less (from 3 to 2 hours) while on call. “While employers clearly have no control over employees' amount of sleep outside work, residents should be informed of the evidence of how fatigue affects performance and should be encouraged to obtain enough sleep when not on duty,” the authors wrote.

The Research Pipeline

Drug researchers are currently developing 446 medicines aimed at the diseases that disproportionately affect women in the United States, according to the Pharmaceutical Research and Manufacturers of America (PhRMA). These medicines are either in clinical trails or awaiting approval by the Food and Drug Administration. The bulk of the drugs are for the treatment of cancer, including 62 for breast cancer, 38 for ovarian cancer, and 13 for cervical cancer. Fifty-eight medicines are being developed to treat obstetric and gynecologic conditions, according to PhRMA.

Stem Cell Support

There is widespread support for embryonic stem cell research across political, religious, and socioeconomic lines, according to a new survey and report from the Genetics and Public Policy Center at Johns Hopkins University. About two-thirds of respondents said they approve or strongly approve of embryonic stem cell research, according to the survey of more than 2,000 Americans. A majority of respondents across the religious spectrum said they approved of the research, except among fundamentalist and evangelical Christians, who were divided on the issue. When asked about stem cell research policy, 39.7% of respondents said the government should fund research to both create and study new embryonic stem cells, 21.6% supported the current policy, and 15.9% supported a ban on all research to create or study embryonic stem cells. “The survey revealed a subtle topography of the public's attitudes with only a small fraction (6% at each pole) of the public occupying the extreme positions that so frequently characterize the public and policy debate,” the report said. The center is funded by the Pew Charitable Trusts in partnership with Johns Hopkins University. The report is available online at

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