Life Before Birth provides a coherent framework for addressing bioethical issues in which the moral status of embryos and fetuses is relevant. It is based on the "interest view" which ascribes moral standing to beings with interests, and connects the possession of interests with the capacity for conscious awareness or sentience. The theoretical framework is applied to ethical and legal topics, including abortion, prenatal torts, wrongful life, the crime of feticide, substance abuse by pregnant women, compulsory cesareans, assisted reproduction, and stem cell research. Along the way, difficult philosophical problems, such as identity and the non-identity problem are thoroughly explored. The book will be of interest not only to philosophers, but also physicians, lawyers, policy makers, and anyone perplexed by the many difficulties surrounding the unborn.
"Bonnie Steinbock's excellent book is . . . consistent, thoroughgoing, and intelligible." --Nature
"Steinbock's book is valuable for all interested in the ethical/legal issues surrounding abortion, prenatal injury and liability, maternal-fetal conflict, and fetal/embryo research. The author provides an excellent historical overview of these issues, but she also addresses the issues from the stance of a particular theory of moral status, namely, interest theory. This gives coherence to her discussion as well as allowing testing of the viability of interest theory."
--Choice
"A focused, lucid, analytically fine-grained discussion of a wide variety of problems. . . extremely useful as a survey of the current state of the debate." --Religious Studies Review
"Merits serious consideration by physicians. Steinbock's interests-based approach treats all questions as open -- another and most welcome breath of fresh air." -New England Journal of Medicine
"An extremely valuable contribution to the literature. The author carefully identifies the many bioethical issues to which the status of embryos and fetuses is relevant....She thoroughly reviews the extensive medical, bioethical, and legal literature on all of these issues, offering well-developed critiques of many standard positions. She articulates and thoughtfully defends interesting positions on all of theses topics. Anyone with an interest in these issues will learn a great deal from her knowledgeable and judicious treatment of them." -- The Journal of Clinical Ethics

Improving clinicians' understanding of effects nutrition can have on maternal health and fetal and neonatal development can have considerable impact on achieving a healthy pregnancy and reducing childhood morbidity. This book defines the nutritional requirements with regard to each stage of fetal development and growth, placing scientific developments into a clinical context. Clinicians and scientists discuss: how the fetus grows and what macro- and micronutrients it requires; what happens when there is nutrient deficiency and when placental development is abnormal; aspects of infant feeding, both with breast milk and formula milk. Specific problems encountered in pregnancy that pose a nutritional challenge are also considered, including pregnancy in teenagers, multiple pregnancies and pregnancy in those who are vegetarians or vegans. All doctors, health-care workers or scientists who either care for women, their newborn and growing infants, or who are involved in research in these areas, will find this to be essential reading.

Discover new concepts in cardiovascular and hemodynamic functionality during pregnancy, with international experts in feto-maternal medicine. During the early stages of pregnancy, the maternal heart and circulation are subject to major gestational adaptive changes that allow for a normal course and outcome for both mother and baby. Any disruption to these processes can precipitate the onset of severe maternal and fetal complications such as preeclampsia, or intrauterine growth restriction. This invaluable reference work provides a comprehensive discussion of each aspect of the circulation. With a focus on the physiologic and pathophysiologic aspects of maternal cardiovascular function, this guide supports non-invasive assessment, management and prevention techniques for cardiovascular disease, for all stages of fetal and neonatal life. This text supports researchers and specialists in maternal-fetal medicine, whilst providing a key grounding in the topic, for trainees wishing to be at the cutting edge of theories and research.

An A-Z practical guide on the pharmacology and toxicology of pregnancy and nursing

"Medication Safety in Pregnancy and Breastfeeding: The Evidence-Based, A-to-Z Clinician's Pocket Guide" gives you comprehensive, authoritative coverage on the effects of prescription and over-the-counter drugs as well as herbals, chemicals, and radiologicals, on the mother, fetus, and nursing child. Organized A-Z for ease of use, this hands-on resource also includes evidence-based recommendations from the renowned Motherisk Program at the Hospital for Sick Children in Toronto.

The stimulus of this study was the question as to whether current program strategies can reduce maternal mortality quicker than in the historically successful countries for Malaysia and Sari Lanka. Through cases studies, research and analysis of extent data of safe motherhood programs in seven countries, the answer is yes: lessons learned concern six factors associated with recent success in reducing maternal mortality. This book provides a thorough analysis of factors reducing maternal mortality through three retrospective case studies in China, Honduras and Zimbabwe; and four research studies in Bolivia, Egypt, Indonesia, and Jamaica. Reduction of maternal mortality has now become an explicit focus of many programs. Where such is targeted, and strategies adapted to address the local barriers to move women into appropriate care for birth has resulted, this has impacted on the reported maternal mortality.

Frank Lake was a British psychiatrist and lay theologian who substantially influenced the interplay of psychology and theology in the United Kingdom over the last several decades. Even though he died in 1983, his ideas continue to be debated through his books and the organization he founded, the Clinical Theology Association. Lake called his discovery and formulation of 'a new paradigm for psychodynamics with revolutionary implications' the 'Maternal-Fetal Distress Syndrome.' He wrote that this 'new perspective changes almost everything in counseling, ' constituting 'a radical departure from all that has gone before.' Furthermore, he noted that the 'understanding of psychodynamics can never be the same again. Nor its practice.' The description and analysis of this 'new paradigm' and its 'revolutionary implications' are the topics of this work.

Based on the curriculum of the Royal College of Obstetricians and Gynaecologists' Advanced Training Skills Module in Fetal Medicine, this book provides a comprehensive knowledge base for all doctors practising in obstetrics and maternal-fetal medicine worldwide. It acts as a reference source for the many changing concepts in fetal medicine and is well-illustrated with images of normal and abnormal findings in pregnancy that will facilitate proper understanding of normal and pathological fetal development. Coverage includes embryology, fetal physiology; fetal anomalies; fetal diseases; prescribing and teratogenesis in pregnancy; termination of pregnancy; fetal growth and wellbeing; multiple pregnancy; the placenta and amniotic fluid; and diagnostic and therapeutic invasive procedures. Readers will benefit from the theoretical knowledge and vast clinical experience of the internationally renowned authorship. Overall this book will prepare you for dealing with congenital abnormalities detected during pregnancy, including the organization and supervision of screening programmes for structural and chromosomal anomalies.

Prenatal testing for genetic abnormalities has transformed pregnancy and motherhood. Using sociological research, this book analyses the social-psychological and ethical implications of invasive prenatal testing, particularly CVS and amniocentesis. Among the issues covered are: changes in the genetic counselling profession and in client demographics; the challenge of nondirective genetic counselling; decisions of testing and on which test to have; the timing and risks of the procedures; abortion and grief; the ethics of sex education; potential uses and abuses of genetic knowledge; and policy and ethical implications.

It is now possible for physicians to recognize that a pregnant woman's foetus is facing life-threatening problems, perform surgery on the foetus, and if it survives, return it to the woman's uterus to finish gestation. Although foetal surgery has existed in various forms for three decades, it is only just beginning to capture the public's imagination. These still largely experimental procedures raise all types of medical, political and ethical questions. Who is the patient? What are the technical difficulties involved in foetal surgery? How do reproductive politics seep into the operating room, and how do medical definitions and meanings flow out of medicine and into other social spheres? How are ethical issues defined in this practice and who defines them? Is foetal surgery the kind of medicine we want? What is involved in reframing foetal surgery as a women's health issue, rather than simply a paediatric concern? In this ethnographic study of the social, cultural and historical aspects of foetal surgery, Monica Casper addresses these questions. The Making of the Unborn Patient examines two important and connected events of the second half of the 20th century: the emergence of foetal surgery as a new medical speciality and the debut of the unborn patient. Drawing on a wide range of sources, Casper shows how biomedical work has intersected with reproductive politics for three decades to generate new cultural meanings of foetuses, women and medicine itself. Since its inception, foetal surgery has been controversial both inside and outside of medicine precisely because it transgresses a number of boundaries, challenging our most cherished assumptions about pregnancy, maternal sacrifice, foetal life and death, and the limits of technology. Like many other medical innovations, especially those at the beginnings and ends of human life, foetal surgery is proceeding rapidly but without careful reflection about what it means and without public debate about its consequences. Foetal surgery is risky, expensive and fraught with peril for both women and their foetuses. This book offers a critical social and cultural analysis of this nascent yet significant innovation in biomedicine. Analyzing original data, Casper explores early foetal surgery efforts and the emergence of the unborn patient in the 1960s. She examines several related practices, including foetal physiology, diagnostic technologies, animal experimentation, and foetal wound healing research, and the ways in which they have shaped foetal surgery. She presents ethnographic data collected at one of the premier US foetal treatment facilities, offering a behind-the-scenes look at the various kinds of work involved in operating on human foetuses. She also examines the many ethical dilemmas involved in research on human subjects in experimental foetal surgery. Perhaps most significantly, the book draws attention to the many ways in which foetal surgery affects women's health.

The purpose of this book is to review the basic science and clinical findings concerning maternal substance abuse and the developing nervous system of unborn children. The short-term but vitally significant repercussions of such exposure on biological development, with particular reference to the nervous system, are discussed. The book also discusses the profound influence of maternal substance abuse on behavior in adulthood, which is caused by subtle changes in the chemistry or structure of the developing nervous system. The subject will not only be of interest to clinical and basic science researchers and teachers in the field of maternal substance abuse, but also to individuals in psychology, social work, cellular and molecular biolgoy, embryology, neuroscience, pharmacology, and in clinical professions such as pediatrics, neonatology, and obstetrics. The breadth of topics covered includes alcohol, cocaine, opiates, nicotine, benzodiazepines, marijuana, and the role of stress and hormones. Emphasis is placed on the relationship of the effects of substance abuse on neurotrophic factors and receptors.
Key Features
* Shows how abused substances act directly or indirectly to mimic or influence the action of neurotrophic factors
* Explains that the transient expression of peptides, neurotransmitters, and receptors can be markedly disturbed by drugs
* Demonstrates that animal and tissue culture studies are consistent with clinical observations and important in understanding and ameliorating adverse actions of drugs in early life

Fetal Echocardiography is a comprehensive, lavishly illustrated guide to fetal heart scanning for anyone involved in obstetric ultrasound. Authored by a leading pediatric cardiologist with over 30 years of experience, it brings together all the information needed by cardiologists, obstetricians, sonographers or maternal-fetal medicine clinicians in order to obtain clear, high-quality echocardiograms and interpret them. Initial chapters provide the basic principles of echocardiography and how to obtain the standard views, giving numerous illustrations of each standard view and the possible deviations from normal. Subsequent chapters present a complete pictorial representation of almost all malformations recognised in fetal life. An overview of the likely outcome of each malformation is given, backed up by personal data involving nearly 4000 abnormal fetal hearts. Additional chapters cover Fetal Arrhythmias and Early Fetal Heart Scanning. Highly illustrated and full of practical guidance, Fetal Echocardiography is an invaluable resource for all practitioners involved in obstetric scanning.

This handy pocket atlas is a complete and convenient guide to the normal sonographic appearances of the embryo and fetus and its uterine environment. The book equips practitioners with the thorough knowledge of normal fetal anatomy that is essential for the timely recognition of abnormalities.The images in this atlas were produced with state-of-the-art high-resolution ultrasound imaging systems and depict a spectrum of normal anatomy encountered during pregnancy. The book begins with the fetal environment (including the cervix, uterus, placenta, and umbilical cord), progresses through successive embryonic stages, and then examines fetal organ systems. The appendix provides a set of basic biometry tables for convenient daily use.

Electronic Fetal Heart Rate Monitoring: The 5-Tier System, Third Edition reviews the practice of fetal heart rate monitoring. Beginning with a description of the anatomy of fetal circulation, placental function as a respiratory organ, and acid-base balance, it also presents normal fetal cardiovascular and cerebral metabolism. In addition, the pathophysiologic mechanisms involved in progressive fetal asphyxia are examined via a review of the seminal animal and human studies conducted in this field. Also included is a brief summary of fetal heart rate monitoring technology currently used in clinical practice and standard nomenclature for fetal heart rate characteristics. Variant fetal heart rate patterns and the underlying physiologic mechanisms are presented as well. The Third Edition summarizes the research identifying the relationship between specific fetal heart rate patterns and an increasing risk of fetal acidemia, including the effect of deceleration depth, duration, and pattern evolution. It also evaluates the scientific basis that supports management algorithms currently in use and recommends the Parer/Ikeda 5-tier system. This algorithm assigns fetal heart rate patterns to 5 categories based on their progressive risk of fetal acidemia and has been tested in several studies. Clinical management using the 5-tier system is presented in detail.

Supporting a Physiologic Approach to Pregnancy and Birth: A Practical Guide provides an overview of current evidence and a range of practical suggestions to promote physiologic birth within the United States healthcare system. Presenting the latest evidence available on practical approaches and minimal interventions, this book looks into clinic exam rooms and hospital labor units to investigate the possibilities for improving the pregnancy and labor experience. Contributors discuss recent research and other published information and present a range of ideas, tools, and solutions for maternity care clinicians, including midwives, nurses, physicians, and other members of the perinatal team. An invaluable resource, Supporting a Physiologic Approach to Pregnancy and Birth is a must-have practical guide for those involved in all aspects of pregnancy and birth.

There is a documented link between fetal nutrition and the development of disease risk in adult life. Including the early postnatal period, during which a newborn continues to grow rapidly influenced by environmental factors, suggests that individuals are subject to risks for more than just the fetal period. Fetal and Early Postnatal Programming and its Influence on Adult Health focuses on interrelated aspects of cellular programming related to early nutrition and this potential global health problem.

With higher risks to mother and baby in pregnant women with renal disease, critical decision-making is key. Giving practical guidance for antenatal, post-partum and maternity unit challenges, this book supports good practice and evidence-based management. The book includes evidence on antenatal and post-partum care; management of acute kidney injury in the delivery suite; and care guidelines for acute, chronic, and previously undiagnosed kidney diseases. The book also covers acute kidney injury, transplant, dialysis, pre-conception counselling, and medications. Previously published by RCOG, this revised edition includes: * Updated expert consensus statements * Complete revision, with a new chapter on contraception * Updates in management of acute kidney injury, hypertension, dialysis and pregnancy, renal transplantation and pre-eclampsia. Structured to help clinicians make decisions, this book is for use by obstetricians, renal physicians, maternal medicine clinicians, midwives, urologists and specialist nurses.

Timely diagnosis and management of neurological diseases during pregnancy poses major therapeutic challenges to neurologists and other non-neurologist health care providers. Pregnancy is a unique period in life associated with significant hormonal and other physiologic changes in female patients, which may trigger or alter the course of neurological and psychiatric disorders. In addition, many diagnostic proceduresthat can be performed in non-pregnant women are prohibited during pregnancy for safety reasons. Therapeutic decisions and management of a pregnant patient with neurological disorders heavily depends on the issue of the reasonable balance between the risks of no treatment versus active treatment for the mother and her fetus.

This book provides a review of the latest findings in this field, giving the neurologist and non-neurologist the information they need to determine the best treatment. Neurological disorders covered include multiple sclerosis, stroke and epilepsy.
Discusses how neurological disorders shouldbemanagedin a pregnant patientIncludes contributions from leading authorities"

Pregnant drug users are the focus of this new study that argues that women who abuse substances should not be treated differently during their pregnancies but should instead be treated the same way as women who have medical problems with obstetric consequences. The social issues that produce drug abuse during pregnancy are discussed, and valuable information about top practices and policies for caring for maternal drug users is provided.

Cambridge Pocket Clinician / Maternal-Fetal Medicine is designed to provide the busy clinician with precisely the information needed where and when it is needed. The text covers a wide variety of topics related to maternal and fetal medicine, as well as clinical questions that will challenge providers both in the outpatient setting and on Labor & Delivery. Special attention has been paid to incorporating an evidence-based approach to obstetric management, and a number of chapters have been included to assist in the management of obstetric emergencies. In total, over 000 diseases and conditions are discussed in detail.

At least one in five pregnancies ends in miscarriage, yet pregnancy loss remains a taboo topic and effective aftercare is rarely available for those who have experienced it. Grief Unseen explains the different kinds of childbearing losses, such as failed fertility treatment, ectopic pregnancy, and stillbirth, and explores their emotional impact on women and their partners, and the process of healing. An established art therapist and mental health counselor, Laura Seftel shares her own experiences of miscarriage and recovery, and describes the use of art and ritual as a response to loss in traditional and modern cultures. She presents a rich variety of artists who have explored pregnancy loss in their work, including Frida Kahlo, Judy Chicago, and Tori Amos, and shows how people with no previous artistic experience can generate creative responses as part of the healing process. The book includes step-by-step exercises in guided imagery, poetry, visual art, journaling, and creating rituals. This accessible, positive resource will be useful to practitioners in the fields of medicine, mental health, art therapy, and counseling, as well as women and families who have suffered pregnancy loss.

Pregnancy and the Pharmaceutical Industry: The Movement towards Evidence-Based Care for Pregnant Women explores the issues surrounding the decision to undertake clinical trials with pregnant women. There is currently a lack of data on the safety and effectiveness of medications used during pregnancy as it is impossible to extrapolate that information from drug studies on men and non-pregnant women. As a majority of pregnant women confront a medical condition during their pregnancy, from simple pain, to ongoing or new medical issues, this book quantifies the current absence of pregnant women in drug studies and identifies ethical issues, barriers, litigation fears and opportunities. Those in the pharmaceutical industry, IRB members who approve or deny drug study plans, doctors, nurses and midwives working in obstetrics or involved in conducting studies at their institutions will find this book an essential resource.

With collaboration of Dr. Lucky Jain, Consulting Editor, Dr. Caplan has assembled articles devoted to the most current clinical advances in necrotizing enterocolitis. He has invited expert authors from top institutions to contribute timely reviews on the following topics: Biomarker Discovery: New markers that improve early diagnostic capability; Probiotics: State of the art; NEC Pathophysiology: How microbiome data alters our understanding; Effect of Human Milk on NEC; Influence of Growth Factors on the Development of NEC; Can Fish Oil Reduce the Incidence of NEC by Altering the Inflammatory Response; Oral Mother's Milk: State of the art and influence on NEC; Does Surgical Management Alter the Outcome of NEC; Epidemiology of NEC: New considerations and influence of PRBC transfusions and anemia; Role of Abdominal Ultrasound in Diagnosis of NEC; and Modifiable Risk Factors in NEC: 2018. Readers will come away with the scientific and medical information they need to make clinical decisions to improve patient outcomes.

The acclaimed quick-reference guide to the diagnosis and treatment of fetal abnormalities - completely updated in full color Structural Fetal Abnormalities delivers practical, authoritative coverage of the detection and treatment of more than 100 of the most common fetal anomalies, grouped by organ system, and discussed in concise, bulleted text. This unique resource puts at your fingertips valuable content that includes the features of a condition, its differential diagnosis, how to manage the pregnancy, and what to expect in the neonatal period and beyond. Each condition and syndrome discussed is presented in a standardized fashion with input from experienced clinicians in many different specialties, including maternal-fetal medicine, genetics, sonography, neonatology, pediatric cardiology, and pediatric surgery. This edition has been updated to include all new images that demonstrate many of the new and improved technologies, including 3-D and power Doppler. FEATURES * Conditions were selected for inclusion in the book because they are relatively common, or have distinctive features that allow definitive recognition * Includes numerous high-quality ultrasound images and photographs of the fetus or infant * Each section has an updated bibliography of suggested readings to provide you with a source of greater detail for each condition * Completely updated sections on important topics such as genetic etiologies of the structural malformations, reflecting the rapid advances in genomics and molecular diagnostics that have occurred over the past decade * Consistent, efficient templated chapter structure covers important topics such as Epidemiology/Genetics, Sonography, Pregnancy Management, Neonatal Management, Interventions, and Surgical Options * Hundreds of sonographic and gross clinical images illustrate the common features expected of each condition. * Valuable appendices include Differential Diagnosis of Abnormal in Utero Sonographic Findings and Sonographic Features of Other Less Common Syndromes

The full renewal program slides are also included on the CD. Difficult concepts are simplified and brought to life for all levels of learners. S.T.A.B.L.E. stands for the 6 assessment parameters covered in the program: Sugar, Temperature, Airway, Blood pressure, Lab work, and Emotional support for the family.