Preventing pediatric disability

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    Now that I am involved with pediatric private duty nurisng, I am seeing children suffering needlessly.

    How (in what types of nurse positions) can nurses get to young people and educate them about the things that cause birth defects, especially drug use/abuse, during pregnancy??

    I would be quite willing to even volunteer to help get the word out.

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  2. 24 Comments...

  3. 3
    First of all, please do not assume that all "birth defects" are due to the ingestion of drugs, alcohol or smoking - most are not. The biggest cause of disability in this country is prematurity, these are babies who would have been "normal", but for whatever reason are born too early. Babies who are born very early 23 - 26 weeks gestation have a great problem with respiratory regulation and are often put on ventilators. They can have brain damage from brain hemorrhages (strokes basically) causing many issues such as cerebral palsy, mental retardation, seizures, etc. The causes of prematurity are very complex. Many multiples are born too soon, especially in a first pregnancy. Other causes can be cervical weakness, various illnesses during pregnancy, advanced maternal age, among others. And in addition, over 50% of preemies are born with no known underlying reason. Don't assume all these parents are neglectful and addicts. That's a March of Dimes fallacy.

    Part of the reason there are so many children now with severe disabilities, is thanks to the 1984 "Baby Doe Legislation" passed under Pres Reagan that says basically every baby must be aggressively treated no matter how sick or small. What this caused was a neonatal over-zealous treatment to severely premature and ill newborns without regard to the wishes of the parents. These would have been babies who would have been miscarriages 30 years ago, but because of medical intervention, these babies are not saved. But many have very significant life-long issues.

    It certainly is commendable that you would like to help prevent this suffering. But the issue is surely much more complex than drug use, etc. during pregnancy. Best to you. .
    TeenyTinyBabyRN, nursel56, and tewdles like this.
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    should have been "now saved" rather than "not saved."
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    That is interesting and helpful. Thank you.
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    ****** Ronald Regan
    Last edit by tnbutterfly on May 13, '11 : Reason: Language
  7. 1
    Quote from JaredRN
    ****** Ronald Regan
    Oh, I see now. I guess they dismissed the Congress that had to vote on it before it was signed into law.

    That is a simplistic comment. Though it doesn't matter any more, I get all little tired of all the urban legends about the various calamities Reagan supposedly is responsible for. And, no. He didn't think ketchup was a vegetable. :uhoh21:
    Last edit by tnbutterfly on May 13, '11
    ArwenEvenstar likes this.
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    Reagan rushed through a law called the Baby Doe Laws, that essentially forces medical care on extremely premature and ill newborns, regardless of the wishes of the parents. Preemies, for the most part do not have "birth defects" - they are born severely immature, and need vast amounts of support to stay alive. Many of these kiddos then sustain brain hemorrhages, hypoxia, etc that damage their brains which can result in "acquired disabilities" such as cerebral palsy, mental retardation, seizures, blindness, autism, etc.

    Because of this ill-thought-out law, these babies who could have been allowed to go peacefully, must now be forced to endure sometimes months of intensive care followed by pretty difficult lives. Again, parents, depending upon the NICU's interpretation of the law, have few rights if they want to terminate treatment and let nature take it's course.
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    astoundingly good article about the impact of reagan's baby doe laws:
    http://markleehunter.free.fr/babydoe.html
  10. 2
    Quote from tralalaRN
    Reagan rushed through a law called the Baby Doe Laws, that essentially forces medical care on extremely premature and ill newborns, regardless of the wishes of the parents.
    I will go look that up because I don't think what you wrote above is quite as cut and dried as you make it seem to be. You can make it sound as if whatever negative consequences that arose from the law are Reagan's fault by using words such as "rushed through". A law is a law and every law must pass both houses of Congress before they are signed. Therefore anyone who voted for it as just as responsible for it as Reagan is, but that doesn't fit with people's certainty that Reagan is the cause of homelessness, AIDS, mental illness and a whole host of other bugaboos hung around this man's neck.

    Additionally, Reagan left office almost 25 years ago. As far as I know, bad laws can be repealed or modified. There are hosts of other reasons micro-preemies get over-zealous treatment. The parents demand it. The OB is afraid of a lawsuit if he doesn't pull out all the stops. Last I checked mothers still hit the crack pipe while pregnant. OH yeah. Reagan spread crack throughout our urban areas in the 80s all by himself.
    JeanettePNP and ArwenEvenstar like this.
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    Please do look it up. Meanwhile, I've also posted above, a link to an excellent article done by Dr. Mark Hunter. You may want to look at other contributors such as Helen Harrison, Dr. William Silverman. There is an excellent book published in the past couple of years called "Baby At Risk" that discusses the Baby Doe Laws at length and their impact on neonatal care. Also may want to check out the "Messenger Case" in Michigan and especially the "Sidney Miller" case in Texas.

    Most preemies are born having nothing to do with crack cocaine. May want to look up all the reasons for prematurity too.


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