Preventing pediatric disability

  1. 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.
  2. Visit PerfectlyPlump profile page

    About PerfectlyPlump, RN

    Joined: Jun '10; Posts: 185; Likes: 93
    RN; from US
    Specialty: Peds, developmental disability


  3. by   tralalaRN
    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. .
  4. by   tralalaRN
    should have been "now saved" rather than "not saved."
  5. by   PerfectlyPlump
    That is interesting and helpful. Thank you.
  6. by   JaredRN
    ****** Ronald Regan
    Last edit by tnbutterfly on May 13, '11 : Reason: Language
  7. by   nursel56
    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
  8. by   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. 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.
  9. by   tralalaRN
    astoundingly good article about the impact of reagan's baby doe laws:
  10. by   nursel56
    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.
  11. by   tralalaRN
    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.
  12. by   nursel56
    Quote from tralalaRN
    . .Most preemies are born having nothing to do with crack cocaine. May want to look up all the reasons for prematurity too.
    I always respect the integrity of someone's argument a bit less when they come out with the suggestion that perhaps one's education isn't up to snuff --?

    I respect the integrity of their argument less still when they pull a minor point out of the whole, alter it just a bit, and respond to that rather than the key issues at hand.

    I respect your intelligence enough not to rehash what those more important points are, but perhaps another read through will make them a little clearer.

    As far "Mark Lee Hunter" well -- I have no idea who he is and apparently very few others know either. From what I could surmise he is a self-proclaimed "investigative journalist" and hawks his videos and seminars on youtube.

    I don't get my credible information from sources like that, just as I don't believe Alex Jones or Orly Tait when they make claims.
  13. by   tralalaRN
    No idea who Orly or Alex are. There are numerous other sources listed, so it's certainly up to you as to whether or not you'd like to dig further. Dr. William Silverman is considered to be "The Father of Neonatology." Helen Harrison wrote the original "Premature Baby Book" - considered by many to be the bible on prematurity. The Miller case was of parents in Texas who asked that their 23 weeker not be resuscitated - hospital ignored them and did anyway. Messenger case in Michigan - Dr. who removed his own infant from life support charged with manslaughter - later acquitted.
  14. by   nursel56
    TralalaRN - it looks like you've never worked as an NICU nurse or in a pediatric hospital, that you are a preemie mom yourself, and that you have a long-standing vendetta about this Baby Doe Law.

    You may hint that your knowledge is vastly superior, but I have worked both in the NICU, and at CHLA in every dept there. I only mention it because of your remark suggesting that perhaps I should look up the causes of premature birth.

    However, I see that there is a personal involvement here, I do not want to disrespect you, or your political views. I'll take a breather now - I will think about it overnight. I am not a knee-jerk republican supporter. I just have heard Reagan blamed for so many things that either were passed into law before he got there (as in deregulating state mental hospitals) or were mistakes with both parties having a hand in it.

    Best to you.