Jason Umans, an internist and maternal-fetal pharmacologist at Georgetown University tells Time: "In emergencies, you always hear, 'Treat the pregnant women first!' The joke should be 'Yeah, how?'" Because when it comes to drugs, and drug testing, pregnant women are often left out of the equation.
According to a report by Bonnie Rochman,
As recently as 20 years ago, some in the medical community were still using the male body as their research prototype and extrapolating for women. The approach, as summarized by Anne Drapkin Lyerly, an obstetrician and bioethicist at Duke University, was "If you happen to have boobs and a uterus, then we'll adjust things."
These days, women are included (the "First Wave"), but, Rochman points out, more data on pregnant women is needed. That's why "an élite group" of 30 doctors, ethicists, scientists and government officials gathered in Washington this spring to launch a movement they're calling the Second Wave of clinical research.
As Rochman notes, Chronic illnesses like depression, diabetes and hypertension don't magically disappear during pregnancy. And more and more women are having children later in life, increasing the chances that they have other health problems. How you you weigh the benefits of certain drugs for the mother versus the health risk to the fetus? Given shifts in her metabolism and weight gain, what is what is the appropriate dosage for a mom-to-be? And, of course, what issues arise regarding testing drugs on pregnant women?
"Everyone thinks, Oh, my God, research on pregnant women! All kinds of ethical flags go up," says Ruth Faden, director of the Berman Institute of Bioethics at Johns Hopkins University. "We don't have to start with high drama." There's enough "low-hanging fruit," she says, "that we could keep lots of medical researchers busy for a long time."