content notice this issue: ongoing genocide in Palestine, Brittany Watts’ miscarriage and criminalization, the Holocaust
This week I’m sending a long reflection to all subscribers, so I hope you’ll take a moment to read that separate email coming tomorrow. I’m planning to get back to long-form writing in this space - I miss the depth of blogging and having some space to work through ideas more deeply than I’ve allowed myself to in the weekly recaps. Looking forward to your insights and responses. Also getting back to my discussion of abortion-related books the first week of January, so keep an eye out for that!
For now, I’d like to share with you two new papers I have out with some brilliant coauthors! Both are in the special issue of the Journal of Midwifery & Women’s Health focus on “Contemporary Issues in Contraception and Abortion Care.”
The first, “Toward Opt-In Consent for Pregnancy Testing,” reviews the ethical imperative that providers stop - neutrally, casually, without critical thinking - collecting urine and conducting pregnancy testing from a “it’s what we’ve always done” stance and instead seek explicit consent for pregnancy testing. An intentional approach to the routine practice of urine pregnancy testing must focus on not only evidence-informed clinical indications, but also situate the testing - and its associated care - within a rights-based approach recognizing the sociopolitical framework impacting the results of that testing on the patient - and the provider’s - choices. Documenting a positive pregnancy test, in a medical record that becomes a legal record, in a state hostile to abortion will carry grave consequences for that patient as well as the provider. We must reframe our approach accordingly. My coauthors and I discuss the example of urine drug testing in pregnancy and its slippery slope toward state surveillance, particularly for Black, Indigenous, and Latine patients, and the resulting legal case leading to our current practice of explicit consent for this testing. The same is now the case for pregnancy testing, though while this has been true in many areas for a long time the national urgency calls for renewed attention. We hope this paper offers language to clinicians and patient advocates thinking holistically about safe pregnancy and abortion care. Opt-in consent should be the standard of care for pregnancy testing going forward.
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