Intense public debates over reproductive technology (e.g., surrogacy, multiple births, fate of frozen embryos) and pregnancy (e.g., maternal-fetal conflicts, abortion) would suggest that medicine’s primary interest in motherhood centers on the limited time between conception and birth. Contributors to the September 2013 issue of widen that circle of medicine’s interest to women’s lifelong experiences as mothers—biological and non. Motherhood-related concerns include a woman medical student’s planning for family and career, the exclusion of pregnant women from drug trials, inducing lactation for nongestating mothers, and women—generally poor and often immigrant—who care for the children of others.
Recommendation for induced lactation in nonbiological mothers is widespread in the medical literature. To resist offering the service for nongestating lesbian mothers bespeaks potential discrimination.
Research findings that nutritional inadequacy and exposure to environmental toxicants, especially in utero and in early life, induce epigenetic changes that last throughout life raise complicated questions about maternal responsibility.
Anne Drapkin Lyerly, MD, MA and Ruth R. Faden, PhD, MPH
Participation in a research study—in which there are rigorous standards and close monitoring—may be a safer context for the use of medications in pregnancy than the clinical setting, where the evidence base is lacking.