Friday, January 23, 2015

Potential Moms and Painkillers! Today's Study Popularization.

If you ovulate you are a potential mom.  Indeed, you can be regarded as one if you are a woman between the ages of fifteen and forty-four!   It doesn't matter one whit if you are not going to become pregnant any time soon (or ever).  You are still a potential mom.

And perhaps you should just take any serious pain you have, without mega-strength painkillers.

Here's a story about all that with the headline:

Potential moms using painkillers, study finds

That means women between the ages of fifteen and forty-five, and the painkillers the headline refers to are opioid painkillers, such as Vicodin and OxyContin.  Those can cause birth defects in a fetus.

But how does that relate to women in that age group who are not pregnant or not planning to become pregnant?

Well, my dears, here's the answer:

Previous studies of opioid use during pregnancy suggest that the medicines could increase risk of major defects of the baby’s brain and spine, heart and abdominal wall.
But this is the first time that the CDC has looked into opioid painkillers specifically among women of child-bearing age, which is important because many pregnancies aren’t recognized until well after the first few weeks, and half of all U.S. pregnancies are unplanned, officials said.

Emphasis mine.

The study summary I discuss here gives not one single recommendation for all those "potential moms" out there.  It's hard not to read it as implying that pain is something "potential moms" should just bear bravely, or at least seriously consider that alternative.

I got carried away a bit thinking about all the stuff "potential moms" aka women do.  They might drink (gasp!), they might ski downhill at a rapid rate, they might dance all night through!  Perhaps all women of the fertile ages should be moved into protected housing where their diet and lifestyles could be controlled?

The CDC's own summary on the study is quite a bit saner.  It recommends this:

“Women, who are pregnant, or planning to become pregnant, should discuss with their health care professional the risks and benefits for any medication they are taking or considering.” said Coleen Boyle, Ph.D., MS.Hyg., Director of CDC’s National Center on Birth Defects and Developmental Disabilities. “This new information underscores the importance of responsible prescribing, especially of opioids, for women of child bearing age.”

But to return to that bolded bit in the above quote:

It's based on an interesting flaw in how that statistic is used.  That half of all US pregnancies are unplanned does NOT mean that half of all pregnancies of every US woman are unplanned.  In particular, it doesn't take into account the difference between women who use contraception and women who do not use contraception.

Here's the Guttmacher Institute on that distinction:

To repeat from the graph:  The two-thirds of women at risk of unintended pregnancy who practice contraception consistently and correctly account for only 5% of unintended pregnancies.

I'm not quite certain why that distinction is so seldom made in these types of studies.  If it was made, angry Echidne wouldn't have to keep going all haywire* over the same stuff.

This distinction also matters, because now health care providers can ask women in the fertile age categories whether they practice birth control or not, and they can also tell the women who are prescribed opioid painkillers to be very careful not to get pregnant.


*I've tried to figure out why I get so angry with the particular flavor of the pieces which use the "half of all pregnancies are unplanned" in this manner.  The reasons are  1)  that the assumption takes away all agency from women in the fertile age category (it doesn't matter what the women themselves do, pregnancy just "happens") and 2) that there is often a sense in these articles that fertile women really are just temporarily empty fetus aquaria rather than full human beings.