STD Awareness: What Does “Congenital Syphilis” Mean?

Treponema pallidum, the bacteria that causes syphilis

Treponema pallidum, the bacteria that causes syphilis

Congenital syphilis, for centuries a leading cause of infant mortality, is often thought of as an antique affliction, relegated to history books — but it is on the rise again. Between 2012 and 2014, there was a spike in congenital syphilis rates, which increased by 38 percent and are now the highest they’ve been in the United States since 2001. As of 2014, the last year for which we have data, more babies were born with syphilis than with HIV.

The word “congenital” simply means that the baby was born with syphilis after being infected in the womb. When an expecting mother has syphilis, the bacteria that cause the disease can cross the placenta to infect the fetus — and will do so 70 percent of the time. As many as 40 percent of babies infected with syphilis during pregnancy will be stillborn or will die soon after birth. It can also cause rashes, bone deformities, severe anemia, jaundice, blindness, and deafness. Congenital syphilis is especially tragic because it’s almost completely preventable, especially when expecting mothers have access to adequate prenatal care and antibiotics. Penicillin is 98 percent effective in preventing congenital syphilis when it is administered at the appropriate time and at the correct dosage.


More babies are being born with syphilis — but this trend can be reversed with wider access to prenatal care.


Incidence of congenital syphilis is growing across all regions of the country, but rates are highest in the South, followed by the West. Rates have also been increasing across ethnic groups, but, compared to white mothers, congenital syphilis rates are more than 10 times higher among African-American mothers and more than 3 times higher among Latina mothers, illustrating the need to increase access to prenatal care for all expecting mothers — and to ensure that this prenatal care is adequate.

Anyone receiving prenatal care should be screened for syphilis at their first visit, and some pregnant people — including those at increased risk or in areas where congenital syphilis rates are high — should be screened a second time at the beginning of the third trimester and again at delivery. Continue reading

“Instrument of Torture”: The Dalkon Shield Disaster

This Dalkon Shield is archived at the Dittrick Medical History Center and Museum at Case Western Reserve University. Photo: Jamie Chung

This Dalkon Shield is archived at Case Western Reserve University. Photo: Jamie Chung

These days, IUDs, or intrauterine devices, have stellar reputations as highly effective contraceptives. Along with implants, IUDs can be more effective than permanent sterilization, and their safety record is fantastic. We also have powerful regulations in place to keep dangerous medical devices off the market, and the FTC can keep manufacturers from making false claims in advertising.

But a previous generation of birth-control users might associate IUDs with dangerous pelvic infections and miscarriages. That’s because a single device, called the Dalkon Shield, almost single-handedly destroyed an entire generation’s trust in IUDs. At the time of its debut, there were dozens of IUDs on the market — but the Dalkon Shield unfairly tainted the reputation of all of them. With no FDA or FTC regulations reining in untested devices or false advertising, women in the late 1960s and early 1970s didn’t enjoy the protections that we take for granted today. And it was actually the Dalkon Shield’s string, which was made with a material and by a method that hasn’t been used in IUDs before or since, that made it dangerous.


Today, IUDs are the most popular form of contraception among physicians wishing to avoid pregnancy.


We’ve known about IUDs for more than a century, and have made them out of ebony, ivory, glass, gold, pewter, wood, wool, and even diamond-studded platinum. These days, IUDs release hormones or spermicidal copper ions, but these older devices were simply objects inserted into the uterus that acted as irritants, possibly enlisting the immune system to kill sperm. They were not as effective as modern-day IUDs.

The Dalkon Shield was invented in 1968, was made primarily of plastic, and had “feet” — four or five on each side — to prevent expulsion. In 1970, after being marketed independently, it was sold to family-owned pharmaceutical giant A.H. Robins Company, of Robitussin fame. It was manufactured in the same factory where ChapStick was produced, and retailed for $4.35.

Dr. Hugh J. Davis, the Dalkon Shield’s primary inventor, claimed that users of his device had a 1.1 percent pregnancy rate — but that number was based on a small, methodologically flawed study conducted over eight months. In fact, the Dalkon Shield had a 5.5 percent failure rate over the course of a year. The fact that the Shield didn’t provide high protection against pregnancy was a huge problem, but its design also dramatically increased risk for pregnancy complications. Of the tens of thousands of users who became pregnant while wearing the Dalkon Shield, 60 percent of them had miscarriages. Continue reading

Over 90 Percent of What Planned Parenthood Does, Part 24: Miscarriage Management and Counseling

Welcome to the latest installment of “Over 90 Percent of What Planned Parenthood Does,” a series on Planned Parenthood Advocates of Arizona’s blog that highlights Planned Parenthood’s diverse array of services — the ones Jon Kyl never knew about.

holding handsMiscarriage. It’s a common occurrence — at least 10 to 15 percent of all pregnancies end this way — but one that is not often spoken about. When carrying a wanted pregnancy, its sudden loss can trigger a range of emotions. During this time, Planned Parenthood can help.


There is no “right” or “wrong” way to feel after having a miscarriage.


What Is Miscarriage?

When a pregnancy ends before it has reached the 20-week mark, a miscarriage has occurred; most miscarriages occur within the first eight weeks of pregnancy. Pregnancy loss after the 20-week mark is called stillbirth, and while it isn’t as common as miscarriage, stillbirth occurs in 1 out of 160 pregnancies.

Signs of a miscarriage include vaginal bleeding or spotting, severe abdominal pain or cramping, pain or pressure in the lower back, or a change in vaginal discharge. These symptoms aren’t specific to miscarriage — they could indicate other problems, so visit a health-care provider if you experience them during your pregnancy.

After a miscarriage, you might have pregnancy-related hormones circulating in your body for one or two months. Your period will most likely return within 4 to 6 weeks. While you may be physically ready to get pregnant again after you’ve had a normal period, you might want to consult with a health-care provider about the need for medical tests. You also might need to think about when you will be emotionally ready to try for another pregnancy. Continue reading

STD Awareness: Is Syphilis Making a Comeback?

men syphilisBefore antibiotics, syphilis was the most feared sexually transmitted disease (STD) out there. It was easy to get, quack cures were ineffective and often unpleasant, and it could lead to blindness, disfigurement, dementia, or even death. When we were finally able to zap infections away with drugs like penicillin, it seemed like we’d finally won the battle against this scourge. Whereas syphilis rates were highest before antibiotics became widespread in the 1940s, by 2000 we saw a low of 2.1 cases of syphilis per 100,000. At the dawn of the new millennium, many scientists thought the United States was at the dawn of the complete elimination of syphilis.


Using condoms, regular STD testing, and limiting sex partners are the best ways for sexually active people to stay healthy.


Must all good things come to an end? They shouldn’t have to, but in the case of syphilis, the Centers for Disease Control and Prevention (CDC) has announced that syphilis rates are rising, with incidence doubling since 2005. In the United States, there are now 5.3 cases of syphilis per 100,000 people, but that number is a bit misleading because it represents an average across the general population. When you break the population down by age, race or ethnicity, gender, or sexual orientation, that rate might be much higher or much lower. For example, syphilis rates are actually on the decline among women (at only 0.9 cases per 100,000), but among men it is 9.8 per 100,000. In fact, most new syphilis cases — 91.1 percent of them, to be precise — are in men, most of whom are gay or bisexual.

Syphilis is rising the most dramatically among men in their twenties, especially among men who have sex with men (MSM). While some wonder if syphilis is growing among twenty-somethings because this group didn’t live through the early era of AIDS, when HIV was seen as a death sentence and safer sex practices were more common, it might also be due to the fact that STD rates are higher among young people in general. Continue reading

STD Awareness: Sexually Transmitted Diseases and Pregnancy

Every month since January 2011, we’ve been sharing installments of our STD Awareness series, and each month, we’ve encouraged you to protect yourself from sexually transmitted diseases (STDs) by using dental dams and condoms. But what if you’re trying to get pregnant? In that case, you’re probably not using condoms! However, it is very important that partners know their STD status — being screened and treated for STDs prior to pregnancy is a good idea for your health, and can protect your future baby.


If you and a partner are trying to get pregnant, you might consider being screened for STDs together.


When present during pregnancy, certain STDs can have negative health effects for you or your future baby (including preterm labor, stillbirth, low birth weight, pneumonia, certain infections, blindness, and liver disease), especially if they are not cured or treated in time. Receiving prenatal care can help prevent these problems, so it is important to be screened and treated for STDs prior to or early in your pregnancy.

During pregnancy, the immune system undergoes changes, which are probably necessary to ensure that the body doesn’t reject the fetus — normally, the immune system recognizes non-self cells as potential pathogens and attacks. These immune system changes might make a pregnant person more susceptible to disease. Latent viral infections, like genital warts or herpes, might come out of dormancy. Additionally, anatomical changes lead to a larger exposed area of the cervix, which is potentially more vulnerable to initial infections. Continue reading