Sound Science and Unsound Ideology: Sixty Years of Obstetric Ultrasound

Ultrasound image used in an anti-abortion billboard in Ireland, 2012. Photo: The Vagenda

For decades now, ultrasound technology has been a fixture in the journey from pregnancy to parenthood. It has also become a prized weapon among abortion opponents in the battle over reproductive rights.

Ultrasound, which uses high-frequency sound waves to render images of a developing fetus, had its beginning 60 years ago this week, with the publication of a seminal paper in the British medical journal The Lancet. The development of the technology has a colorful history, one involving flying mammals, German submarines, a desert-dwelling inventor, and countless medical professionals who saw a range of patient care possibilities.


Ultrasound is a powerful tool, which can benefit patients or be used as a cudgel by abortion opponents.


But that colorful history belies the drab and fuzzy appearance of most ultrasounds. That limitation, though, has never stopped it from taking on enormous significance. When the technology was first developed, it gave obstetricians an unprecedented ability to survey fetal development, making it one of the most important advances in their field during the latter half of the 20th century.

By the same token, ultrasound has not only been a valuable medical tool but also a powerful storytelling tool. Today, it is often put to use four or more times before a patient’s due date. While the FDA and other authorities advise against ultrasounds that aren’t medically necessary — recommending just two for a low-risk pregnancy — many patients opt for additional, elective ultrasounds for the sake of having keepsake images. Posting those images online has become a popular way to share their news with family and friends. Continue reading

STD Awareness: Prevention vs. Punishment

Before antibiotics, syphilis could kill and gonorrhea was responsible for most cases of infertility. Both diseases could spread from husband to wife to baby, potentially destroying families. So you’d think medical breakthroughs in prevention and cures would be welcomed with open arms.

The actual history, like the humans who create it, is much more complicated.


Compassion, rather than fear and guilt, should guide medical practice.


During World War I, sexually transmitted diseases were a huge problem — second only to the 1918 flu pandemic in the number of sick days they caused (7 million, if you’re counting). The Roaring Twenties saw a sexual revolution, and by World War II, the military was once more fretting about losing manpower to debilitating infections that drew men away from the front lines and into the sick bays.

The armed forces did what it could to suppress prostitution and distract soldiers with recreational activities. But the human sex drive could not be contained: The vast majority of U.S. soldiers were having sex — even an estimated half of married soldiers were not faithful to their wives during WWII. Victory depended on soldiers’ health, so during both WWI and WWII, the military provided its sexually active soldiers with “prophylaxis,” medical treatments that could reduce risk for venereal disease — or VD, as sexually transmitted diseases were called back then.

Anyone who thinks condoms are a hassle or “don’t feel good” should read medical historian Allan M. Brandt’s description of a WWI-era prophylactic station, which soldiers were instructed to visit after sexual contact: Continue reading

STD Awareness: Gonorrhea, Women, and the Pre-Antibiotic Era

Penicillin, the first cure for gonorrhea, was developed for mass production in the 1940s.

Penicillin, the first reliable cure for gonorrhea, was mass produced in the 1940s.

It’s Women’s History Month, a time to reflect on the achievements of women worldwide — like Margaret Sanger, Rosalind Franklin, and Florence Nightingale, or contemporary heroes like Wangari Maathai. But it may also be a time to examine some of the sadder aspects of womanhood, including the increased burden gonorrhea imposes on women. While gonorrhea is no picnic for anyone, it wreaks the most havoc in female reproductive tracts. In fact, before antibiotics, gonorrhea was a leading cause of infertility — one 19th century physician attributed 90 percent of female infertility to gonorrhea. Not only that, but the effects of gonorrhea could seriously reduce a woman’s overall quality of life.


With gonorrhea becoming more resistant to antibiotics, the CDC warns of a return to the pre-antibiotic era.


Gonorrhea is described by written records dating back hundreds of years B.C. Ancient Greeks treated it with cold baths, massage, “cooling” foods, and vinegar. In the Middle Ages, Persians might have recommended sleeping in a cool bed with a metal plate over the groin. A bit to the west, Arabs tried to cure gonorrhea with injections of vinegar into the urethra. Kings of medieval England might have had their gonorrhea treated with injections of breast milk, almond milk, sugar, and violet oil.

Although gonorrhea is as ancient an STD as they come, because women rarely have symptoms while men usually do, for much of history it was mostly discussed in terms of men. The name gonorrhea itself derives from the ancient Greek words for “seed flow” — gonorrhea was thought to be characterized by the leakage of semen from the penis. This confusion inspired many misguided notions throughout the millennia, such as the idea that almost all women carried gonorrhea and transmitted it to their unwitting male partners. Continue reading

STD Awareness: Scabies and Pubic Lice

Latex barriers, such as condoms and dental dams, offer fantastic protection against most sexually transmitted diseases (STDs). They are not 100 percent effective, however, and there are even some STDs for which latex poses no obstacle. Because barriers only cover a portion of the genital area, they do not offer sufficient protection against scabies or pubic lice, both of which are caused by infestations of tiny arthropods.

Both scabies and pubic lice are treated with topical medications. A Planned Parenthood health center, as well as other health care providers, clinics, and health departments, can provide testing and treatment. Follow treatment instructions to the letter to ensure success. During this time, you can take actions to prevent reinfection, including vacuuming floors and cleaning rooms, and thoroughly washing all clothing, towels, and bedding in hot water. Your sexual partner(s) might also need to receive treatment.

Now let’s learn more about both specific STDs.

Scabies

Sarcoptes scabiei, the mite that causes scabies. Image from the Public Health Image Library.

Three-hundred million people carry the eight-legged mite that causes scabies, Sarcoptes scabiei var. hominis. While it’s so small that you need a microscope to see it, it causes an itchy condition that you can definitely feel. The female mite burrows under the skin, usually starting between the fingers and then spreading to the rest of the body, digging until she dies and laying eggs along the way. When the eggs hatch, the nymphs travel to the surface of the skin, where they may transfer to another host or reinfect the original host. Continue reading