A new article critiques the âfirst everâ drug for postpartum depression as being a form of âobstetric violence.â
The authors, Alicia Ely Yamin of Harvard Law School and Lisa Cosgrove of the University of Massachusetts argue that addressing the social and economic factors that contribute to PPD, such as lack of parental leave and childcare support, is a more effective approach than simply prescribing medication. They also sound alarms about dangers associated with the drug, such as its potential for addiction. Yamin and Cosgrove write:
âWe argue here that the reduction of reproductive subjectsâ experiences to biochemical disorders, together with the lowering of regulatory standards for the pharmaceutical industry, threatens to perpetuate a subtle but damaging form of obstetric violence, which detracts from structural concerns of reproductive justice. Taking the recent approval of the âfirst-everâ pill for postpartum depression, zuranolone (brand name Zurzuvae) as a case example, we maintain that prescribing this medication without robust informed consent about its potential harms represents a subtle but dangerous form of obstetric violence.â
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This article concentrates too much on social and economic factors that contribute to PPD. I would have preferred an analysis of the effectiveness of this drug. When Zurzuvae was first approved I was very unimpressed by a mostly favorable article about it in the New York Times. So I looked at the Zurzuvae label and calculated that it was not effective for 85% of the study participants when compared to placebo (I did calculations based on Table 5 from study 1). Given that this is a pharmaceutical company study who knows if itâs effective at all.
Iâm not a statistician and I canât guaranty that my calculations are correct. But there could be no worse obstetric violence than prescribing an ineffective drug, especially one with significant adverse effects. Whether new mothers should have more support is undoubtedly true but a totally separate issue.
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