Saving Babies

It has been close to six decades since Watson and Crick discovered the structure of DNA and more than ten years since the human genome was decoded. Today, through the collection and analysis of a small blood sample, every baby born in the United States is screened for more than fifty genetic disorders. Though the early detection of these abnormalities can potentially save lives, the test also has a high percentage of false positives—inaccurate results that can take a brutal emotional toll on parents before they are corrected. Now some doctors are questioning whether the benefits of these screenings outweigh the stress and pain they sometimes produce. In Saving Babies?, Stefan Timmermans and Mara Buchbinder evaluate the consequences and benefits of state-mandated newborn screening—and the larger policy questions they raise about the inherent inequalities in American medical care that limit the effectiveness of this potentially lifesaving technology. Drawing on observations and interviews with families, doctors, and policy actors, Timmermans and Buchbinder have given us the first ethnographic study of how parents and geneticists resolve the many uncertainties in screening newborns. Ideal for scholars of medicine, public health, and public policy, this book is destined to become a classic in its field.

Introduction: the consequences of newborn screening -- The expansion of newborn screening -- Patients-in-waiting -- Shifting disease ontologies -- Is my baby normal? -- The limits of prevention -- Does expanded newborn screening save lives? -- Conclusion: the future of expanded newborn screening

Previously published: Baltimore: Johns Hopkins University Press, 1990.

Details the characteristics of favorite cute animals, from roly-poly polar bears and waddling penguins to funny monkeys and energetic tiger cubs.

“A mosaic mystery told in vignettes, cliffhangers, curious asides, and some surreal plot twists as Raffel investigates the secrets of the man who changed infant care in America.”—NPR, 2018's Great Reads What kind of doctor puts his patients on display? This is the spellbinding tale of a mysterious Coney Island doctor who revolutionized neonatal care more than one hundred years ago and saved some seven thousand babies. Dr. Martin Couney's story is a kaleidoscopic ride through the intersection of ebullient entrepreneurship, enlightened pediatric care, and the wild culture of world's fairs at the beginning of the American Century. As Dawn Raffel recounts, Dr. Couney used incubators and careful nursing to keep previously doomed infants alive, while displaying these babies alongside sword swallowers, bearded ladies, and burlesque shows at Coney Island, Atlantic City, and venues across the nation. How this turn-of-the-twentieth-century émigré became the savior to families with premature infants—known then as “weaklings”—as he ignored the scorn of the medical establishment and fought the rising popularity of eugenics is one of the most astounding stories of modern medicine. Dr. Couney, for all his entrepreneurial gusto, is a surprisingly appealing character, someone who genuinely cared for the well-being of his tiny patients. But he had something to hide... Drawing on historical documents, original reportage, and interviews with surviving patients, Dawn Raffel tells the marvelously eccentric story of Couney's mysterious carnival career, his larger-than-life personality, and his unprecedented success as the savior of the fragile wonders that are tiny, tiny babies. A New York Times Book Review New & Noteworthy Title A Real Simple Best Book of 2018 Christopher Award-winner

Every day, everywhere, babies are born. They're kissed and dressed and rocked and fed--and completely adored by the families who love them. With an irresistible rhyming text and delightfully endearing illustrations, here is an exuberant celebration of playing, sleeping, crawling, and of course, very noisy babies doing all the wonderful things babies do best.

A key question for health care reform in the U.S. is whether expanded health insurance eligibility will lead to improvements in health outcomes. We address this question in the context of dramatic expansions in the Medicaid eligibility for pregnant women that took place during the 1980s. We build a detailed simulation model of each state's Medicaid policy during the 1979-1990 period, and use this model to estimate 1) the effect of changes in the rules on the eligibility of pregnant women for Medicaid, and 2) the effect of Medicaid eligibility changes on birth outcomes in aggregate Vital Statistics data. We have three main findings. First, the expansions did dramatically increase the Medicaid eligibility of pregnant women, but did so at quite differential rates across the states. Second, the expansions lowered the incidence of infant mortality and low birthweight; we estimate that the 20 percentage point increase in eligibility among 15-44 year old women was associated with a decrease in infant mortality of 7%. Third, earlier, targeted changes in Medicaid eligibility, such as through relaxations of the family structure requirements from the AFDC program, had much larger effects on birth outcomes than broader expansions of eligibility to all women with somewhat higher income levels. We suggest that the source of this difference was the much lower takeup of Medicaid coverage by individuals who became eligible under the broader expansions. We find that the targeted expansions, which raised Medicaid expenditures by $1.7 million per infant life saved, were in line with conventional.