Male-mediated teratogenesis and other reproductive effects: biologic and epidemiologic findings and a plea for clinical research

Wireless technologies, non-ionizing electromagnetic fields and children: Identifying and reducing health risks

Children today are conceived and live in a sea of wireless radiation that did not exist when their parents were born. The launch of the digital age continues to transform the capacity to respond to emergencies and extend global communications. At the same time that this increasingly ubiquitous technology continues to alter the nature of commerce, medicine, transport and modern life overall, its varied and changing forms have not been evaluated for their biological or environmental impacts. Standards for evaluating radiation from numerous wireless devices were first set in 1996 to avoid heating tissue and remain unchanged since then in the U.S. and many other nations. A wide range of evidence indicates that there are numerous non-thermal effects from wireless radiation on reproduction, development, and chronic illness. Many widely used devices such as phones and tablets function as two-way microwave radios, sending and receiving various frequencies of information-carrying microwave radiation on multiple simultaneously operating antennas. Expert groups advising governments on this matter do not agree on the best approaches to be taken. The American Academy of Pediatrics recommends limited screen time for children under the age of two, but more than half of all toddlers regularly have contact with screens, often without parental engagement. Young children of parents who frequently use devices as a form of childcare can experience delays in speech acquisition and bonding, while older children report feelings of disappointment due to 'technoference'-parental distraction due to technology. Children who begin using devices early in life can become socially, psychologically and physically addicted to the technology and experience withdrawal upon cessation. We review relevant experimental, epidemiological and clinical evidence on biological and other impacts of currently used wireless technology, including advice to include key questions at pediatric wellness checkups from infancy to young adulthood. We conclude that consistent with advice in pediatric radiology, an approach that recommends that microwave radiation exposures be As Low As Reasonably Achievable (ALARA) seems sensible and prudent, and that an independently-funded training, research and monitoring program should be carried out on the long term physical and psychological impacts of rapidly changing technological milieu, including ways to mitigate impacts through modifications in hardware and software. Current knowledge of electrohypersensitivity indicates the importance of reducing wireless exposures especially in schools and health care settings.

Mapping the past, present and future research landscape of paternal effects

BACKGROUND

Although in all sexually reproducing organisms an individual has a mother and a father, non-genetic inheritance has been predominantly studied in mothers. Paternal effects have been far less frequently studied, until recently. In the last 5 years, research on environmentally induced paternal effects has grown rapidly in the number of publications and diversity of topics. Here, we provide an overview of this field using synthesis of evidence (systematic map) and influence (bibliometric analyses).

RESULTS

We find that motivations for studies into paternal effects are diverse. For example, from the ecological and evolutionary perspective, paternal effects are of interest as facilitators of response to environmental change and mediators of extended heredity. Medical researchers track how paternal pre-fertilization exposures to factors, such as diet or trauma, influence offspring health. Toxicologists look at the effects of toxins. We compare how these three research guilds design experiments in relation to objects of their studies: fathers, mothers and offspring. We highlight examples of research gaps, which, in turn, lead to future avenues of research.

CONCLUSIONS

The literature on paternal effects is large and disparate. Our study helps in fostering connections between areas of knowledge that develop in parallel, but which could benefit from the lateral transfer of concepts and methods.

Parental occupational exposure to low-frequency magnetic fields and risk of leukaemia in the offspring: findings from the Childhood Leukaemia International Consortium (CLIC)

OBJECTIVES

Previously published studies on parental occupational exposure to extremely low-frequency magnetic fields (ELF-MF) and risk of acute lymphoblastic leukaemia (ALL) and acute myeloid leukaemia (AML) in their offspring were inconsistent. We therefore evaluated this question within the Childhood Leukemia International Consortium.

METHODS

We pooled 11 case-control studies including 9723 childhood leukaemia cases and 17 099 controls. Parental occupational ELF-MF exposure was estimated by linking jobs to an ELF-MF job-exposure matrix (JEM). Logistic regression models were used to estimate ORs and 95% CIs in pooled analyses and meta-analyses.

RESULTS

ORs from pooled analyses for paternal ELF-MF exposure >0.2 microtesla (µT) at conception were 1.04 (95% CI 0.95 to 1.13) for ALL and 1.06 (95% CI 0.87 to 1.29) for AML, compared with ≤0.2 µT. Corresponding ORs for maternal ELF-MF exposure during pregnancy were 1.00 (95% CI 0.89 to 1.12) for ALL and 0.85 (95% CI 0.61 to 1.16) for AML. No trends of increasing ORs with increasing exposure level were evident. Furthermore, no associations were observed in the meta-analyses.

CONCLUSIONS

In this large international dataset applying a comprehensive quantitative JEM, we did not find any associations between parental occupational ELF-MF exposure and childhood leukaemia.

Histopathological and Reproductive Evaluation in Male Rats Fed Jatropha curcas Seed Cake with or without Alkaline Hydrolysis and Subjected to Heat Treatment

Jatropha curcas cake, a by-product of biodiesel production, is rich in protein and has potential to be used in livestock feed; however, the presence of antinutritional factors and phorbol esters limits its use. Thus, this study investigated toxicological and reproductive effects in male Wistar rats after subchronic exposure to J. curcas cake subjected to detoxification procedures. Rats were divided into seven groups (n = 10) and treated for 60 days. The control group received commercial feed, while experimental groups received a diet containing 5% J. curcas cake nonhydrolyzed or hydrolyzed with 5 M NaOH. The cakes were unwashed or washed with ethanol or water and were autoclaved at 121°C for 30 minutes. Alkaline hydrolysis combined with ethanol washing decreased the phorbol ester concentration in the cake by 98%. Histopathological findings included diffuse degeneration of the liver and edema around the pulmonary vessels in the nonhydrolyzed groups. In addition, nontreated females mated with males of nonhydrolyzed unwashed group showed a decreased number of live fetuses and an increased placental weight. There were no signs of toxicity in rats given hydrolyzed cakes washed and unwashed, indicating that alkaline hydrolysis associated with heat treatment is an efficient method for detoxification of the J. curcas cake.

Assessment of Pradosia huberi effects on the reproductive system of male rats

Pradosia huberi is a species found in the Amazon region and used as an antiulcerogenic and gastroprotective agent; however, phytochemical analysis has revealed the presence of compounds with potential toxic effects on the reproductive system. For the evaluation of the toxicity of P. huberi on male fertility, male Wistar rats were divided into four groups: one control (distilled water p.o.) and three treated (hydroalcoholic extract of the stem bark of P. Huberi (PH-HAE) at doses of 1.22, 6.1, and 30.5 mg/kg p.o.) once daily, for 63 days. In the last week of treatment (from the 57th to the 63rd day), the rats were mated with untreated virgin females (n = 30/group) and were killed on day 64. To investigate the toxic potential of PH-HAE on the reproductive system of rats the following parameters were evaluated: sperm production, genotoxicity, and general development. The production of gametes and their morphology did not differ between control and treated groups. Treatment with PH-HAE did not result in fewer vaginal plugs formed, indicating that the ability to mate was not impaired, but caused an increase of 14.3 and 10.8% in the preimplantation loss index, a reduction of 14.3 and 10.8% in the implantation index, and a reduction of 5.6 and 8.2% in the postimplantation loss index of female rats mated with rats treated with 6.1 and 30.5 mg/kg, respectively, indicating a possible toxic action of PH-HAE on the reproductive system of rats.

Exposure to household painting and floor treatments, and parental occupational paint exposure and risk of childhood brain tumors: results from an Australian case-control study

PURPOSE

Childhood brain tumors (CBT) are the leading cause of cancer death in children, yet their etiology remains largely unknown. This study investigated whether household exposure to paints and floor treatments and parental occupational painting were associated with CBT risk in a population-based case-control study conducted between 2005 and 2010.

METHODS

Cases were identified through all ten Australian pediatric oncology centers, and controls via nationwide random-digit dialing, frequency matched to cases on age, sex, and state of residence. Data were obtained from parents in mailed questionnaires and telephone interviews. Information on domestic painting and floor treatments, and parental occupational exposure to paint, in key periods relating to the index pregnancy and childhood was obtained for 306 cases and 950 controls. Data were analyzed using unconditional logistic regression, adjusting for frequency matching variables and potential confounders.

RESULTS

Overall, we found little evidence that parental, fetal, or childhood exposure to home painting or floor treatments was associated with risk of CBT. There was, though, some evidence of a positive association between childhood exposure to indoor painting and risk of high-grade glioma [odds ratio (OR) 3.31, 95 % confidence interval (CI) 1.29, 8.52] based on very small numbers. The OR for the association between CBT and paternal occupational exposure to paint any time before the pregnancy was 1.32 (95 % CI 0.90, 1.92), which is consistent with the results of other studies.

CONCLUSIONS

Overall, we found little evidence of associations between household exposure to paint and the risk of CBT in any of the time periods investigated.

Paternal drug use: before and during pregnancy

OBJECTIVE

Exploratory investigation on drug use by fathers before and during pregnancy with regard to the number of pregnancies.

RESEARCH DESIGN AND METHODS

Data of Dutch community pharmacies were used in which fathers were linked to children. The prevalence of the 15 most prescribed drug groups were calculated per trimester for one trimester preconception and three trimesters during pregnancy. Drugs with possible harmful effect on the semen and/or embryo based on recent safety issues were analyzed for two trimesters before conception. Descriptive statistics was used.

RESULTS

During the four trimesters, fathers had used one or more drugs in 73% of the pregnancies. Per trimester, drug use ranged from 35 to 39%, with the highest prevalence in the third trimester, statistically significant for the use of one or two drugs. Drugs used most frequently belong to 'anti-inflammatory and antirheumatic products'. Drugs such as SSRIs with possible harmful effect on the semen and/or embryo are used in 1.4% by fathers before conception.

CONCLUSION

A proportion of 73% of fathers used drugs before and during pregnancy, increasing toward the third trimester. To increase the knowledge on possible effects, organizations like EUROCAT and (EN)(O)TIS might be encouraged to also collect paternal drug use.

Paternal treatment with cisplatin impairs reproduction of adult male offspring in rats

This study evaluated the acute and persistent effects of paternal cisplatin-treatment on progeny. Wistar male rats (45 days old) were assigned into 2 groups. Control and cisplatin (CP: 1mg/kg-d, 5 days/week, for 3 weeks, ip.). Male rats at 66 (end of treatment, acute effects evaluation) and 140 days old (after recovery period, persistent effects evaluation) were mated with females. Fetal and post-natal developments of the offspring sired by treated-male mated in both ages were evaluated, including fertility of adult male offspring. No adverse effects in fetal development or puberty onset were seen in CP offspring. However, testicular descent was delayed and postnatal growth was impaired in these animals (acute effect). Moreover, seminal vesicle weight and epididymal sperm count from adult progeny were affected (acute effects) by paternal CP-exposure. The only persistent effect found was alterations in the spermatogenesis. We conclude that paternal CP-administration during peri-puberty affects reproductive endpoints of the progeny.

The limits of two-year bioassay exposure regimens for identifying chemical carcinogens

BACKGROUND

Chemical carcinogenesis bioassays in animals have long been recognized and accepted as valid predictors of potential cancer hazards to humans. Most rodent bioassays begin several weeks after birth and expose animals to chemicals or other substances, including workplace and environmental pollutants, for 2 years. New findings indicate the need to extend the timing and duration of exposures used in the rodent bioassay.

OBJECTIVES

In this Commentary, we propose that the sensitivity of chemical carcinogenesis bio-assays would be enhanced by exposing rodents beginning in utero and continuing for 30 months (130 weeks) or until their natural deaths at up to about 3 years.

DISCUSSION

Studies of three chemicals of different structures and uses-aspartame, cadmium, and toluene-suggest that exposing experimental animals in utero and continuing exposure for 30 months or until their natural deaths increase the sensitivity of bioassays, avoid false-negative results, and strengthen the value and validity of results for regulatory agencies.

CONCLUSIONS

Government agencies, drug companies, and the chemical industry should conduct and compare the results of 2-year bioassays of known carcinogens or chemicals for which there is equivocal evidence of carcinogenicity with longer-term studies, with and without in utero exposure. If studies longer than 2 years and/or with in utero exposure are found to better identify potential human carcinogens, then regulatory agencies should promptly revise their testing guidelines, which were established in the 1960s and early 1970s. Changing the timing and dosing of the animal bioassay would enhance protection of workers and consumers who are exposed to potentially dangerous workplace or home contaminants, pollutants, drugs, food additives, and other chemicals throughout their lives.

Effect of parental morphine addiction on hippocampal long-term potentiation in rats offspring

Attention to addiction of women alone for fetus and infant's health has caused the possible role of father's status was less considered, while some developmental impairments including decrease of liter size, weight loss, congenital deficiencies, behavioral disorders, and learning and memory impairments in offspring with addicted father have been reported. In this study the effects of addiction of one or both parents to morphine on male and female offspring hippocampal long-term potentiation (LTP), were assessed. One hundred twenty female and 48 male rats (4-5 months, 250-270 g) were used. Forty females and 16 males were addicted by oral administration of morphine (32 mg/kg twice daily) for 5 days before mating. Then each two males with five females were housed (coupled) per cage as five groups for coupling: (A) addicted females+5% dextrose males (add.F); (B) addicted males+5% dextrose females (add.M); (C) addicted females+addicted males (add.MF); (D) 5% dextrose females+intact males (dex.F); (E) 5% dextrose males+intact females (dex.M). In puberty offspring LTP was induced in hippocampal dentate gyrus by stimulation of perforant path (pp). Changes of population spikes (PS) amplitude and LTP slope at 0, 5, 30, 60 and 120 min were evaluated. Slope of LTP at 30, 60 and 120 min, and amplitude of PS at 60 and 120 min in add.F and add.M offspring were significantly lower than dextrose groups (P<0.01). LTP slope and PS amplitude of male and female offspring did not different between add.F and add.M groups. Our results suggest that both parental and paternal addiction to morphine may cause memory deficiency through reduction of LTP in hippocampus.

Maternal and paternal risk factors for cryptorchidism and hypospadias: a case-control study in newborn boys

Little is known on environmental risk factors for cryptorchidism and hypospadias, which are among the most frequent congenital abnormalities. The aim of our study was to identify risk factors for cryptorchidism and hypospadias, with a focus on potential endocrine disruptors in parental diet and occupation. In a case-control study nested within a cohort of 8,698 male births, we compared 78 cryptorchidism cases and 56 hypospadias cases with 313 controls. The participation rate was 85% for cases and 68% for controls. Through interviews, information was collected on pregnancy aspects and personal characteristics, lifestyle, occupation, and dietary phytoestrogen intake of both parents. Occupational exposure to potential endocrine disruptors was classified based on self-reported exposure and ratings of occupational hygienists based on job descriptions. Our findings indicate that paternal pesticide exposure was associated with cryptorchidism [odds ratio (OR) = 3.8; 95% confidence interval (95% CI), 1.1-13.4]. Smoking of the father was associated with hypospadias (OR = 3.8; 95% CI, 1.8-8.2). Maternal occupational, dietary, and lifestyle exposures were not associated with either abnormality. Both abnormalities were associated with suboptimal maternal health, a lower maternal education, and a Turkish origin of the parents. Being small for gestational age was a risk factor for hypospadias, and preterm birth was a risk factor for cryptorchidism. Because paternal pesticide exposure was significantly associated with cryptorchidism and paternal smoking was associated with hypospadias in male offspring, paternal exposure should be included in further studies on cryptorchidism and hypospadias risk factors.

Men's influences on women's reproductive health: medical anthropological perspectives

Reproductive health has emerged as an organizational framework that incorporates men into maternal and child health (MCH) programs. For several decades, medical anthropologists have conducted reproductive health research that explores male partners' effects on women's health and the health of children. This article summarizes exemplary research in this area, showing how ethnographic studies by medical anthropologists contribute new insights to the growing public health and demographic literature on men and reproductive health. The first half of the article begins by exploring reproductive rights, examining the concept from an anthropological perspective. As part of this discussion, the question of equality versus equity is addressed, introducing anthropological perspectives on ways to incorporate men fairly into reproductive health programs and policies. The second half of the article then turns to a number of salient examples of men's relevance in the areas of contraception, abortion, pregnancy and childbirth, infertility, and fetal harm. Medical anthropological research--as well as prominent gaps in that research--is highlighted. The article concludes with thoughts on future areas of anthropological research that may improve understandings of men's influences on women's reproductive health.

Parental occupation at periconception: findings from the United Kingdom Childhood Cancer Study

AIMS

To study the risk of childhood cancer in relation to parental occupation and related exposures.

METHODS

Self reported occupational data from mothers and fathers of 3838 children with cancer and 7629 control children were analysed. Odds ratios were calculated for 31 "occupational groups" by parent, diagnostic group (leukaemia, acute lymphoblastic leukaemia (ALL), central nervous system tumours, and other cancers) and time of exposure (periconception, birth, and diagnosis).

RESULTS

Findings did not support the hypothesis that occupational exposure of fathers to ionising radiation increases the risk of childhood cancer in their offspring. Specific examination of periconceptual chemical exposures showed small but statistically significant increased risks for leukaemia and ALL among children whose fathers were exposed to exhaust fumes, driving, and/or inhaled particulate hydrocarbons. In the remaining analyses, a fourfold increase in the risk of other cancers was observed among the children of fathers working with leather but based on small numbers. Both maternal and paternal exposure to textile dust was related to an increased risk of other cancers.

CONCLUSION

Results failed to produce any strong evidence to link parental occupational exposures with an increased risk of childhood cancer. No relation was found for paternal periconceptual exposure to ionising radiation. The consistency of the associations observed between childhood leukaemia and paternal occupational exposure to exhaust fumes, driving, and/or inhaled particulate hydrocarbons at periconception suggest a small risk for vehicle related exhaust. However, other explanations cannot be excluded and further research into the nature of the associations is required.

Lead: male-mediated effects on reproduction and development in the rat

The present study was designed to determine the effect of relatively low levels of lead acetate (25 and 250 ppm) exposure on fertility and offspring viability in male Sprague-Dawley rats. Protein synthesis in 2-cell embryos was monitored by [35S] methionine labeling and two-dimensional SDS gel electrophoresis. Fertility was reduced in males with blood lead levels in the range 27-60 microg/dL. Lead was found to affect initial genomic expression in embryos fathered by male rats with blood lead levels as low as 15-23 microg/dL. Dose-dependent increases were seen in an unidentified set of proteins with a relative molecular weight of approximately 70 kDa (Mr). These results indicate that male-mediated effects of lead may be observed in the 2-cell embryo. The alteration observed in embryonic gene expression with paternal lead exposure may be useful for studying the role of the paternal contribution to the activation of the embryonic genome and protein synthesis in the early embryo.

Childhood cancer and paternal employment in agriculture: the role of pesticides

Previous studies have suggested that the offspring of men potentially exposed to pesticides at work may be at increased risk of kidney cancer (Wilms' tumour), brain tumours, Ewing's bone sarcoma and acute leukaemia. This paper examines the association between potential occupational exposure of fathers to pesticides and offspring's death from cancer in a large national database. Records for 167703 childhood deaths occurring during 1959-63, 1970-78 and 1979-90 in England and Wales have been analysed. Among the offspring of men with potential occupational exposure to pesticides there were 5270 deaths, of which 449 were due to cancer. Associations were assessed using proportional mortality ratios (PMRs), with adjustment for age, year of death and paternal social class. Of the childhood cancers previously linked with potential paternal occupational exposure to pesticides, the only statistically significant excess was for kidney cancer (PMR=1.59, 95% CI=1.18-2.15, based on 42 deaths). Although these results offer some support for the suggestion that paternal occupational exposure to pesticides may be related to the subsequent development of kidney cancer in offspring, other explanations cannot be excluded. In the light of the findings presented here and elsewhere, further, more detailed, research into the nature of this relationship is warranted.

Criminalizing Women's Behavior

Legal precedent for criminalizing the behavior of pregnant women has been established in an attempt to protect the fetus. Elevating fetal rights over maternal rights is based on questionable assumptions and inconclusive medical evidence. These criminalization policies are sexist and serve to victimize poor, pregnant women. This paper examines the evidence and policies and suggests an alternative policy approach to dealing with families with parental drug use issues.

Paternal exposure of rabbits to lead: behavioral deficits in offspring

Paternal exposures to exogenous agents have been reported to produce a variety of developmental defects in the offspring. In experimental animals, these effects include decreased litter size and weight, increased stillbirth and neonatal death, birth defects, tumors, and functional/behavioral abnormalities-some of these effects being transmitted to the second and third generations. The majority of experimental studies assessing nervous system function of offspring following paternal exposures have utilized rats as the experimental animal, but other species can be used. The National Toxicology Program (NTP) has initiated studies to validate the rabbit as an animal model for human reproductive toxicity, because rabbits are the smallest laboratory animal from which ejaculates can be collected repeatedly. An important part of reproductive toxicology is assessment of the reproductive ability of males following exposure, as well as developmental and functional assessment of their offspring. This article describes a pilot study and a main study to investigate the feasibility of using rabbits to assess the functional effects of paternal exposure to lead. The pilot study included seven male rabbits per group exposed for 15 weeks to lead acetate sufficient to produce 0, 50, or 110 micrograms/dl blood lead. The main study included 15 male rabbits per group exposed for 15 weeks to lead acetate to produce 0, 20, 40, and 80 micrograms/dl blood lead. At the conclusion of the exposure, male rabbits were mated with unexposed females. These females carried their litters to term, delivered, and reared their own offspring. The offspring were weighed at 5, 10, 15, 20, 25, 30, and some at 35 days of age. They were also tested for exploratory activity in a standard figure-eight "maze" for 30 min/day on days 15, 20, 25, and 30. A second assessment of exploratory behavior, along with a simple test of aversive conditioning, was attempted in the pilot study, but was judged not to be suitable for the main study. Of the 21 male rabbits that were mated in the pilot study, 16 produced viable litters (6/7, 6/7, and 4/7 in control, low- and high-lead groups, respectively), with a mean number of 6 live births/litter in each treatment group (range 2-8). Of the 60 rabbits mated in the main study, 57 produced litters, and two rabbits died giving birth. Significant postnatal deaths were observed in all groups, with about one half of the offspring dying before testing was initiated at day 15. There were no treatment-related effects on offspring weight gain through wearing. The data suggest that paternal lead exposure of rabbits may reduce figure-eight activity on day 25, the time of peak activity in the offspring.

The politics of reproductive hazards in the workplace: class, gender, and the history of occupational lead exposure

Over the past two decades, several U.S. companies have sought to bar women from jobs that expose them to potential reproductive hazards, justifying these exclusionary policies by their professed concerns for the well-being of unborn children and potential liability. Although recent court cases have stimulated academic interest in this issue, a historical review of the public health and medical literature reveals that this debate is not new. To understand the logic behind the emergence of "fetal protection" policies, one must examine the scientific history of occupational teratogens and the socio-political and economic forces that have driven scientific research in this field. Using lead as an example, the author argues that research on the reproductive hazards of employment has historically emphasized the risks to women and downplayed the risks to men. This results in environmental health policies that do not uphold the ultimate goal of occupational safety for all workers, but rather reinforce the systemic segregation of men and women in the workplace. Although the political struggle over exclusionary policies has a feminist orientation, it also has important class dimensions and ultimately must be viewed within the broader context of American capitalist production.

Paternal exposures: impact on reproductive and developmental outcome. An overview

Experimental and epidemiologic investigations document the adverse consequences of an array of paternal exposures on the development of subsequent offspring. Male-mediated abnormalities have been reported after exposure to therapeutic and recreational drugs, to chemicals in the workplace and environment and to ionizing radiation. The impact on progeny outcome includes: an increase in congenital malformations, spontaneous abortions, fetal resorptions; low birth weight; increase in childhood cancers; developmental, neurobehavioral, neuroendocrine, neurochemical abnormalities; effects in F2 generation progeny. Fertility is often unaffected. The comparative influence of genetic, epigenetic and nongenetic mechanisms in the etiology of paternally-mediated adverse outcomes is unknown. There is no a priori reason to assume that male-mediated effects are limited to the agents studied to date. The broad spectrum of alterations recorded after exposure to a variety of unrelated agents suggests the need for a more focused effort and multidisciplinary exploration of the potential impact of the male parent on reproductive outcome.

Preconception care: a means of prevention

Preconceptional health promotion should provide a prevention framework for interactions with all women of childbearing potential. Preconceptional counselling is properly directed by specialists in the field of obstetrics and gynaecology, but a multispecialty effort may be needed to achieve adequate information for decision-making. Preconceptional health care offers an important opportunity for physicians involved in women's health to expand a primary care and a primary prevention focus. The obstetrician or gynaecologist is not only involved in acute diagnosis and treatment plans but also in disease prevention, risk and behaviour modification and counselling, which are integral parts of primary prevention and co-ordinated women's health care.

A gender analysis of policy formation: the case of fetal abuse

In this paper we argue the value to policy research of taking a feminist perspective on policy issues. We show the development of fetal abuse as a policy issue and how the often unconscious patriarchal stance taken by those participating in the debate has led to fetal abuse being defined as an issue that arises from the negligence of women, when an equally good case can be made for male fetal abuse. We then show how this definition of the problem followed from the patriarchal belief systems of those who framed the issue.