Pregnancy Outcomes in American Women

Sean Flaherty, Department of Economics, Franklin & Marshall College
Alison Kibler, Department of American Studies and Program in Women and Gender Studies, Franklin & Marshall College
Kirk Miller, Department of Biology, Franklin & Marshall College
Berwood Yost, Floyd Institute Center for Opinion Research, Franklin & Marshall College

The US is currently ranked 28th in the rate of infant mortality, the second lowest ranking in the developed world. This upper-division seminar for juniors and seniors examines the pressing civic problem of poor pregnancy outcomes in American women by using locally collected data and multi-disciplinary approach. The course is team taught by a biologist, an economist, a statistician, and a cultural historian of gender, with guest lecturers provide expert coverage of topics related to infant mortality and its prevention, such as medical practices, behavior, and environmental factors. The science topics addressed include the stages of human pregnancy, genetic testing, and the impact of pharmaceuticals, toxins, and nutrition on fetal development. Through readings, presentations and discussions students explore unanswered questions at the intersection of science and public policy, including "what is good prenatal care and does access to it improve pregnancy outcomes? What are the impact of alcohol, smoking, and teratogens on fetal health? When does the fetus become a person with rights equal to the mother's? How do economic status and cultural practices affect pregnancy outcomes?

An overarching goal of the course is to give students experience with the evaluation and use of evidence drawn from multiple sources, so that the
construction and defense of arguments based on statistical data is emphasized. Every week pairs of students lead their peers in a data analysis of results drawn from three local surveys, one of African American and Hispanic women in Lancaster city, one of Amish women in Lancaster County, and a 2002 survey of all women of childbearing age in Central Pennsylvania that was the basis of the Central Pennsylvania Women's Health Study. Students may complete the course by doing an in-depth research paper or a service-learning project. The course was first taught in 2006 and was originally funded as part of a Pennsylvania Department of Health grant to the Penn State College of Medicine to create the Pennsylvania Center of Excellence for Research on Pregnancy Outcomes.

Course Learning Goals for Instructors and Students

Instructor Goals:

The instructors will teach students:

• To perform statistical analyses using data from different sources
• The basic biology involved in pregnancy and infant mortality
• The competing and/or non-medical explanations (social, economic, cultural) for poor pregnancy outcomes
• The ethical and legal debates and issues surrounding policy aimed at improving pregnancy outcomes

Student Goals:

Students will be able to:

• Use evidence, including survey data, from multiple sources and of multiple types
• Evaluate the quality of data and of the conclusions others have made from that data
• Examine a complicated and urgent public health problem and to discuss and debate with one another proposed solutions to the problem
• Make effective presentations and respond confidently to questions about their analysis
• Write short, cogent position papers on narrowly defined topics
• Develop a longer research project and paper