Bhubaneswar: Poor sanitation practices, such as open defecation, are affecting pregnancy outcomes of Indian women, especially premature birth, says a study.
The research, published in the journal PLOS Medicine, studied pregnancy outcomes in two rural areas of Odisha.
Bijaya K. Padhi from the Asian Institute of Public Health, Bhubaneswar, and colleagues enrolled 670 women during the first trimester of their pregnancy, recorded information about toilet access and sanitation practices for each woman at enrollment, and followed them through pregnancy until birth.
They found that compared with women who used a latrine, women who defecated in the open had a significantly greater risk of adverse pregnancy outcomes overall and preterm birth, but not low birth weight.
Although the researchers adjusted for numerous confounding factors in their analysis, including poverty, social class, and caste, the women who defecated in the open may have shared other unknown characteristics that were actually responsible for their increased risk of an adverse pregnancy outcome.
“This study indicates that in the context of maternal and child health prevention research, sanitation is an important dimension of women’s health and distinct from social class and caste,” said senior study author Pinaki Panigrahi from the University of Nebraska in the US.
“We’re really bringing together a solution that is better for women but also better for the planet,” Edwards said.
Born out of research conducted during their graduate studies at the University of Pennsylvania, Lia’s creators say it’s the first flushable and biodegradable pregnancy test developed. The product recently obtained clearance from the U.S. Food and Drug Administration (FDA).
Lia breaks down like toilet paper and can be flushed in a standard-flow sewer or septic systems.
Creating a paper test that could hold up long enough to test urine samples but eventually disintegrate after flushing was a major challenge.
“We really had to develop our own coatings, proprietary coatings, to allow the paper and the materials that we’re using to hold up in use but also be able to break down quickly after you’re done,” Edwards said.
“It’s kind of a very counterintuitive sort of thing,” she added. “You want something that has rigidity and structure, but then after you’re done with it, doesn’t, and is able to become flimsy and separate in water.”
Edwards demonstrated by wetting a Lia prototype under a faucet. In the section that tests urine samples, the water was absorbed, while along the outer edge, a water droplet remained intact.
The test eventually soaked up even more water, becoming pliable enough for its two paper layers to easily separate. Lia’s paper layers are crimped and held together by force, not glue, which helps it dissolve. Users can speed up the breakdown process by tearing the test in half, at notches near the centre.
In addition to being better for the environment, a flushable test has major implications for women’s privacy.
“We know that there’s sometimes fear around getting and obtaining a pregnancy test,” Edwards said. “Those extra efforts or having to ask somebody, the judgment in that is sometimes enough to have somebody not take a pregnancy test as soon as they should.”
“Lots of women tell their stories about hiding pregnancy tests in trash, trash cans, taking them in public restrooms, wrapping them in tinfoil and hiding them in other garbage cans. I mean, some extreme stories,” she added.
Dr Meera Shah, a physician based in New York and a fellow at Physicians for Reproductive Health, spoke of teenage patients whose privacy was compromised when their parents discovered pregnancy tests in the trash. The safety of domestic violence victims can also be potentially threatened by the discovery of a disposed of the test.
“I’ve had patients tell me that their partners found their pregnancy test in the trash can, and that put them at risk for further abuse at home,” Shah said.
“I think that a discreet pregnancy test can empower women and empower people to be able to take a test without worrying about outside interference,” she said. “That has the potential to further engage them with the reproductive health care that they need after that.”
“Often times I hear that pregnancy tests can be expensive,” Shah said. “I tend to work with lower-income patients, patients who have poorer access to reproductive health care services, and so I think the cost can be a barrier.”
Lia will be available in the third quarter of 2018 and sell for between $7 and $8, comparable to pregnancy tests currently on the market. (VOA)