Noncustodial fathers' ability to pay child support.

This article explores the extent to which noncustodial fathers can pay child support by estimating the income of noncustodial fathers and coupling these estimates with simulations of alternative normative standards for how much absent parents should be expected to contribute to the costs of rearing their children. The study indicates that the amount that is currently paid in child support ($6.8 billion in 1983) is far below the amount that should be paid under the various standards--from $24 billion to $29 billion.

The effect of induced abortion on the risks and outcome of a trial of labor after a previous cesarean birth.

Sixty-one women with previous cesarean deliveries who received prenatal care at Boston City Hospital or one of the neighborhood health centers affiliated with its obstetrical service elected to undergo a trial of labor (TOL) and attempt a vaginal birth after a cesarean (VBAC). Overall, 70 percent of these women achieved a vaginal delivery. When women who gave a history of a previous induced abortion were examined as a separate subgroup, they were able to achieve a vaginal birth not significantly different from those women in the overall group. There were no instances of uterine scar dehiscence or rupture in the series, leading to the conclusion that induced abortion, whether it occurs before or after the primary cesarean, is not a contraindication to a trial of labor with subsequent pregnancies.

Methadone maintenance in pregnancy: consequences to care and outcome.

A retrospective analysis was conducted on the outcomes of the pregnancies of 26 narcotic-addicted women who were enrolled in a methadone maintenance program. Of these women, 88% continued to use other drugs during their pregnancy, with opiates the most frequently used, and 56% of these women had urine toxicology screens positive for either heroin, cocaine, or benzodiazepines when they presented in labor. When these women were compared with a similar group of 37 pregnant polydrug users who were not in the methadone maintenance program and who delivered during the same 12-month period, there was no difference in the birth weights or in the infants' one- and five-minute Apgar scores. However, the women in the methadone maintenance program had more prenatal visits, more adequate prenatal care, and less anemia than the non-methadone maintenance program drug users. When these two drug-using groups were compared with a control group of pregnant women who delivered within the same time period, there was a significant difference in the birth weights of these two groups. This raises the question of the effectiveness of methadone maintenance programs in promoting fetal growth and well-being and in reducing polydrug use during pregnancy.