Skip to content
  • About
  • Contact
  • Contribute
  • What Physicians Say
  • My Book
  • Careers
  • Podcast
  • Speaking
KevinMD.com — Social media's leading physician voice
  • All
  • Physician
  • Burnout
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • All
  • Physician
  • Burnout
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
    • All
    • Physician
    • Burnout
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • About
    • Contact
    • Contribute
    • What Physicians Say
    • My Book
    • Careers
    • Podcast
    • Speaking
KevinMD.com — Social media's leading physician voice
  • All
  • Physician
  • Burnout
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
    • All
    • Physician
    • Burnout
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • About
    • Contact
    • Contribute
    • What Physicians Say
    • My Book
    • Careers
    • Podcast
    • Speaking
  • About Kevin Pho, MD, Founder of KevinMD
  • Aging and dementia: what physicians say, in their own words
  • Artificial intelligence: what physicians say, in their own words
  • Be heard on social media’s leading physician voice
  • Cancer: what physicians say, in their own words
  • Children’s health: what pediatricians say, in their own words
  • Contact Kevin
  • COVID-19: what physicians wrote as it happened
  • Custom enhanced author page pricing
  • Diabetes and obesity: what physicians say, in their own words
  • Direct primary care: what physicians say, in their own words
  • DMCA Policy
  • End of life: what physicians say, in their own words
  • Establishing, Managing, and Protecting Your Online Reputation: A Social Media Guide for Physicians and Medical Practices
  • GLP-1 drugs: what physicians say about Ozempic and its successors, in their own words
  • Heart disease: what physicians say, in their own words
  • Immigration and medicine: what physicians say about immigrant doctors and immigrant patients, in their own words
  • KevinMD influencer opportunities
  • Medical errors: what physicians say, in their own words
  • Medical ethics: what physicians say, in their own words
  • Medical malpractice: what physicians say, in their own words
  • Medical school: what students and physicians say, in their own words
  • Mental health: what psychiatrists and physicians say, in their own words
  • Nursing: what nurses and physicians say, in their own words
  • Opinion and commentary by KevinMD
  • Opioids: what physicians and pain patients say, in their own words
  • Physician burnout speakers to keynote your conference
  • Physician burnout: what physicians say, in their own words
  • Physician Coaching by KevinMD
  • Physician keynote speaker: Kevin Pho, MD
  • Physician personal finance: what physicians say about their own money, in their own words
  • Physician Speaking by KevinMD: a boutique speakers bureau
  • Physician suicide: what physicians say, in their own words
  • Physicians and administrators: what physicians say about who runs medicine, in their own words
  • Primary care physician in Nashua, NH | Kevin Pho, MD
  • Primary care: what physicians say, in their own words
  • Prior authorization: what physicians say, in their own words
  • Privacy Policy
  • Private equity and corporate medicine: what physicians say, in their own words
  • Race and medicine: what physicians say, in their own words
  • Recommended services by KevinMD
  • Residency: what residents and attendings say, in their own words
  • Scope of practice: what physicians, nurse practitioners, and PAs say, in their own words
  • Subscribe to the KevinMD enhanced author page
  • Subscribe to the newsletter
  • Surgeons and surgery: what surgeons say, in their own words
  • Take-home messages: what physicians say when asked to leave one
  • Terms of Use Agreement
  • Thank you for subscribing to KevinMD
  • Thank you for upgrading to the KevinMD enhanced author page
  • The electronic health record: what physicians say, in their own words
  • Vaccines: what physicians say, in their own words
  • Violence against health care workers: what physicians and nurses say, in their own words
  • What physicians say: the KevinMD records
  • Women in medicine: what women physicians say, in their own words
  • Women’s health: what physicians say, in their own words

There’s no place for “benevolent deception” in obstetrics

Megan Nix
Conditions and Diseases
November 27, 2023
Share
Tweet
Share

When I was 36 weeks pregnant with my second child, Anna, my obstetrician noted that my fetus had a disproportionately small head, or microcephaly—a condition now commonly known because of its association with the Zika virus. “We’ll just have to wait and see,” he said, meaning we’ll look for answers if the baby is affected at birth. But when my daughter was born, there were no answers then either.

Anna was silent when the midwife held her up. She was only five pounds. And then she failed her newborn hearing tests. The rotating pediatricians came in and out of the room, puzzled but silent, and they discharged us without any further testing. I had an intuitive feeling we were missing something, but I didn’t know which test to request.

When Anna was ten days old, we went to our family’s pediatrician. Noting that she was small for gestational age and had a potential hearing loss, he said, “I think we should test her for a little-known but common virus that can cause issues during pregnancy. That disease is called cytomegalovirus, or CMV.” And that’s when my research began.

The first thing I saw was the striking spectrum of CMV: babies infected in utero (who have congenital CMV, or CMV from birth) can be totally fine or they can be stillborn. In fact, I read that CMV is the leading pathogen linked to stillborn babies. In between these jarring opposites, a child with congenital CMV could also have hearing loss, vision loss, cerebral palsy, epilepsy, behavioral challenges, and/or autism—most of which would not even be linked back to CMV, since less than 10 percent of babies with CMV are ever diagnosed.

Next, a link on the American Academy of Pediatrics website made my jaw drop: unlike Zika, an infection spread through mosquitos, CMV is transmitted primarily through the saliva of toddlers—and, the AAP study revealed, a young child can be shedding CMV for up to 40 months. Because I’d had a toddler at home when I was pregnant, I wondered how likely it was that she’d been carrying CMV. The CDC’s webpage on CMV held the shocking answer: one out of three toddlers is contagious with CMV.

While I’d been warned about toxoplasmosis—the kitty litter disease, which affects about 1 in 10,000 babies—I know that CMV had never been mentioned to me during pregnancy, even though it affects a much more substantial amount of children annually. One in 200 babies, or 30,000 to 40,000 a year in the United States, are born with CMV—6,000 to 8,000 of whom will experience lifelong impairments. These affected babies outnumber the babies disabled by any other congenital disease.

I was certain I hadn’t learned about CMV during pregnancy because if I’d learned the simple prevention measures to reduce my risk (not finishing my toddler’s meals while pregnant; not kissing her on the lips; washing my hands thoroughly after changing her diaper or wiping her nose), I would have implemented these easy, healthy changes to save my next child from potentially life-threatening medical complications. When I looked back to the prenatal packets I’d received during both of my pregnancies, as I suspected, there was no mention of congenital CMV.

In this dizzying whirlwind of what seemed like a systemic and disabling silence, I wondered how this could be. How could 90 percent of the population not know about the leading cause of birth defects, nongenetic deafness, and developmental delays in the United States?

It didn’t take me long to find part of the answer. ACOG, the American Congress of Obstetricians and Gynecologists, recommends that OBs in the U.S. not counsel women about CMV, essentially stating that washing our hands more around our toddlers would be “impractical or burdensome” during pregnancy. When I looked to the bottom of this document, which was published in 2015, there was no actual study conducted on anyone pregnant to verify this claim.

Historically, CMV is not the first disease doctors have withheld from their patients under the guise of caring for the patient’s emotional well-being. As recently as 1961, 90 percent of physicians preferred not to disclose cancer diagnoses to their patients, believing that it would too greatly upset the sick person. This was the case even though a study conducted a decade earlier, in 1950, had shown that the vast majority of patients desired to know the truth.

In the field of medicine, there’s a term for this well-intentioned omission of information. “Benevolent deception” describes the silence I was facing with CMV: ACOG—and many OBs I have since interviewed personally—believe that worrying people of childbearing age about CMV will affect them too negatively for them to know the truth. This is despite the fact that studies have shown that 90 percent of women in the U.S. and in other countries want to know about CMV. And other studies, both here and abroad, have shown a drastic reduction in the risk of contracting CMV if people know how dangerous it is during pregnancy and that toddlers are the primary vector of the disease.

The American Medical Association actually bans the usage of benevolent deception—otherwise known as “the therapeutic privilege”—in medical practice today. And yet, my child would end up testing positive for congenital CMV, we found out a month later she was profoundly deaf, and she would go on to have gross motor delays from a disease I may have prevented through knowledge alone.

While it’s true that we don’t have all the answers for CMV, including a reliable treatment for it during pregnancy, we do have the ability to test newborns and treat them immediately after they’re born. But without having the conversation about CMV during pregnancy and without our doctors being more educated about the disease, these newborns will continue to go undiagnosed and untreated, with their disease unfairly dismissed.

ADVERTISEMENT

In order to dispel the myths about CMV, I’ve spent the last eight years researching and writing a book about my daughter’s disease. Today, Anna can articulate that CMV is the reason she’s deaf. But until all people planning to have a baby know the name of her disease, we do not have benevolence in obstetrical care; we have ongoing deception.

Megan Nix is a writer and author of Remedies for Sorrow: An Extraordinary Child, a Secret Kept from Pregnant Women, and a Mother’s Pursuit of the Truth. 

Prev

Clinicians' transformative health care paths [PODCAST]

November 26, 2023 Kevin 0
…
Next

Top tips to find success as a plastic surgeon, according to an industry veteran

November 27, 2023 Kevin 0
…

Tagged as: OB/GYN

< Previous Post
Clinicians' transformative health care paths [PODCAST]
Next Post >
Top tips to find success as a plastic surgeon, according to an industry veteran

 

ADVERTISEMENT

Related Posts

  • A medical student after an OB/GYN rotation: Here’s what he learned

    Nathaniel Fleming
  • An OB/GYN resident’s perspective on Black Lives Matter

    Sadhvi Batra, MD
  • A retired physician’s medical school memories

    Ronald Halweil, MD
  • The vulnerability of abortion access and training

    Shereen Jeyakumar
  • What can be done to improve our maternal death rate?

    Robert Pearl, MD

More in Conditions and Diseases

  • Shift work and circadian rhythms shape the 24/7 workplace

    Deepak Gupta, MD
  • Telehealth and postpartum psychosis defy simple blame

    Rabia Cheema, MD
  • Underage online gambling needs more than a checkbox

    Kayvan Haddadan, MD
  • Why must fourth trimester care begin after delivery?

    Allison P. Boyle, DPA, PA-C
  • Nutrition during cancer treatment is more than calories

    Dr. Manjari Chandra
  • Why witnessing death outside the hospital felt different

    Denise Moulton, RN
  • Most Popular

  • Past Week

    • Retirement isn’t the end of medicine, it’s a second act [PODCAST]

      The Podcast by KevinMD | Podcast
    • The conflict of interest that discloses as nothing

      Martha Rosenberg | Medications
    • Surgical judgment: the skill no one sees from the gallery

      Mustafa Kemal Çalık, MD | Physician
    • Why haven’t ambient AI scribes boosted productivity?

      Karan Kanwar | Health Technology
    • Physician well-being is not an individual problem

      Heather Buckley | Conditions and Diseases
    • Burnout isn’t only about autonomy, it’s about your bank account [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • Why CDC opioid guidelines get the overdose data wrong

      Richard A. Lawhern, PhD | Conditions and Diseases
    • Retirement isn’t the end of medicine, it’s a second act [PODCAST]

      The Podcast by KevinMD | Podcast
    • Sensory processing in autism and the brain’s volume control

      Josette Pelatan, PhD | Conditions and Diseases
    • What maternity care deserts cost a town

      Manisha Kaliaperumal | Health Policy
    • Why medicine needs a national physician license now

      Vaishali Popat, MD, MPH | Physician
    • A cold cost $945. The cost of primary care is broken.

      Susan Newman, MD | Physician
  • Recent Posts

    • Shift work and circadian rhythms shape the 24/7 workplace

      Deepak Gupta, MD | Conditions and Diseases
    • Paid for twice

      Physicians paid for G2211 twice. Most never bill it.

      Michael Duben, MD | Physician Finance
    • The next child

      Medicaid managed care and the case for mutual stewardship

      Steven Merahn, MD | Health Policy
    • Choosing a limb lengthening surgeon requires accountability

      Hrayr Basmajian, MD | Physician
    • Cited but never checked

      Why AI crisis advice may fail families facing psychosis

      Nicole Drapeau Gillen | Health Technology
    • How AI phone systems in health care create barriers

      Thuy D. Bui, MD | Health Technology

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 1 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Retirement isn’t the end of medicine, it’s a second act [PODCAST]

      The Podcast by KevinMD | Podcast
    • The conflict of interest that discloses as nothing

      Martha Rosenberg | Medications
    • Surgical judgment: the skill no one sees from the gallery

      Mustafa Kemal Çalık, MD | Physician
    • Why haven’t ambient AI scribes boosted productivity?

      Karan Kanwar | Health Technology
    • Physician well-being is not an individual problem

      Heather Buckley | Conditions and Diseases
    • Burnout isn’t only about autonomy, it’s about your bank account [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • Why CDC opioid guidelines get the overdose data wrong

      Richard A. Lawhern, PhD | Conditions and Diseases
    • Retirement isn’t the end of medicine, it’s a second act [PODCAST]

      The Podcast by KevinMD | Podcast
    • Sensory processing in autism and the brain’s volume control

      Josette Pelatan, PhD | Conditions and Diseases
    • What maternity care deserts cost a town

      Manisha Kaliaperumal | Health Policy
    • Why medicine needs a national physician license now

      Vaishali Popat, MD, MPH | Physician
    • A cold cost $945. The cost of primary care is broken.

      Susan Newman, MD | Physician
  • Recent Posts

    • Shift work and circadian rhythms shape the 24/7 workplace

      Deepak Gupta, MD | Conditions and Diseases
    • Paid for twice

      Physicians paid for G2211 twice. Most never bill it.

      Michael Duben, MD | Physician Finance
    • The next child

      Medicaid managed care and the case for mutual stewardship

      Steven Merahn, MD | Health Policy
    • Choosing a limb lengthening surgeon requires accountability

      Hrayr Basmajian, MD | Physician
    • Cited but never checked

      Why AI crisis advice may fail families facing psychosis

      Nicole Drapeau Gillen | Health Technology
    • How AI phone systems in health care create barriers

      Thuy D. Bui, MD | Health Technology

Copyright © 2026 KevinMD.com | Powered by Astra WordPress Theme

  • Terms of Use Agreement
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

There’s no place for “benevolent deception” in obstetrics
1 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...