Reviewer's report
Title:Punishment or harm reduction? Contraceptive access for women who use
drugs
Version: 2Date:16 September 2013
Reviewer: Julie Gregory
Reviewer's report:
Major Compulsory Revisions
n/a
Minor Essential Revisions
1. Cover letter, Methods, fourth line: separate the words "in-depth" and
"semi-structured" with a comma
2. Cover letter, final paragraph, first line: please add the word "to" after the word
"inability" and before the word "make"
3. Introduction, paragraph 6, line two: the word "cause" should appear in the
plural here "causes"
4. Introduction, paragraph 7, line three: add the word "of" after "risk" and before
"neglect"
5. Introduction, paragraph 10, third line from the bottom: omit the word "be" either
before or after the word "easily"
6. Methods, second paragraph, line two: include the word "interviewees" after the
word "recruited"
7. Methods, second paragraph, line five: use a colon rather than a semicolon
8. Methods, final paragraph, final sentence: change the word "were" to "are"
9. Methods, final paragraph: given that this is where the authors note the
strengths and limitations of their study, this paragraph ought to be more explicit.
For example, the authors might tell us WHY "they believe that the findings are
relevant to other Australian women who inject drugs." They also might make
some claims about the extent to which these findings are relevant to other types
of drug use and/or to what extent they speak to men's reproductive desires and
choices. Likewise, the authors might speak to the reasons why their findings are
or are not applicable outside the Australian context. More so, I wonder if the
authors would be willing to end this paragraph by speculating on some of the
differences in experience between women who are in contact with mainstream
health care providers and those who are not.
10. Results, Long-acting Methods, line four: add the words "because of" after the
words "(the pill), and"
11. Results, Easily reversible Methods, paragraph one, line four: replace
semicolon with colon
12. Results, Easily reversible Methods, paragraph three, line one: omit the word
"were"
13. Results, Easily reversible Methods, paragraph three, second line from the
bottom: include the word "that" between the words "within" and "relationship"
14. Results, PREGNANCY & PARENTHOOD, first paragraph, line five: replace
the word "life" with "lives"
15. Results, PREGNANCY & PARENTHOOD, third paragraph, second sentence:
include a comma after the word "user" and before the work "described" AND end
with a colon instead of a semicolon
16. Results, PREGNANCY & PARENTHOOD, sixth paragraph, last sentence:
include the word "a" after the comma and before the part that reads "27 year old
in a..."
17. Discussion, paragraph one, fourth line from the bottom: place semicolon with
colon
18. Discussion, paragraph three, first sentence: add the word "and" after
"meaningful" and change "including" to "included"
19. Discussion, paragraph five, line four: please re-write this part ("For example,
free (rather than incentivised) contraceptive advice and availability") so that it is a
full sentence. In making this revision, it would be useful to link this suggestion
directly to the interview data just presented
20. Discussion, paragraph five, last sentence: please re-write this sentence so
that the second clause ("and adhering to their wishes to have a baby") follows in
structure ALTERNATIVELY, I think that this sentence can be omitted completely.
21. Discussion, final paragraph, line seven, in-text quotation: the letter "t" in the
square brackets does not need to be capitalized AND there should be an
apostrophe added to the word "mothers" (ie mother's)
Discretionary Revisions
1. Cover letter, final paragraph, second line: I suggest adding the word
"informed" before the words "health care choices"
2. Introduction, second line: please consider adding the words "and was" before
"driven" and "largely" after the word driven (i.e. This occurred recently in Australia
and was driven largely by...)
Introduction, line five: please consider adding the word "to" after the word "or"
and before the word "take"
3. Introduction, 7th line: I suggest elaborating on the point being made here that
while Project Prevention addresses men, it's emphasis is on women. This could
be done in the authors own words, or they might cite others who talk about this
issue in relative depth (ie Gregory 2010)
4. Introduction, last sentence of first paragraph: I suggest that this sentence
should read as follows: The program's underlying rationale is that people who
use alcohol and other drugs are incapable BOTH of making appropriate
decisions about their fertility AND of caring for children.
5. Introduction, second paragraph: I suggest that this is a short paragraph (only
two sentences), which could be buttressed by the addition of another sentence
which outlines for readers Program Prevention's rationale of having clients
provide evidence of their drug use and related medical decisions.
6. Introduction, third paragraph, second line: I suggest qualifying the word
"women" here with the words "low-income, minority" for this is the main issue
raised in critiques of the program and one that is raised toward the end of the
article in question.
7. Introduction, third paragraph: again, this is a short paragraph which I suggest
can be developed via inclusion of a sentence of two which explicitly spells out for
readers the punishment theme that critics read into Project Prevention.
8. Introduction, paragraph 6, last sentence: I suggest re-wording this sentence so
that it's main claim is made more explicit. This could be something as simple as
writing: Thus, the effects of such potential confounders are rarely considered for
their possible contributions to poor neonatal outcomes.
9. Introduction, paragraph 7, last sentence: I suggest omitting the words ""issues
with" from this sentence
10. Introduction, paragraph 8: given the title of the paper under review, I suggest
that the authors draw out more explicitly the theme of harm reduction versus
punishment and I believe that the end of this paragraph might be a useful place
to do this.
11. Introduction, paragraph 9, line seven: I suggest adding the word "pregnant"
before the word "women" here to be clear about the population being discussed.
12. Introduction, paragraph 10, last sentence: I suggest beginning this sentence
with the phrase "In other words" or "For these reasons"
13. Introduction, paragraph 11, second line: I wonder if it might make sense to
replace the word "needs" with the word "choices" here. Both work, but, from my
reading, "choices" better mirrors the authors focus on women's agency
14. Methods, first paragraph, last line: I suggest replacing the word "requested"
with the word "received"
15. Methods, second paragraph, first line: I suggest replacing the word "sample"
with the word "represent"
16: Methods, paragraph one and two: I suggest that these paragraphs can be
merged into one. In particular, I suggest that the authors copy and paste the final
sentence of this first paragraph to the end of the second paragraph and move the
second paragraph up so that the sentence which immediately follows "have been
extracted for this paper" is the one that reads: "We employ a purposive sampling
framework..."
17. Results, paragraph one, line one: include the words "amongst interviewees"
after the words "illicit drug use"
18. Results, paragraph one, last line: omit the word "for" after "and" and before
"drugs"
19. Results, paragraph 2, second line from the bottom: include the word
"contraceptive" before the word "methods"
20. Results, Contraceptive use, paragraph one: this is a short paragraph, which I
suggest can be usefully merged with the following paragraph
21. Results, Contraceptive use, paragraph two, line tow: I suggest replacing the
word "their" with the word "interviewees'"
21. Results, Contraceptive use, paragraph two, line three: I suggest replacing the
word " three" with "four"
22. Results, Contraceptive use, paragraph two, line four: given the discussion
that follows, I suggest enumerating "no use" as a fourth category here
23. Results, Sterilisation, line five: I suggest replacing the word "contraception"
with the words "this option"
24. Results, Easily reversible Methods, paragraph one, line four: include the word
"status" after the word "relationship"
25. Results, Non Use of Contraception, paragraph two, line one: replace the
word "women's" with the word "interviewees'"
26. Results, PREGNANCY & PARENTHOOD, second paragraph, second line
from the bottom: replace the word "mother" with "motherhood" so that the second
clause of that sentence reads "what type of motherhood they aimed to realise..."
27. Discussion, paragraph one, line two: replace the word "these" with
"interviewees'"
28. Discussion, paragraph three: this is another short paragraph, which could be
developed with a summarising sentence or two about the importance of these
findings in the context of the authors' driving questions (ie "whether the
underlying assumptions made by Project Prevention about women who use
drugs are valid and whether the program would be appropriate in the Australian
context")
29. Discussion, paragraph five, line two: I suggest beginning the second
sentence of this paragraph with the words "In particular, they suggest that there
are..."
30. Discussion, paragraph five, fourth line from the bottom: I suggest adding the
words "more punishment-based" in front of the word "objectives" here
31. Discussion, paragraph six, line one: I suggest following the word
"Furthermore" with the words "our data suggest that"
32. Discussion, final paragraph, line five: I suggest adding the word "and" before
the ellipsis
33. Discussion, final paragraph, line seven: I suggest adding the word "drug use"
before "pregnancy" here so that the beginning of this sentence reads:
"Particularly when it some to drug use, pregnancy and parenting...:
34. Discussion, final paragraph, third line from bottom: I suggest adding the
words "punish and" after the word "further" and before the word "marginalise"
ALSO it might be worthwhile to note here that such programs also have the effect
of punishing and marginalising drug users more broadly (ie not just 'women')
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests.