Speaking as One of The Pre-Pregnant ...

I just learned that new federal guidelines recommend that all human female Americans between their first menstrual period and menopause should be treated as pre-pregnant, regardless of their future reproductive plans.

Does this sound rather like .. er, The Handmaid's Tale to you?

It certainly does to me!

According to this Washington Post article, what does it mean to be a member of the pre-pregnant? This means that, among other things, all "pre-pregnant" women should take folic acid supplements, refrain from smoking and using alcohol, avoid contact with cat feces and lead-based paint, maintain a healthy weight and keep chronic conditions, such as asthma and diabetes, under control.

The recommendations (sic) aim [is] to "increase public awareness of the importance of preconception health" and emphasize the "importance of managing risk factors prior to pregnancy," said Samuel Posner, co-author of the guidelines and associate director for science in the division of reproductive health at the Centers for Disease Control and Prevention (CDC), which issued the report.

The CDC report notes that the infant mortality rate is higher in America than for most other industrialized nations; citing a report released last week by the advocacy group, Save the Children, they state that US infant mortality is three times that of Japan and 2.5 times those of Norway, Finland and Iceland. Additionally, National Center for Health Statistics data also reflect these disparities: babies born to black mothers, for example, had the highest infant death rate of 13.5 per 1,000 live births while infants born to white women had a death rate of 5.7 per 1,000.

Of course, anytime one talks about race and health, they must also discuss the effects of socioeconomic status.

The CDC report also discusses disparities in care, noting that approximately 17 million women lack health insurance and are likely to postpone or forgo care. These disparities are more prominent among minority groups and those of lower socioeconomic status, the report states.

So considering the Federal Guidelines' draconian* recommendations, the disparities in infant mortality rates between various racial and socioeconomic groups and the apparent importance of female reproductive health in the eyes of the government, don't you think that health care would be provided by the government for all "pre-pregnant" women? Well, in a word ..

No.

* note: I thought these recommendations were something close to "draconian", especially for those who suffer from a chronic lack of health care.

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This seems to coincide with the refusal of most doctors to perform tubal ligations on young women (the pre-pregnant, according to these horrid guidelines, or mothers with only one child.) The next thing you know, you'll need an application and references for a condom or the pill.

What about the Federal Guidelines for us "Pre-Paternals"?

Do we ALWAYS have to start with dinner and a movie?
Will it now be required that we HAVE to cuddle up afterwards? What if we have to leave? And what happens if we don't call, even if we say we will?

Wait! I thought I wasn't supposed to have sex! Now I really don't know what to do with my body.

(I'm being sarcastic just in case it wasn't all too obvious)

"And what happens if we don't call, even if we say we will? "

Posted by: J-Dog

Upon completion of the necessary paperwork by the appropriate pre- or now pregnant person, your calls will be automatically re-routed. You *will* call.

J-Dog: Keep your balls out of hot tubs, tight jeans and x-ray machines.

By natural cynic (not verified) on 17 May 2006 #permalink

J-Dog, the NSA can now easily confirm or deny if you did indeed call (although they can't say what you may or may not have said or even if it was you that made the call or some other pre-paternal that borrowed your phone) so you better watch out and you better not pout.

By CanuckRob (not verified) on 17 May 2006 #permalink

karmen; you'd think that, ideally, pre-parents should pass a background check before they are allowed to reproduce, but this is yet another example of "common sense" at its finest.

this is a non sequitur, sorta, but i am still wondering about the recommendations that all of the pre-dead should follow so they leave a beautiful corpse behind for survivors to pre-serve.

Read the CDC report .
First of all, as explained here, the WaPo article is very typical nut-job-promoting distortion that has only the vaguest resemblance to what the CDC actually said. (Remember: there's a good reason why scientists require those fancy biblio-whatchamacallits. Be cautious about believing anything said by people who don't provide them.)

Second, the CDC's guidelines are really just yet another reminder that birth-control is a vital part of good health.

The report suggests that men and women should make a reproductive plan. Want to bet that any woman who's plan is not to reproduce won't have her plan respected?

The report uses the word "contraceptive" maybe once? Surely, if we're going to plan our reproductive lives, we should have good access to and education about all sorts of birth control options. Why isn't THAT a major part of the report?

The report also makes a tiny mention or two of domestic violence. Isn't domestic violence one of the largest causes of death for pregnant women in the US? Shouldn't the report focus more on that, then?

Finally, the implication in the report that women are only to be valued for our potential to pop one for the patriarchy is just offensive. Sure, let's make prenatal care available to all, and while we're at it, let's treat women AND men as valuable and worth taking care of!

As a report on infant mortality and not pregnancy prevention, birth control is not featured as much as you might like. It's directly referred to, though. Reading re: "reproductive plan" indicates the plan certainly takes into account people that never intend on having children, and the CDC recommends the use of preventative measures to not become pregnant except when you want to. As the target audience is medical professionals, they should be able to figure out that this means birth control.

The paper is well-researched, supported by some 30ish organizations, has some 180 references, and in general says none of the things that people assume that it says.

I was kind of saddened to see the sort of crap on something that mentions the "scientific life". Science is writing something based on a Washington Post summary and inferring what "the man" might be trying to "tell you" with health recommendations when the scientific report is on lowering infant mortality?

The report suggests that men and women should make a reproductive plan. Want to bet that any woman who's plan is not to reproduce won't have her plan respected?

That a woman's right to not reproduce is widely disrespected in America is indeed a serious problem. However, 85% of women bear at least one child by age 44. This leaves the CDC little choice but to assume most women need 'pre-conception care'. The report is best seen as a symptom of under-use of contraceptives and a failure to recognize the right to not reproduce. To portray it as a cause, or a justification of the present situation is to play into the hands of the religious nuts who are themselves quite likely to portray it as a justification of the present situation - or to justify further attacks on women's rights. I don't think we disagree on any of this except the position of the report, and what is implied by what it does not cover.
The report makes no attempt to address the myriad reproductive issues facing our people. Quite the opposite, it clearly intends to focus on one narrow issue. That focus should not be mistaken for disrespect for or ignorance of other issues. If you wish to argue that the CDC disrespects, or is ignorant of other issues, you should at least search their web page for relevant reports, and argue based on those reports. I will grant at the outset that the CDC seems to fail to recognize that the attacks of certain religious nuts on the right to not reproduce or related attacks on contraceptives raises both serious moral concerns (which I feel are properly outside the CDC's domain) and serious health concerns (which are clearly within the purview of the CDC). However the failure to recognize said attacks should not be assumed to imply endorsement of said attacks. The anti-women nuts will attempt to portray nearly anything as support their position. Given the power some of them have, it is a natural reaction to assume that the reports of many organizations are dangerously influenced by them. However, said reaction, though driven by the best intentions, is sometimes mistaken. When a columnist, a reporter, an editorialist, or a blogger, claims a report supports a certain position, it is wise to read the report before deciding said report supports the position.

The report uses the word "contraceptive" maybe once? Surely, if we're going to plan our reproductive lives, we should have good access to and education about all sorts of birth control options. Why isn't THAT a major part of the report?

Contraceptives are covered in other CDC reports. (And I admit that lately I've been remiss in reading these, and have not made time to adjust my views with respect to those I have read.)

The report also makes a tiny mention or two of domestic violence. Isn't domestic violence one of the largest causes of death for pregnant women in the US? Shouldn't the report focus more on that, then?

This too is addressed in other reports. Domestic violence deserves a whole slew of reports dedicated to it. I haven't read enough of the CDC's reports on domestic violence to assess their position. However I don't think it's reasonable to assume a particular CDC position on the issue based on one report.

Finally, the implication in the report that women are only to be valued for our potential to pop one for the patriarchy is just offensive. Sure, let's make prenatal care available to all, and while we're at it, let's treat women AND men as valuable and worth taking care of!

It is true that there are factions of our society who value women only for their child-bearing potential and this is a serious danger to women (and everyone else). However, the report is not about the value of women - it is about how to solve a specific health problem. What you take for an implication is in my opinion a result of the report's narrow focus.

thanks for your input, brodrik. no sadness necessary, unless you don't understand my point, which appears to be well-disguised, as i realize as i reread this a day later. i was reacting to the WaPo article about the CDC report, the WaPo article certainly made the CDC report look stupid, especially because the WaPo used that politically loaded phrase, "pre-pregnant". i have no problem with reducing infant mortality, improving overall health or whathaveyou. I do have a problem with the uneven access to health care in this country, though -- a serious problem!

additionally, the fact that i find that phrase, "pre-pregnant" to be repugnant and even a little bit scary should not inspire sadness, although my lack of clarity in stating my reaction probably should.

I am bothered by some aspects of the original CDC report (which I did read), but like any CDC report, it's focused on one issue: things women can do to have healthier pregnancies. It's not a report on post-natal care, or on general women's health (although there's a lot of overlap just because healthy women tend to have healthy pregnancies), or on domestic violence, or on things men should avoid if they want to keep their sperm counts up.

The CDC report does emphasize better access to health care a lot more than the WaPo article. (I'm frankly not sure I like "preconception" any more than "pre-pregnant," though, and the report does point-blank state that a woman's decision not to reproduce, ever, should not be respected by her doctor. Sterilization is often unobtainable until a woman has already had at least two children, so that's not a way out.)

The WaPo article is pretty awful, though, and should be roundly criticized. As a sometimes-journalist, I'm always embarassed to read articles like that.