New federal guidelines ask all females capable of conceiving a baby to treat themselves — and to be treated by the health care system — as pre-pregnant, regardless of whether they plan to get pregnant anytime soon.
So even though you aren’t pregnant, and you aren’t planning on being pregnant, you should be treated as if you are pregnant. For the babies, of course.
Among other things, this means all women between first menstrual period and menopause should take folic acid supplements, refrain from smoking, maintain a healthy weight and keep chronic conditions such as asthma and diabetes under control.
Now, I’m all for encouraging these behaviors simply because they’re healthy. It’s better for people not to smoke, to control their diabetes and asthma, to maintain a healthy weight, and to take vitamins. Doctors should be recommending these things because they keep their patients healthier, not because their patients are potential breeding grounds for something else.
The idea of preconception care has been discussed for nearly 20 years, experts said, but it has drawn more attention recently. Progress toward further reducing the rate of unhealthy pregnancy results, including premature birth, low birthweight and infant mortality, has slowed in the United States since 1996 “in part because of inconsistent delivery and implementation of interventions before pregnancy to detect, treat and help women modify behaviors, health conditions and risk factors that contribute to adverse maternal and infant outcomes,” according to the report.
Nearly 28,000 U.S. infants died in 2003, according to the National Center for Health Statistics (NCHS). The infant mortality rate increased in 2002 for the first time in more than 40 years to seven deaths per 1,000 live births, but it did not change significantly in 2003. Birth defects, low birthweight and sudden infant death syndrome (SIDS) were the leading causes of infant death in 2003, according to NCHS.
The U.S. infant mortality rate is higher than those of most other industrialized nations — it’s three times that of Japan and 2.5 times those of Norway, Finland and Iceland, according to a report released last week by Save the Children, an advocacy group.
This is a big problem, and obviously we need to figure out some solutions. But we should be encouraging women to be healthy for themselves, not because they’re potential baby-makers.
“The recommendations say we need to be opportunistic,” or deliver care and counseling when opportunities arise, said Merry-K. Moos, a professor in the University of North Carolina’s maternal fetal medicine division who sat on the CDC advisory panel. “Healthier women have healthier pregnancies.”
And healthier women are healthier women. That should be enough of a motivation, shouldn’t it?
Women should also make sure all vaccinations are up-to-date and avoid contact with lead-based paints and cat feces, Biermann said.
The report recommends that women stop smoking and discuss with their doctor the danger alcohol poses to a developing fetus.
Avoid cat feces and discuss fetal alcohol syndrome when you aren’t pregnant and don’t plan to be? Sure, doc, I’ll give up my pets and stop drinking because it might hurt the fetus that I’m not carrying.
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.
The NCHS data also reflect these disparities. Babies born to black mothers, for example, had the highest rate of infant death — 13.5 per 1,000 live births. Infants born to white women had a death rate of 5.7 per 1,000.
Well, perhaps this has a little more to do with our shameful infant mortality rates than anything else.
Again, the issue isn’t with giving women full and proper healthcare, it’s the motivation behind it. When care is being given because women are potential reproducers and not because they’re deserving of that healthcare in their own right, we have a problem. Scaring women away from drinking moderately and having cats is just ridiculous. And it’s indicative of a profoundly fucked-up view of women’s personhood when we don’t see them as individuals, but as vessels for something else.
Chaos Theory has more. Thanks to Lauren for sending me the link.
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