I am Pre-Pregnant

And they say that they don’t treat women like incubators:

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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33 comments for “I am Pre-Pregnant

  1. zuzu
    May 16, 2006 at 4:39 pm

    Women should also make sure all vaccinations are up-to-date and avoid contact with lead-based paints and cat feces, Biermann said.

    If I avoid all contact with cat feces, eventually there will be a big pile of cat feces in the corner of the bathroom. But then, I’ve snipped the wires on my biological clock, so I continue to have to scoop out the litterbox.

    You know, I’ve seen ads on the subway that encourage young women who want kids to get folic acid. Because there is actually a benefit to doing so before you even get pregnant, and it isn’t something you need to do for yourself to stay healthy, like treating diabetes (which, WTF? You should only treat a serious chronic condition for the sake of the occupants of your uterus???). But the ads make it pretty explicit that this is something you should do IF you want kids. There’s an element of choice there.

  2. May 16, 2006 at 4:47 pm

    The government knows what is best for you “huney”

    And why you are pre-pregnant take care of your self like you were presick. Now just incase you are a preterrorist or prefelon, we will monitor you so that those who live in fear of life can feel presafe.

    While people are being presafe in this postl-liberties and freedoms times, remember that we are watching you, always, stop using so much damn hot water in the shower, consider your self prewarned because you are precancerous.

  3. May 16, 2006 at 5:35 pm

    Yeah, this sounds to me like single women just shouldn’t have cats, Just In Case. Which completely ruins God’s plan to make them all into crazy cat ladies, doesn’t it?

    And I’m not supposed to drink alcohol or eat sushi EVER? What if I’m not even getting laid, should I abstain to save a future rapist’s baby from FAS?

    Thinking like this just gives you depressing headaches, man.

    As for the folic acid, I’ve thought about taking it just for the nice shiny hair benefits, but then I thought, “Anyone catches me taking these and I’m going to get “you’re pregnant!” bingos out the ass.”

  4. Magis
    May 16, 2006 at 5:36 pm

    And don’t drive and don’t fly and put that goddam bon-bon down this instant!

  5. May 16, 2006 at 5:53 pm

    Folic acid is in a category of its own, though. March of Dimes suggests that a woman should start taking folic acid before she “start[s] trying to get pregnant,” since it’s the first month of pregnancy — before she even knows she’s pregnant — that it’s most needed, and because neural-tube defects are pretty serious. In this case, it actually makes sense to urge women to take folic acid even before pregnancy is planned (and enrich flour for everyone), since women do have kids they weren’t planning on but still want.

  6. May 16, 2006 at 6:04 pm

    Don’t you see, we have to protect you women from yourselves!!!

    /sarcasm :D

  7. Julie
    May 16, 2006 at 6:13 pm

    Leyan did mention the one thing I was going to mention… extra folic acid is a particularly good thing to take even if you aren’t trying to become pregnant, because if you do have an unplanned pregnancy that you carry to term (and I think something like 50% of unplanned pregnancies are carried), the folic acid is especially good before you even know you’re pregnant. I’m thinking that could be made a whole seperate campaign though. The March of Dimes is huge on promotion of folic acid in women. Obviously, this is a silly precaution if you know you wouldn’t carry an unplanned pregnancy, or if you can’t conceive, or aren’t having sex, etc… but if you are sexually active and unsure if you would carry to term, or are relatively sure you would it’s not a bad precaution. However, if you’re eating healthy, enriched foods and taking a multivitamin, you’re probably covering your bases.
    That aside, it is more than a little scary that we are being advised to take every single thing out of our lives that could possibly or remotely hurt a potential fetus simply because we are of childbearing age. First, drinking in moderation is very unlikely to hurt the baby if you don’t know you’re pregnant… there are tons of women who have unplanned pregnancies who drink, smoke, etc.. until they find out who have very healthy babies. Obviously, not a good idea throughout the pregnancy, but certainly not going to hurt anyone in the couple weeks before you know. And who avoids cat litter on the off chance they might unexpectedly become pregnant? I mean, maybe when you’re trying to conceive (I admit, I’m paranoid, and when we were trying to have children, I avoided everything like the plague) but on the off chance you might become unexpectedly pregnant seems a bit far fetched. The list of stuff you are not supposed to do while pregnant is fairly extensive, and not something I would expect anyone to follow while not pregnant. It really does seem scary that we have taken to encouraging women to be healthier simply for the sake of their potential fetuses instead of the fact that, I don’t know, it’s just better in general to be healthier. Ugh… it’s really starting to get scary how much women are viewed as baby makers instead of people.

  8. kathryn from sunnyvale
    May 16, 2006 at 6:15 pm

    What about men? Studies I’ve read suggest that children of *men* who smoke are more likely to get cancer in childhood. Not the mothers, *fathers.* Drinking can cause sperm damage.

    So pre-fathers should also stop smoking, stop drinking, and do everything possible to make for healthy sperm.

    What about Europe? If its all about the smoking and the drinking, why is the US’s infant mortality rate higher than almost all European countries?

    If they care about infant mortality and health, then they should fight for it in order of priority. Not having health insurance is far, far worse than owning a cat. But its easier to lecture about cats and smoking than than do do anything about the 80 million Americans who won’t have insurance for more than 2 months this year.

  9. May 16, 2006 at 6:37 pm

    After hashing this shit out with Auguste, who knows a researcher on the effects of taking folic acid as a preconception way to aid the baby (he also pointed out that the research being done also points to a long list of things men are supposed to do when the trying-to-conceive process starts), it was firmly determined that we need to read the actual report. And lo and behold, the CDC recommendations are not at all what this article reports.


    The CDCs recommendations are pretty easy to summarize. They suggest that doctors seek out opportunities to talk to women about their reproductive plans for the future, encourage women to actually make a plan for when they have babies, consult with doctors before they begin the process of trying to conceive to make sure they are doing everything possible to conceive the best way they can, get prenatal care (duh), and then after the baby is born doctors are to encourage women to delay having another one for a couple of years because it’s been shown that spacing babies apart at least 2 to 3 years encourages healthier infants. I didn’t see anything about acting as if you’re always ready to get pregnant; in fact the opposite. It was clear they’re trying to get women to take the possibility of getting pregnant seriously and not leave it up to chance.

  10. kathryn from sunnyvale
    May 16, 2006 at 6:37 pm

    To add to the information not provided in the article, including that toxoplasmosis incidence Is not related to cat ownership (a):
    1. Indoor cats don’t get toxoplasmosis
    2. If a cat gets toxoplasmosis, it is only infectious for a few weeks
    3. Cat poops are only dangerous after a day of sitting around: if the cat box is cleaned daily, it isn’t a risk.
    4. .Its only women who’ve never had toxoplasmosis and get it during pregnancy who can pass it to a fetus.
    5. Toxopl. infection in a fetus is dangerous and damaging, causing “mental retardation, blindness, and epilepsy in infancy or much later in life,” with 400 to 4000 cases per year in the US (ref c). But compared to the damage from not having health insurance and prenatal care, this number is tiny.

    (a) http://www.cvm.uiuc.edu/petcolumns/showarticle.cfm?id=476
    (b) http://www.cdc.gov/ncidod/dpd/parasites/toxoplasmosis/factsht_toxoplasmosis.htm
    (ref c) review article: Congenital Toxoplasmosis, Jones (2003) http://www.aafp.org/afp/20030515/2131.html

  11. Patrick Bateman
    May 16, 2006 at 7:48 pm

    Listen, the Sons of Jacob have only your welfare in mind. Auntie will show you the truth of that down at the Red Center, if you’re so lucky.

    Oh, and if you’re female but incapable of being a pre-pregnant state for some reason, there’s a lovely job lined up for you already. Promise.


  12. Frumious B.
    May 16, 2006 at 7:57 pm

    to add to kathryn’s statments:

    point 1: so keep your cats indoors already
    point 4: if a woman has a cat prior to getting pregnant, she will be exposed prior to getting pregnant, and it will not be a problem.
    point 6 (mine): more toxoplasmosis exposure occurs from improperly cooked pork than from cat poop.

    source: my friend the vet.

  13. Dianne
    May 16, 2006 at 8:22 pm

    Re cats: If you’re interested in becoming pregnant and have a cat, get a toxo antibody level checked. If you’ve got antibody to toxo, which most people do, your risk is minimal. If you don’t, get the person who is helping you to get pregnant to change the cat litter. And avoid undercooked meat.

    This whole emphasis on what women should do to avoid having pregnancy problems is very American somehow: all the emphasis is being put on what the indivdual should be doing to prevent problems, none on what the society should be doing. For example, no suggestion of universal health care for pregnant women and children, muchless the whole population, or suggestions on how to decrease the number of people living in poverty, despite the fact that either intervention would be more likely to improve infant mortality than simply lecturing women on the dangers of drinking during pregnancy. The implicit statement seems to be that if something’s wrong with your baby it’s ALL YOUR FAULT–you must have done something wrong– so don’t expect any help or sympathy.

  14. May 16, 2006 at 9:30 pm

    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.

    You know, I’ll bet if somebody came out with guidelines asking all pregnant women to treat themselves as pre-abortion, regardless of whether they plan to have one, there would be mass outrage on the scale of September 11th.

    This complete neglect of individual inclination as any sort of mitigating factor is downright repulsive, although no longer surprising. Common sense, were such a thing not thouroughly unknown to the Right, would dictate that there is no point in asking women to rewrite their lives for the health and well-being of a pregnancy that not only doesn’t exist, but will be terminated, as is the case with many of the women who have no plans to get pregnant. Says something about the comparative worth of women and fetuses in their worldview, doesn’t it?

  15. Ledasmom
    May 16, 2006 at 9:56 pm

    The woman from whose cats I probably acquired my toxoplasmosis immunity had nothing but indoor cats, indoor since kittenhood. It may be rarer for indoor cats to contract it, but it’s not unknown – and I’m thankful they did have it, as it meant I didn’t have to worry about toxoplasmosis during pregnancy.
    Correct me if I’m wrong, but aren’t all refined flour products in this country supplemented with folic acid?

  16. May 16, 2006 at 10:38 pm

    Again, I would caution that the paternalistic language is from the WaPo article. The CDC report indicates that doctors favor education and empowerment as methods of increasing the rate of healthy births.

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  18. May 17, 2006 at 4:37 am

    But Amanda, the problem is that the women’s health issues are being approached strictly from the “childbearing” angle. Why is women’s health not being promoted by the CDC just so women can be healthy? Why is it being promoted specifically because of infant mortality? That is what bothers me. Tehre seems to be an underlying quality of “you are just a vessel” there even though they aren’t using the over the top expressions the WAPO article does.

    Also as it was discussedi n your thread, the cat issue is only an issue if you are *actually* pregnant so I don’t understand why they should have that as a general guideline at all. In fact at your blog it seemed to be the consensus that it is good to have cats so that you’ve already been exposed to the toxin in question.

  19. May 17, 2006 at 7:58 am

    I’m going to go off on a tangent on my blog. But I was very surprised to read this on a feminist blog:

    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.

    One of these things is not like another. Not only do I wonder what ‘maintaining’ a healthy weight means (presumably if there’s such a thing as an ‘unhealthy’ weight, some people are already at an unhealthy weight). But there’s no evidence of causation between weight and health, and therefore to talk about a healthy weight is meaningless. I also think it’s really anti-woman to talk about women ‘maintaining a healthy weight’ in our current eating-disordered society.

  20. Commentariat
    May 17, 2006 at 8:51 am

    Imagine if the CDC were instead promoting the health of Mexican immigrants not because of concerns for them as human beings, but rather because they are all potential laborers.

    “New federal guidelines ask all Mexican immigrants capable of labor to treat themselves — and to be treated by the health care system — as pre-producers…Experts say it’s important that workers follow this advice throughout their productive lives…”

    Gotta keep the machine running smoothly, and take care of the equipment.

  21. Coopster
    May 17, 2006 at 9:04 am

    If this whole thing started with the embarassing infant mortality rate America is now sporting, how about this angle?

    Our infant mortality rate is so high because we don’t provide healthcare to the most needy among us – the same poor (usually minority) women who are forced to carry their babies to term because we’ve also virtually outlawed abortion and stopped providing birth control in most areas.

  22. May 17, 2006 at 9:13 am

    Well, I guess I better stop taking my schizophrenia medication, since there’s a chance it can cause birth defects, and I’m a woman of childbearing age.

    That’s a really good point, and it’s true for a lot of drugs. For instance, methotrexate treats autoimmune diseases like lupus and rheumatoid arthritis, many of which disproportionately strike women of childbearing age. It has far fewer side effects than prednisone, the drug it generally replaces. But it causes birth defects and miscarriage. You have to be really careful not to get pregnant when you’re on it. So are doctors supposed to prescribe prednisone, which causes all manner of serious short and long-term side effects, instead of a drug that is harmful to fetuses but much better for their potential human incubators?

  23. Marian
    May 17, 2006 at 9:20 am

    This is interesting because my mother tells me the same thing, albeit not from menarche on but from the time you start “thinking about” children.

    She told me that it’s good to give up all alcohol and caffeine several months before you even start trying for a kid, so that it’s “out of your system.” Now I’d probably give up alcohol anyway while trying, since it apparently makes it harder to conceive for some people and just isn’t that safe when babies are a possibility. Plus it’s making me gain weight so I should really stop anyway. :-)

    But not months before trying, when we’re still using birth control! And even my doctor told me that one cup of coffee a day is fine until you actually find out you’re PG. I do not have cats, but if I did I would not give them up just becasue I’m thinking about kids.

    However, I think there’s a fine line between picking up healthy habits just prior to pregnancy, versus always treating your body as if you’re already pregnant. I was a virgin all through high school and much of college, so what sense would it have made to act pregnant then? In case I got raped?

  24. Tammy
    May 17, 2006 at 10:12 am

    But Amanda, the problem is that the women’s health issues are being approached strictly from the “childbearing” angle. Why is women’s health not being promoted by the CDC just so women can be healthy? Why is it being promoted specifically because of infant mortality?

    The report is about a very specific initiative, to get doctors in the course of caring for women altogether to initiate conversations about their reproductive health. In the report it specifically states that this is not intended to replace or supersede well-woman care. That this is in fact much less than well-woman care, just another factor in it.

  25. May 17, 2006 at 11:18 am

    Uhhhh….Maia? You do read about health, yes? You do know that there is indeed such a thing as unhealthy weight, yeah? Leads to heart disease, high blood pressure, and can be linked to adult onset diabetes, cancers, and a whole raft of fun for the whole family? Now, I only popped in here becuase Ilyka Damen told me to and I’ll do anything Ilyka tells me to (must be a submissive chick thing) but nowhere does Jill say “you should have a healthy weight otherwise men will think you’re ugly. UGLY! You’ll get left behind at the balls and no one will ask you about your pot roast! Now stop reading my blog and go put some makeup on, you miserable man-less whore!” No. She says we should have healthy weight.

    There is such a thing as unhealthy weight, for both men and women (thereby proving that fat? It is not misogynistic.) There is a doctor term (not a feminist term) called “morbidly obese”. This applies to men and women, and means that the fat ratio on a person has indeed become unhealthy. Arteries can clog. Hearts can stop. Lungs strain to breathe. This has nothing to do with being attractive. It has to do with health. Do people find others moribdly obese unattractive? I’m sure they do, just as others find the Calista Flockhearts unnattractive. Looking good was not the point of the statement.

    I don’t mean to pick up on a side tangent here in the comment section, I just felt that the waving of the “shame on you, and you a feminist!” was being waved unneccessarily at the canvas. Must be all that folic acid I’m on.

  26. Ledasmom
    May 17, 2006 at 12:23 pm

    Is there any current evidence for a deleterious effect from caffeine in pregnancy? If I were thinking of having another crib lizard, the only way I’d stay awake long enough to conceive would be by using caffeine.

  27. Julie
    May 17, 2006 at 2:27 pm

    Ledasmom… the current idea is if you drink in excess of 5-6 cups of coffee a day, you have a higher risk of miscarriage. One or two cups of coffee a day isn’t going to hurt. Some doctors recommend abstaining completely, but I drink iced tea on a regular basis, which has about half the caffeine as coffee. They haven’t found the same effect with tea or soda, just iced tea. (Did I prove how much of a nerd I am about these things yet?)
    Maia…. my mom currently weighs about 325 pounds. Because of this, she can barely walk and struggles with chest pain, digestive issues, and a higher risk of diabetes. I really don’t think Jill is saying that everyone must be a size 2 or they will die of fatness. There really is a point where your weight starts becoming an issue. I don’t think it’s where they try to push women to be, but there is such a thing as an unhealthy weight.

  28. May 18, 2006 at 5:24 am

    First of all by endorsing the medical profession’s idea to maintain a healthy weight, you are not talking about a wide range of sizes. The medical profession’s idea about a healthy weight is based on the BMI, and includes a narrow range of body weights, and very little scientific evidence that those body-weights will help you live long and prosper, any more than any other.

    But more importantly there is actually very little evidence that weight is an independant variable when it comes to health.

    This actually works at both end of the spectrum. Very thin women are prone to osteoperosis, but is this because there’s a natural link between osteoperosis and weight, or because women who are very thin are statistically more likely to also be women who over-exercise and eat restricted diets.

    Until we do know to say that we know that a particular weight class (as opposed to lifestyle decisions that may or may not coincide with you being in that weight class), I think it’s a little bit premature to talk about a ‘healthy weight’. Let alone maintaining a healthy weight.

  29. May 18, 2006 at 10:44 am

    Why is women’s health not being promoted by the CDC just so women can be healthy? Why is it being promoted specifically because of infant mortality?

    The CDC does promote women’s health in general; it just doesn’t address that in this specific report. The CDC isn’t currently in the hands of people agitating for Gilead, really; it just happens to be part of an administration which is. So I wouldn’t put this report on the level of politicized decisions like the blocking of OTC approval for Plan B.

    On caffeine, this particular childbearing age woman has no intention of worrying about the one or two caffeine-containing soft drinks that she may drink in a week. I think it’s only a problem if you drink a ton of coffee. Besides, my premie niece was actually given caffeine during the first weeks of her life to make her healthier, so it can’t be a total disaster during pregnancy.

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