Tuesday, November 28, 2006

Preconception Care? Treating women as eternally prepregnant

An article in today’s New York Times quotes public health experts who tell women that they ought to start thinking in terms of “preconception care” as opposed to prenatal care if they want healthy babies. The reasoning is that by the time women know they are pregnant, it is already be too late to avert birth defects: “For many women the most important doctor’s visit may be the one that takes place before a pregnancy is conceived.” Last May folks at the division of reproductive health at the Centers for Disease Control and Prevention (CDC), advised that women ought to be treated, and treat themselves, as if they were about to conceive a child. But women are to be assured that not ALL women ought to be treated thus, only those between their first menstrual period and up until menopause.

Family planning, child spacing and encouraging young people to develop a reproductive life plan is sound advice given that in the US half of all pregnancies are unplanned and preparing for a healthy pregnancy can require behavioral changes that may take months. But a policy whose goal is safe uterine environments ought not to be centered on warning women that they could get pregnant at any time in their reproductive life so they had better act as if pregnancy was imminent. Sexual relationship education, birth control access, STD care, battered women’s safe houses, environmental and occupational safety, etc. etc. etc. factor in when considering what makes for a healthy pregnancy.


Anonymous said...

What concerns me about the public health experts' warnings are that they support a notion of women's health that prioritises women's potential reproductive role over limitless other possibilities. Moreover, their notion of rational care for producing healthy babies would appeal to those women who would be most likely to already subscribe to such planning models, serving merely to reinforce pressures on those women to conform to that model of rationality and marginalise others further. I agree with Marin that there are many other societal (and personal) forces that produce a different rationality for many women who find themselves with an 'unplanned' pregnancy.

However, I am alarmed at Marin's description of the healthy maternal body as an 'efficient uterine environment'. This echoes much medical discourse about rational pregnancy care, which constructs the fetal body as separate from the woman's. Furthermore this does a disappearing trick on the woman's body - material, cognitive, and emotional - she's now simply a part of 'nature', presumably without a will of her own, which contradicts the notion of being able to rationally 'plan'.

marin gillis said...

I absolutely agree.

bob koepp said...

This is just one more step in the long process of medicalizing human reproduction. Of course, given that women occupy the center stage of reproduction, it might be more accurate to view this as just one more way to try to control female sexuality.

Anonymous said...

You know, there is a flip side to this. A large portion of women dealing with infertility had no idea that drugs they were given would have an adverse effect on their ability to conceive - most doctors don't know it either.

Our society does a piss poor job at preparing people for reproductive realities. True, for some they so much as lose control and they are pregnant - for many more it is a more complex process. Men and women should be thinking about reproductive health since it is integral to their overall well-being.