Gilead, Here We Come

[filkertom]

Even the WaPo is labelling this one "Forever Pregnant":

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.

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.

And if you're wondering why I've got the "religion" tag on this one... you simply don't get it, do you?

Comments

[dbcooper.livejournal.com]

I absolutely must ask this...

Does the federal government also recommend that women spend as much time barefoot and in the kitchen as possible?

the "New" new?

[anneb.livejournal.com]

Hard to say how "new" for the fed. The FDA's been requiring folic acid supplements in certain food and listing on labels since '98. Many doctors have been pressing for that for a long time, as well My son's 10, and I was getting the spiel to take multivitamins with folate before he was born from my midwife and from my doctor. March of Dimes has been pushing it for at least that long.

I don't think it's religious. I think it's going to be used for fueling an upcoming health care coverage debate.

Re: the "New" new?

[anneb.livejournal.com]

Here's a ref for March of Dimes: http://www.marchofdimes.com/professionals/681_1151.asp

This came up in the 90's 'cause young professional women in my age group and a bit older weren't eating enough veggies, and people feared the spina bifida rates were going to skyrocket.

Re: the "New" new?

[filkertom.livejournal.com]

It's the phrasing. They aren't saying "stay as healthy as possible for as long as possible"; they're saying "consider yourself potentially pregnant at all times". They want to get people used to the idea.

[vulpine137.livejournal.com]

Well, that's offically the creepiest thing I'd read. Not just the guidelines, but the bit about Handmaiden's tale. I'd never thought of that in the context of possible near futures til now. *shudder*

[tigertoy.livejournal.com]

I think there probably are some individuals out there who actually do see this in the terms you're trying to cast it in -- that the purpose of women is baby factories. But even I -- and I'm pretty cynical and suspicious of the motives of the current government -- believe that most of the people in the FDA who come up with these rules are genuinely concerned about minimizing suffering.

If you're familiar with spina bifida (a ghastly birth defect associated with folate deficiency), you'd realize that having all women get enough folate has a legitimate purpose. Even women who aren't planning to get pregnant do, and unless you're going to say that they should be *required* to have abortions -- which is nearly as repugnant as saying they *can't* have them -- folate supplements aren't a bad idea.

The other recommendations are more general "good health" advice. From a public health standpoint, we should encourage everyone to not smoke, etc., and if some percentage of the population won't do it for themselves but will do it for the sake of children they might have, that isn't necessarily a bad thing.

That's not to say the message can't be twisted by taking it too far. But if that's happening, it's the fault of the political leadership that screws up the reports just before they're published, not the rank and file scientists that do the research and make the recommendations.

Phuque The Folate

[filkertom.livejournal.com]

Yes, that's exactly right, Phil, and haven't you been paying attention to the past five years!?

That's what BushCo does. It's like the Terminator, except all they do is fuck things up to fit their twisted agenda. "Pre-pregnant"? What the hell kind of phrasing is that?

These are the people who don't believe in global warming, energy conservation, the Big Bang theory, evolution, or any form of birth control besides abstinence. It's like I said above -- if they want women to keep healthy, tell them "keep healthy". This is telling them "be ready for pregnancy".

[mtgat]

It's not the scientists, no, but it is the subtexty goodness in the article, and the specific phrasing: "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."

All females. All women of possible childbearing years between first menstruation and menopause. That includes lesbians, and twelve year old girls, and fifty year old grandmothers, and childfree women, and women who have already had children and don't want any more, and women who for various medical reasons shouldn't have children. I agree whole-heartedly that folic acid supplements are good things, and more, that not smoking and keeping one's self healthy are really good things. More, I like that the article mentions the problems of healthcare and how better healthcare for everyone would lead to healthier babies. But I don't like the implication that I should do these things in case I get pregnant. My spouse and I have taken steps to make sure I don't, so if I do, I've got a lot more problems on my hands than just not eating my veggies. But now it sounds like my doctor has to follow guidelines that include treating me as though I could be pregnant, regardless of my intentions to ever get or stay pregnant again. And this is annoying, especially because my husband isn't being told that detrimental effects that drinking and smoking and bad diet have on his sperm, and he isn't being treated by his doctor as a potential father at all times.

[jenrose]

There is a hell of a lot of difference between forced impregnation through rape and simply *asking* or *recommending* that women take care of themselves. Frankly, if someone is not on one of a very select few types of birth control, and one is heterosexually active, there is a clear risk of pregnancy. Even sterilization is not 100%, but that, Mirena, injectibles and norplant are the only birth control that I know of where the risk of pregnancy is less than 1 in 100 women per year using that method. Even the pill... 2-3 in 100.

Why, pray tell, is it bad to say, "Gosh, you really should take folic acid, not smoke, maintain a healthy weight and keep your health conditions under control"? I fail to see the bad, as long as it is not "enforced with weight of law". But recommending? Asking? They've been asking people not to smoke for decades.

I got pregnant unexpectedly at age 21. It happens. And hell, *I* recommend to young women who are sexually active take the same steps. Although I'm not a healthy weight, the rest of it I do, though I *am* on the Mirena and don't plan another pregnancy any time soon. Because my body deserves it.

That said, it's not lack of vitamins that causes the US's low birth rate, but our abysmal and atrocious approach to "caring" for pregnant women and babies. You want to understand why so many babies die? Look at the crap healthcare poor women get and the crap guidelines the doctors use anyway.

[jenrose]

low birth rate=high infant mortality. Doh. Getting sick. Brain full of goo.

[filkertom.livejournal.com]

Again, again, again: It's not what they're saying. It's how they're saying it. It's the psychological imprint they're putting forth. Hell, yeah, pre-natal care should be a major priority. Hell, yeah, women's health in general gets back-burnered horribly. But this is trying to create a mindset.

[smoooom.livejournal.com]

For the most part I agree with you here Tom, except for a few things that are directly conected to the babies health. Spina Bifida see the comment above.
FAS - Fetal Alcohol Sydrome, a TOTALLY preventable problem. Even one night of drinking duringthe first three months of pregnancy can leave a baby with FAS, drugs? Same thing, smoking? Short term? I'm not aware of research in this area, but low bithweight and other problems are associated with somking during pregancy. There are Women who abuse all three while they are pregnant, and society is left to deal with the child.

I appreciate how you feel on this, as I said for the most part I feel the same way. Keeping women down etc, but there are consequences for some things women do while they are pregnant. I should calm down, I am glad I live in Canada rather than in the States, religion pay a part in politics up here, but I don't think it's to the same degree as you guys have.

[wouldyoueva.livejournal.com]

Even one night of drinking duringthe first three months of pregnancy can leave a baby with FAS,

Cite, please? I can't argue that drinking is *good* if you're pregnant, but if one night of drinking during the first trimester can cause FAS, then we'd be seeing a LOT more of it.

This whole "pre-pregnant" thing chillingly reminds me of the requirement I had to take a pregnancy test right before my hysterectomy. WTF? If I'm bad enough to need my entire reproductive system ripped out, how the *hell* would I carry a pregnancy to term?

[catalana.livejournal.com]

Ghastly.

It reminds me of one of the worst questions I was ever asked was the first time I went in for x-rays for my back when I was 12 and the tech asked if I could be pregnant. *wryly* I know that they have to ask, but I was dreadfully embarassed at the time.

(Yeah, I know these days having sex at 12 is probably no big deal. But it was when I was 12.)

I hate it when doctors ask the date of my last period - I always want to tell them "None of your goddamned business." Usually I just make a date up, since it's not like I keep track; I'm on Seasonale - I have periods when I run out of pink pills. Sheesh.

[jenrose]

Sex at age twelve was then and still is rape.

[eleri.livejournal.com]

Pre-pregnant is a medical term. Just like pregant or postpartum or menopausal. Reguardless of a persons reproductive choices, or sexual orientation, biologically any woman between puberty and menopause who is not currently pregnant or postpartum *is* pre-pregnant. It's the medical state of having the physical potential for conception.

They've had these recomendations in place for declared pre-pregnant women for years... that is, if a woman says "I want to get pregnant", suddenly they were supposed to be worried about folic acid and not smoking and vitamins and such. And doctors ignored those issues until a woman said she wanted to get pregnant. What these reccomendations say now, is that all women should be treated as if they are 'pre-pregnant', not just the women who say they want to conceive. They shouldn't wait for an arbitrary decision to conceive, to work to maintain an optimum state of health.

And, biologically, womens bodies work best when the optimum conditions for healthy conception and birth are maintained. If need be, I can trot out the studies done on the effects of long-term birth control use, or missed periods in athetes, there's a weath of information out there that shows the more you muck with a woman's reproductive system, the more chance for long term problems.

This doesn't mean, at all, that evey woman has to get pregant to be healthy, it does mean that women need to be more aware of the basics of reproductive health, and not freak out at the idea of pre-pregnancy as some moral attack on women who chose not to conceive.

[kightp.livejournal.com]

While I don't disagree with the health-care recommendations - for women or for men - as such, there's much in the language of these guidelines that's troubling.

In particular, I'd draw your attention to Recommendation 4, "Interventions for Identified Risks."

Certain women and men need additional counseling and interventions. For example, women who have conditions treated with medications that are known teratogens (e.g., anticonvulsant or anticoagulant medications and isotretinoins) might need to change prescriptions. Women with medical conditions associated with increased risks for morbidity and mortality to mother and fetus (e.g., diabetes, hypertension, heart disease, rubella sero-negativity, thrombophilias, dental disease, or obesity) need to control these conditions. Women with behaviors associated with increased health risks for the fetus (e.g., smoking and alcohol and illicit drug use) also need targeted interventions. Another group with specific counseling needs includes prospective parents with a family history of inherited (i.e., genetic) disorders.

The whole notion of "targeted interventions" rubs my concept of adult autonomy the wrong way. And there are already women being denied the best treatment for their disorders because - despite their assertions to the contrary - a doctor has decided they might wish to get pregnant some day.

As someone who spent seven years trying to find a doctor who would tie my tubes because I knew I didn't want to have babies, that chills the hell out of me. Especially because I've seen no evidence that the same treatment is being applied to fertile men, despite the fact that there are drugs that have an equally adverse effect on sperm.

[que-sara-sara.livejournal.com]

I think that is the last straw. Tell Anne I'm coming in to get my tubes tied at the very least. If I can find a way to have a full histeroctomy that'd be even better.

Take my uterus away!!!!

[morpheus0013.livejournal.com]

Just...boggled.

I actually plan on having more children, and I still find this offensive.

The words "federal guidelines" are what make me most woozy here.

[batyatoon]

I actually plan on having more children, and I still find this offensive.

Me too.

I've been trying to think of something more coherent to say than AAAARGH TOON SMASH, and it's not working.

Someone needs to invent the goddam uterine replicator already.

[omimouse.livejournal.com]

Y'know, before this administration, I would've said that it was impossible to be enraged for this prolonged of a time period.

I think that's the only coherent thing I have to say on this subject, really.

[sylverwolfe.livejournal.com]

see, i consider myself, because of my diabetes and my family history of PCOS, as NOT capable of conceiving a baby. pregnancy could quite possibly kill me, if i could even catch a podling to begin with. therefore, not an option in my book. as soon as i figure out from my health insurance what procedures can be done to prevent a such a lethal possibilty, i'm going under the knife/laser and getting as much of my apparatus tampered with as is necessary.
and if i have to, i'll save my pennies and get it done in canada.

[ericthemage.livejournal.com]

When you have doctors told to consider women to either be pregnant or pre-pregnant, this language makes its way into court decisions. When the language makes its way into court decisions, then these precedents become law. It's a slow process, but it will influence lawmakers and courts, and that's a very scary thought.

[melaniedavidson.livejournal.com]

...about half of pregnancies are unplanned and so much damage can be done to a fetus between conception and the time the pregnancy is confirmed.

The recommendations aim to "increase public awareness of the importance of preconception health"...

Because increasing public awareness of and access to birth control, thereby eliminating many of those unplanned pregnancies, wouldn't be a better way to try to decrease the infant mortality rate, not to mention the number of abortions?

See icon.

[melaniedavidson.livejournal.com]

...Darn quote tags. Pretend the first two paragraphs were italicized and blockquoted, then.

[fractalwolf.livejournal.com]

There are just so many problems with this I couldn't even begin to list them (and I suspect most of them are or will be covered elsewhere in the comments), but...

At Montefiore Medical Center in Bronx, N.Y., a form that's filled out when checking a patient's height, weight and blood pressure prompts nurses to ask women, "Do you smoke, and do you plan to become pregnant in the next year? And if not, what birth control are you using?"

Somehow I don't think "marriage to a woman" would be considered acceptable birth control to these people.

[vettecat.livejournal.com]

Ok, that's scary...

[the-dark-snack.livejournal.com]

A friend of mine pretty much summed up my feelings on the whole thing and made a few points to the CDC regarding the matter as well (http://penguido.livejournal.com/210052.html?mode=reply).

[selenesue.livejournal.com]

So if I have to have my rapist's child, at least the poor critter won't have to live with spina bifida as well. And the gommint won't have to pay for treatment thereof, more to the point. Just Ducky.

[bardicwench.livejournal.com]

When I first read "The Handmaid's Tale" the scariest thing was that I could see this in our future... *shiver*

Yeah... can anyone picture ME passively being a brood mare? Hell no. I'll be off in "the colonies" with all of the other useless women.