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*

Re: the "New" new?

[anneb.livejournal.com]

10 years ago, though, it wasn't "stay as healthy as possible," it was "you could be pregnant and not know it, make sure you take your Folic acid supplements." Honestly, I don't read this current phrasing as all that different, but possibly it's because I got worn to it the last time this furor came around.

We need a scale. Which is more pregnant? "Partially?" "Potentially?" "Schroedinger's wife?"

The timing on this as a news release is indeed curious. I still think it's fuel for the "The american people can look after themselves, we don't need no stinkin' universal health coverage," not religion.

But that's probably just me.

Re: the "New" new?

[filkertom.livejournal.com]

No, I'm sure it's not just you. That would be right up their privatize-ever-damn-thing alley. I don't trust any of these bastards in BushCo as far as I can spit while inhaling.

[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.

[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.

Re: the "New" new?

[jenrose]

If you just tell people to stay healthy, they may not do it. The potentially pregnant is saying, "do it for your kid". HOWEVER... it totally misses the point that people who are not planning on getting pregnant who get pregnant are, you know, *not* planning...

[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.

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".

[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.

Re: the "New" new?

[filkertom.livejournal.com]

This is why the religious angle is in it. Dobson and his ilk are criticizing Republicans (http://tinyurl.com/rc9rr) for not moving quickly enough on their psychotic, superstitious, anti-woman and anti-gay agenda. You think this isn't a sop to the Religious Reich? 'Cause it sure smells that way to me.

[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.

[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.

[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?

[salkryn.livejournal.com]

Yeah, that's one thing that bugged me about that. It's only women who are being told to stay healthy. Apparently, it doesn't matter if people like me pay no attention to our physical well-being, only the people who will have to carry our by-blows.

[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.

[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!!!!

[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.

[andpuff.livejournal.com]

Yes, but they're not saying 'women who are hetrosexually active' they're saying 'all females capable of conceiving a baby'. They're not using a definition that defines the subset of women with the potential to get pregnant, they're using a definition that narrows us all down to our reproductive cycles.

I am a female capable of conceiving a baby. I am also a nearly fifty year old lesbian so my health is in no way tied to my ability to reproduce nor should it be. By these federal guidelines, it is.

Am I willing to have it defined that way in order to wipe out spina bifida? Hell yes. Do I think that recommending women be defined by the possession of a functioning uterus will accomplish that? Not likely.

[emiofbrie.livejournal.com]

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.

and that is the issue with these guidelines, as now, even if they don't want kids, fertile women will have prescriptions tailored for the *possibility* that they may have kids, whether they want them or not. -.- basically, it changes all those "if you think you may be pregnant" warnings to "if you are a fertile woman" warnings... -.-

[omimouse.livejournal.com]

Don't know if this is urban legend or not, but this was the reason I was given:

Woman trying to have baby. Is having major problems getting pregnant. Trying really hard. Starts showing symptoms of various and sundry Potential Nast Stuff in regard to reproductive organs. Dr recomends and performs hysterectomy.

Women was pregnant. Lawsuits ensue.

I should probably really Snopes this, but right now, I'm just generally feeling extremely pissed off.