javasaurus (![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png)
javasaurus) wrote2006-05-17 06:14 pm
javasaurus) wrote2006-05-17 06:14 pm
Preconception and the CDC
OK, I've read the CDC preconception guidelines several times now. I don't see what the hubbub is about.
First, there is a national problem: 85% of all women give birth at least once, and about a third of the children have health problems. Also, about half of the women unintentionally get pregnant at least once. So there is definitely a problem. Part (maybe most) of the problem stems from a lack of knowledge and a lack of available/appropriate health care. A large part of the country can't afford health care. The intent of the CDC guidelines seems to be to address these issues.
Second, if you are physically able to get pregnant, then you might get pregnant, whether you want to or not. Accidents happen. Being "childfree" is not 100% effective against pregnancy.
Third, there has also been some hubbub about the focus on women's health, not men's. Note that the guidance is all about getting a healthy child at the end of the pregnancy, not about getting pregnant, for which the man's health and activities would be important. Frankly, the man's health doesn't really matter much for this process (yes, I know there are exceptions to this). If he's got reproductive problems, most likely the swimmers won't find their target, and pregnancy doesn't happen. Unfair as it may seem, the woman gets to be the incubator.
The guidelines seem focused primarily on providing healthcare and information that was not previously provided. Even those with health insurance may find that insurance doesn't always cover preconception issues. It is not about withholding medicine from those that need it, but making the patient aware of the effects of the medicine on a potential pregnancy.
Several have posted about doctors that won't prescribe certain medicines to women of child-bearing ability, even if the woman never plans to have children. That has nothing to do with the current guidelines, but about poor doctor-patient relationships. Get a different doctor.
Yes, I understand that some are afraid of how the guidelines will be abused by over-conservative doctors and politicians. However, it is apparent that those same docs and politicians will do so anyway, while the guidelines work towards providing much needed information and resources to those who don't have them.
First, there is a national problem: 85% of all women give birth at least once, and about a third of the children have health problems. Also, about half of the women unintentionally get pregnant at least once. So there is definitely a problem. Part (maybe most) of the problem stems from a lack of knowledge and a lack of available/appropriate health care. A large part of the country can't afford health care. The intent of the CDC guidelines seems to be to address these issues.
Second, if you are physically able to get pregnant, then you might get pregnant, whether you want to or not. Accidents happen. Being "childfree" is not 100% effective against pregnancy.
Third, there has also been some hubbub about the focus on women's health, not men's. Note that the guidance is all about getting a healthy child at the end of the pregnancy, not about getting pregnant, for which the man's health and activities would be important. Frankly, the man's health doesn't really matter much for this process (yes, I know there are exceptions to this). If he's got reproductive problems, most likely the swimmers won't find their target, and pregnancy doesn't happen. Unfair as it may seem, the woman gets to be the incubator.
The guidelines seem focused primarily on providing healthcare and information that was not previously provided. Even those with health insurance may find that insurance doesn't always cover preconception issues. It is not about withholding medicine from those that need it, but making the patient aware of the effects of the medicine on a potential pregnancy.
Several have posted about doctors that won't prescribe certain medicines to women of child-bearing ability, even if the woman never plans to have children. That has nothing to do with the current guidelines, but about poor doctor-patient relationships. Get a different doctor.
Yes, I understand that some are afraid of how the guidelines will be abused by over-conservative doctors and politicians. However, it is apparent that those same docs and politicians will do so anyway, while the guidelines work towards providing much needed information and resources to those who don't have them.
no subject
In Recommendation 1, it talks about the need for everyone to have a "reproductive life plan." So, what if, instead of calling the whole initiative "Preconceptive care", they instead called the whole thing "Reproductive Life Planning"? I mean, keep the entire program, all it's ambitions, all it's scientific facts completely the same, and do nothing -- *nothing* -- but change the name?
It seems pretty obvious to me how that simple change dramatically changes the effect on the political debate, the effects on the mental headspace.
I mean, just try out "Preconceptive Care is an important women's health issue" vs. "Reproductive Life Planning is an important women's health issue". The exact same set of practical actions, with two different names -- to me, the implications on the shaping of the collective consciousness, on the political debate, are as obvious as a two-by-four to the forehead. And if I could think of that while microwaving ramen, I'm certain the folks whose full time job was to create this surely could have thought of the same. They chose one over the other. They almost certainly didn't do it by accident -- and almost certainly didn't do it unaware.
no subject
And that's what bothers me. The wordsmithing that has currently been used most definitely leans towards the direction of "women need to have kids" instead of "women should plan their reproductive lives". And in the hands of a politician, that can be very, very dangerous. What the CDC said slants in the one direction more than the other, and therefore leaves what "should" be done versus what "must" be done up to interpretation... And there's a lot of interpretation that a politician can do with the current wording that can take this to a whole new level.
no subject
I don't doubt that a lot of thought went into the term. I suspect there was no joyous huzzah at the choice but a resigned compromise. Why? There really isn't a single word or simple phrase that refers to women who are biologically able to become pregnant. I can understand that it sounds like conception as the eventual outcome is assumed by the term (and apparently for the vast majority of women, 85%, pregnancy happens at some point).
no subject
Or, put bluntly, if a woman deliberately chooses to abort any child not deliberately sought, she could argubly not need preconceptive care; since any baby she did want she would scrupulously avoid endangering from the moment of attempted conception; and she would not need to take precautions to make sure any unplanned baby was not harmed because no unplanned baby would ever make it to term. Almost all the guidelines deal with that -- harm to fetus -- and very few to harm to the *potential* fetus -- that is, the eggs of the mother. And for very good reasons, basically centering on anything good for the eggs of a woman (or a man's sperm) is good for every other cell in their body, and you'd need no particular reason to single out the reproductive cells from the rest.
*That's*, in my mind, the *real* difference between "reproductive life planning" and "preconceptive care". Because, at least by what is currently legal in America, the strategy I laid out in the prior paragraph is an entirely legal and completely rational means of avoiding the dangers of harm to an unplanned pregnancy. One doesn't need to take measures to protect an unplanned pregnancy if one decides their contingency against an unplanned pregnancy is that no unplanned pregnancy will ever reach term.