Preconception and the CDC
May. 17th, 2006 06:14 pm![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
javasaurusOK, 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.
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no subject
Date: 2006-05-17 11:15 pm (UTC)The trade of a jeweler is the shaping of gems. The careful choice of stone; the exact, deliberate placement of facet. The perfect shaping of gems is the product, the life's work of a jeweler. And they do their work with the precision and attention to detail that the trade calls for. Same with a swordsmith, to take another example.
What jewels are to a jeweler and steel is to a swordsmith, words are to a politician -- to anyone involved in the shaping of policy. Because the exact arrangement of words *is* their entire product. The shaping of ideas, the shaping of memes. To effect change, one's tools are words -- speeches, policies, guidelines, articles, etc. Those are the wedges and picks, the files and putty, by which one changes the mental landscape, the collective gestalt. One seeks to shape the collective gestalt of the 100 senators in the Senate such that the final result is one more vote than the other side. One seeks to change the collective gestalt of the voters of a region to lead to the passage of a particular bill or the election of a particular politician. Politicians and activists do what they do because they ultimately want to shape the world -- and words are their tools. And their choice of words is no more an accident than the choice of facets is to a jeweler or the choice of succession of hammering and filing is to a swordsmith.
The crafters of the CDC guideline, for example, obviously wanted to affect change. That's the whole point of a guideline. And at the level of the CDC, it is possible that the shaping of such a document might be done without excruciatingly careful consideration of the multiple messages that are intended to be sent -- but I highly doubt it. On issues lying as close to the heart of so many political movements, anyone with the brains God gave a turnip would realize how such a document could have the power to change the collective gestalt, advance or retard agendas, influence the mental landscape. Because *everything* is just another piece in the puzzle, another opportunity to play another stone on the Great Board. Politicians -- especially those at that level -- know that and do not waste a single opportunity. It's sort of the same way why it *matters* when a parent calls a kid "stupid" all the time. Yes, it's just a word. But it has an effect. It changes the kid's mental headspace into very profound, real-world results. And the same goes for something like a CDC guideline. Any politician knows the most powerful thing you can do to lay the framework for a paradigm shift is to first change the language. It's possible the authors of the CDC guideline didn't fully consider all the ramifications of the way they framed their document. But I highly doubt it.
I spent years in activism, on many committees charged with drafting all kinds of language -- statements, policies, resolutions, bills. And I've spent much time and many a fight battling over the most subtle of word choices -- and then, months or years later, using those word choices as the launchpads for still further movement. Subtle word choices can change a debate radically, steer -- or allow it to be steered -- in dramatically different directions. Words matter, and none know it better than professional politicians. Because they could have reframed or rewritten that guideline to provide the exact same information more than one way. That they chose the way they did chose to do it could have been an accident. But that would be like a jeweler who banged out cuts on a jewel at random or a swordsmith who filed without thought. Amateurs might do that; but amateurs don't play on the Washington DC level.
That's my take, anyway.