May 20, 2006

Everybody's pregnant now!

According to a front-page article in Tuesday's Washington Post, new Federal guidelines recommend:

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.
No, you are not high on crack. If you're between puberty and menopause and are even hypothetically capable of becoming pregnant, the Federal government is going to tell you and your health care providers what to do in order to protect the GOD-GIVEN RIGHTS OF THE UNCONCEIVED.
Experts acknowledge that women with no plans to get pregnant in the near future may resist preconception care. "We know that women -- unless you're actively planning [a pregnancy], . . . she doesn't want to talk about it," [report co-author Janis] Biermann said.
Um, maybe people don't "want to talk about" prenatal care because they actually have no intention of giving birth to a child any time soon. The Post article explains the need for "preconception care" by comparing the U.S.'s infant mortality rate to that of other developed countries:
The U.S. infant mortality rate is higher than those of most other industrialized nations -- it's three times that of Japan and 2.5 times those of Norway, Finland and Iceland
Hmmm ... now, I'm just gonna take a wild stab in the dark here, but might that have something to do with the fact that those countries all have universal health care?

Check out this response while I go disembowel myself with a rusty spoon.


Anonymous said...

I'm pregnant too! And have been for years before it was fasionable.

tea cozy said...

I don't know who this guy is but I like his response:

Anonymous said...

It never ceases to amaze me that the country puts the so-called "rights" of an idea--the unconceived--before the basic health of women. Perhaps if women were finally encouraged to be healthy simply for their own well-being then there might possibly be a simultaneous drop in infant mortality rates, abortion, heart disease, diabetes, etc. etc. I'm a woman who enjoys being healthy for myself and ENJOYS the fact that I've never wanted children. It makes me so angry, b/c the choice not to be viewed as "pre-conception" should be my innate right!!!! But no, my government's chosen to openly scorn me, and I have to live with attempts by my government to coerce me into becoming a breeding machine. What the fuck???

icarus said...

Oh, great. Now we can have more ways for the government to spy on who we're sleeping with. Will we have to prove that we're only sleeping with people who can't get us pregnant?


tea cozy said...

naw, icarus, they don't CARE that you never come into contact with semen, because as a woman who theoretically ovulates, you are host to innumerable theoretical children, and the rights of the theoretical are important, damn it. they'll want you to take folic acid anyway.

SERIOUSLY. I'm glad that women's health is only important between the ages of 13 and 45, and I'm super-duper glad that it's only important because of some theoretical infants.

Does anyone know anything about prenatal care? Can you REALLY do that much damage to a fetus in the first 4 weeks of a pregnancy? or could infant mortality rates actually have more to do with the later prenatal care which millions of women aren't getting because they can't afford it?

And can we focus for a minute on the fact that FIFTY PERCENT OF PREGNANCIES ARE UNPLANNED?!?!! if we were to eliminate (or close to eliminate) unplanned preganancies, I think that would be a step in the right direction... I don't think it's the planned pregnancies which are deficient in folic acid. so can we get a screaming, screaming movement for MANDATORY AND COMPREHENSIVE SEX EDUCATION AND EASY ACCESS TO FREE BIRTH CONTROL? And by "comprehensive," I don't mean "If you don't have sex, you can't get pregnant... next lesson!"

The Mirrorball Man said...

I agree with Tea Cozy and the call for sex ed. and contraception access as a way to fix a lot of these problems. I think this is about more than just "rights for the unconceived." It's also a way of thinking among conservatives: The role of women is to get pregnant. That's what women should do. If you're capable of getting pregnant, now's a good time to start getting ready. It's such a bad way of thinking.

Just want to be careful though: Universal Health Care is a topic that needs to be discussed some more. I'm not convinced that it's going to solve all our health problems in this country; in fact it will make many of them worse. So while I agree that this is ludicrous, I'm not sure that Universal Health Care is the solution.

In fact, I don't think it's the reason why the infant mortality rate is so high in the U.S. If so many pregnancies are unplanned, then perhaps parents would be less likely to do what is necessary to care for the child (i.e. take Folic Acid, etc.). Then there's a higher mortality rate.

garçon-fille said...

I think this is being blown way out of proportion. First of all, when judging an article like this, you need to consider that the writer also has a bias. That being said, the direction this is going (i.e. that all women be treated as though 'pre-pregnant') is ridiculous. However, I think the message they are trying to get across is that just because you might not be planning on having a baby for another 20 years, doesn't mean that the stuff you do now doesn't affect that. I can totally respect women who never want to have children. But I think the idea behind this is to force people who very likely will get pregnant to wake up and realize some of the ways they may be harming their bodies and their future children. I'm not saying this should be some sort of mandatory thing, but in terms of education and prevention, this is probably a big step towards reducing unwanted infant mortality.

icarus said...

I disagree.

I think it's ridiculous and embarassing that we don't have universal health care already. My freshman year, I spoke with Robert Reich, former US Secretary of Labor, and asked him about universal health care. He replied "It's embarassing that we haven't done this already. We can afford to do it. Our administration just doesn't care."

For people like me, who have grown up on Medicaid, or for undocumented immigrants, legal immigrants who recently arrived, and the desperately poor, health care doesn't exist, especially any preventative care. Instead, people wait until their condition is so severe that they have to go to the emergency room, costing a FAR greater amount than if they had proper primary care.

I've worked at Boston Medical Center, the main source of health care for low-income people in Boston, and I've seen the cost of health care inequality in this country: children with terrible dental care, young mothers who never received prenatal care, undocumented women who can't afford the co-pay for their child's asthma medicine - or who are terrified to bring them in at all.

We need health care for everyone, not just the rich, the documented, the employed (and few of those employed).

According to the US Census Bureau in 2005, nearly 11 million children (15.5 percent of all children) have no health insurance, and 500,000 children are homeless.

Stanley D. Eitzen and Kelly Eitzen Smith's book "Experiencing Poverty: Voices From the Bottom" notes: "The infant mortality rate in some U.S. inner cities rivals that of Malaysia." (6)

Is that something to be proud of? Until poor, homeless and undocumented people can safety and affordable access health care in this country, they will continue to suffer from disproportionate rates of preventable disease, poor dental, neonatal care, and a plethora of other health-related problems.

My own father has been taking half the daily dosage of Coreg, a heart medication needed to keep him alive, because the co-pay is insanely high.

Think about these things when you think about universal health care.

The Mirrorball Man said...

Ok, perhaps I should qualify a bit.

You're 100% right that the health care system needs to be reformed. There's no reason for anyone to take half the medication they need to stay alive. There's no reason that people shouldn't be able to see a dentist. Etc.

But a close friend of the family died in Canada due to the Universal Health Care system there. It's not universally good. Usually it ends up with the government fronting the money, so they do it on the cheap. This guy got misdiagnosed and passed around from doctor to doctor and never treated becuase IT WASN'T ECONOMICALLY WORTH IT FOR A DOCTOR TO TREAT HIM. That's also wrong. When doctors shunt patients away because they can't afford to treat them; that's a problem too.

The system needs reform; yes. But "Universal Health Care" as a universally wonderful concept is flawed. We need to find a system that evaluates procedures for their true worth and covers everyone that needs it. I don't know how it would work. But we can't just point to other countries and say "Universal Health Care = Good." Sometimes it's there, and it fails.

tea cozy said...

garcon-fille, I disagree. This is not about making decisions to take care of fertility for later --- this is about acting like you're pregnant NOW when you are, in fact, not pregnant (abstaining from alcohol, taking folic acid supplements, etc. are not things you need to do to take care of fertility later in life). While it is important to manage long-term health problems, maintain a healthy weight, not smoke, and consume alcohol in moderation, that's not all of what's being proposed, and it's not being proposed for anyone except women ages 13-45, even though basic health-management things like that are important for everyone. I think mirrorball man is absolutely right when he says this is about treating women as if their role is to be pregnant and have babies. This is not just a physician's association making recommendations, these are federal guidelines from the CDC. I would be ok with the "American College of Obstetricians and Gynecologists, the March of Dimes, Dartmouth Hitchcock Medical Center, the National Center for Chronic Disease Prevention's Division of Reproductive Health and the National Center on Birth Defects and Developmental Disabilities" recommending that everyone who might get pregnant anytime soon take certain precautions (like maybe BIRTH CONTROL) like the folic acid, healthy weight, etc. etc., but this is, in fact, an agency of the federal government advising that I keep my baby-making factory in good working order.

I would prefer not to treat my body as a baby-making factory, thank you very much.

icarus said...

About universal health care again:

I understand that sometimes people receive poor medical care in Canada. The difference is, there, everyone is covered under the same insurance. Thus, sometimes wealthy citizens face (a very, very, very lesser) kind of troubles that uninsured people face.

People die here EVERY DAY because of poor medical or because they can't receive medicine, preventative care or basic health treatment. Poor people in Boston rarely see the same doctor twice. They almost never get good dental care (even though MassHealth, the version of Medicaid here) theoretically covers dental for children, the majority of dentists won't treat, or have a quota for, MassHealth clients.

They can't choose to get specialists, second opinions, or where they receive medical care. My dad, for example, couldn't choose that. He received poor health care in Maine, was misdiagnosed and then had an incredibly risky open-heart surgery that was done incorrectly, and he was not informed of the risks. He had to have another one shortly after he went into cardiac failure. He now has scar tissue in his heart, and a huge amount of very expensive medicine to take every day. Yeah, maybe if he'd been rich, he could have afforded a heart specialist a few years earlier. But you know what? That's not how it works here. Why? Oh, wait, because it "wasn't economically worth it for a doctor to treat him."

So, maybe for a very small minority of America, the health care system is wonderful. But you know what? If we switched to universal health care here, they could still get fancy doctors, second opinions, and any other health services they wanted to buy - and the rest of us could stop worrying that their father can't afford the medicine that makes his heart work.

ps. My girlfriend is from Canada, and says that, in her experience, she has never had problems with the health care system, and there is not a social uproar about it there. If it was really so terrible for everyone to have insurance, I feel like someone would probably protest?

ok, I'm done. This just really matters to me.


icarus said...

ps. sorry for my grammar incoherence, but I'm too lazy to go back and re-post, so bear with me. :)

gromphus said...

On a similar note, I lived for two years in Paris, France, where they've got SOCIALIZED MEDICAL CARE. Omg. I can say without doubt that Paris was where I recieved the best medical care of my life, from being able to have ultrasounds and urine tests completed very very quickly and without hassles, to hospitalization, to amazing feel-better-instantly-compared-to-US-meds cold and cramp relief, to incredibly caring and dedicated family doctors. We're talking house visits. Multiple ones. Admittedly, this is just my childhood and adolescent experience, but I think it's pretty impressive. I'm not even a French citizen, and I don't know how the system works, but I remember my parents being shocked at how little it all cost.

garçon-fille said...

Ok, I'm sorry; I misread the article... I do think it's stupid that women should be treated as pregnant on the off chance that they may have an unknown unplanned pregnancy. (Excluding healthcare systems, because I don't know enough about that to argue the point) The best thing they could do to keep that from happening would be to prevent unplanned pregnancies in the first place, through, for example, better national sex education (i.e. not abstinence-only) and providing free (or less expensive) condoms and other contraceptives.

The Mirrorball Man said...

Hi Icarus,

I will do some research on the issue and see if my opinions change. I do completely agree, but you'll definitely hear different things from different people.

One thing is your idea that if everyone had universal health care they can just see a second doctor and get everything they want. I doubt that will be the case here because the costs of medicine are too high. The government will be unable to afford the exorbitant costs levied on Americans by pharmeceutical companies and the result will be scaling back benefits or worse care. They then cut pay for doctors back more, and doctors start making less and less. Yes, doctors get paid a lot now, but the rising costs of malpractice insurance and malpractice lawsuits means they start losing money.

I think inherently we need to remember two things:

a) Drugs/procedures are MORE COSTLY in the U.S. Drug companies charge more money domestically than in foreign places; that's why there's the whole uproar about importing drugs from Canada.

b) Malpractice costs in the U.S. are absurd.

Combined = Different culture; different problems. I'm not sure if universal health care can be as successful because of the different strains it puts on doctors.

I'll admit: Universal Health Care is great! I'm all for it! But we need to have a RADICAL change in the U.S. Health Care system FIRST. Otherwise I feel UHC will only compound the problems and make things worse.

Leyan said...

I've read in a few places that one factor contributing to the higher infant mortality rate in the US is that neonatalogists here tend to try to save more of the sickest and most premature newborns rather than letting them die soon after birth and recording the death as a stillbirth (as apparently is done elsewhere). That way, according to this theory, babies who die very early in life despite the measures taken to save them count towards the infant mortality rate, whereas elsewhere they don't.

Has anyone else encountered this hypothesis?

Also, on the pre-pregnant issue... folic acid is in a class of its own, I think, since it's needed so early in pregnancy (often before the woman knows that she's pregnant) and folic acid deficiency can cause some very severe problems. That's why March of Dimes advises women to take folic acid even before they start *planning* to become pregnant, since not all unplanned pregnancies are unwanted.

icarus said...

Regarding folic acid and why I don't need to take it:

Some of us sleep with people who couldn't get us pregnant. Apparently, federal guidelines don't care. Also, sometimes people who become accidentally pregnant might choose to have an abortion, another women's right that our government wants take away. Just sayin.

Leyan said...

Icarus, you're right, and I should have been clearer about to whom these guidelines should be applicable. (They are not applicable to me, either, for different reasons.) But I still think it's a good idea to advise women who could become pregnant to take folic acid early, since a lot of women who become pregnant unexpectedly do decide to carry to term (60%, according to one pro-choice source). That's a couple million kids a year who are vulnerable to serious disability without preventional folic acid.