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All Women are Pre-Pregnant

A new set of CDC guidelines suggests that all women of child bearing age be considered potentially 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.

While most of these recommendations are well known to women who are pregnant or seeking to get pregnant, experts say it’s important that women follow this advice throughout their reproductive lives, because 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” and emphasize the “importance of managing risk factors prior to pregnancy,” said Samuel Posner, co-author of the guidelines and associate director for science in the division of reproductive health at the Centers for Disease Control and Prevention (CDC), which issued the report.

While this strikes me as plain common sense and something that would do no harm–not smoking, not getting obese, getting enough vitamins, and so forth would be good advice for men, after all–this announcement will have profound political implications once word gets around (the report was in yesterday’s WaPo).

Bitch, Ph.D., perhaps not surprisingly, is outraged.

Yes. “Healthier women have healthier pregnancies.” But healthier women are also healthier. Not that we give a s— about women’s health.

Because, after all, there are no guidelines out there for healthy living for women–it’s all about the fetus?

She also notes that she did all sorts of things she wasn’t supposed to when she was pregnant and her baby turned out just fine. N=1 and all that.

Shakespeare’s Sister joins in:

All I have to say is I AM NOT A BABY INCUBATOR! I am a human being who may or may not (and very likely not) give birth to another human being someday. The healthy decisions I make, I make for me, and I can’t think of a reason with a lesser capacity to dissuade me from making unhealthy decisions than the possibility I might accidentally get pregnant someday. If and when I decide to use my body to create another life, I’ll start making decisions on behalf of that potential life. Until then, my body is mine and mine alone, and I’d really f—ing appreciate it if everyone else would regard it that way as well. F—ing hell.

Even echidne, who once won an award for being a polite blogger, is angry about the tone of the report.

[T]he overall argument is that preconception care should apply to all women in their fertile years, including those who never plan to be pregnant, those who are not partnered and those who have finished their childbearing. Or rather, the existence of such groups of women among the fertile age group is mostly ignored in the report. It also ignores preconception planning for men but perhaps that is something that will appear in a separate recommendation around Father’s Day.

What exactly would “pre-conception planning for men” entail? Aside from producing and delivering sperm, men’s role in the process is rather limited.

And I’m still unhappy with the idea that all fertile women should live as if they might become pregnant tomorrow, even if they have no plans to have children any time soon. Consider alcohol. Drinking some red wine can be good for your heart but bad for an embryo. Should all women abstain from alcohol consumption, even at some risk to their own health? Or take a more serious question: What happens when a medical treatment a fertile-age woman needs might also harm a potential fetus? Is the recommendation that the woman should suffer without the treatment, even if she has no plans of becoming pregnant?

While I’m a doctor, I’m not a medical doctor. Still, one presumes that women of child bearing age would be pregnancy tested if there is any doubt, allowing them to make informed decisions. It would, after all, be devastating to accidentally kill one’s baby by thoughtlessly undergoing a procedure. And drinking a glass of red wine or two early in one’s pregnancy is unlikely to cause harm.

Indeed, as Ezra Klein reasonably notes:

Welcome to medical literature. If we actually listened to the reports, we’d all do aerobic exercise for 60-90 minutes a day, eat between 9 and 11 servings of fruits and vegetables (of different colors!), and never touch a donut. These are papers written by doctors intimately acquainted with the most heartbreaking and tragic eventualities imaginable. Their guidelines are written to create medically optimal outcomes. It’s up to us to balance them with our lives, our pleasures, and our risks.

Quite so. This isn’t a conspiracy of the evil patriarchy to keep women in their place. It’s the best judgment of the medical community at this point in time for avoiding what, to most women, would be devasting–inadvertantly killing or permanently harming a baby one didn’t realize one was carrying.

Is it fair that men don’t have to worry about taking folic acid? Uh…no? So what? That’s reality, not politics.

Update: Bradley Biggers thinks this is actually a sneaky tactic by the Leftist medical establishment:

This isn’t a case of “them” trying to disguise an anti-abortion agenda as being about healthy babies. This is a case of “us” trying to disguise the progressive agenda as being “pro-family.” We’re fighting fire with fire. Poor women, under the guise of “prepregnancy checkups,” will have added access to birth control. Minority women will have fewer poor pregnancy outcomes thanks to effective preventive care. Women as a whole will be given greater access to affordable health insurance… and all we have to do is put up with it being called “prepregnancy care” (a term taken from the scientific literature). Talk about the lesser of two evils.

An interesting hypothesis, at any rate.

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About James Joyner
James Joyner is the publisher of Outside the Beltway, an associate professor of security studies at the Marine Corps Command and Staff College, and a nonresident senior fellow at the Atlantic Council. He's a former Army officer and Desert Storm vet. He earned a PhD in political science from The University of Alabama. Views expressed here are his own. Follow James on Twitter.

Comments

  1. you know they want to try and make public schools that are separated by gender? Check out the 3rd link, it mentions it. Here are some sources on the “Pre-Pregnant” issue and an explanation of the “Lite-Brite” terrorism I mentioned. Pre-Pregnant Pre-Pregnant Bush & Co. Putting the Toy in Terrorism… if there were a y…

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  2. idle worship says:

    can’t get abortions in South Dakota, can’t buy a dildo in Mississippi (or Georgia, or Louisiana, or the four other states where devices marketed for sexual pleasure are criminal), and, according to the CDC, should (must?) consider myself perpetually in a state of pre-pregnancy, lest something bad (jail-birth?) happens to all the fetuses I don’t have, and don’t want to have, anyway. All day I long is an onslaught of proposed and/or passed government sanctions attempting to outlaw my right to get my orgasm on without making a

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  3. four years. Anyway, I got told that everything looks good (why, thank you, doctor), got my prescription written out, and then she turns to me and very seriously says, Her: [Moonshine], I just wanted to let you know about folic acid. Me: . o O (OHNO YOU DID NOT JUST…!

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  4. My “never going to be baby” is not so special as to deserve such priorities or “privileges”. If you would like to compare human or health statuses, I can assure you that I am by far the more complete and also, alive/living. In any case, more articles:All Women are Pre-pregnant Barefoot and “pre-pregnant” Barefoot and pre-pregnant U R Yr Uterus Women and pregnancy: 2 getha 4 eva The actual CDC report Comments following said articles are interesting and enlightening, to say the least. Also, it turns out that the CDC report

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  5. Outside the Beltway posts on a new medical guidelines that asks that all women of child bearing age be consideredPre-Pregnant regardless of their personal intention to bear children in the near future.

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  6. DANGEROUS, but I could be wrong, because I’m NOT A DOCTOR YET. Look, no one wants to be treated like she’s no more than the sum of her reproductive parts, and yes, it’s a little insulting that the guidelines are not more explicitly geared towardsmen, who also should be NOT SMOKING and MOVING THEIR FAT ASSES and VISITING THE DOCTOR ON OCCASION. But on the other hand, have you *seen* spina bifida? Have you? Because it’s ugly, and sad, and ALMOST COMPLETELY PREVENTABLE

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  7. Pandagon says:

    that fits our agenda, either. The report firmly states that it’s in a woman’s best interests to plan her pregnancies to fit her life goals. All that said, the fury in the feminist blogosphere is completely understandable. There is no reason tofeel like this is a great opportunity to condescendingly tell the little womb-bearers that we shouldn’t be offended when someone dehumanizes us. The WaPo article was smugly misogynist when it recommended that women’s behavior be constrained and that all women should view themselves primarily as incubators.

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  8. Frank says:

    I agree, it is not a conspiracy. But in lawyer friendly America the unforseen consequences may be negative. Will a doctor take a routine radiograph on a “pre pregnant” patient? will a consult to the OBGYN be necessary for all patients? what happens when a patient files a complaint that radiation during “pre pregnancy” caused her baby’s defects? …Lawyers will have a new weapon to exploit what many consider a broken health care system.

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  9. James Joyner says:

    Frank: Could be, I suppose. What’s the alternative, then? Hide these findings from America’s women? One would think that might lead to some lawsuits, too.

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  10. Frank says:

    how?

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  11. Brad says:

    I don’t think any of these people actually read the CDC report itself. Its tone is not objectionable, and its focus is not on treating women as incubators. My blog has my full thoughts on this.

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  12. James Joyner says:

    Frank:

    Ask the tobacco companies. Or pharamaceutical companies. Or the U.S. government, which hid the results of Agent Orange, nuclear testing, Tuskegee Airmen studies, etc.

    Putting out guidelines, in addition to being informative, is an excellent CYA measure.

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  13. HOLD YOUR FIRE!…

    More bloggers are weighing in, mostly without reading the report first, it seems.

    Fortunately…

    Outside the Beltway gets it….

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  14. Christopher says:

    Wow, some of those women are really upset! Maybe it is that time of month…

    Like or Dislike: Thumb up 0 Thumb down 5

  15. Shinobi says:

    Just reading the phrase “pre-pregnant” makes me want to do about 50 tequila shots and then go fall down some stairs.

    Like or Dislike: Thumb up 7 Thumb down 0

  16. Frank says:

    “New federal guidelines ask all females capable of conceiving a baby to treat themselves â?? and to be treated by the health care system â?? 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”

    …this means that when a patient shows up to the ER with an emergency, not life threating, but emergency nonetheless, diagnostical radiation will be contraindicated for almost all females. It makes the practice of medicine a paper circus, as most guidelines do…and yes, they can CYA. But we wouln’t need to CYA if more emphasis was placed on personal responsibility and less on government parenting…If you want to inform patients, let the physicians do it. That’s why they went to med school, that is why they take continuing education courses etc etc…

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  17. Kathy says:

    What exactly would â??pre-conception planning for menâ?? entail? Aside from producing and delivering sperm, menâ??s role in the process is rather limited.

    1.Not smoking in a woman’s presence (any woman, not just his partner). Not drinking alcoholic beverages, because that could damage the health of his sperm (not to mention impairing his judgment, which could lead him to make decisions harmful to a prepregnant woman’s health). Not committing acts of physical violence against his partner, which could endanger her ability to conceive children and could harm a fetus if she is pregnant. Giving up bike riding, because studies have shown bike riding can lower sperm counts, thus depriving a woman of a pregnancy she wants. Not wearing tight underwear, for the same reason. Only boxers would be acceptable.

    I’m sure I could come up with more, and they would be just as reasonable as telling all women in their childbearing years that they should not scoop their cats’ litter (which of course is the same as telling all women in their childbearing years that they should not have a cat or cats at all, because not all women have a husband or boyfriend).

    2. Assuming that these “guidelines” would lead to more affordable and higher quality health care for poor women is absurd.

    3. And Christopher, your comment illustrates to perfection why women have every good reason in the world to feel that treating all women as “prepregnant” might reveal a contempt for their value as individual human beings, quite apart from their childbearing plans or intentions.

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  18. Josh Cohen says:

    My wife’s OB — she’s 6.5 months pregnant now — said that when you’re even considering getting pregnant, you should start taking various supplements like folic acid. We weren’t planning on this kid — if it happened, great, if not, great — but next time around we’ll probably get her started on supplements first.

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  19. James Joyner says:

    Kathy: As a matter of course, I refrain from smoking, being drunk, and beating my wife. And that was even before this study came out!

    As to the cat litter and such, I agree. It’s smart, however, to be cognizant of the risks involved and to exercise some judgment. And, if you can afford it, a self-cleaning litter box might be a good investment.

    Josh: My wife will soon start on pre-natal vitamins for that reason. The worst case scenario is, what, that she’ll just get too darned healthy for no good reason?

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  20. Deb says:

    This is the sort of thing that happens when you have a government that thinks this sort of thing is its business. In a sane world, we wouldn’t be having this conversation.

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  21. LJD says:

    What exactly would ‘pre-conception planning for men’ entail?

    Consider yourselves pre-laid.

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  22. ICallMasICM says:

    ‘I AM NOT A BABY INCUBATOR! I am a human being who may or may not (and very likely not) give birth to another human being someday’

    Something tells me she’s free most Saturday nights.

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  23. McGehee says:

    James: What�s the alternative, then? Hide these findings from America�s women? One would think that might lead to some lawsuits, too.

    Frank: how?

    James: Ask the tobacco companies.

    The same tobacco companies who had been required for years by federal law, to post the Surgeon General’s warning on every pack of cigarettes — and were still accused of hiding the potential harm of smoking from all those smokers, and forced in court to hand over billions of dollars for it.

    It’s hilarious that lawyers have come to see disclaimers and warnings as some kind of inoculation against legal liability.

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  24. Shinobi says:

    I found this interesting post via Echidne about how these “guidelines” affect the health care of women, even before this was published. It seems this woman cannot get proper treatment for her seizures because she MIGHT get pregnant. It sounds like her health is suffering considerably as a result. 90 pounds is not a healthy weight.

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  25. floyd says:

    might i suggest a dietary regimen for some of those you quote.[lol]

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  26. Kathy says:

    As a matter of course, I refrain from smoking, being drunk, and beating my wife. And that was even before this study came out!

    That’s good of you, James, but not every man is as ethical as you are. And, even more to the point, the CDC is not advising you to refrain from smoking, drinking, or hitting your wife because you might be in a state of pre-impregnation.

    Women apparently are to be considered at all times in a state of “pre-pregnancy,” as if pregnancy is the default, normal state for a woman, and the rest of the time a woman is in some kind of limbo.

    When men are told to consider themselves to be at all times in a state of “woman pre-impregnator,” and told not to drink or smoke because they might be unintentionally harming a baby they didn’t know they had made, then come back and we can talk.

    As to the cat litter and such, I agree. Itâ??s smart, however, to be cognizant of the risks involved and to exercise some judgment. And, if you can afford it, a self-cleaning litter box might be a good investment.

    When and if you find one, let me know. I am in a state of permanent post-pregnancy myself, but I would still be happy to have my cats’ litter box clean itself.

    As an added note, did you know that pregnant women are not supposed to eat sushi and sashimi (or any raw fish) for the same reason they are advised not to scoop the kitty litter? I guess women from start of menses to menopause should refrain from eating that, too.

    Which means that my 16-year-old daughter — pre-pregnant by definition — is endangering her nonexistent fetus when she indulges in one of her favorite foods.

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  27. Kathy says:

    ICallMasICM quoting another blogger: â??I AM NOT A BABY INCUBATOR! I am a human being who may or may not (and very likely not) give birth to another human being somedayâ??

    ICallMasICM responding to the above quote: Something tells me sheâ??s free most Saturday nights.

    Something tells me ICallMasICM is a fool, and a stupid fool at that. The blogger who posted the quoted comment — Shakespeare’s Sister — is happily married. Her Saturday nights are permanently booked.

    Fortunately for her, she is married to a man who does not think that a woman’s attractiveness is connected to her ability or wish to reproduce.

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  28. Men are pre-rapists

    Minorities are pre-criminals

    President Bush is pre-dictator-for-life

    The Pope is a pre-cannibal

    Your newborn baby girl is a pre-prostitute.

    Does either the word, or the concept behind the word still make sense?

    Like or Dislike: Thumb up 3 Thumb down 0

  29. The Agitator says:

    “Pre-Pregnant”…

    The Washington Post reports:New federal guidelines ask all females capable of conceiving a baby to treat themselves — and to……

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  30. ICallMasICM says:

    Kathy – get over yourself

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  31. Raven says:

    Actually, you are incorrect about guidelines for “pre-pregnant” men. The difference is that we haven’t (yet) seen any CDC reports about it.

    Some men are not aware that certain lifestyle factors affect theirreproductive health. Fertility Specialists Hummel and Kettel advice men trying to conceive to follow a few recommendations for optimalhealth of their sperm.1. Eat healthy. Healthy food contains vitamins that are essential for the synthesis and development of normal sperm and that reduce the risk ofsperm agglutination (clumping). Taking a multivitamin that supplies 400µg of folic acid and 60mg of vitamin C every day promotes healthysperm and therefore healthier babies.2. Quit smoking. The toxins in cigarettes have adverse effects on sperm quality. Especially when smoking marijuana sperm quality is severely impacted. 3. Limit alcohol consumption. Excessive alcohol drinking decreases sperm production andaffects male potency.4. Halt the heat. Sperm thrive at moderate temperatures. A little bit of heat for a short time wonâ??t decrease sperm counts, but prolonged heat will. Men should avoid wearing tight briefsor other restrictive underwear or workout gear that may increase the overall scrotal temperature. In addition, men should avoid the sauna and hot tub when trying to conceive.After making changes for the better, wait a while before trying for a baby. High quality sperm take up to 12 weeks to produce

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  32. James Joyner says:

    Raven: True. Most of that, though, is about what effects the ability of men to impregnate women, not anything that would affect the health of the baby.

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