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The CDC “pre-pregnancy” report — argle-bargle or fooferaw?

PrelesOkay. Dan Savage has ranted about it. Susie Bright has ranted about it. The blogosphere is supposedly going apeshit over it. And I have a giant question: Is it really that bad?

I’m talking about the recent CDC report about pre-conception health care — the one that the Washington Post reported on, the one that supposedly advises treating all women of child-bearing age as “pre-pregnant.” (BTW, that’s the Post’s phrase — the CDC doesn’t use it at all).

I read the actual report — not the Washington Post story about the report, not the opinion pieces about the Post story about the report, but the actual CDC report itself. And to me, it seems pretty reasonable. Am I missing something?

Here’s my layperson’s summary of what the report actually says:

1) Most women by far (85%) in the U.S. give birth by the time they’re 44.
2) Many problems in pregancy and childbirth (birth defects, complications, premature delivery, etc.) are preventable.
3) Therefore, the health care system should be trying to, you know, help prevent them.
4) Ways to help prevent these problems include planning your pregnancies if you’re going to have them, and taking care of your health in an assortment of ways before you get pregnant.
5) This is harder for poor women, and this disparity should be recognized and addressed.

Here, I think, is the key sentence:

“Preconception care offers health services that allow women to maintain optimal health for themselves, choose the number and spacing of their pregnancies and, when desired, prepare for a healthy baby.”

Please note the “When desired.”

As far as I can tell, they’re not saying “All women are baby factories and we have to treat them as such.” They’re saying “Most women of childbearing age will eventually bear children — so we should help make this a conscious, planned choice with a good outcome.”

The one part of the report that I think is even remotely problematic is the recommendation that all women — and men, for that matter — of child-producing age be given “pre-conception health care,” regardless of whether they currently plan to have children. But given that their idea of “pre-conception health care” centers on planning ahead of time when — AND WHETHER — you’re going to have kids… well, I don’t see the bad.

The CDC is saying — it seems to me — that since (a) most women of childbearing age do wind up bearing children, and (b) many pregnancies are currently unplanned, therefore primary care providers and gynecologists (who are the medical professionals most people see most of the time) should initiate discussions about the patient’s plans — if any — for having kids, and if they want kids, help them do it in a conscious, healthy way.

Again I ask: Why is this bad?

A final key sentence: “Each woman, man, and couple should be encouraged to have a reproductive life plan.”

You know — planned parenthood.

And once again I ask: Why is this bad?

So am I missing something? I’ll admit that I didn’t painstakingly read every sentence of this report — there’s a lot of medical and public-health jargon that I didn’t understand and therefore skimmed. If anyone out there works in public health/reproductive health/related fields, or is familiar with them, or even just knows how to read a CDC report, please speak up:

Is the hysteria over this report justified — or do we all need to just chill the fuck out?

P.S. Apropos of nothing: When I was doing an image search on Google for images of pregnant women (before settling on The Ultimate Guide to Pregnancy for Lesbians), fully one out of four images on the first search page were of Britney Spears pregnant. I don’t know what that says about us as a society, but it can’t be good.

Comments

  1. laura says

    Greta asked me to add my comments over here, so here they are -
    well, based on the author’s recommendations, none of us should be cleaning the cat boxes, which would result in some pretty unhappy cats…
    Here are my issues, after reading it:
    - most of those health recommendations (don’t smoke, treat your diabetes) are far more important for a woman’s health than her potential offspring. I find it a bit insulting that the authors are more concerned about those interventions because they could help my non-children than because they would be good for my health. It’s all pretty standard public health messages. I’m surprised wearing seat belts wasn’t included. These things should be pushed because they are good for all of us now, not just because of some future child. It’s the prioritizing of the unborn over the born thing, and it icks me out.
    - some of the other interventions are just really impractical for ALL women 15-44, like cleaning the litter box, or not drinking ANY alcohol ever. Are you going to stop drinking, start taking folic acid, and not clean the litter box? Should I? They make sense if one is pregnant or TTC, but aren’t sustainable in the long term.
    - the assumption that because MOST women will get pregnant, these interventions should be applied to ALL women. It’s a variation of the question asked by the gynecologist about birth control: Q1 are you sexually active – yes. Q2 are you using any birth control – no. followed by either a look, a question about do you WANT to get pregnant, or a lecture. Of course there’s several other options. We’re not all having procreative sex. I’m really not having any kids. Really. And I would fire any doctor who didn’t take my word for it. It reeks of not trusting women to know what’s going on in their lives, or their reproductive self-determination.
    I’m pretty distrustful of anything coming out of the CDC these days, though, so I am assuming the worst possible motives from a group of researchers who are really just trying to improve birth outcomes, which is a perfectly reasonable thing to do.
    Yes, more women should have health care! Maybe even, you know, universal health care. I hear it does really good things for all sorts of people, including moms and babies. The authors get props for pushing for more health coverage, even if they won’t explicitly call out the government policies that limit it.
    I think they really are more concerned about saving the babies than the moms, and are seeing all women as potential mothers, and may believe that they are doing that for benign motives but in this Reagan, I mean Bush era, I think that even clueless birth defect researchers need to think about the context in which they present things like this.
    I think we’re all so primed to jump to the defense of our reproductive rights that we’re seeing evil intent everywhere. That may not be true, but I think the report authors are a little naive if they didn’t anticipate this sort of response. Also, they came across a bit more hard core in the WaPo article, which could be editing.

  2. says

    The Ultimate Guide to Pregnancy for Lesbians-this one very helpful book for lesbian mothers and their kids.I used it during my pregnancy and it helped me alot.It’s really great.

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