Pre-Conception Care: Women’s Health as Individuals or Incubators?

Improvements to studies in women’s health have been long overdue and slowly improving. Apparently some of the current policies towards women’s health look past the woman as individual, and see her only as potential incubator. Among them, recently released guidelines from the CDC regarding the status of women and their health care are causing great sparks, particularly in the blogosphere.

According to UPI, the CDC is now recommending that “All women who are able to become pregnant should treat themselves and be treated by healthcare professionals as being pre-pregnant.” This includes preteen girls just beginning menstruation, as well as women who have no plans to become pregnant – ever.

While there is no arguing that the guidelines themselves are great for women intending to become pregnant and ultimately contribute to healthy pregnancy outcomes, the implication of the “potential mother” label, as written on Pandagon “…fits into a long tradition of using theoretical pregnancies as an excuse to discriminate against women.”

For instance, Shadesong Live Journal writes, “I have been unable to obtain adequate medical care for my epilepsy because I am what they'd call pre-pregnant. As my neurologist puts it, I am a woman of child-bearing age. As such, they flat-out refuse to try me on any medicines other than the ones proven least likely to affect a fetus … despite the fact that I have declared my belly a no-fetus zone.” At the same time, Brad at AIDSCombatZone encourages progressives to look carefully at the proposal before trashing it, saying, “Look, I'm as much about keeping the government's hands off of my wife's uterus as anybody, but these guidelines are about empowering women to take control of their reproductive health.”

With organizations like the American College of Obstetricians and Gynecologists, the March of Dimes, and the National Center for Chronic Disease Prevention's Division of Reproductive Health involved in creating the guidelines, arguably the idea of preconception care and “reproductive life plans” seems innocuously positive. And as Ezra Klein points out, “If we want to remain the side committed to serious science and the preservation of expertise, we've got to support well-documented research when it emerges, even if its leaves us uncomfortable.”

But let’s be clear: the discomfort is not about the guidelines. It is about the status of women. The feel-good labeling of pre-conception care creatively hides the underlying public health issues facing women that need to be addressed unabashedly – the high rate of unintended pregnancies in America and women’s lack of access to basic reproductive health care, distinct from pregnancy. Even though the report touches on women’s reproductive health, it is written within the framework of “pre-pregnant” care largely regardless of a woman’s intention, desire, or age.

A recently published report from the Guttmacher Institute found that unintended pregnancies among under-educated, lower-income women actually increased by 29% since 1994. Many of these women were in need of affordable birth control but due to budget cuts imposed by ideologues opposed to contraception, it was not available. Women need affordable birth control. Additionally, the CDC acknowledges that 17 million women lack insurance and cannot seek health care of any kind, including annual doctor visits, cancer screenings, and other health services related to their overall well-being. Improvements for women’s health are welcome, but they should not be made solely because women may decide to be mothers. Those mothers’ lives and health matter in their own right, and we want to be sure that they are cared for regardless of their choices about reproduction.

These guidelines are a step in the right direction, but they carefully tiptoe around critical issues. It seems the only way the Bush Administration is willing to talk about women’s health care is if it can avoid direct talk about the multi-faceted health care needs of women as individuals. This Administration has already created a female incubator mentality through fetal insurance benefits, rights, and personhood – we don’t need yet another “status” policy that overlooks the woman for the sake of a potential child.

Creating this status of the pre-pregnant womb-man fails to meet the critical reproductive needs of every American woman, and this failing is another marker in a long record of policies that favor ideology over science. And that subjugation of science is the real issue with masquerading these “preconception” guidelines.

Click here to read the CDC preconception guidelines.

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