Treat Women as "Pre-Pregnant"

[jenniferblaufrau]

Hoooo boy. (Emphasis mine.)

Forever Pregnant
Guidelines: Treat Nearly All Women as Pre-Pregnant

By January W. Payne
Washington Post Staff Writer
Tuesday, May 16, 2006

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.

Other groups involved include 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.

The idea of preconception care has been discussed for nearly 20 years, experts said, but it has drawn more attention recently. Progress toward further reducing the rate of unhealthy pregnancy results, including premature birth, low birthweight and infant mortality, has slowed in the United States since 1996 "in part because of inconsistent delivery and implementation of interventions before pregnancy to detect, treat and help women modify behaviors, health conditions and risk factors that contribute to adverse maternal and infant outcomes," according to the report.

Nearly 28,000 U.S. infants died in 2003, according to the National Center for Health Statistics (NCHS). The infant mortality rate increased in 2002 for the first time in more than 40 years to seven deaths per 1,000 live births, but it did not change significantly in 2003. Birth defects, low birthweight and sudden infant death syndrome (SIDS) were the leading causes of infant death in 2003, according to NCHS.

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, according to a report released last week by Save the Children, an advocacy group.

Preconception care should be delivered by any doctor a patient sees -- from her primary care physician to her gynecologist. It involves developing a "reproductive health plan" that details if and when children are planned, said Janis Biermann, a report co-author and vice president for education and health promotion at the March of Dimes.

"The recommendations say we need to be opportunistic," or deliver care and counseling when opportunities arise, said Merry-K. Moos, a professor in the University of North Carolina's maternal fetal medicine division who sat on the CDC advisory panel. "Healthier women have healthier pregnancies."

Women should also make sure all vaccinations are up-to-date and avoid contact with lead-based paints and cat feces, Biermann said.

The report recommends that women stop smoking and discuss with their doctor the danger alcohol poses to a developing fetus.

Research shows that "during the first few weeks (before 52 days' gestation) of pregnancy" -- during which a woman may not yet realize she's pregnant -- "exposure to alcohol, tobacco and other drugs; lack of essential vitamins (e.g., folic acid); and workplace hazards can adversely affect fetal development and result in pregnancy complications and poor outcomes for both the mother and the infant," the report states.

The CDC report also discusses disparities in care, noting that approximately 17 million women lack health insurance and are likely to postpone or forgo care. These disparities are more prominent among minority groups and those of lower socioeconomic status, the report states.

The NCHS data also reflect these disparities. Babies born to black mothers, for example, had the highest rate of infant death -- 13.5 per 1,000 live births. Infants born to white women had a death rate of 5.7 per 1,000.

Obstacles to preconception care include getting insurance companies to pay for visits and putting the concept into regular use by doctors and patients. 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," Biermann said. So clinicians must find a "way to do this and not scare women," by promoting preconception care as part of standard women's health care, she said.

Some medical facilities have already found a way to weave preconception care in with regular visits. At Montefiore Medical Center in Bronx, N.Y., a form that's filled out when checking a patient's height, weight and blood pressure prompts nurses to ask women, "Do you smoke, and do you plan to become pregnant in the next year? And if not, what birth control are you using?"

"It's a simple way of getting primary care providers to think about preconception care," said Peter Bernstein, a maternal fetal medicine specialist who sat on the advisory committee that helped produce the report. "It's simple and [it] costs nothing."

http://www.washingtonpost.com/wp-dyn/content/article/2006/05/15/AR2006051500875.html

[jeth]

They are already doing that. My own doctor refused me a particular, effective treatment on the grounds that he wanted to preserve my fertility. When I made it clear that I don't want kids they countered with the fact that I would change my mind.

I'm really not surprised by this. It's essentially how they've been treating us all along.

[Rinky vs.4.0]

I just posted this in OIT, figuring it affected everyone.

I can't stress how much this wording repulses me, and how much I think this is simply more pro-liar chicanary disguised under the heading of health.

The other thing that occurs to me is that is refuses to acknowledge the main reason for the major discrepancy between US infant mortality and many other rich countries is that in the US, the woman whose babies are likely to die are likely to have little to no real access to proper health care either prior to, during or after pregnancy, or be substance abusers, and this seems to be passing the buck onto them in the form of 'self-care' rather than implementing programs that actually address those issues.

If anyone ever dares to use that revolting phrase in my presence I will correct them with a swift "I'm not pre-pregnant, dear, I'm pre-abortion. Put that in your pipe and smoke it."

I take care of my health for my quality of life, not because I might be a mother some day (I won't). Plus, asthma and diabetes uncontrolled can kill BOTH sexes - what the fuck has controlling them got to do with whether or not I can, cannot or want to get pregnant?

[Kari]

I am so disgusted by this article. So, so, SO disgusted.

I am NOT pre-pregnant. If anyone said that to me, I would light up a cigarette and tell them I was trying to smoke out my uterus.

This almost, ALMOST makes me want to re-neg my plan to quit smoking next week. Cause, you know. But I won't. That's for MY health, not anyone else's, and they can all go fuck themselves.

[Rinky vs.4.0]

I'll count you in for one of my 'I'm not pregnant, I'm just pre-abortion' t-shirts, then, Kari?

[Kari]

I'll count you in for one of my 'I'm not pregnant, I'm just pre-abortion' t-shirts, then, Kari?

You know it!

Seriously. This shit makes me want a tubal. I didn't think I wanted a tubal, but I am seriously considering it.

[Charles:]

Do you think maybe the audience for this article isn't women who choose to be childfree?

[Kari]

Charles, they don't even MENTION the possibility of that. It doesn't matter who the audience is, they said "women", as in all women.

And then this...

"We know that women -- unless you're actively planning [a pregnancy], . . . she doesn't want to talk about it," Biermann said. So clinicians must find a "way to do this and not scare women," by promoting preconception care as part of standard women's health care, she said.

So, meaning they're going to implement this in all women and not necessarily tell them its to keep them healthy for babies. It's fucking insane. If my doctor reccomended certain treatments/vitamins for me, you bet I'd want to know why.

And, did it ever occur to them that the reason we have the highest infant mortality rate of most industrialized nations is because women in this country go without healthcare for their entire term of pregnancy and not cause they smoked a few cigs or had a glass of wine their first few weeks of being pregnant? That women in this country cannot afford proper pre-natal care? Once again, they pin the blame for this all on the women and not on the assholes who run this country. It makes me fucking sick. Women have been THE scapegoats of human history and again we're being blamed for bad domestic policy.

/rant

(and Charles, I know you were playing devil's advocate. My rage is not for you, dear. :)

[jenniferblaufrau]

And what about men? As potential future inseminators, shouldn't they be taking certain precautions as well?

[Rinky vs.4.0]

Do you think maybe the audience for this article isn't women who choose to be childfree?

New federal guidelines ask all females capable of conceiving a baby..

There's your answer right there.

[Charles:]

I guess I look at it like any other article geared to helping people be healthy. I mean, would you feel the same if it said "it's best for all people NOT to smoke"? If you're a smoker, you pretty much don't care. Would you feel upset that they're trying to get more doctors to incorporate questions about your smoking habits?
It's best for all women to be healthy if an unplanned pregnancy occurs, but if you don't plan on keeping or conceiving children, should you really care what the article says?
And I know, I guess it boils down to them trying to sneak in their agenda to doctor visits, but again, doctors often ask certain questions about your health that you might disagree with or find slightly annoying.
I think in the end, if your doctor knows you don't want kids, s/he's not gonna pull the shit they're mentioning.

[Charles:]

And what about men? As potential future inseminators, shouldn't they be taking certain precautions as well?

Sure...if you plan on having children in the future. I don't, so I'll be boozin it up later tonight.

[jenniferblaufrau]

I get your point, Charles. They're not asking anyone to do anything that's not good for them anyway, it's true. The subtext of the article, though, is that women are mere incubators and that childbirth is our destiny. Also, I take issue with anything that looks down upon free choice -- if I want to live a wildly hedonistic lifestyle, rife with drugs, drink, and any number of other vices, and skip the whole mothering schtick, that's my choice. It reads to me as a slightly updated 50s manual on how to be a good girl.

[Kari]

It's best for all women to be healthy if an unplanned pregnancy occurs, but if you don't plan on keeping or conceiving children, should you really care what the article says?


Yes, we should care what the article says, because it implies a number of nasty things.

1. That the infant mortality rate in the US is somehow women's fault.

2. It assumes that all women want children, and if we don't, our doctors will be sure to tell us that we'll "change our minds" and whatever.

3. French women smoke and drink 24/7. Let's look up their infant mortality rates and see how high they are. Has nothing to do with their habits, does it? But they have - Oh Em GEE!- universal health care. Hmmm.

4. It implies that women are only as good as their healthy uterus and that as soon as we get our periods we should focus on baby making. I'm sorry, but 13-14 year old girls shouldn't have to worry about that shit. They have enough to worry about.

It's not that I pay it any mind, or that my doctor will annoy me. It's that this kind of presumption and accusation of how women play some part in infant mortality that INFURIATES me when there are millions unisured in this country. They should be looking there first before telling a poor, inner city woman to take her vitamins.

[Steve SFM]

I get your point, Charles. They're not asking anyone to do anything that's not good for them anyway, it's true. The subtext of the article, though, is that women are mere incubators and that childbirth is our destiny. Also, I take issue with anything that looks down upon free choice -- if I want to live a wildly hedonistic lifestyle, rife with drugs, drink, and any number of other vices, and skip the whole mothering schtick, that's my choice. It reads to me as a slightly updated 50s manual on how to be a good girl.

Exactly right. Charles, of COURSE women - and men, for that matter - should care about public policy that treats women as nothing more than potential baby-makers, for the reasons that Jennifer and Kari have already outlined. If this were really about encouraging women to be in good health, they'd just say that, without the "pre-pregnant" bullshit. This administration ONLY cares about health or science or anything like that when it plays into their agenda. Like Kari said, if they really gave a shit about pre-natal and natal health, they'd fuckin' fund it sufficiently, AND provide for contraceptions and abortions for women who weren't ready to raise a child. You don't have to be a sociologist to see what this is really about.

Steve the Sweet Fat Man

[Charles:]

If this were really about encouraging women to be in good health, they'd just say that, without the "pre-pregnant" bullshit.
Steve the Sweet Fat Man

I agree, and..hmm... I see this as an article that is pointed to women that intend to have babies. Yes yes, they said ALL women, but that's pretty much the only line that outright says ALL. Everything else is based on the assumption that these women are planning or aren't opposed to the idea of getting pregnant.
As far as the socialized healthcare...well, I dunno. THere's really not much the CDC can do about that, so in the meantime, they're trying to get potential mothers to be a bit healthier.
Kari, I don't think they're blaming females for the high mortality rate, but again, this is the CDC. They aren't responsible for making the laws, all they can do is work with what we all have. As it stands, a lot of mothers don't take care of themselves when they're pregnant. They're trying to change that.

[jenniferblaufrau]

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.

In other words, even if you never plan on getting pregnant, you might, and you owe it to your unborn fetus to be clean and free of anti-baby chemicals and habits. This assumes that someone who's determined not to have children will and should do so anyway if she accidentally gets pregnant.

[jeth]

Not to mention that a federal guideline encouraging doctors to harp on women about staying healthy in the event they get pregnant will only make matters worse for people who are seeking healthcare when they have made it absolutely, positively clear that they do not ever want children, ever ever ever.

It's bad enough that my own doctor gave me a different and less effective treatment because I don't have kids than he would have given another patient with the same diagnosis who had already popped out a few. How much harder is it going to be for me to get adequately treated now that guidelines require doctors to be more vigilant about prepping their patients for future pregnancies? I've already gotten the line about wanting to preserve my fertility because I'll change my mind. I can just see this becoming yet another roadblock for me to deal with as I try to keep healthy under what is already an ongoing, time consuming, and incredibly expensive and less effective, fertility preserving treatment.

[cold pressed olives]

They are already doing that. My own doctor refused me a particular, effective treatment on the grounds that he wanted to preserve my fertility. When I made it clear that I don't want kids they countered with the fact that I would change my mind.



you did switch doctors, right? what a jerk.

[Charles:]

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.

In other words, even if you never plan on getting pregnant, you might, and you owe it to your unborn fetus to be clean and free of anti-baby chemicals and habits. This assumes that someone who's determined not to have children will and should do so anyway if she accidentally gets pregnant.

Totally don't see it that way. To me, they're saying, yeah, you might not be trying to get pregnant now, but even if you did get pregnant and would keep the baby, maybe you should take care of yourself a bit better.
I mean, if you know you definately won't have kids, I don't think they're talking to you. Why would they care if you're keeping your body pregnancy ready if you know you're not going to keep the baby if you get pregnant??

As far as how doctors treat you when you say you don't want kids, that's a different topic and I can totally understand being pissed about your doc leaning you towards treatment for becoming pregnant, but again, all this is saying that they want docs to ask patients if they plan on getting pregnant, and IF you do, make a reproductive plan. If you're not, say no...and be done with it? If it goes past that, then it's the docs fault and maybe time for a new one.

[Kari]

The article is CLEARLY aimed at women who don't want children/aren't having children. If someone plans to have children, then they're more than likely already thinking about their reproductive health. They're trying to alter women's behavior, all women, from the ages of 13 to 50. It's facism, the worst kind. Behavior control is where I draw the line.

And, they're also implying that if someone accidentally gets pregnant, that they will keep the child.

I understand where you're coming from, Charles, but I think you're off the mark on this one.

[Steve SFM]

As far as how doctors treat you when you say you don't want kids, that's a different topic and I can totally understand being pissed about your doc leaning you towards treatment for becoming pregnant, but again, all this is saying that they want docs to ask patients if they plan on getting pregnant, and IF you do, make a reproductive plan. If you're not, say no...and be done with it? If it goes past that, then it's the docs fault and maybe time for a new one.

The problem is, the way this initiative is conceived and explained - and IMO, it's not overly suspicious to assume this is deliberate, given the governmental and social context - it reinforces the behavior of doctors like Jess'. The underlying assumption is that any woman might get pregnant at any time, and if she does, she will definitely carry the baby to term. That simply isn't the case - well, assuming that this country isn't turned into the fuckin' Handmaid's Tale. You have to look at what lies underneath the surface, Charles. The surface might be benign, but it doesn't take much scratching to see the rot underneath, which at best is based in ignorance and at worst is based in backwards-thinking premeditation.

Steve the Sweet Fat Man

[Charles:]

The article is CLEARLY aimed at women who don't want children/aren't having children. If someone plans to have children, then they're more than likely already thinking about their reproductive health. They're trying to alter women's behavior, all women, from the ages of 13 to 50. It's facism, the worst kind. Behavior control is where I draw the line.

And, they're also implying that if someone accidentally gets pregnant, that they will keep the child.

I understand where you're coming from, Charles, but I think you're off the mark on this one.

No, it's clearly aimed at women who aren't planning children, but who would more than likely keep it if they got pregnant and at women who are planning for children. Sorry, I don't see how this is targeted to the child free.

Steve...I can see how it can be seen that way, but again, I think any doctor who has an iota of sense will not press the subject when you tell him you don't want children. Even after reading that article. It's simply saying they should ask...which I think is good. It doesn't say "ask, and if they say no, give them a spiel about why they should change their mind and press family planning on the patient". Then again, I'm not a girl who doesn't have kids, so I don't get asked too often when I plan on having children and have to deal with the looks that come along with the answer of "hell fucking no"

[jeth]

you did switch doctors, right? what a jerk.

Unfortunately I didn't realize until after the fact what a big risk he put me at by going with an alternate treatment. At the time I was kind of irked that they passed over the 100% guaranteed effective treatment for the longer, more drawn out wait and see method, but I didn't realize that the longer more drawn out method would be so much less effective either. I figured that out when I did my own research later on, and when I posed the question during my next visit he seemed very surprised and offered some non-commital comments about how we should just wait and see what the outcome would be. I'm still mad about it, but I haven't switched doctors mainly because at this time I'm stabilized and no other doctor would proceed with the best course of action while I'm stable. So I have to sit and wait, and if things get worse then I can put my foot down and make them listen to me, but even then it's nearly impossible to get a doctor to listen to you if you don't fit their criteria (being over 30, having x number of kids already, etc).

Hell, I know people who had accidental pregnancies at a young age and requested a tubal after the baby was born so they wouldn't have any more slipups only to be told that unless they hit a minimum age (usually 30) or had several more kids no doctor would even consider it. It's virtually impossible to find a doctor who will perform a procedure, even a medically necessary procedure, that could jeopardize your future fertility. I don't doubt for a second that at least a part of the "she'll change her mind" logic comes from the fear of getting socked with a lawsuit by someone who really did change their mind.

And to be honest I'm not sure if I would even be able to change doctors. I had to be referred to this one, so I'm sure I would have to be referred to another one, and I've heard so many horror stories about other doctors in this area that I'm not certain I would be doing myself any favors by going elsewhere. Yeah, I got put at a higher risk because they wouldn't listen to me and felt I would change my mind, but I know of other women who went to other area doctors who ended up with very, very serious problems due to misdiagnosis (including full blown cancer because the doctor repeatedly ignored abnormal test results until it was too late). I worry that I would be at risk for getting even worse care if I did try to get referred to someone else.

[nirak]

you did switch doctors, right? what a jerk.

You are assuming, of course, that she's able to switch.

My mom and I had THE WORST doctor for years because we were on an HMO plan and could not get another one. Oh, he sucked. And he creeped me the hell out.

It's part of the problem- even if you DO have insurance, if it's an HMO you're probably out of luck anyway. I'm glad that around here there's nothing but PPO's.

[Steve SFM]

Steve...I can see how it can be seen that way, but again, I think any doctor who has an iota of sense will not press the subject when you tell him you don't want children.

I think it has less to do with "sense" than it does with the attitudes the doctor holds. And yes, we would like to believe that a doctor's attitudes are based on science and respect for the agency of the patient. Sadly enough, that's not always the case; doctors are subject to socialization - good and bad - as anyone else.

Steve the Sweet Fat Man

[Boomer #8]

I can understand a doctor wanting the best health for his/hers patient, but dictating what the patient has to do because you may change your mind, that's ridiculous.
This is by far the most hilarious thing I've read all year.
I mean, seriously - they might as well declare from now on that all women are stripped off their rights as human beings and that they really are indeed grown up children, and need to be told what to do.

[cold pressed olives]

You are assuming, of course, that she's able to switch.

My mom and I had THE WORST doctor for years because we were on an HMO plan and could not get another one. Oh, he sucked. And he creeped me the hell out.

It's part of the problem- even if you DO have insurance, if it's an HMO you're probably out of luck anyway. I'm glad that around here there's nothing but PPO's.

yep, i've got health insurance through an HMO but fortunately, i picked a good doctor...i know with the benefits at my work, you can only change your preferred doctor once a year...in december, when you choose your benefits for the next year.

idaho, the best of luck. i just find that incredibly condescending to be treated like that.

[Kari]

No, it's clearly aimed at women who aren't planning children, but who would more than likely keep it if they got pregnant and at women who are planning for children. Sorry, I don't see how this is targeted to the child free.
"

Well, we're just going to have to agree to disagree, then.

[Charles:]

Ok, can we agree that it's assuming most women want children and therefore is addressing the majority when it comes to prenatal health?

Think about it. Why would they write an article like this and direct it to an audience that could give two shits about pregnancy? What I can agree with is what Steve has been saying, but even with that, if you have a doc like the one Jess had, this article is just gonna reinforce his idiocy. I doubt a doc who understands that women have a brain and can make decisions about their bodies when it comes to pregnancy, will be swayed by this.

But hey, maybe it's really the clever hand of the Gov marauding as the CDC in order to persecute the childfree via discriminatory patient questionaire forms.

[Master Shaman]

I realize that most of you want to stab Charles right now, but I have to say that he does have a point.

Reading the article, it's obvious to me that the whole thing started because of one or more public health issues (low birth weight, malformations, infant mortality etc.). Public health doesn't work with people; it deals with numbers and statistics, mortality, morbidity and countless other indicators. If, say, the incidence of a certain disease goes up, measures are taken to help the removal or lessening of the risk factors that favor the development of that disease.

In this case, they have looked at what causes low birth weight, malformations and other pregnancy-related problems. Common causes for problems include the lack of folic acid, toxoplasmosis, exposure to lead, alcohol, cigarette smoke. Naturally, those issues were at the center of this prevention campaign.

Are those guidelines badly phrased? Definitely, but keep in mind we're talking public health here. These people are crunching numbers all the time, and social skills are not the most important requirement for their job. Unlike clinicians, they don't have to constantly watch their wording to avoid offending or upsetting the patients, because they don't deal with individual patients.

Furthermore, we have to keep another thing in mind: most women on this planet are not childfree. More so, childfree women are a minority even among the childless; whether you care or not, a vast majority or women want and have children, or have them even if they don't want them, or they don't want/have them due to specific, temporary issues (not enough money, lack of partner etc), which may change at a certain point. These are the women targeted by those guidelines.

Then there's the whole issue of pushing those measures down women's throats. Well, that's basically how preventative medicine works; it's extremely difficult to convince a clinically healthy person to change his/her lifestyle, so doctors have to be pushy and annoying about it. Anyway, doctors can't force you to comply; all they can do is give you advice. You are free to tell them to fuck off at any time.

As for the guidelines themselves, they don't promote anything that would be harmful to the woman's health or well-being, so I don't see a major problem there either. If not for the whole anti-abortion movement in the US right now, this topic wouldn't even be considered worthy of discussion.

[Kari]

Sigh.

First of all, I don't want to shoot anyone. It makes total sense that this is how the article is targeted, and that's great. I just don't agree. The way that the culture has been shifting just doesn't lead me to believe that this piece/campaign wasn't somehow intended to speak to women who don't want children/would have an abortion if they did get pregnant. My husband and I had a long conversation about this last night and it's clear that they want to inject this "YOU MUST HAVE BABIES" mentality into women. This isn't the first article, nor will it be the last. They don't even mention the possibility of child-free women OR abortion, as if neither is a possibility. It's agenda pushing. Certainly infant mortality isn't our most pressing medical issue, now is it?

Yes, it's clear that CF women are in the minority, that much is obvious. But women deciding not to have children is on the rise.

I don't know. There is just a really insidious undertone to this whole thing in my opinion, and it's going to make things worse for every woman, not just those who are CF. The war on women's reproductive rights and the attempt to keep women barefoot and pregnant has been going on for some time now in this current political climate. The fact that ALL women are supposed to think of themselves as "pre-pregnant" is utter mind control. It's a way for them to instill their ideals into women's heads, to implant the idea. All you have to do is plant the seed and an idea will spread. Can you imagine if the Pro-Lifers run with this idea? Suddenly, a woman who has a few glasses of wine is pre-murdering her pre-baby. Suddenly a can of Miller Lite becomes an abortifacient. I just really think there are more serious cultural implications in this article than you are perceiving. Disagree with me all you want, that's fine, and both of you have excellent points. I just read this article and immediately my blood ran cold. Day after day I keep reading things like this and I can't just chalk it up to some sort of "concern" for women. It's bullshit.

[jenniferblaufrau]

Can you imagine if the Pro-Lifers run with this idea? Suddenly, a woman who has a few glasses of wine is pre-murdering her pre-baby.
Exactly. It's like suddenly every 20-something gal in the country becomes an irresponsible baby-hater. I mean, the terminology alone is cringe-inducing. "Pre-pregnant"??? Lordy, lordy.

[Master Shaman]

Sigh.

First of all, I don't want to shoot anyone. It makes total sense that this is how the article is targeted, and that's great. I just don't agree. The way that the culture has been shifting just doesn't lead me to believe that this piece/campaign wasn't somehow intended to speak to women who don't want children/would have an abortion if they did get pregnant. My husband and I had a long conversation about this last night and it's clear that they want to inject this "YOU MUST HAVE BABIES" mentality into women. This isn't the first article, nor will it be the last. They don't even mention the possibility of child-free women OR abortion, as if neither is a possibility. It's agenda pushing. Certainly infant mortality isn't our most pressing medical issue, now is it?

Yes, it's clear that CF women are in the minority, that much is obvious. But women deciding not to have children is on the rise.

I don't know. There is just a really insidious undertone to this whole thing in my opinion, and it's going to make things worse for every woman, not just those who are CF. The war on women's reproductive rights and the attempt to keep women barefoot and pregnant has been going on for some time now in this current political climate. The fact that ALL women are supposed to think of themselves as "pre-pregnant" is utter mind control. It's a way for them to instill their ideals into women's heads, to implant the idea. All you have to do is plant the seed and an idea will spread. Can you imagine if the Pro-Lifers run with this idea? Suddenly, a woman who has a few glasses of wine is pre-murdering her pre-baby. Suddenly a can of Miller Lite becomes an abortifacient. I just really think there are more serious cultural implications in this article than you are perceiving. Disagree with me all you want, that's fine, and both of you have excellent points. I just read this article and immediately my blood ran cold. Day after day I keep reading things like this and I can't just chalk it up to some sort of "concern" for women. It's bullshit.

Kari, you have to understand that the opinions of a medical body concerning reproductive health generally do NOT stem from religious or moral beliefs, but from cold hard medical facts.

You say they don't mention childfree women. This may come as a surprise, but 99.99% of the planet is not even aware of this childfree movement, if you can call it that. As long as they never have children, those public health issues simply don't concern those women, so what would be the point of mentioning them?

The article doesn't mention abortion, indeed. It does mention planning and contraception, on the other hand. Strange as it may seem, one of the goals of reproductive healthcare is the prevention of abortion, not because of moral or religious reasons, but because it's not a completely risk-free procedure and it's not very pleasant, either. You don't have to be a bible thumper to realize that a D&C is not a lot of fun.

Then there's the whole "survival of the species" thing. While some women being childfree is not going to have the human race wiped out, a rise in infant mortality, combined with lowered natality, means less children, and therefore, over time, an aging of the population, with the economic imbalances we've all heard of.

[Steve SFM]

Good post, Dan. And good response, Kari.

After reading your post, Dan, I am more inclined to believe that the way this was put out there was due more to ignorance than premeditation. (And, of course, you did agree it was poorly phrased.) Still, though, while we do have to take public health realities into account here, I also think - at the risk of inflating my own chosen profession :D - that we also have to take sociology into account. For example, yeah, we can always tell the doctor to fuck off, but there is a social imperative to Listen To Your Doctor. Doctors have authority conferred onto them by society, and challenging them in that context is easier said than done for a lot of people.

And you may be right about the childfree movement (although I seriously question the 99.99% thing; I hope that was just hyperbole ;)), but the simple fact is that the only way for the movement to gain any traction in society is to speak out about stuff like this. Childfree people need to say that these kind of assumptions are not acceptable, and why they're not acceptable.

Steve the Sweet Fat Man

[Rinky vs.4.0]

I think any doctor who has an iota of sense will not press the subject when you tell him you don't want children.

Ahhahaaaaaaa. No, really. I wish sometimes I had collated every female friend bith in the USA and here who'd been through some patronising wank with a doctor over this subject or been refused certain treatments or reproductive health choices because apparently they know better than we do.

And Dan - it's both the wording AND the context that this stuff is happening in that makes it sinister - not just to childfree women but also to women who want children and who ALREADY have children. 99.9% of women may not be childfree - although actually, I think in western industrialised countries not to mention places like Japan a rather significant and growing percentage actually are and counting in unintentional childlessness, even more - but 99.9% of women seem to be appalled and repelled by this recent annoucement. That's why I posted this article in OIT yesterday - it affects everyone, not just childfree women.

[Kari]

Kari, you have to understand that the opinions of a medical body concerning reproductive health generally do NOT stem from religious or moral beliefs, but from cold hard medical facts.

I wish that were true. But if it were, then why does the FDA refuse to endorse the morning after pill being sold OTC? Why is there refusal to endorse a vaccine for HPV? I don't think the medical institutions in the US are as apolitical as you think.

You say they don't mention childfree women. This may come as a surprise, but 99.99% of the planet is not even aware of this childfree movement, if you can call it that. As long as they never have children, those public health issues simply don't concern those women, so what would be the point of mentioning them?

It's not about mentioning the CF movement. There are, however, women who choose to adopt, women who can't conceive. Nowhere in the article does it say "These guidelines are for women who want to have children one day". That phrasing would have helped. But its suspiciously absent, and says "All women".

The article doesn't mention abortion, indeed. It does mention planning and contraception, on the other hand. Strange as it may seem, one of the goals of reproductive healthcare is the prevention of abortion, not because of moral or religious reasons, but because it's not a completely risk-free procedure and it's not very pleasant, either. You don't have to be a bible thumper to realize that a D&C is not a lot of fun.

Well, no shit a D&C isn't a lot of fun. I sure try to avoid it.

Then there's the whole "survival of the species" thing. While some women being childfree is not going to have the human race wiped out, a rise in infant mortality, combined with lowered natality, means less children, and therefore, over time, an aging of the population, with the economic imbalances we've all heard of.

The world is grossly overpopulated. I doubt that the maybe 1 or 2 percent of women not popping kids out is going to have a huge effect on the species, nor do I think that there won't be many kids and the world will be overrun by old people.

Listen, these are all very good points. I don't totally disagree with you on most of them, but I still think you're missing the political and sociological implications in this article, one very important one being the attempt to control women's behavior through manipulation and role reinforcement. Phrasing, especially now, is VERY important. The current political climate has created an entirely new vernacular in the US. What you say and how you say it has a lot more weight than it used to.

[Rinky vs.4.0]

I actually checked the childlessness rate for the UK: it currently stands, according to the last census figures, at one in five women not having a child in her 'fertile' lifetime, or 20%.

http://www.statistics.gov.uk/cci/nugget.asp?id=951

The stats for Australia seem to indicate 28% . (http://www.abs.gov.au/ausstats/ABS@.nsf/90a12181d877a6a6ca2568b5007b861c/1decc52b47fc8e26ca2569de002139c1!OpenDocument)

I'll add stats for other countries as I find them.

[Master Shaman]

Obviously, I realize all the political connotations and the nutjob-fodder that these guidelines provide. However, everyone here was already aware of it, and that's why I based my posts on the other side of the story.

The world as a whole may be overpopulated, but the Western countries are not. In Europe, for instance, natality has decreased in recent years. Wealthier countries have lower natality, and on a smaller scale, well off people tend to have fewer children. Look at the childfree communities: most people there tend to be educated and with a reasonable financial status (not necessarily rich, but not starving in trailers either). The statistics that Helen provided only go to prove what I'm saying.

Steve, people generally don't listen to their doctors when it comes to preventative measures. I'm a smoker, for fuck's sake, and it's not like I'm uninformed about the dangers of smoking.

[Kari]

I actually checked the childlessness rate for the UK: it currently stands, according to the last census figures, at one in five women not having a child in her 'fertile' lifetime, or 20%.

http://www.statistics.gov.uk/cci/nugget.asp?id=951

The stats for Australia seem to indicate 28% . (http://www.abs.gov.au/ausstats/ABS@.nsf/90a12181d877a6a6ca2568b5007b861c/1decc52b47fc8e26ca2569de002139c1!OpenDocument)

I'll add stats for other countries as I find them.

Wow. Well, color me surprised. That's MUCH higher than I thought, though my 2% conjecture was sort of globally based.

[Rinky vs.4.0]

Wow. Well, color me surprised. That's MUCH higher than I thought, though my 2% conjecture was sort of globally based.

There a whole bunch of stats from the US census here (http://www.census.gov/population/www/documentation/twps0037/twps0037.html) if you care to wade through them, Kari.

Of course childlessness varies globally due to emancipation of women, access to contraception and abortion, and cultural pressures and so on.

[Kari]

http://www.census.gov/population/www/documentation/twps0037/page02.gif

Wow. 19% of all women aged 40-44 in the US are childless, as of 1998. Not so much the tiny minority we thought.

[Charles:]

Dan, that's kinda what I was trying to say, but you did a much better job.

Also, I'm really on your side here, but I guess since I'm not as entrenched as some here, I don't see things in the same light.

[empresskara]

You know, another sad outcome of this is; this makes me less likely to go to a doctor anytime soon. Is that logical, no. But it's bound to effect more than just me.

Just sickening!

[jenniferblaufrau]

Maybe I'm naïve, but I don't think most doctors are going to take this very seriously. I think the ones who are inclined to push the baby agenda will glom onto it, and the ones who aren't won't.

[empresskara]

But hey, maybe it's really the clever hand of the Gov marauding as the CDC in order to persecute the childfree via discriminatory patient questionaire forms.

Honestly, I see it as an extension of the Pro-life propoganda kabal. It reads as if once a woman is pregnant, there is NOTHING else she can do but keep it/adopt it out.

[Kari]

Honestly, I see it as an extension of the Pro-life propoganda kabal. It reads as if once a woman is pregnant, there is NOTHING else she can do but keep it/adopt it out.

Yes, yes, yes. This is what I've been trying to say.

[Master Shaman]

And what I've been trying is make you see this not through the eyes of a pro-choice OR pro-life activist, but through the eyes of a medical professional, for whom those political issues are less important.

Keep in mind that not every woman who has an unplanned pregnancy chooses to abort. If she doesn't, the baby ends up forever influenced by the mother's behavior and lifestyle during the pregnancy, especially during the early stages of it. Women need to be aware what the risk factors are and how they can fight them. Abortion is a tough choice, and not every woman is capable of making that decision. If, say, a woman who finds herself pregnant says she will abort anyway, and therefore she doesn't change her lifestyle at all, then discovers she is not willing or able to go through with the procedure, the choices she makes in those early stages can have a drastic influence, and she can end up with a severely malformed baby. It's easy to see things in black and white, pro-life vs. pro-choice etc., but in a lot of cases, life is a lot more complicated than that.

[Steve SFM]

Maybe I'm naïve, but I don't think most doctors are going to take this very seriously. I think the ones who are inclined to push the baby agenda will glom onto it, and the ones who aren't won't.

That's a good point. Indeed, no doctor worth his or her salt should take ANYTHING the government says about practicing medicine very seriously. :D

Steve the Sweet Fat Man

[Rinky vs.4.0]

Dan, no-one is saying pre-natal care is not important and useful. What everyone except Charles is objecting to is using this stuff to cloak a right-wing agenda. How anyone can look at this in the context of the ongoing erosion of women's reproductive rights and frighteningly pro-natalist nature of the current conservative Xtian-backed US administration and NOT see this is beyond me. Just the choice of language alone SHRIEKS of agenda from the bloody rooftops. My country offers and promotes pre-natal and reproductive health care for everyone regardless of income and I've never heard the phrase 'pre-pregnant' or been asked to think of myself as that until this article appeared, possiboly because we don't have a culture infested with conservative Xtian nitwits right now.

I mean, look at what has happened in the US regarding women's rights have been in the past few years: the erosion of abortion rights to the point where it is now effectivly outlawed in several places; pharmacists being allowed to deny women contraceptive and emergency contraception on 'moral grounds' and countless legal attempts to put 'fetal rights' above women's rights in various underhanded ways. You get the picture. If this stuff was coming from a place where women's reproductive rights were not under threat I would still be disgusted at the phrasing and concept but rather less concerned at what was behind it.

[Rinky vs.4.0]

OK, and here's a post from a 38 year-old childfree woman on my f-list, posted with permission:

I have an example here for those of you who are trying to put a positive spin on the CDC's new guidelines for treating all women of childbearing age as "pre-pregnant."

Did you know that part of those guidelines include not prescribing any medications to us that *might* be teratogenic (e.g., known to cause birth defects)?

Example: I went to the doc last week for a UTI, and instead of giving me Cipro, which is the standard, they gave me another antibiotic that was, in their words, "not known to cause birth defects."

Even with my assurances that (a) my period should be starting "any day now" (it arrived the next day), (b) that hubby and I had been using birth control, AND (c) my self-proclaimed childfree status, which isn't about to change -- they still settled on a less effective drug, because, after all, I might be pregnant.

If I EVER catch a doctor here giving me less effective meds because of some imaginary fucking fetus, I swear to god, I won't be responsible for my actions.

[Kari]

Wow, Helen. That's amazing. Unfuckingbelievable.

[Charles:]

That's a good point. Indeed, no doctor worth his or her salt should take ANYTHING the government says about practicing medicine very seriously. :D

Steve the Sweet Fat Man

Or religion for that matter!

And yes, Helen, that is absolutely wrong. Do we have access to the actual release from the CDC?

And hey, I'm the first to believe that women's reproductive rights are slipping away. It was one of the main reasons I was campaigning against Bush. Even as a father, I have no problems with abortion, nor do I have problems with a woman's right to chose (until it starts to cross over into the father's role as well, but we won't get into that as it's another subject), so trust me, I'm right behind you when you're standing up for your rights. I just don't see this as a cloaked undermining of those rights. Maybe if it was released by the Surgeon General, but the CDC seems a bit too removed from the conservative right.

But hey, at this point no one's mind is changing.

[Master Shaman]

If I EVER catch a doctor here giving me less effective meds because of some imaginary fucking fetus, I swear to god, I won't be responsible for my actions.

Well, what you quoted was just insane. That wasn't mentioned in the article, though, and I'm willing to bet it's more about overzealous doctors who are trying to use the guidelines for in fact pushing the pro-life agenda.

From a medical point of view, though, it makes sense to use a less powerful antibiotic than Ciprofloxacin, for instance Norfloxacin, as it's equally effective on UTIs. Remember, with antibiotics you want to use the least powerful thing that gets the job done properly. In my example, though, the teratogenic effects are probably similar, as the drugs are from the same class. The fetal reason is just ludicrous and any sane, non-fundie doctor would laugh his or her ass off hearing that.

[Steve SFM]

^That's true (edit: responding to Charles), but unfortunately, not always the case. Which is why childfree people should absolutely be squawking about this. Like Helen just said (great post), it's all about the context. And it doesn't matter whether the creepy implications were intentional or not. They need to be responded to.

Steve the Sweet Fat Man

[Jamie.]

I'll count you in for one of my 'I'm not pregnant, I'm just pre-abortion' t-shirts, then, Kari?

I'm not a woman, but can I have one anyway?

As for the matter, I can't say anything more eloquently than has already been said in the thread. So I'll just say, instead, that it's bullshit. I think HPOC! made a Handmaid's Tale allusion--and it couldn't be truer. Next thing you know, the goverment will attempt to bar women from purchasing booze, alcohol, anything that could be considered dangerous to the pre-pregnancy. Okay, probably not, but I'm a bit paranoid.

Also (I haven't read through the thread), this is almost blatantly right wing in stance. I think Master Shaman may have said it was more a true medical concern, but what I see when I read this is pro-life, anti-gay propaganda. By treating all women as pre-pregnant, any alternative option (the option to not have children, the option to abort, or the option to fuck other women--thereby being unable to conceive with those women) is rendered null and void. Those options are made invisible. And I just don't see that as solely a medical concern. The fucking surgeon general warning on the box of cigarettes should be enough. No one needs a doctor to patronize them and treat them as future mothers. It's disgusting.

[babbleon]

Something that supports the argument that this is geared towards treating all women as walking incubators is that the CDC report does not mention birth control (beyond one brief sentence). Taking control over our fertility is not in the plan.

They recommend getting people to be more responsible about their smoking/diet/exercise habits, but never mention getting more responsible about their sex habits.

At least they don't talk about abstinence, though.

I wanted to post a link to the cdc page, but I'm too new. you can go to the CDC site (cdc.gov) and search for "mmwr preconception" and it pops up.

One plus: they do recommend two different strategies for getting better health care for lower income women.

The recommendations make sense for everyone, not just women. But the verbage and lack of certain recommendations do make it pretty clear that this is intended to be used to support the current political agenda.

[The March Hare]

I smoke, drink, and own a cat. I don't need any coat hangers, according to this article!

I feel very offended by this article. I also have heard of a lot of doctors here in Texas(wretched state for women's reproductive rights anyway) who will pull this whole "pre-pregnancy" thinking bullshit. It just adds more fuel to the fire, it seems.

[SMMY]

I wouldn't be surprised if this is just more of the current administration's tinkering and fine-tuning another agencies' policies to reflect the Bush administration's view. This reminded me of the recent 60 Minutes story, Rewriting Science (http://www.cbsnews.com/stories/2006/03/17/60minutes/main1415985.shtml) on how the administration is pressuring scientists as to what they can say in public appearances and press releases. I wouldn't be surprised since the CDC is overseen by the DoHHS, if there is pressure to couch their language in a way that suits the administration's faith-based agenda. I can't imagine under a less radically conservative administration that the CDC would ever issue guidelines using the term "pre-pregnant". I wonder what idiot came up with that term.

[Mrs.Rollins]

This issue angers me to no end. Anyone who knows me, and most of you here who know me, are well aware that the reason I never received proper medical care was because I didn't have children. It didn't matter that I can't conceive naturally; no, they wanted to leave the possibility that I could try IVF. Instead of performing a complete hysterectomy as they should have, every fucking doctor refused. Now, I'm 25 and have no insurance, and am in wracking pain most of the time.

I'm fucking sick to death of every doctor assuming that your fertility should take precedence over other health concerns. What good does it do for me to have a uterus to carry a kid if I'm in too much fucking pain to function?

[Kari]

^ I'd fucking sue the bastards. I was talking to my husband about this issue last night and he can't believe that doctors refuse women medical treatment that would alleviate pain and potentially cancer for the off-chance that they can have children.

I'm sorry for your pain, Jen. :( I really wish that things would change so no one has to go through what you are. Bastards, every last one of them.

[CRISPY]

Not to mention that a federal guideline encouraging doctors to harp on women about staying healthy in the event they get pregnant will only make matters worse for people who are seeking healthcare when they have made it absolutely, positively clear that they do not ever want children, ever ever ever.

It's bad enough that my own doctor gave me a different and less effective treatment because I don't have kids than he would have given another patient with the same diagnosis who had already popped out a few. How much harder is it going to be for me to get adequately treated now that guidelines require doctors to be more vigilant about prepping their patients for future pregnancies? I've already gotten the line about wanting to preserve my fertility because I'll change my mind. I can just see this becoming yet another roadblock for me to deal with as I try to keep healthy under what is already an ongoing, time consuming, and incredibly expensive and less effective, fertility preserving treatment.
I was going to rant about how refusing you the best treatment available because of the DOCTOR'S beliefs seems like it would go against the Hippocratic Oath, but then I did some quick research on the Net and found this info:
http://www.imagerynet.com/hippo.ama.html

Apparently the AMA doesn't even use the oath or any modern variations of the oath. Damn!

[Mrs.Rollins]

^ I'd fucking sue the bastards. I was talking to my husband about this issue last night and he can't believe that doctors refuse women medical treatment that would alleviate pain and potentially cancer for the off-chance that they can have children.

I'm sorry for your pain, Jen. :( I really wish that things would change so no one has to go through what you are. Bastards, every last one of them.


It's okay, K. I'm healthy in all other respects, so I know that I'll get through. And, eventually, someone will do an emergency hysterectomy on me and I'll be okay. I just have to hang on until then, be vigilant, and pay close attention to my symptoms.

[iciclespark]

Rather than start a new thread....

Well. *sigh* At least they don't use "pre-pregnant". This is, BTW, the more intelligent newspaper here. This story was a front page event, even, albeit not the central focus of the headlines. Emphasis mine.


Daily dose of multivitamins cuts birth defects, study says


ANDRÉ PICARD
From Thursday's Globe and Mail



All women of childbearing age should be taking a daily multivitamin to reduce the risks of having a child with birth defects, according to the results of a Canadian study.


The new research shows that ensuring an adequate intake of vitamins and minerals by taking a single, cheap pill on a daily basis sharply cuts the likelihood of a wide range of severe birth defects, including neural-tube defects such as spina bifida, brain-damaging hydrocephalus, heart malformations, truncated or missing limbs, urinary-tract abnormalities and cleft palate.


"The data are really very striking. It seems almost too good to be true that a prenatal multivitamin can have such an impact. But it is true," Gideon Koren, director of the Motherisk Program at the Toronto Hospital for Sick Children, said in an interview.


Earlier research showed that increasing the level of folic acid (a type of B vitamin) in the diet of pregnant women with supplements and fortification of foods could virtually eliminate horrific birth defects such as spina bifida.
But the new data, published in today's edition of the Journal of Obstetrics and Gynaecology of Canada, show a far more wide-ranging effect from prenatal multivitamins.


"This is more than folic acid and it's not just spina bifida," Dr. Koren said.
Based on the study, he said all women of childbearing age should be taking a prenatal vitamin daily. Because half of all pregnancies are unplanned and almost all birth defects develop in the first trimester, Dr. Koren said the recommendation should apply to all women.


But he stressed that they should take a specific prenatal multivitamin.
These differ from standard multivitamins in three important respects:
More folic acid, more iron and less vitamin A -- high levels of which can harm the fetus.


The study is a meta-analysis, a compilation of previously published studies.
Dr. Koren said research has shown, in dribs and drabs, the possible benefits of prenatal multivitamins, but this paper is the first to pull the data together.


The study shows that taking a daily prenatal multivitamin results in a:
48 per cent reduction in neural-tube defects;
39 per cent drop in cardiovascular defects;
47 per cent lower rate of limb deformities;
58 per cent reduction in cases of cleft palate;
52 per cent decrease in urinary-tract defects;
63 per cent drop in hydrocephalus (a dangerous accumulation of cerebrospinal fluid on the brain).


The research did not show any decrease in the number of cases of Down syndrome, pyloric stenosis (which causes chronic vomiting), undescended testis or hypospadias (a malformation of the penis).


Dr. Koren said it is impossible to know which vitamins and minerals are responsible for protecting the fetus from birth defects, but he noted "there is really no downside" to taking a multivitamin.


Donald Davis, president of the Society of Obstetricians and Gynaecologists of Canada, agreed, saying the research adds important new details on how to prevent birth defects.


"This study fills a gap in that we can now offer women some concrete advice," he said, backing the recommendation that women of reproductive age take a daily prenatal multivitamin.


A report published earlier this year showed that one in every 17 babies born in the world has a serious birth defect -- a hidden epidemic of global proportions.


The study, commissioned by the March of Dimes, said that, all told, almost eight million children annually suffer from a birth defect, including 3.3 million who die and another 3.2 million who live with severe mental and physical disabilities that often condemn them to a life of poverty and suffering.
Birth defects principally involve deformities of the heart and spine, and blood disorders, but up to 70 per cent of the conditions are preventable with simple public-health measures and basic medical technologies.
The March of Dimes report catalogued the extent of birth defects on a country-to-country basis, and shows the prevalence ranges from a low of 39.7 per 1,000 live births in France to a high of 82 per 1,000 in the Sudan.
Canada ranked 14th among 193 countries, with a prevalence of 45.5 birth defects per 1,000 live births.



I'm still quite pissed at the presumption that a) All women intend to have children and therefore, we should all go buy pricey prenatal vitamins NOW, and b) All unplanned pregnancies simply must come to term.

Of course, they completely blow past the fact that poverty has a lot to do with prenatal care, and telling poor women to go take expensive vitamins is fucking retarded.

In any case, anyone want to help me write letters in? Anyone have those stats on the % of childfree women in the world? I'm bitchy and PMSing today.

EDIT: Direct yer emails to Letters@globeandmail.com

[Rinky vs.4.0]

Why do they want me to take vitamins? So I have a healthier abortion should I ever get knocked-up?

You know, have I no problem with them telling us that a multivitamin is a good idea for EVERYONE, for general health purposes, which includes reproductive stuff.

However, the blanket assumption that we're all going to breed and this implication, that this is the sole health reason for taking vitamins, is quite nauseating. I know women here who despite being CF and loud about it, keep being offered folic acid supplements by their doctors, 'just in case'. They cannot seem to get it through their heads that no means no and that for some of us, all an unplanned pregnancy means is an early abortion.

[iciclespark]

I wrote a bitchy email. I feel better. I also located Canadian statistics on those identifying as childfree, from 2001 Census data: 7% of women, 8% of men. I couldn't locate the physical number of women post-menopause who'd never had children, alas. However, StatsCan states that while the % of women wanting children decreases sharply from age 20-34, the rate of childfree self-indentifiers remains constant.

My bitching follows:

While reading Thursday's article on the benefits of
prenatal vitamins in preventing birth defects, I
couldn't help but be insulted at the tone of Dr.
Koren's comments, which your staff fails to contradict
in any form throughout the piece.

Koren maintains that, as prenatal vitamins are of such
benefit, and half of all pregnancies are unplanned,
that all women of child-bearing age should be taking
these vitamins daily. All. The implication here is
two-fold: a) Abortion is never an option for
unplanned pregnancy, and b) All women will and want to
conceive and have children.

Frankly, I'm insulted. According to Statistics
Canada, based on information from the 2001 Census, 7%
of women ages 20-34 in Canada have no intentions of
having children, myself included. This number remains
steady throughout each age bracket, whereas the number
of women who desire a child decreases sharply after
the late twenties. Women are not simply machines
created to give birth, nor should we all be lumped
into such categories or framed in such a manner. Men,
too, are childfree (the term we refer to ourselves
with); Statistics Canada indicates 8% of men share my
perspective of childfreedom.

What's more: these statistics may be lower than the
current reality, given more current assessments in the
UK or Australia, as an example, where statistics run
in the range of 19-28%.

Further, the last I checked I was not in South Dakota,
so why is Dr. Koren assuming all unplanned pregnancies
will come to term, thus justifying his proclamation
that all women immediately head out to the drug store
for vitamins? Were I, for example, to accidentally
conceive, I would have an abortion. Far too many
children languish in the care of social services for
me to ever feel comfortable carrying to term and
giving a child up.

Your article also fails to mention that, for a single
woman living on minimum wage, prenatal vitamins are
expensive when compared to one's overall budget, nor
does it examine the rates of birth defect based on
family income.

Encouraging women to be in a state of readiness at all
times for pregnancy (or, as the Washington Post cited
from the American research in this area this May,
"pre-pregnant") dismisses any possibility that a woman
is meant for more than procreation in a manner akin to
dismissing gay marriage as invalid due to the
inability to procreate. It's abhorrent and
disrespectful. I expected better of a paper with The
Globe's reputation.

[Rinky vs.4.0]

Nice one!

[jenniferblaufrau]

What I want to know is: Where are all the articles insisting that men who could potentially impregnate take vitamins, refrain from using drugs, and do anything else they can to make sure they're not contributing to the creation of a problem fetus?

[Steve SFM]

Further, the last I checked I was not in South Dakota,

;l

Nice job! *dots*

Steve the Sweet Fat Man

[iciclespark]

Thought you'd like that one ;) I had to.

What I want to know is: Where are all the articles insisting that men who could potentially impregnate take vitamins, refrain from using drugs, and do anything else they can to make sure they're not contributing to the creation of a problem fetus?

But JBF, don't you know it's all about the womyn? It's all their fault if they become pregnant. Women are made for procreation.

[SisterDew]

great email :)

[iciclespark]

They didn't have the cahones to print it, nor the others I know were sent by fellow CF'ers. They did however print one that basically said, "No shit! OH BTW why not reduce poverty so that women can eat properly and maybe that will help children's health?"

They've been known to print letters for a few days after an article, but I won't hold my breath. If nothing else, they got a lashing from the CF community.

[Fox in Socks]

What I want to know is: Where are all the articles insisting that men who could potentially impregnate take vitamins, refrain from using drugs, and do anything else they can to make sure they're not contributing to the creation of a problem fetus? [satan] probably because those with the womb are the ones doing the incubating. its not so much "vitamins" but folic acid. the point is, by the time you know youre pregnant, neural tubes are laid down, so the damage could already be done.

that said, i suppose technically anyone trying to conceive should moderate on the booze and caffeine and eat healthy and with variety. but shouldnt everyone?

[HideAndSeek]

I'm in Australia and as far as I know no one has tried to implement this type of "strategy" over here as yet. I do have a friend, however, how is just into her late 30's and has been having extraordinary problems with her reproductive organs. Things got so bad that she ended up sitting on the toilet with blood just pouring out of her when she got her period. The stupid arse doctor refused to give her a hysterectomy because it would prevent her from having children later on. Anyway, they ended up operating on her and pinning her uterus to her, knowing full well there was a reasonable risk it would detach, and also knowing the chances of her being able to carry a child to term were pretty much non-existent. She had 6 weeks off of work to recover and still wasn't that well when she was able to come back. One year later and she is back in the same position, with the same problems, and now has to go ahead and have the hysterectomy anyway.

All of that being said, if anyone dared to refer to me as 'pre-pregnant', I would absolutely rip them to shreds in every way I could think of.

[Kari]

Iciclespark, that letter was AWESOME.

[post28]

[on the vine]

Woo hoo! That's for when the country goes all "Handmaid's Tale" and all women who can conceive are sperminated by men to comtinue the population.