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Wednesday, May 17, 2006

Forever Pregnant update: CDC good, WaPo evil

posted by bitchphd
Okay. Thanks to the commenter who pointed us all over to Pandagon, where Amanda actually bothered to look up the CDC report the WaPo article talks about, we find out that it is not the CDC, but the WaPo, which is evil and sexist. In fact, it seems to me that the CDC report is probably the kind of thing they come out with all the time, without anyone bothering to pick it up, and that in this case the WaPo picked it up in order to be deliberately inflammatory--as well as, to be fair, because public concern for "prepregnant women" is at an all-time high right now.

Amanda points out that
the recommendation is not to scold all women between 12 and 60 never to drink or smoke or own a fucking cat. In fact, while there’s not a lot of language in the actual report condoning social control of all women as a health care initiative, there’s a whole shitload of suggestions to doctors that they discuss the importance of spacing children and preventing unplanned pregnancies. Prepregnancy visits are also encouraged, which again indicates that these guidelines are more about doctors telling women to take conception and pregnancy seriously than they are trying to imply that doctors should assume all women are equal pregnancy risk.

And the report specifically singles out the fact that many women can’t afford to see a doctor on a regular basis as a factor contributing to infant health problems."
In fact, the first paragraph of the report states clearly that "The goal of these recommendations is to improve the health of women and couples"--an unimpeachable goal. Women's health good! And notice the language w/r/t a couple of specific recommendations:
Isotretinoins. Use of isotretinoins (e.g., Accutane®) in pregnancy to treat acne can result in miscarriage and birth defects. Effective pregnancy prevention should be implemented to avoid unintended pregnancies among women with childbearing potential who use this medication (65--67). . . .
Anti-epileptic drugs. Certain anti-epileptic drugs are known teratogens (e.g., valproic acid). Recommendations suggest that before conception, women who are on a regimen of these drugs and who are contemplating pregnancy should be prescribed a lower dosage of these drugs (74--78).
They are not saying that women shouldn't use Accutane, or teratogens. What they're saying is that if you use Accutane, it's important to use reliable birth control, and if you have epilepsy and want a kid, your doctor should try lowering your teratogen dosage to lower your risk of birth defects. Basic common sense.

Although I do have a bit of a problem, still with the statement that "No time during pregnancy is safe to drink alcohol, and harm can occur early, before a woman has realized that she is or might be pregnant. Fetal alcohol syndrome and other alcohol-related birth defects can be prevented if women cease intake of alcohol before conception." While factually true, it's rather misleading in presenting alcohol use as an all-or-nothing proposition.

But that's really a minor quibble. It seems to me that the biggest news here isn't the CDC; it's the interpretation of this document in the broader context of increasingly conservative ideas that women are primarily baby-factories and mothers, rather than actual human beings whose health care matters for its own sake. Luckily the CDC (and, in my experience, most health care providers, especially in women's health) still belong to the reality-based community.
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