A Handmaid's Tale?

May 19, 2006 9:18 AM

Forever Pregnant. The CDC has released guidelines for improving the "preconception health" of all women of childbearing age whether they plan to have children or not. From the the WaPo article: "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." So ladies, don't even think of touching the litter box. You know, just in case.
posted by kimdog (121 comments total)

What is wrong with preventive health care?
posted by keswick at 9:30 AM on May 19, 2006

Holy smokes. My first reaction was total Nanny State outrage. Then I read further and was reminded that US infant mortality is a huge problem (which I knew) and that 85% of women will give birth (which I didn't). Doctors starting conversations isn't a bad idea, but five years from now if I can't get served in a bar without proof of protection along with an ID, that's a problem, to put it mildly.
posted by rainbaby at 9:34 AM on May 19, 2006

I think this is great. The infant mortality rate in this country is truly horrible, and needs to be addressed. My fear is that this won't be followdd up with other means of addressing it. While I understand that there is something about this which seems ominous coming from an Executive Branch in thrall to fundamentalists, that doesn't make it wrong or a bad idea.
posted by OmieWise at 9:37 AM on May 19, 2006

You know, I get the feeling this post is supposed to make me think the CDC thinks about all women as baby-making machines, and my feminist sensibilities should be screaming for blood right now.

But somehow I can't see anything wrong with encouraging women to not smoke, control their asthma and diabetes, and stay generally healthy. It's going to help you whether you ever have a baby or not. When the CDC starts introducing forced pregnancies or shit like that, then I'll get excited.
posted by schroedinger at 9:37 AM on May 19, 2006

It's not a bad idea to reccommend that women refrain from smoking and try to eat right, but I find the term pre-pregnant to be a little creepy.
posted by Alison at 9:37 AM on May 19, 2006

Why is this bad?
posted by MrMoonPie at 9:38 AM on May 19, 2006

So wait, women aren't baby-making machines? If not, who else is?
posted by NationalKato at 9:40 AM on May 19, 2006

I'm all for encouraging people to be as healthy as possible, but I think they should want to be healthy for themself, not for a possible baby which they may or may not want.

I'm offended by the term pre-pregnant because I'm childfree for life. I wouldn't want some doctor to not treat me for any problem that might coome up just because the medication would possibly be harmful to a fetus.

On the cats issue, if the woman has an indoor only cat, who eats commercial cat food, the risk of toxoplasmosis is extremely low. She's more likely to get it from improperly cooked meat, or doing gardening outside with no gloves on.
posted by mabelcolby at 9:44 AM on May 19, 2006

There's nothing wrong with preventative health care.

But the implication here is that a woman is first and foremost a baby-producing factory and her lifestyle must be modified to protect not only the unborn but the unplanned, the outrageously unlikely and the forever banished faux or pre-baby.

It could therefore be read as an attempt by govt. to prescribe behaviour to follow babyproducing and thus good godfearing lifestyles.

Many would likely suggest that preventative health policy should actually focus on making the living healthier. This may be somewhat splitting hairs but I reckon that many women will not respond well to this sort of psychological coercion.
posted by peacay at 9:44 AM on May 19, 2006

The very real problem with this is that it treats women as baby-making machines. No, it is not okay. A machine is not a human, with free will and self determination.
posted by rougy at 9:46 AM on May 19, 2006

Healthy sperm is important to the health of a child.
posted by birdie birdington at 9:48 AM on May 19, 2006

I wonder what this guy would say?
posted by NationalKato at 9:49 AM on May 19, 2006

It's not bad, MrMoonPie, but as a 15%-er who won't give birth, it's IS a little creepy, especially given the political climate, vanishing abortion providers, and controversy over Plan B. It makes me afraid for little girls who maybe won't have as much - here comes the word - choice as I did. It just hit me in the gut at first. As it stands now. . .it does make sense now that I understand it better.
posted by rainbaby at 9:49 AM on May 19, 2006

You know, I didn't read the articles, but I'm under the impression these are recommendations and that the Gestapo is not going hunt down women and force them to take their daily folic acid supplement.
posted by keswick at 9:49 AM on May 19, 2006

Nowhere does the CDC use the term "pre-pregnant." It's a term the Washington Post made up to make the story more shocking and to sell more papers.
posted by needs more cowbell at 9:53 AM on May 19, 2006

preconception is their second word.
posted by peacay at 9:55 AM on May 19, 2006

As far as I can see from the CDC document, pre-pregnant is a term only applied to people who are actually planning to get pregnant. I found all uses using CTRL-F. Reading the abstract, the document doesn't imply that all women are baby factories, it just recognizes that we can improve healthcare for women who may be planning a pregnancy or may get pregnant inadvertently (which happens quite frequently). Indeed, one of four reasons for developing these guidelines have to do with couples who've had poor pregnanceies in the past.
posted by OmieWise at 9:57 AM on May 19, 2006

Now they are recommendations, keswick, which is why I'm ok with it. But as mabelcoley said, what if a doctor won't prescribe a medication for a woman of childbearing age because they assume she will change her mind, or because of their political/religious beliefs? Or the pharmacist? It just feels like another little step down the road to the past. It's not. But it feels like it, and that's scary.
posted by rainbaby at 9:57 AM on May 19, 2006

The terminology seems odd, but I have to wonder - is preconception a common term to describe the state of non-pregnant, mature, pre-menopausal women?

And, if that isn't the case, was the term put in there by someone who really does think of women as baby making machines, or by someone who thinks women's health deserves more funding and assigned it a title that the right either has to support, or look like absolute hypocrites. (Not that they ever seem worried about that.)
posted by Kid Charlemagne at 9:58 AM on May 19, 2006

All pre-dead men and women are also advised to stop smoking, cut down on alcohol intake, and maintain a healthy weight, so they can be healthier organ donors.

I'm serious. What's the point of signing up as a donor if you ruin your liver and heart?
posted by funambulist at 10:00 AM on May 19, 2006

I think it's creepy - women should have as much right as men to be stupid, to drink too much, to eat badly. Of course, you could look at it this way: the CDC doesn't care about men's health.

If they really cared about reducing infant mortality, they would be dealing with the health inequalities in the US. Canada, the UK, lots of places, have all the same problems with women not getting enough folic acid, smoking and in the UK they drink so much more than in the US. But the infant mortality is significantly lower. The differing factor?

Universal health care. I can't prove causation, but there is one heck of a strong correlation. Rich (anglo, bad-eating, non-exercising, heaving drinking, fish and chip loving) countries with universal health care have lower infant mortality than rich countries without universal health care.
posted by jb at 10:01 AM on May 19, 2006 [1 favorite]

Of course, reproducing and re-mixing the gene pool is not just the most important thing but the only important thing that 99.999999% of the dudes and dudettes in the world are ever going to do. If they don't do that, then they did--well, basically nothing, just loaded down the planetary support system for a while. Well, those two sure were double zeros. Oh well, put 'em together and let 'em roll the dice again. Maybe we'll get another Rembrandt on the next try."
posted by jfuller at 10:01 AM on May 19, 2006 [1 favorite]

I find the term pre-pregnant to be a little creepy

That's just the natural extension of "unborn baby," isn't it? If we assume that all conceptions lead to babies (when 15% end in miscarriage), it's only one small step to assume that all women lead to conceptions (when 15% never get pregnant). Next we start referring to embryos as "unborn parents" and the cycle of hypothetical life is complete.
posted by scottreynen at 10:01 AM on May 19, 2006

There's nothing wrong with preventative health care.

But the implication here is that a woman is first and foremost a baby-producing factory.

The implication is simply that pregnancies are frequently unplanned. Therefore, action must be taken, ahem, prophylactically.
posted by 1-2punch at 10:01 AM on May 19, 2006

OK, unless there is a secret, doctor's only internet out there, it's not the common term.
posted by Kid Charlemagne at 10:02 AM on May 19, 2006

Most of these are good advice for anyone of any age or gender. As long as it remains advice and doesn't become a law enforcement or other government concern it is a good idea.
posted by TedW at 10:03 AM on May 19, 2006

rainbaby, you mean like this: http://shadesong.livejournal.com/2871261.html

(Short take for those who do not want to read the link, shadsong is epileptic, but they refuse to give her certain epilepsy medications which may affect a fetus, despite the fact that she has an 11 year old daughter and does not want any more children.)
posted by fings at 10:05 AM on May 19, 2006

The term pre-pregnant is uniquely shocking because it directly describes women: someone I know expressed her shock at the CDC report (after reading the Washington Post article) by saying "I'm pre-pregnant!" Most women don't want to be thought of that way.

The CDC does not use that term, that adjective, anywhere. The CDC has not stated that it believes you are prepregnant. They refer to preconception health care.
posted by needs more cowbell at 10:09 AM on May 19, 2006

Wow, fings, that is seriously fucked up. Is she looking at new doctors?
posted by schroedinger at 10:11 AM on May 19, 2006

Are you sure that infant mortality is a "huge problem"?
posted by Kwantsar at 10:12 AM on May 19, 2006

"...the only important thing that 99.999999% of the dudes and dudettes in the world are ever going to do. If they don't do that, then they did--well, basically nothing."

How asinine. Getting pregnant and having a kid is about as difficult as falling off a unicycle. Procreation is about as impressive and as important as spitting out watermelon seeds.
posted by rougy at 10:16 AM on May 19, 2006

"The 10 recommendations in this report are based on preconception health care for the U.S. population and are aimed at achieving four goals to:
[..]
2) assure that all women of childbearing age in the United States receive preconception care services (i.e., evidence-based risk screening, health promotion, and interventions) that will enable them to enter pregnancy in optimal health"

Again, I agree that many of the recommendations are a good idea for anyone. But the stated outcome is to make the breeding stock healthy. And they regard the breeding stock as any and all menstruating women.

Again, this is splitting hairs in terms of overall health outcomes for the female gender perhaps; but it will probably grate with a lot of womens' groups because there is an explicitly stated aim to affect all women simply because they are capable of carrying a child.
posted by peacay at 10:17 AM on May 19, 2006

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.

Well Christ, let's put and end to that right now. Far better a few thousand babies are born with spina bifida than someone is offended.
posted by LarryC at 10:17 AM on May 19, 2006

The implication is simply that pregnancies are frequently unplanned. Therefore, action must be taken, ahem, prophylactically.

Amen to that. My nephew, an MD in residency, and his girl friend, a lawyer just out of school, announced that she was pregnant. If a doctor and a lawyer, two supposedly highly educated young people, can't manage the, ahem, prophylactic part, who can?

Well, I could, my wife and I were married 6 years before we decided we were ready for kids. But far too many pregnancies are are.
posted by cptnrandy at 10:18 AM on May 19, 2006

All your uterus are belong to fundies.

Pop 'em puppies out once a year or be white-person-hating,
treasonous, lieberal biiaatch!

6 billion too many?
Nonsense!
Brown people don't even count.

Thank you. I'll be here all week.
posted by nofundy at 10:26 AM on May 19, 2006

If only they cared as much about the post-pre-mothers and the post-unborn as they do about the pre-mothers and the unborn. Seriously.

This report is a bandaid for a mortal wound.
posted by rougy at 10:27 AM on May 19, 2006

from fing's link: 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 ...

posted by armacy at 10:29 AM on May 19, 2006

The implication is also that unplanned pregnancies should not be terminated. Or am I reading into it too much?

Yes, I know that unplanned pregnancies often result in loved and wanted babies. That's great.

What if a woman thinks it through and concludes - gee, I messed up, I've been smoking and drinking or more, I didn't plan on this, this baby's health could be compromised, I want to terminate. Then she can't afford the two 300 mile round trips to an abortion provider. I'd think that factor drives up our infant mortality rate too.
posted by rainbaby at 10:29 AM on May 19, 2006

"The implication is also that unplanned pregnancies should not be terminated. Or am I reading into it too much?"

I don't think you're reading into it too much, rainbaby. I think you're starting to see more of the iceberg.

"If only they cared as much about the post-pre-mothers and the post-unborn as they do about the pre-mothers and the unborn. Seriously."

Amen, rougy.

"Far better a few thousand babies are born with spina bifida than someone is offended."

It goes further than offense, LarryC. Denial of vital medication has already started, aptly illustrated by the livejournal entries mentioned above.
-----
I do see the point in encouraging one's populace to be healthy. If it weren't so marred by the realities of our healthcare system and the skewed priorities it represents, it would be a beautiful idea.

It is not too cynical to keep in mind that healthcare is unevenly and unreliably available in this nation, and to think that they would prioritise the most remote possibility over an existing human's suffering is quite chilling.
posted by batmonkey at 10:44 AM on May 19, 2006

> Procreation is about as impressive and as important as spitting out watermelon seeds.

Right you are. It's just that nothing else you're ever likely to do will be considered to have risen even to that microscopic level of significance. You're a meat machine whose evolved role is to contain (temporarily) and convey genes. To imagine that what the meat does while it's containing and (perhaps) conveying takes a really hyperinflated self-importance lobe.
posted by jfuller at 10:45 AM on May 19, 2006 [1 favorite]

It seems like this could also be a sneaky way of encouraging birth control methods. I actually like the example in that Washington Post article about the clinic that asks women about their plans. If women say no, they're not planning on becoming pregnant in the next year, then the doctor/nurse has an excellent opportunity to discuss options with them, and hopefully prevent an unwanted pregnancy. This is a good thing, yes?
posted by coffeespoons at 10:50 AM on May 19, 2006

"It's just that nothing else you're ever likely to do will be considered to have risen even to that microscopic level of significance."

Thomas Jefferson - a really great father. Albert Einstein, best remembered for his fathering skills. Anias Nin - total worthless loser because she never had a child. William Shakespeare - best dad in the world.

According to your argument, this is the only reason we remember these people.

The "hyperinflated self-importance lobe" is in the people who think that the only reason they're here is to serve as a bipedal Memorex machine.

We are here to give of ourselves and to make things better. Having children is neither the sole nor the most lofty of those goals. In fact, it’s tangential at best.
posted by rougy at 10:51 AM on May 19, 2006 [1 favorite]

I thought that this:
"So ladies, don't even think of touching the litter box."
Was a reference to some kind of sexual act (anal perhaps?) Am I alone in thinking this?
posted by ob at 10:54 AM on May 19, 2006

I think the implication is that, oh, men and women have a reproductive life plan (e.g. whether or when they want to have children and how they will maintain their reproductive health). With the goal being to hmm, reduce unintended pregnancies, age-related infertility, fetal exposures to teratogens, and to improve women's health and pregnancy outcomes.

I'm not sure where I got such crazy ideas.
posted by needs more cowbell at 10:56 AM on May 19, 2006

This outrage and irritation reminds me of the outrage in the "Turn off the TV Day" thread — so much grousing about how condescending and controlling it was, etc.

I'm not outraged. I think almost any initiative that works towards encouraging people to improve their lives or their health is a good initiative. The fact that it doesn't apply to you personally because you're child-free or Mother Superior doesn't mean it's not a good idea. There are lots of women out there who don't take proper care of themselves, and it does hurt the children most of them will have. Why not encourage them to think ahead to the time when they'll want to become pregnant?

I know that when I was 25 or so when I suddenly got hit with the realization that the body that I'd subjected to considerable abuse in the previous dozen years might someday have to produce a baby and I'd better start taking better care of it unless I wanted my future child to suffer the consequences.

No matter how much value one attaches to one's own life, that realization that one also has to take responsibility for a future baby's life gives one significantly greater incentive to take care of oneself.
posted by orange swan at 10:59 AM on May 19, 2006

batmonkey writes "Denial of vital medication has already started, aptly illustrated by the livejournal entries mentioned above."

Call me when the crisis makes it over to MySpace. I feel for that woman, but I'm not convinced that her livejournal should be driving public policy or even expansive public discourse.

peacay, I just don't read it that way. Yes, I understand why it can be read that way and why one might, without cynicism, read it that way from this administration (my own baliwick of pre-HIV health has been very affected by CDC fundamentalism), but when you read the whole justification for the recs, they seem quite balanced and sane. Just because women need not have babies doesn't mean we should ignore the fact that they might. (And rainbaby, I disagree with you, I don't think that there's any implication about abortion one way or the other. I'm pro-choice as are most of my friends, and maybe it's just my time in life (mid-30s), but most of my female friends are now saying that while pro-choice they would not have an abortion if they were to get pregnant by chance.) I don't know the history of the term pre-conception, but it seems to be a term of art for those planning pregnancies or likely to be so in the future. I wonder if it was simply used since it's an exsisting term.

The full statement of purpose:

The 10 recommendations in this report are based on preconception health care for the U.S. population and are aimed at achieving four goals to 1) improve the knowledge and attitudes and behaviors of men and women related to preconception health; 2) assure that all women of childbearing age in the United States receive preconception care services (i.e., evidence-based risk screening, health promotion, and interventions) that will enable them to enter pregnancy in optimal health; 3) reduce risks indicated by a previous adverse pregnancy outcome through interventions during the interconception period, which can prevent or minimize health problems for a mother and her future children; and 4) reduce the disparities in adverse pregnancy outcomes.
posted by OmieWise at 11:02 AM on May 19, 2006

Uh-oh, some influential think tank finally worked out the math for the perpetual war and our volunteer army.
posted by milovoo at 11:13 AM on May 19, 2006

OmieWise, I can see the sense and good in this, I really can. Still, just read goals 1 & 2 that you quoted above, and leave out 3 & 4. Does it ring a little different? I have to wonder why the points were ordered in such a way. Also please remember that your friends opinions about abortion may differ from public to private, and from hypothetical to actual experience. They also do not universally apply to all other pro-choice women in their mid-thirties.
posted by rainbaby at 11:17 AM on May 19, 2006

So amusing, OmieWise. So very amusing.

Are we now saying that everything a government agency tells us is 100% true and every motivation is 100% transparent?

Like I said, if our healthcare system were more evenly and reliably applied/available, I might feel less dubious.

It's not, though, and it seems quite silly to buy into this hook line and sinker just because they put a sweet little angel face on it.
posted by batmonkey at 11:18 AM on May 19, 2006

The more I read of the actual CDC document, rather than the inflammatory Washington Post article, the more I think that the concerns about this being some covert attempt to turn all women into baby-making factories is misplaced. The recs are very balanced, and while there is conspicuous derth of mentions of contraceptives, there are plenty of places where an astute reader can see that things were written in which contraceptives and planning not to have any kids are implicit choices and expectations. Indeed, since no specific choices regarding number of kids is anywhere mentioned that I've seen, everything is implicit.

You have to read with quite a bit of pre-judgement this introductory part about a "reproductive health plan" in order not to see that having no kids is as viable a plan as any other:
A reproductive health plan reflects a person's intentions regarding the number and timing of pregnancies in the context of their personal values and life goals. This health plan might increase the number of planned pregnancies and encourage persons to address risk behaviors before conception, reducing the risk for adverse outcomes for both the mother and the infant.

As to those who think this fails to address the reality of the choices made by real women, they cite this statistic about childbearing in the US which seems to suggest that this plan addresses the vast majority of US women:

By age 25 years, approximately half of all women in the United States have experienced at least one birth, and approximately 85% of all women in the United States have given birth by age 44 years.

It isn't pejorative to make health recommendations based on such numbers, especially when one admits that the 15% of US women who do not have babies are not the same 15% who might have said that they weren't going to have kids when they were 20.
posted by OmieWise at 11:26 AM on May 19, 2006

rainbaby, sure, it reads differently when the last two points are left off, and I'm not sure why the report was written in this way, but those last two goals are in there.

I really encourage people to read the report. At least the part I've read suggests that if anything it was written by people who share the concerns raised here re. women and reproduction. Unfortunately you can't write a report about preconception health without talking about preconception health, even if it only applies to the 85% of US women who have a child by age 44.
posted by OmieWise at 11:29 AM on May 19, 2006

Are we now saying that everything a government agency livejournal tells us is 100% true and every motivation is 100% transparent?
posted by OmieWise at 11:30 AM on May 19, 2006

After perusing the report a little closer, I have to admit I was reactionary as to its contents.

But I stand by the bandaid on a mortal wound remark.

How many "potential childbearing" women are going to bother reading this report? How many even know it's there?

To me, it's representative of just how little the government actually cares one way or the other.

Throw a report up on an obscure website - bit whoop.

Stop villainizing sex, start talking openly about contraception and health care, start providing accessible "brick and mortar" resources for women and men - that would be progress.
posted by rougy at 11:32 AM on May 19, 2006

OmieWise you rightly note that this is fundamentally a question of language and reading, or at least that's the way I see it. As much as I would like to have an all-in brawl with you over semantics, this is not so outrage-inducing for me so as to muster the necessary vitriol. I will keep it all in stock...but, somewhere....sometime, when you least expect it!

Were I to combine my slant on the reading with an even halfway cynical view of yon' whitehouse and their policies however, I think I would find some bolstering support. But I won't.
posted by peacay at 11:39 AM on May 19, 2006

peacay, you can't hide your fear behind semantics. I'll be prepared for you when you come again. (My point is actually that I think that the report was probably meant, by fundy political appointees, to be as condemning as you fear, but that brave beaurocrats and doctors wrote it in a sane manner. In other words, I think the subtle reading is pro-women's rights, leaving only the appearance of something to be worried about.)

rougy--the report makes recommendations for doctors and clinics, for how they should shape care, not directly to women.
posted by OmieWise at 11:50 AM on May 19, 2006

The very real problem with this is that it treats women as baby-making machines.
posted by rougy at 12:46 PM EST on May 19

So you're removing the defining trait of life, to create life, and assigning this trait to a lifeless automaton, a machine. And, you do this without irony.

What a strange, fucked up way of thinking.
posted by Mean Mr. Bucket at 11:55 AM on May 19, 2006

They talk about an advertising campaign for this initiative.

That "each woman, man and couple should be encouraged to have a reproductive life plan." That health professionals should address with me the "social, psychological, and spiritual (emphasis mine) components of pregnancy."

I dare anyone to stage a "preconception intervention" on me. You'll have to wrench my vices from my cold barren womb.

It is a question of reading and semantics. I realize this. I can guess how current policy makers will read this, though, and extrapolate from that guess into a scary future.
posted by rainbaby at 11:58 AM on May 19, 2006

No one with a livejournal blog would ever use hyperbole. It's a fact I learned on livejournal.
posted by docpops at 12:07 PM on May 19, 2006

Actually, rainbaby, those are the consumer awareness preconception guideliness from Canada.

I would like to point people to the CDC's FAQs on preconception care for the general public, which--believe it or not--most of you are.

The only odd thing I've found in it is in #4: [...]women who might be sexually active with male partners should consider their health.

Clearly, Geoge W. Bush the CDC doesn't care about black people lesbians.
posted by needs more cowbell at 12:10 PM on May 19, 2006

Just want to remind everyone this is the same administration that won't approve vaccinations for prevention of cervical cancer because it might "encourage promiscuity." Perhaps with another administration in charge I might allow the benefit of a doubt, but not these clowns.

Time for all women to get hysterectomies so they can't possibly be "pre-pregnant?"

This is not about proper pre-natal care or even pre-pre-natal care, its about who owns women's uteruses.
posted by nofundy at 12:10 PM on May 19, 2006

Folks, if a woman can get Accutane for acne - with nearly a sure bet of causing birth defects - then I have to imagine somewhere, somehow, there is a daring, caution-to-the-wind, fuck-it-all Neurologist just crazy enough to consider prescribing this lady a drug that has a chance of causing fetal malformation.

Oh, and this line is priceless (bold italics mine):

As such, they flat-out refuse to try me on any medicines other than the ones proven least likely to affect a fetus (read: the ones that are paying off my neurologist)

What a dipshit.
posted by docpops at 12:11 PM on May 19, 2006

(and I should add that I think that's just a bit of funny wording, not some deeply intentional thing on the CDC's part.)
posted by needs more cowbell at 12:12 PM on May 19, 2006

nofundy: this is the same administration that won't approve vaccinations for prevention of cervical cancer because it might "encourage promiscuity."

Care to document that baseless slur? Just yesterday the FDA unanimously approved that vaccine.
posted by peeping_Thomist at 12:12 PM on May 19, 2006

FDA advisory panel voted 13-0 yesterday to recommend approval of Gardasil, and HPV vaccine to prevent cervical cancer, nofundy. But we'll see what happens from here.
posted by docpops at 12:13 PM on May 19, 2006

Do you care to document your assertion that it was approved yesterday?
You first.
They have delayed approval for a very long time and that was not a baseless slur, it is fact.
posted by nofundy at 12:15 PM on May 19, 2006

Well, peeping_Thomist, the administration has said that repeatedly about Plan B. You're being disingenuous if you really believe that isn't on the minds of the FDA when considering any sort of therapy that would seem to self-select sexually active individuals.
posted by docpops at 12:16 PM on May 19, 2006

nofundy, I read it in my craptastic local paper, off the AP wire.
posted by docpops at 12:17 PM on May 19, 2006

nofundy, they were reporting the panel's approval on CNN this morning.
posted by NationalKato at 12:18 PM on May 19, 2006

Hold on - the FDA did not approve it, pT. An advisory panel recommended it be approved. Biiig difference.
posted by docpops at 12:18 PM on May 19, 2006

Yes, this is good general health advice, which is why it should have been a genderless message. By specifically assigning these guidelines to fertile women with the assumption that all women will make the choice to reproduce, it just underlines the point that a woman's uterus is the only part of her the government is concerned with. And at this time, when the social conservatives are loudest and in a position to inflict damage to Roe vs Wade, it's very worrisome.

[Everyone should be healthy...but you, you baby making machine, you especially should be careful because you have a job to do. That's why you're important.]

It's a sentiment smacking of male privilege that when delivered (even with the best intentions) comes across like Margaret Atwood being psychic. I resent being reduced to a walking uterus on my behalf and on behalf of my daughters, and having it assumed that the only worthy contributions I can make to the world is giving birth.

If the government was generally interested in the health of future mothers and their children, they would admit the increased infant mortality rate has more to do with the fact that millions of women in this country do not have health insurance and can't afford proper pre and postnatal care, and then instead of releasing guidelines of common sense steps, actively fixing the state of our healthcare system.
posted by FunkyHelix at 12:18 PM on May 19, 2006 [1 favorite]

Here's the CNN article posted today.
posted by NationalKato at 12:19 PM on May 19, 2006

An advisory panel recommended it be approved. Biiig difference.

It's my understand the FDA usually follows their panel's recommendations. No?
posted by NationalKato at 12:20 PM on May 19, 2006

Clearly, Geoge W. Bush the CDC doesn't care about black people lesbians.

Because lesbians never want children and all hetero women do.
posted by rainbaby at 12:20 PM on May 19, 2006

They have delayed approval for a very long time and that was not a baseless slur, it is fact.
posted by nofundy at 3:15 PM EST

Reading the link I just posted, voting is set for June 8th. Not that long a delay, nofundy.
posted by NationalKato at 12:21 PM on May 19, 2006

Giving women better access to pre-conception care is one thing. It's quite another to ask that all women, from menstrual age until menopause, make health decisions as if they were pregnant.

So is it unhealthy or irresponsible for women under 50 to drink?

To take epilepsy medication?

The report cites "workplace hazards can adversely affect fetal development" .. so does that mean certain workplaces should be off-limits to women of childbearing age?

Notice that absent from the recommendations is whether or not a woman is intending to get pregnant, nor does it matter if a woman is sexually active. The recommendation is for all women capable of childbearing.

For 20 to 30 years is a woman supposed to change her medications, and her lifestyle, to accomodate an imaginary child? Even one that she doesn't want? That's absurd.

The report is subtle, but this is what it's saying. It doesn't say it outright, and it dresses this up in "better care", but it's better care *for an imaginary child* and not necessarily better care for *the woman*. And this standard is supposed to be applied for decades of a woman's life!

The danger is that a caregiver won't give a woman the choice of a potentially more effective medication because of concerns for a pregnancy. It is very clear in the report that the recommendation is that health care providers do exactly that. This might sound wise in general until you realize that the decision isn't being made by the patient, to weigh her general health against her reproductive health. The standard would be that the reproductive health comes first.
posted by adzuki at 12:24 PM on May 19, 2006

Uh, rainbaby the thing I quoted said "women who might be sexually active with male partners should consider their health."

Lesbians who want to bear children don't tend to go about it by being sexually active with male partners--they tend to use artificial insemination. That's why I'm being snarky about the CDC not caring about lesbians; they've unintentionally (I hope) excluded them when trying to say "all women who may become pregnant should consider their health."
posted by needs more cowbell at 12:26 PM on May 19, 2006

So you're removing the defining trait of life, to create life, and assigning this trait to a lifeless automaton, a machine.

As you may have noticed, one of the problems here is that people disagree about what "the defining trait of life" actually is. There are problems with your view as well; if you take the defining trait of life to be the capacity to create more life, well, that doesn't actually tell us what "life" means, does it? It's just anything that can reproduce itself, in that case.

This is a discussion that cannot be cut short by two or three sentences of caustic commentary. It is also one that should force people to (a) re-evaluate their beliefs based on facts brought to the table by other conversants, and (b) explain those beliefs when required. The problem here is that we aren't getting through (a) properly.
posted by voltairemodern at 12:30 PM on May 19, 2006

I thought that this:
"So ladies, don't even think of touching the litter box."
Was a reference to some kind of sexual act (anal perhaps?) Am I alone in thinking this?
posted by ob

I'm afraid so....
posted by Floydd at 12:31 PM on May 19, 2006

Care to document that baseless slur?

Do not feed the troll.
posted by solid-one-love at 12:38 PM on May 19, 2006

The opening paragraphs of the article clearly read as a straightforward set of guidelines attempting to codify recommendations for women considering pregnancy or who could possibly become pregnant. There is a lot of non- evidenced based stuff floating around that this helps clear up. The most common exchange I have with sexually active women when discussing birth control goes like this:

"Are you sexually active?"
"Yes"
"What type of birth control are you on?"
"None"
"Are you planning to become pregnant?"
"No, but I guess if I did it would be OK"

So the authors of the article clearly need to be chastised for not having the sort of forward-thinking, PC mentality to keep their verbiage bloated enough to clarify their position and keep from offending people who vociferously maintain their right to not be baby-factories.

Or maybe their intentions were slightly more innocuous and benevolent.
posted by docpops at 12:49 PM on May 19, 2006

So then what do you say, docpops? Do you find these CDC guidelines helpful or potentially helpful?
posted by rainbaby at 12:59 PM on May 19, 2006

nofundy writes "Just want to remind everyone this is the same administration that won't approve vaccinations for prevention of cervical cancer because it might 'encourage promiscuity.' Perhaps with another administration in charge I might allow the benefit of a doubt, but not these clowns."

Yeah, this is precisely the problem. Why don't you try being a bit less fundamentalist in your objections to the Bush Administration, read the paper, and then decide if it sounds like it's trying to covertly find ways to make women into baby factories.

FunkyHelix writes "Yes, this is good general health advice, which is why it should have been a genderless message. By specifically assigning these guidelines to fertile women with the assumption that all women will make the choice to reproduce, it just underlines the point that a woman's uterus is the only part of her the government is concerned with."

Welcome to specialized medicine. You can find these as general guidelines all over the place (again, if you read the report you'll see how it's tied into Healthy Bodies 2010), but this is about preconceptual health so it concerns, you know, women. One of the authors is from the March of Dimes for christ's sake! The March of Dimes.
posted by OmieWise at 1:07 PM on May 19, 2006

"By age 25 years, approximately half of all women in the United States have experienced at least one birth, and approximately 85% of all women in the United States have given birth by age 44 years."

US Census Bureau Population Division. Table 2: annual estimates of the population by selected age groups and sex for the United States: April 1, 2000, to July 1, 2004. Washington, DC: US Census Bureau, Population Division; 2005. (NC-EST) 2004-02.

Damn CDC, taking account of 85% of the female population of this country. What the hell are they thinking?
posted by OmieWise at 1:13 PM on May 19, 2006

with the assumption that all women will make the choice to reproduce, it just underlines the point that a woman's uterus is the only part of her the government is concerned with

Axe, meet grindstone.

Rainbaby, yes, they are essentially a summation of what we try to iterate but often don't completely discuss. Some, like thyroid levels, or hepatitis B vaccination are slightly more esoteric or situation specific.

A point that people seem to be missing is that papers like this often form an objective platform for public policy, i.e., public health expenditures, that ideology can't overcome in the end.
posted by docpops at 1:34 PM on May 19, 2006

OmieWise, I fail to see how objecting to a group's resistance to approve a medicine which is proven effective in preventing disease and which appears to have an adverse event profile similar to other such medicines can be characterized as a fundamentalistic in nature.

Or am I failing to use the new double plus good definition of fundamentalist?

In general, I agree that the advice in the report is solid, however its packaging is suspect, particularly when looked at as part an parcel of a larger slime trail body of work.
posted by Kid Charlemagne at 1:37 PM on May 19, 2006

Uh, rainbaby the thing I quoted said "women who might be sexually active with male partners should consider their health."

Lesbians who want to bear children don't tend to go about it by being sexually active with male partners--they tend to use artificial insemination. That's why I'm being snarky about the CDC not caring about lesbians; they've unintentionally (I hope) excluded them when trying to say "all women who may become pregnant should consider their health."

Presumably, lesbians using artificial insemination will not have an unintended pregnancy, and will already be somewhat concerned about their health. The point of these guidelines, I think, is to reduce health problems with unintended pregnancies.

Not everything the government does is controlled from the White House. Most government employees are driven by bureaucracy, not ideology.
posted by me & my monkey at 1:43 PM on May 19, 2006

Whatever.
posted by delmoi at 1:45 PM on May 19, 2006

Damn CDC, taking account of 85% of the female population of this country. What the hell are they thinking?

85% have a pregnancy by the time they're 44 years old. So we should treat 100% of adult women less than 44 years old as if they were pregnant?

Most women are not in a state of perpetual pregnancy for their adult lives. Why construct a standard of care that assumes that they are?

It's not a simple matter that better "preconception care" means overall better care for the woman. It means better care for her uterus and a potential child. Who is the patient?

A glass of wine a week might have health benefits for a woman, but be disasterous for a fetus. So, general health and fetal health may not always agree. What do the standards say about the woman's choice? They say women of childbearing age shouldn't drink at all.

85% of women have children, but that doesn't mean that all women should be planning for pregnancy until menopause.
posted by adzuki at 1:45 PM on May 19, 2006

Is infant mortality in the US really that high? I had some dude trying to tell me that neonatal care in Mexico is way better than the US and that their infant mortality rate was way lower than here in the US.

So which one is it?
posted by drstein at 1:48 PM on May 19, 2006

I thought that this:
"So ladies, don't even think of touching the litter box."
Was a reference to some kind of sexual act (anal perhaps?) Am I alone in thinking this?
posted by ob

No, fortunately nothing so puerile as that.

The danger is that of Toxoplasmosis - specifically infection by T. gondii. This is a small parasite which has a natural reservoir in domestic cats. They shed viable cysts of the parasite into their feces. Most people (and especially cat owners) are seropositive (possess antibodies) for this organism, meaning they have prior exposure. The danger is for seronegative pregant women who are infected with the parasite for the first time. The parasite can infect the fetus and cause spontaneous abortion in the first trimester and mental retardation and worse in later trimesters.
posted by i_am_a_Jedi at 2:10 PM on May 19, 2006

It's my understand the FDA usually follows their panel's recommendations. No?

Used to. Then Plan B happened.
posted by desuetude at 2:26 PM on May 19, 2006

Getting pregnant and having a kid is about as difficult as falling off a unicycle.

I'll grant you that getting pregnant is / can be easy. So can having a baby cut out of you. But *pushing* a baby out is not, in the large, an easy task. Nor is taking care of one after it's born.

I really don't take someone seriously on their opinions about how "easy" it is until they've done something like this themselves. Or at least been an adjunct for a significant period of time (so they could see how it really is, close-up), such as working as a labor support person and babysitter. Have you done either of these things, rougy? I'm guessing not.

The larger picture about birth in the U.S. and our infant mortality rate is that poor (uninsured) women simply do not have access to good prenatal care (as someone mentioned above). Until we fix this part, our infant mortality rate will suck.
posted by beth at 2:37 PM on May 19, 2006

It's my understand the FDA usually follows their panel's recommendations. No?
posted by NationalKato at 12:20 PM PST on May 19 [+fave] [!]

The advisory panel also approved selling Plan B 23 to 4 but the decision was rejected by the FDA, because they don't like the thought of teenagers having sex. I believe the first time such as thing has happened. So you'll forgive me if I'm feeling a little skeptical.

In another time, this report would have maybe made me raise my eyebrows at the most. But taken in the context of this administration's record regarding women's rights it just adds to the stench. Anyway, it's already pointed out upthread that these guidelines will do little to affect the infant mortality rate in the US, as those that its meant to reach cannot afford the pre and postnatal health care they need.

I mean, we live in a world now where people object to a cancer-preventing vaccine because they think it will encourage nine-year olds to have sex, and they're actually taken seriously. It's a fucked up world we live in.

On preview, desuetude beat me to it.
posted by kosher_jenny at 2:43 PM on May 19, 2006

God, the comments on that blog make it necessary to come up with a new word that surpasses histrionic.
posted by docpops at 2:56 PM on May 19, 2006

In regards to why the preconception plan doesn't say anything about prevention...could it be because they can't?
posted by nomisxid at 3:51 PM on May 19, 2006

For as long as I'm in preconception I'd like to have the morning-after pill available to me otc. I think that's reasonable.
posted by birdie birdington at 3:53 PM on May 19, 2006

To provide a counter to whatever medication denying is going on in LJ-land: I have epilepsy. I am a woman of childbearing age. I PLAN on having children.

I have never been denied any medication, no matter how harmful it may be to a fetus, so long as I was on adequate birth control. Sure, I had to be on Depo Provera in order to get Tegretol, but I wasn't planning on getting knocked up at that moment, so no harm - no foul.

(Though if this woman is on birth control, her doctor is seriously just being a douche and she should see someone else.)

I have no problem having my doctor talk to me about health issues as if I were to become pregnant tomorrow because hey, better safe than sorry. If there are women out there who really ARE offended by the idea of someone recommending that they take folic acid because they are not "baby-making machines," well, I'm glad that they're not producing children to offend them by demeaning them to milk-factories and poop-scoopers.
posted by grapefruitmoon at 4:28 PM on May 19, 2006

Good god, how did we ever manage to 6.6 billion humans without CDC and their guidelines?
posted by c13 at 5:00 PM on May 19, 2006

"...the only important thing that 99.999999% of the dudes and dudettes in the world are ever going to do. If they don't do that, then they did--well, basically nothing."

If people gave a shit about the future of this planet, they'd stop having kids. I can't cite this, but it's accepted in the ecology community that the earth's carrying capacity for humans is around 4 billion. In our childrens' lifetime, the population of the world will increase to around 11 billion. That's almost 3 times the carrying capacity. Sounds to me like billions of people are going to be suffering from disease and famine, like is already happening in Africa. The best thing anyone can do for the future of this planet is to have no kids. Or, if you think your genes are really worth passing on (and seriously, give this some thought) then find yourself a nice, genetically fit partner and have a kid. Two MAX. Anything more is pure selfishness.

Getting pregnant and having a kid is about as difficult as falling off a unicycle. Procreation is about as impressive and as important as spitting out watermelon seeds.

Precisely.
posted by salad spork at 6:15 PM on May 19, 2006

Good god, how did we ever manage to 6.6 billion humans without CDC and their guidelines?

Though plague, famine, disease, and all manner of stuff that you really don't want to be exposed to. I'm not saying that CDC is superfantastic, but please.
posted by JekPorkins at 6:47 PM on May 19, 2006

Procreation is about as impressive and as important as spitting out watermelon seeds.

I'm firmly anti-reproduction, but I must say that there aren't many 8-pound watermelon seeds around.
posted by stavrosthewonderchicken at 7:04 PM on May 19, 2006

(Though if this woman is on birth control, her doctor is seriously just being a douche and she should see someone else.)

She mentions in the comments that she is on birth control, I believe. She also talks about a massive weight loss she suffered as a result of her previous and current medications, that dropped her current weight to the 90 lb range. According to her primary care doctor, were she to actually get pregnant, her body would not be able to sustain the fetus. So she's being withheld medication in case of a pregnancy that would most certainly miscarry. Sheesh. No mention of any communication between the two doctors though.
posted by kosher_jenny at 7:20 PM on May 19, 2006

People who need medication for conditions like pain or ADHD already do face a number of roadblocks caused by overzealous DEA prosecutions of doctors and, sometimes, doctors who think it's all in their head (studies show that women patients are less likely than men to get the pain medication they need). So some of us may be a little sensitive about anything that might make it even more difficult.
posted by transona5 at 7:34 PM on May 19, 2006

When I went in for a check-up in the summer of 2004 and told her that I was getting married and that my husband to be were talking about starting a family, my doctor announced me as "pre-pregnant". I have to say, I found the phrase a little annoying in and of itself, not to mention the assumption behind it - consider yourself pregnant at all times because you just *might* be without even knowing it! Nevermind the fact that up to that point, I had managed my reproductive health well enough not to have never gotten pregnant.

I think that this is what makes this pronouncement rankle with me. As a result of having access to all of the appropriate information, I managed to prevent an unintended pregnancy -the information is NOT so complex that it's beyond the capabilities of the average woman to comprehend it. Certainly healthcare outreach to women can encompass both information on the proper use of birth control AND infomation on being healthy enough to sustain a healthy pregnancy, should you be open to that possibility. Nevermind not treating women like baby factories, how about not treating women like idiots who can't manage to maintain and control their own bodies?

And what about the health information for men who might be open to being a father? Shouldn't they be advising guys against doing the sort of things that can curdle their man gravy, such as smoking, drinking, drugging, handling toxic substances, wearing tighty-whities and sitting in hot tub, because the next load blown might be calling them "Dada" in a year or two? Yes, reproductive health issues impact women in a more direct way, but if it's so damn important, shouldn't the message be a more universal one?
posted by echolalia67 at 7:36 PM on May 19, 2006

on the face of it, these recommendations seems innocuos enough. that is, as long as they remain recommendations. i always fear the slipperry slope when government gets involved, particularly public health folks, as they love power. i look at seat belts and second-hand smoke as two great examples of 'public health issues' that start out as sensible crusades and then become far reaching and codified into law. the CDC recently made 'recommendations' about HIV testing being 'routine' for all americans between the ages of 13-64. will these so-called 'recommendations' turn into mandatory HIV testing some day? i remember back in the day when the anti-smoking nazis only wanted the back of the plane. now look where we are. i think we've lost alot of freedom. i always ask the question 'how much power do we want to give the government?'
posted by brandz at 7:53 PM on May 19, 2006

Just more fucking nanny-statism. And I'm a doctor. But come on...
posted by i_am_a_Jedi at 9:11 PM on May 19, 2006

transona5: it's all in their head (studies show that women patients are less likely than men to get the pain medication they need). So some of us may be a little sensitive about anything that might make it even more difficult.

As someone who was accused by her ortho of being drug seeking because she asked a question about the efficacy of the different pain meds she'd been on, well...yes, I can see this being a problem. (I've also woken up on the table during surgery, and have run through most of the migraine meds on the market...my body chemistry's just weird). So, if I began to have crippling migraines every few days again, do you really think I would want some idiot keeping me off the good drugs just because I might be pre-pregnant? Nooo.
posted by bitter-girl.com at 10:17 PM on May 19, 2006

All the same, I won't hold my breath for the subsidized pre-natal vitamin distribution to start.
posted by Scram at 11:47 PM on May 19, 2006

"All the same, I won't hold my breath for the subsidized pre-natal vitamin distribution to start...."

Unless Halliburton gets the contract...
posted by rougy at 12:42 AM on May 20, 2006

"rougy--the report makes recommendations for doctors and clinics, for how they should shape care, not directly to women."

Who put the sand in the vasaline?
posted by rougy at 1:00 AM on May 20, 2006

I guess now I have the option to avoid all women under the pretense that they'll just be forcing me to do unneccessary work, and being extra bitchy even though they aren't pregnant and no where near it.
posted by taursir at 3:21 AM on May 20, 2006

A glass of wine a week might have health benefits for a woman, but be disasterous for a fetus.

Actually, this is not true. Excessive alcohol is very bad for a fetus, but moderate is not.

A while back, I had read somewhere that all the studies of Fetal Alcohol Syndrome looked at women who were alcoholics and heavy drinking, not the wine glass once a week drinkers at all. In fact, my mother in law was prescribed Guinness when pregnant and then (as now) drinks a glass of wine a day (those crazy Europeans), and had three extremely intelligent children who are all now in postdocs/graduate school/medical school.

But anecdotal evidence aside - a link to a professor's page summarising recent medical research on the issue.

A recent analysis of seven major medical research studies involving over 130,000 pregnancies suggests that consuming two to 14 drinks per week does not increase the risk of giving birth to a child with either malformations or fetal alcohol syndrome.
posted by jb at 3:39 AM on May 20, 2006

Um, we all know the other developed nations don't call anything that may come out of a woman's vag a baby? For example premies under 15" are frequently not counted as live births. The reason being, they frequently die.

Our infant mortality "problem" is another non-problem unless you count the amount of time devoted to "solving" it.

I think a bigger problem is treating women as they were treated in the early days of Reich the III.
posted by shownomercy at 7:41 AM on May 20, 2006

It's true that not all countries have the same definition of "live birth", but I think that Canada and Australia both follow the UN guidelines on defining live births, like the US, but both have lower infant mortality rates. (It's in an article linked somewhere in this long thread - the article noted how Switzerland and France have different definitions).
posted by jb at 8:24 AM on May 20, 2006

As someone who was accused by her ortho of being drug seeking because she asked a question about the efficacy of the different pain meds she'd been on, well...yes, I can see this being a problem.

Shudder.

My GP got really uptight when I started to ask him something about the Prozac my psychiatrist prescribed; he seemed to think I was trying to get him to prescribe it, when all I wanted was to know if I could take ibuprofen while on it. I've become increasingly uncomfortable asking doctors any questions at all.
posted by transona5 at 8:44 AM on May 20, 2006

I read the article and the entire time i was reading it, I felt sick to my stomach. I have no argument with the recommendations, but the fact that they assume that any woman will eventually get pregnant and then automatically keep the baby is sort of freaky. I'm 16; I don't want a doctor treating me like I'm in danger of making a baby at any time, especially because I'm on birth control and not sexually active. I think that telling people to eat well, not smoke, and drink less is good advice for anyone. Treating these things like they're only important for "preconception" women is stupid and creepy. Why not focus on improving the health of post-birth people and not the unborn and unconceived? The whole thing comes across (intentionally or not) as another government effort to make babymaking the focus of women's lives.
posted by MadamM at 3:36 PM on May 20, 2006

Wow, talk about vitriol in this thing. If anyone wanted to know why public health budgets have been slashed to the marrow over the last 30 years, this thread is a perfectly good answer.

And on the HPV vaccine: The initial testing was completed in 2004. The Phase III clinical trials were ended in 2005. All showed Gardasil to be extremely effective in preventing HPV. I can't remember the percentage, but I think that it was well over 90%. The unanimous panel approval reflects this. It's being fast-tracked through.

If it's not approved in June, it will be a shock to everyone. Again, Gardasil had no opposition on the board. The science says it's safe and effective. And once it's in widespread use, it could potentially save 300,000 lives a year globally. We will have the first vaccine against a form of cancer, ever.

And the groups lining up to oppose it aren't using "ban it" language. I saw an article today (which I can't seem to dig up on Google News) where a spokesperson for Concerned Women for America was talking about the religious objection clause on vaccines that most states have on the books. They know that Gardasil is going to be approved, and they can't stand in its way.

Let me say this again: Gardasil WILL BE APPROVED. If it's not, it will be because the entire FDA was fired and then packed full of unscientific clones of Jerry Falwell, or vaccinated women started having V babies. Stop saying otherwise.

And stop hating on public health, people. You're going to need them one day. The CDC is putting out a clear list for women who are looking to have kids, and all you can do is pile on them for offering decent and comprehensive advice in a country where people still think cats smother babies. Geez.
posted by dw at 4:28 PM on May 20, 2006

And stop hating on public health, people. You're going to need them one day. The CDC is putting out a clear list for women who are looking to have kids

I think that it's less about hating on the CDC and more about people's concern that govenment agencies like the CDC have in recent years been hijacked to further a certain political and social agenda and that this sort of pronouncement may be part of furthering said agenda.
posted by echolalia67 at 7:19 PM on May 20, 2006

I think that it's less about hating on the CDC and more about people's concern that govenment agencies like the CDC have in recent years been hijacked to further a certain political and social agenda and that this sort of pronouncement may be part of furthering said agenda.

Except that the "certain political and social agenda" everyone is running in fear from ISN'T coming out of the CDC. I think the CDC's diminishing budget -- even in a time when this administration screams "WMDs!" and "Bird flu!" -- clearly reflects how exactly the power in Washington feels about public health.

I mean, look at Recommendation 7: Health Insurance Coverage for Women with Low Incomes. When in the last SIX years has this administration given a flying rat's ass about health insurance coverage for low income people, much less women? Does that recommendation SOUND like it's coming out of the mouths of these idealogues you're lumping the CDC and these other groups into?

No one is telling people to have babies. Healthy People 2010 is not about making women into babies factories. It's about righting health disparities based on race, gender, and income as well as improving quality of life for Americans. We have an infant mortality rate of 5 per 1000. Japan's rate is 1.8 per 1,000. That's ridiculous. We're the goddamn richest country in the history of the world, and it's a fucking travesty that our infant mortality rate is 2.5 times Japan's. The CDC is trying to lay out a framework for improving that number. This is what public health is all about.

And what do they get in return? Handmaid's Tale references. That's total bullshit. Get some context, people.
posted by dw at 9:39 PM on May 20, 2006

Metafilter: the sort of thing that can curdle your man gravy
posted by InfidelZombie at 8:39 AM on May 22, 2006

You know what's nice about being a doctor? When you're with a patient, it's you and the patient sitting there in a little room, having a conversation, a dialogue. You got taught a lot of statistics in med school; now it's time to sit down and find out what the unitary discrete being sitting in front of you is interested in, what she's concerned about, what her plans and hopes and fears are.

You don't deliver cookie-cutter, color-by-numbers healthcare according to the CDC ukase. You read the CDC ukase, and then you do a little thinking about how it relates to the person you're having a dialog with, and then you and she decide what's going to happen, together, in a way that makes sense.

I've been in touch with that person who posts on shadesong.livejournal.com, and I've been an epilepsy specialist, and, without going into too much detail, the experiences she relates are quite unusual. In fact, I'm doubtful that her neurologist would relate the same story in a way that would be recognizable. That's unfortunate, but so it goes.

Women of childbearing age who have epilepsy receive teratogenic antiepileptic medicine all the time, and I can assure you that's unlikely to change in the near future.
posted by ikkyu2 at 5:48 PM on May 22, 2006