The handmaid’s wail: forever pregnant

Now, of course, encouraging women to engage in healthy habits is a good thing, but framing it as purely a need to keep babymaking machines in shape is appalling. Why stop at supplements and stopping smoking, as Rebecca Traister at the Salon blog Broadsheet wonders:

What about avoiding sushi, uncooked meats and unpasteurized cheeses? Perhaps women should only be allowed on planes once it has been determined, by routine pelvic exams administered at the gate, that they are not carrying a fetus that could experience trauma midflight....

Pretending that we're going to solve this problem by instituting guidelines that treat women as baby incubators is not the solution. All it does is reinforce an attitude that problems women have with reproduction are the only ones worth worrying about. How about federal recommendations about using birth control to prevent HIV and other sexually transmitted diseases? How about federal guidelines that require doctors to talk to women about the dangers smoking, poor nutrition, unprotected sex, drug use, lack of exercise, and heavy drinking can pose for them, and not just their precious potential cargo?

But perhaps the best illustration of how ridiculous -- and scary -- this kind of thinking is, just imagine if men’s health issues were treated merely as adjuncts of their duty to make healthy babies:

Forever Fathering
Guidelines: Treat Nearly All Men as Pre-Inseminators
by MaryAnn Johanson
Geek Philosophy Staff Writer
Wednesday, May 17, 2006

New federal guidelines ask all males capable of fathering a baby to treat themselves -- and to be treated by the health care system -- as pre-inseminators, regardless of whether they plan to impregnant a woman or women anytime soon.

Among other things, this means all men between first nocturnal emission and death should take L-Carnitine supplements, refrain from smoking, maintain a healthy weight, avoid wearing jockey shorts, quit taking hot showers or baths or soaking in hot tubs, and keep chronic conditions such as asthma and diabetes under control.

While most of these recommendations are well known to men who are inseminators or seeking to inseminate, experts say it's important that men follow this advice throughout their reproductive lives, because about half of pregnancies are unplanned and so much damage can be done to a fetus if the inseminating sperm is not as healthy as possible.

The recommendations aim to "increase public awareness of the importance of preconception health" and emphasize the "importance of managing risk factors prior to insemination," said Samantha 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 Urologists, 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 insemination to detect, treat and help men modify behaviors, health conditions and risk factors that contribute to adverse maternal and infant outcomes," according to the report.

Preconception care should be delivered by any doctor a patient sees -- from his primary care physician to his urologist. 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 paternal fetal medicine division who sat on the CDC advisory panel. "Healthier men are healthier inseminators."

Men should also make sure all vaccinations are up-to-date and avoid contact with lead-based paints, radiation, pesticides, and other chemicals, Biermann said.

The report recommends that men stop smoking and discuss with their doctor the danger alcohol poses to semen.

Research shows that "during the days before insemination" -- during which a man may not yet realize that he’s about to impregnate a woman -- "exposure to alcohol, tobacco and other drugs; lack of essential vitamins (e.g., L-Carnitine); and workplace hazards can adversely affect semen production and result in pregnancy complications and poor outcomes for both the mother and the infant," the report states.

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 men with no plans to inseminate in the near future may resist preconception care.

"We know that men -- unless you're actively planning [an impregnation], . . . he doesn't want to talk about it," Biermann said. So clinicians must find a "way to do this and not scare men," by promoting preconception care as part of standard men'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 men, "Do you smoke, and do you plan to inseminate a woman or women 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 Patricia Bernstein, a paternal fetal medicine specialist who sat on the advisory committee that helped produce the report. "It's simple and [it] costs nothing." ·

But that would never happen, right? Long before then, we’ll be seeing this kind of thing:

(Technorati tags: Handmaid’s Tale, Republic of Gilead, dystopia, science fiction, feminism)