Friday, February 3, 2012

Female Bodies and the Issue of Choice: Part One

Part One: On the idea that all women can be mothers, should be mothers, or want to be mothers.


A blog post was recently shared with me in which a woman writes about a surgery she had to have on her reproductive tract that would make her unable to have biological children. She told her male surgeons that she was ready to have the surgery because she didn't want children anyway. But the male surgeons couldn't accept this, and, exerted their patriarchal attitudes and power...
"The director of the surgical team advised tactics to delay the operation as long as possible, so that I could “try to complete my family”. That my family could already be complete was not, apparently, something they considered. 
Because the male surgeons advised that she wait to at least try to become pregnant before having the surgery, her surgery was delayed. She finally had to go to a different surgeon, a female, who "told me, with refreshing frankness: 'A pregnancy would be completely disastrous for your body. It will be a very good thing if we end your fertility.'" It turns out that waiting, which the woman did not want to do, led to the need for a more dangerous surgical procedure.

This gets at an essential point that I, and many birth activists, try to make: that women should be able to make choices about their bodies. 

This argument is made in discussing that women should be able to be fully informed and accept or refuse any procedure during pregnancy, any procedure during birth, and any procedure done to them at all. It is a woman's right (and a patient's right, and any person's right) to be able to choose what happens to her body, whether or not it is the choice that another person might make. While the choice to not be resuscitated when dying is not the choice that everyone might make, many people make the choice to put DNR, or Do Not Resuscitate, on documentation (or tattoo it on their bodies).

Furthermore, it gets to the idea that our society has: that all women should be mothers, or want to be mothers. The assumption is made that women want to have children, even despite any harm to themselves. Research shows that women weigh these odds all the time - their survival vs. the survival of offspring (I encourage you to read Mother Nature by S. B. Hrdy for more on this).

Women are more than their ability to be mothers. And moreover, biological motherhood is not the only way a woman can be a mother.

Society's assumption that all women might one day be mothers is also an important consideration in public health. What I'm thinking about specifically is Preconception Care. You may have heard of preconception care before; It is growing in popularity in the public health arena. You can read more about it on the CDC page here. I hadn't seen the issue here until my public health academic adviser brought it to my attention when she said something along the lines of:
"I have a problem with the assumptions of preconception care... It assumes that all women are going to get pregnant or want to get pregnant."
I have been left thinking about this for months, because she is right. Preconception care assumes that all women should receive the same screenings, nutrition, etc, and that all of these are done with the goal of safe, healthy pregnancies, birth outcomes and infants. But should we treat all women as if they are potential baby makers? My feminist adviser would say definitely not. And this is something I struggle with, because I think that preconception care is a good idea.

Perhaps the solution is that all doctors truly practice patient-centered care - Listen to their patients needs and wants, and don't treat everyone the same. And, of course, never assume!

Please feel free to share your thoughts on this!


2 comments:

  1. I agree that preconception care is a good idea. Of course, as with a lot of health care, it is most available to and most used by the people who need it least. The question, I suppose, is what part of women's health care is important to her living a full, healthy, active life and then what is needed beyond that to ensure a healthy pregnancy.

    My guess is that the answer is 'not much' because a woman with a full, active, healthy life is already doing the things necessary for a healthy pregnancy. The difference is that many women are more motivated by a potential pregnancy than they are by their own health.

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  2. I agree with Jennifer in that my extremely limited understanding of preconception care lines up with what would mean a healthy body for any woman. However, preconception care shouldn't be applied until a woman tells her physician that she wants to conceive.

    I do not want to conceive. I wouldn't want my physician pushing preconception care on me. I'd simply expect him to provide care that would equal a healthy outcome for my body as a whole, not as a walking reproductive tract.

    I sometimes feel pressured to explain myself when I say to people that I don't want to have children. It's either because they ask why, or because society pressures me to say so in other ways.

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