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Bringing Up Baby: Is Pregnancy A Disease?

Poster that reads America, Wake Up! We Have An Epidemic!Consider the following:

  • "Treating the Nation's Epidemic of Teen-Age Pregnancy" (headline, The New York Times)
  • "Teenage mothers are not exclusive to the Lone Star State. They're part of a national epidemic…" (excerpt, Houston Chronicle)
  • "Teenage Pregnancy: Medical Risks and Realities" (page heading, WebMD.com)
  • "Teen Pregnancy Epidemic? Memphis Officials Say No, But Do See Problem" (NPR story)
  • "Love Child Gets to Heart of Teen Pregnancy Epidemic" (Chicago Tribune)
  • "Teen Pregnancy: An Epidemic in Foster Care" (Time magazine)

I'm surprised our nation has survived this epidemic! With a virulent pathogen, hundreds of thousands of infected individuals would lead to a true pandemic. Millions dead. The streets lined with corpses. Why didn't this happen? How have we been saved?!

Oh, right, I got confused there. Pregnancy isn't actually a disease. But the language we use treats it as such, and not just teen pregnancy. Consider the following:

  • The Centers for Disease Control has a program for research related to health in pregnancy. Its name? PRAMS: Pregnancy Risk Assessment Monitoring System
  • "Advanced Maternal Age is an independent risk factor for intrauterine growth restriction" (National Institute of Health research paper)
  • "Determining Your Risk of Pregnancy at Time of Exposure to Sperm (page heading, sisterzeus.com)

Language in the scientific literature has historically lent itself to the "pregnancy as disease" paradigm; the fetus is an invading parasite and the mother an infected host. Again, consider the following:

  • "If the restriction is severe enough to induce maternal body weight losses, obviously the fetus becomes an active parasite…" (The American Journal of Clinical Nutrition)
  • "A genetic conflict can be said to exist between maternal and fetal genes. Fetal genes will be selected to increase the transfer of nutrients to their fetus, and maternal genes will be selected to limit transfers in excess of some maternal optimum….during implantation, fetally derived cells (trophoblast) invade the maternal endometrium and remodel the endometrial spiral arteries into low-resistance vessels that are unable to constrict."
  • "Failure of the trophoblast to invade sufficiently is important in the development of some cases of pre-eclampsia." (Wikipedia page for "Trophoblast")

Fetus-as-parasite vocabulary is pervasive in the biological sciences; I myself learned it as a student of biological anthropology. This deeply entrenched metaphor influences the way we think about pregnancy. Why must the trophoblast "invade" the endometrium? Why doesn't it "enter"?

In the political and media realm, this "pregnancy as disease" model is one thing that pro- and anti-choicers agree upon, although they use it for different ends. Consider this public service ad from The Candie's Foundation:

Bristol Palin stands in a room with a baby in the background. Things look pretty bleak

What happened to Bristol Palin?! Was she robbed? Is she a drug addict? Did she contract a terminal disease? No, she had a baby, which apparently results in spartan decorative proclivities and bad hair. Here's another PSA that treats pregnant teens as vaguely diseased abominations:

Poster of a pregnant girl. Text reads: Halloween in Alabama--the scariest things aren't wearing masks

This framework legitimizes abstinence education. If pregnancy is a disease, it's an unpredictable pathogen that results from exposure to sperm. Mere prevention techniques (birth control) aren't sufficient. Quarantine is prudent. Best to avoid sex altogether. Since social constructs of diseased conditions create fear and social stigmatization, effective and realistic impediments to pregnancy, like condoms, are nothing but impotent strips of latex when compared to the vague, looming and shaming concept of "teen pregnancy."

The "pregnancy as disease" framework detracts focus from the real reasons that teen pregnancy might present a problem: poverty, lack of access to healthcare and information, low social support, and so on. Consider the curious syntax of this sentence from the CDC website: "…factors that increased the teenager's risk for pregnancy; such as, growing up in poverty, having parents with low levels of education, growing up in a single-parent family, and having low attachment to and performance in school...."

Wait, what? Poverty, low education, and poor performance in school are all "risk factors" for pregnancy? "Correlated with" is more precise, and mightn't we frame poverty as being the big bad here, not pregnancy itself? Is there something inherently wrong with a pregnant teenager? Mightn't the circumstances be relevant? Indeed, the absurdity of the Bristol Palin campaign shows how confused our notions of teen pregnancy have become.

There's fear in both political camps that straying from scare tactics would increase the number of pregnant teens. This is baseless. Research shows that increased knowledge about sex, sexuality, birth control, and pregnancy doesn't increase the numbers of teens who are having sex, but does decrease the numbers who have unprotected sex. Acknowledging pregnancy as a natural result of sex without birth control—not a disease—would be a good thing. Let's not allow pregnant teens and teen moms to live in shame. Those who live in shame think they don't deserve help. They don't seek it, and they don't demand it politically.

All told, the disease framework legitimizes intolerance against pregnant women and moms. Why demand choice when you didn't sufficiently "protect yourself"? Why institute paid parental leave when mom unnecessarily allowed herself to contract pregnancy? Why demand economic justice when you're the one who got yourself "into this mess"? Why require that dad pay child support when it's mom who didn't prevent her "condition"? In a healthcare system that treats even a socially sanctioned pregnancy as a "burden to the system," every woman is part of an "at-risk" population, and every pregnancy is conceived of as a disease.

Related: The Myth of the Teen Pregnancy Epidemic

Previously, on Bringing Up Baby: The Real Housemoms of Bravo TV, Motherhood as the Dream Deferred

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Comments

10 comments have been made. Post a comment.

Also, the pregnant disease is

Also, the pregnant disease is always harms the mom. The dad of the baby isn't forced or looked down upon. It's girls who need to stop sleeping around casually with no protection. The scare tactic doesn't punish the guys in the relationship because they are nameless faces of the many boyfriends the girl had.

it's one of the many overlooked problems with Teen pregnancy. Love this article.

In other words ...

... it's another form of slut-shaming and victim-shaming/blaming. Make no mistake.

Totally agreed about the

Totally agreed about the slut-shaming, though lumping teen moms together as "victims" doesn't seem quite right, especially since the term 'victim blaming' is usually used in reference to those who have been molested, harassed, or raped.

Katherine Don

PRAMS

In PRAMS, "risk" refers to risks or dangers that could negatively affect the pregnancy - not the pregnancy itself. "Risk of a low birthweight baby," etc. There are a lot of people who care about healthy mothers/babies who work with PRAMS.

It's data to inform medicine to ideally improve pre- and postnatal healthcare: http://www.cdc.gov/prams/

PRAMS

I didn't intend to malign the work of PRAMS in any way. PRAMS does fantastic work, and if recent bills such as the Maternal Health Accountability Act actually pass (not too much reason for optimism there though), PRAMS would be a vitally important model. I realize that the "risk" refers to the dangers that affect maternal and baby health; however, this often means the pregnancy itself, since factors such as "advanced maternal age" are included, which arguably is part of the "pregnancy" insofar as a woman is a complete person rather than the sum of her "risk factor" parts. The language of PRAMS is not alone in using disease/epidemiological terms for pregnancy. I'm not questioning the program itself, but I am questioning the usefulness of this type of nomenclature.

Katherine Don

Although I agree with you on

Although I agree with you on most points, I think that an important reason why pregnancy is perceived as a disease is because a lot is lost in translation of scientific language into everyday language. In epidemiology the term "risk factor" doesn't just apply to adverse outcomes. Risk factors are simply exposures that are associated with an outcome. Whether that outcome (pregnancy) is a good or a bad thing is a different story.

Also, I can't be sure about why the term "invade" is used, but "enter" is not a suitable substitute. Our goal is to avoid misinterpretation (granted, most papers don't live up to this ideal) and that means using words that are as specific as possible. In this example perhaps "implant" would suffice, I'm just making a point as to what could have motivated that word choice.

I agree that "implant" would

I agree that "implant" would be more precise. "Integrate with" could've worked too. Word choice is difficult. "Invade," most certainly, is not precise. I argue that these words are selected because of the entrenched tendency in the sciences to view the embryo/fetus/other stages as an invading parasite. As for language getting lost in translation from science to media, this certainly happens, but I think the disease nomenclature is prominent in both the sciences and in the media. I'd wager that the wikipedia article on trophoblast, for example, was written by a scientist, and that the use of "invade" was not a lost in translation problem.

Katherine Don

This is something I've just

This is something I've just noticed for myself yesterday. Not only is pregnancy often refereed to as if it were a disease but it's often talked about as if it were something disgusting, scary, and at one point equivalent to torture. I'm beginning to notice a lot more negative feelings towards mothers and children lately. Maybe it's always been this intense either way I'm completely creeped out by it.

I have always had a difficult

I have always had a difficult time with this. I'm severely tokophobic, and have no desire to have kids. The thought of pregnancy repulses me, and can trigger nightmares and panic attacks. At the same time, I acknowledge that it's a valid choice for other people and, although I don't understand, can be fulfilling and desirable for some.

I went to high school in a very poor area, and I've known (at least tangentially) a lot of women who have been pregnant during high school. My mother, and my partner's mother, both had children relatively young. I absolutely agree that their decisions should be supported. Parenting is difficult, especially when young.

I appreciate neutral language when discussing pregnancy. And personally (when speaking freely and not to someone who I know is currently interested in having children), I do tend to use "aggressive" language if I do talk about it - words like "invade" or "parasite." Aggressive terms, however, have no place in medical, scientific, or otherwise morally neutral realms - but neither do positive terms. Reading about "implantation" is one thing, but words that value motherhood as a beautiful experience are horrible for me to read, and I don't want them anywhere near my professional documents.

I am all for reframing the narrative around pregnancy to be more positive towards mothers, even (especially) young ones, but I would hate to see that mean it becomes more acceptable to shame and trigger people like me.

In regard to adults - the

In regard to adults - the language is kind of inflammatory...Adult women are responsible for their own lives & if they are pregnant shouldn't be treated as if they are suffering from some kind of illness.

IN REGARD TO CHILDREN getting pregnant...Teens are typically not the ones responsible for themselves. Their parents are. If I had pregnant 15 yr old...Who is paying for her medical care? Who will take care of the baby when it's born (we're going to assume the baby is born b/c obviously that's the TRUE problem with teen pregnancy...there's a BABY at the end of it!)? Who pays for the basic needs for the infant? Breastfeeding rates among teens are notoriously low. Which means formula - who is paying for this? WIC? Me? Even if bfing were successful - mom will [hopefully] be returning to school at some point - can she possibly be pumping between classes? Suppose I work...And my husband works. And there are no other adults living in my house. Who will watch the baby? When I last had an infant (my youngest is 4 now) and I checked in to daycare rates it was about $800-$1000 a month in our area (lots of suburbs, lots of daycare options). Maybe it won't be as expensive if my kid can get her daycare subsidized by the state (my friend's teen daughter was eligible for a program)...but if both my husband and I are working - we will probably make too much to qualify.

Adding a new baby to the house can have a pretty big impact on other children in the house as well. Why should my younger kid get fucked up b/c they have to compete with all the other shit going on??

I don't think it matters what kind of language is used when it comes to teens and pregnancies. The bottom line is - IT SHOULD HAPPEN AS LITTLE AS POSSIBLE. Teens are less likely to have adequate pre-natal care (b/c they often hide their pregnancies for as long as possible - that friend I mentioned above...her daughter revealed her pregnancy at nearly 7 months). They are more likely to have pregnancy-related hypertension & pre-eclampsia, low birth weight, premature birth, & post partum depression.