CDC recommends greater pre-conception care

So now, despite the fact that women over 45 are contantly being told there is absolutely no hope of getting pregnant, yet they are to continue their contraception... Now them must also keep their bodies healthy & take their folic acid, in case they get pregnant - until menopause? (Which, btw, is one year without an a period!)

Of course, women DO get accidently pregnant over 45 - in fact, they have the highest abortion rates next to teens. But it would be nice if the medical profession would be less confusing...

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Just like with the Missouri couple, people need to mind their own business and let people do what they feel is best for themselves. How are they expecting to tell women not to do or to do those things and actually have them listen? Could you imagine a 13 year old girl taking prenatal vitamins? That's insane! I think they should leave the care of our bodies to our own judgement.

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I was going to write something really biting about how they can't make recommendations like this without taking into account the state of health care and health insurance in this country.

But then I tracked down the actual report from the CDC at http://www.cdc.gov/mmwr/PDF/rr/rr5506.pdf . I haven't read the whole report (it is 30 pages long) but what I did read is MUCH more balanced and reasonable than the Washington Post report. It turns out they do talk about health care access at length. They also frame everything in terms of "these are risk factors doctors should evaluate" NOT everyone should take folic acid from 13 to 50.

The recommendations are "1) individual responsibility across the lifespan, 2) consumer awareness, 3) preventive visits 4) interventions for identified risks, 5) interconception care, 6) prepregnancy checkup, 7) health insurance coverage for women with low incomes, 8) public health programs and strategies, 9) research, and 10) monitoring improvements."

The first recommendation of Individual Responsibility Across the Lifespan is later defined as "Each woman, man, and couple should be encouraged to have a reproductive life plan." I can't really argue with that! Like all plans, I'm sure it is adaptable.

They also spend a lot of time discussing the fact that doctors are missing an opportunity to advice women who might conceive, since more than 80% of women have had *some* interaction with a doctor in the year before they conceive. So they intend these recommendations to remind doctors to discuss these issues before a woman conceives.

I think the interesting issue is: why is the reporting on this so far from the content of the report? Why do they focus so much on the alcohol/folic acid/smoking when issues like depression are mentioned in the same sentence in the report? Why was the health insurance issue close to the bottom of the article when it is close to the top of the report?

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Just because a government entity says something "should" be done, doesn't mean they are legislating that every woman *must* do it. They are just recommending this, and we are free to ignore it if we want.

Personally, I think it is a good idea to make health recommendations so that people get to know what it means to lead a healthy lifestyle. I agree that this is not realistic for many people who (1) lack health insurance (2) lack access to good nutrition and (3) do not have time to become educated on health issues because they are living paycheck to paycheck with 3 jobs. I wish there were a simple solution to this.

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Once this starts, there is no end to it. Once again, the government is sticking its long, blue, nose into every aspect of our lives; this time almost from the cradle to the grave.

Except for a cursory nod to health insurance, the report does nothing to address the problems of poverty, the soaring cost of medical care and the lack of it for the poor, the lack of sex education and affordable, readily available birth control.

Unless I missed something, it's strangely silent on men. Guys, get rid of your jockey shorts forthwith. Only boxers will do.

All in all, it comes across as one more attempt to portray women as nothing more than breeders. Enough already.

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It's nice as a reminder for women who considering getting pregnant. There are quite a few doctors who do this already. It's very irritating if you're still in your 20s and have decided you're done having children or that you're childfree. You get told you'll change your mind, so go ahead and treat your body like you're going to get pregnant.

It's also frustrating, because when you try to get a tubal/ablation combo to prevent unwanted pregnancies, you're denied because everyone knows women aren't capable of making a decision without changing their mind. Well, unless you're 35 and have 3 kids, that is.

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I wonder about the actual mortality statistics. They were referenced but not stated in this report. One has to ask the question, is making the birthing mothers accountable for infant mortality the right approach? Is the CDC also analyzing our medical birthing system and comparing it with countries with lower mortality rates? I appreciate that these suggestions have the well being of unborn children in mind but really, is this the right place to concentrate efforts?

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I find the whole thing offensive. I really hope that the report by the CDC isn't as bad as the Washington Post makes it out to be. Women are more than just the potential to produce children. What's next? No woman between menarche and menopause can legally drink alcohol - just in case they might be pregnant?

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Trisha, the WaPo article, according to a couple of reports I've read, was somewhat alarmist. If you're interested, click on my name, I'll send you the link.

It doesn't change my opinion because I saw the summary of the report before I looked at the Post.

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Wow. Some of you people really need to lighten up!! This is merely a recommendation - not an official mandate that can and will be enforced! Sheesh!

Anyway, I've thought about this very same recommendation myself. My pregnancy was unplanned and though luckily, my daughter is healthy, I often thought about what if the things I did or didn't do to my body would have affected her well-being?

I am not opposed to alcohol, but I sometimes think of one of my good friends who's Muslim and doesn't consume alcoholic beverages and how she'd never be at risk for dealing with fetal-alcohol syndrome.

I've also thought about how overall, I'm generally not one who eats healthfully and I know there are many areas of nutrition that I need to improve. What if the fact that I didn't take folic acid supplements prior to getting pregnant caused some deformations or poor neurological development in my child?

Anyhow, regardless of the intent of becoming pregnant or not, maybe it's not a bad idea in general to promote a more healthy lifestyle for women. Nothing wrong with telling women - let's take care of ourselves!

Of course, in the end, it's your choice whether you heed the advice or not! Take it easy, people!

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Sheena got the point: it's advice about what to do, not a legally binding directive. It is an opportunity to enable women.

Like it or not, the mother and no one else is responsible for FAS, unless someone is injecting alcohol into her blood stream.

And spina bifida is prevented by folic acid in a woman's bloodstream. It might do husbands some good to take it, but it won't help their babies.

Having health insurance and access to medical care certainly would be helpful, but it is not sufficient - witness Gyneth Paltrow and her pint of Guiness.

Let's see, what's more offensive: advising every woman who could have a child, planned or not, how to reduce the risks of complications in a child, or telling no one except those women who ask because they're planning on having a child and want to know what they can do?

Before you answer, find someone who didn't know the risks and is now living with a child with unnecessary challenges. Ask them if they'd be offended.

Oh, and by the way, if you think it's offensive because you're not planning on having a child, better get to work ripping out the seat belts, deactivating the air bag, and repealing the seat belt laws, because surely you don't start out on a drive planning to have an accident. Tear up the insurance policies, because you're certainly not planning on hospitalizations or death. Better to live an ideologically consistent life, however short or ill-prepared, than to accept advice you didn't ask for.

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