Monday, August 24, 2009

Pregnancy is not a Medical Condition

I just got done reading a post on my friend Jill's blog about the bizarre complexities of the insurance industry. In it she mentions that pregnancy is not considered a medical condition, but in her opinion, it should be. Well, Jill, wish granted: The Irish newspaper, The Independent, has an article by one Caitriona Palmer, a foreign journalist living in the US, who has been denied insurance coverage due to her "pre-existing condition" -- being 5 months pregnant. More on this later.

I would posit that pregnancy is not a "medical condition" -- a condition, perhaps, but there is nothing intrinsically medical about it. No more than my monthly period is a medical condition. Pregnancy is treated like a medical condition here in the US, but in much of the rest of the world women see a midwife throughout their pregnancy and give birth at home, with a midwife, not nurses or doctors, and only see a hospital or doctor in the event of the need for an actual medical intervention -- which, in much of the rest of the world, happens a lot less.

(Huh. I wonder if there's a connection?)

The follow-up comment to this bit of information is always, "In other countries mothers and babies die more often -- without all of our medical advancements, right?" Wrong. The US is 44th on the list of infant mortality -- worse off than Cuba and Czech Republic, to name two. And a woman in the US has a greater chance of dying while pregnant or giving birth than those in Malta, Sweden, Switzerland, the former Yugoslav Republic of Macedonia, etc. etc. etc. We are 43rd on that list. Just even with Belarus. Something tells me we are not doing this right. No offense to Belarus -- I'm sure it's lovely there.

I believe that the maternal and infant mortality rates are higher in the US because we treat mothers and fetuses as though something is wrong with them that must be fixed. For an overwhelming number of pregnancies, this is simply not the case.

My personal case-and-point: I reluctantly went to the hospital to give birth to Tilia (due to the actual medical condition of hypertension) and was told repeatedly through 36 hours of unmedicated labor that we should do a c-section because the goal was to "get the baby out." It wasn't until I read this article, and the timely partnering with Jill's thoughts, that I realized how the doctor's attempts to medicalize my labor were meant to make me a patient instead of a mother going through a natural, biological event. One they have control over and one they don't. I wonder which they prefer?

To get back to the article by Palmer, I will say this: To be denied health care because you are pregnant is one more example of the backwards way that pregnancy and childbirth are viewed in the US. It's also another example of how the industry of insurance has become "The Decider" now: Who will go bankrupt due to an illness? Who lives, who dies, who get care, who gets worse? They get to tell us and we have no choice but to listen and, like Palmer, make our medical decisions with the threat of financial ruin hanging over our heads. This is the first thing we need to worry about fixing -- then we can work on solving that medical condition all the pregnant women have.

9 comments:

Amie Newman said...

Rock on, Alex. I agree 100% and thank you for writing this...when I can, I'm going to link to this on my blog. Just insanity, pure and simple. The fact is, in countries with poor health outcomes for mother and baby, the goal is to train more midwives as the typical birth attendant and to ensure access to hospitals and other health care providers for those women who require critical, immediate medical care - not for those women who are experiencing a healthy pregnancy and birth. The United States maternal and newborn mortality rates, with our "excellent medical care" should be shameful and humiliating and instead we seek to medicalize pregnancy and birth even more?! Thanks again for being so amazing and for such an incredible post!!

Logos Mori said...

Thanks for commenting, Amie! It's infuriating and sad where we are as a country. xxoo
-A.

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Anonymous said...

The countries at the top of the list for infant mortality, as you linked, are absolutely those countries that have no access to medical advancements and proper care: Afghanistan, Mali, Somalia, Burkina Faso, Niger, etc.

I don't know what happened in the last four years, but the US is now #174. So... yeah.

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