The Handmaid's Tale
I will try to inhale and exhale slowly and calmly so I may continue to type. If this post turns into this: jigf[o wjotpkwr klpeklq40892eramf jl;akpe2 o94, know that I stopped typing and just started repeatedly banging my head against the keyboard.
Very selfish reason #1: As a doctoral student in the field of health education/public health, I thought that eventually, once I became Dr. Teacher Lady, I would work for a while at the CDC in some capacity. My advisors are well connected; a few of my professors have worked there. It's sort of a rite of passage - before you go off in the world to torment your very own doctoral students. Now? Not so much. I am so much more than my uterus, thank you very much.
Reason #2: This is the most backasswards recommendation I have seen in a long, long time. Here's why: So, the CDC's recommendations are for all physicians treating menstruating women to address them as "pre-pregnant." Don't clean out the litterbox (which has led some women to embrace these new treatment guidelines and all I can say is, "Hello!? Emph-ASS-is on the wrong Sy-LAB-bull.") Take your folic acid supplements. Quit smoking. (It's really bad for a fetus, you know?) Manage your chronic illnesses (aka Diabetes). Don't drink.
Now, why on earth are all women with an ovum popping out to say hello every month to be treated as "pre-pregnant?" Because the United States of America is the leader of the free world, all right. We lead the free world in unplanned pregnancies and teen pregnancies (compared to all other "developed" nations.) And, even more alarmingly, while the rates of unplanned pregnancies have decreased 20% among women living two times above the federal poverty line, rates of unplanned pregnancies have increased 29% among women living below the federal poverty line. As a friend of my mother's says, "The rich get richer and the poor get kids."
So, instead of doing things that would reduce the rates of unplanned pregnancy in the U.S., like mandating comprehensive sex education in all public schools (aside - We, the U.S. have five times (that's right - five times!) the teen pregnancy rate of countries like Finland, where comprehensive sex ed is part of the curriculum starting in kindergarten. We have three times the teen pregnancy rate of countries like France, where comprehensive sex ed is part of the curriculum starting in eighth grade. Also? Studies show that rates of sexual activity among teens in developed countries are about the same - 47-49% of high school seniors are engaging in sex - (G'head! Make yourself a little table. Play around with the YRBS! It's fun in a nerdy sort of way) it's not like the U.S. leads the world in teens doin' the nasty. We just lead the world in denying that fact), requiring insurance companies to cover birth control (especially if they cover Viagra!), and making emergency contraception available over the counter, we do this! Ladies: You are officially "pre-pregnant."
Am I the only one who sees the lunacy of this argument? "We're helpless to lower the rate of unplanned pregnancies in the U.S., so instead we'll just treat all women like they're potentially pregnant." I plan to write my dissertation on teen pregnancy and emergency contraception. Let's just say I've done a little research on the subject. I won't post the bibliography for my literature review here, but if you're interested, I'm happy to e-mail it to you. But I digress.
The point is, I feel like the CDC is acting like the proverbial dumb blonde of bad joke fame, faced with a technical task of any sort. "Oh. My. God. Like, um, what? I totally don't get it. Um, help?" We know there are strategies that work to lower the rates of unplanned pregnancies among teens and all women. And this is the best we can come up with? I'm sorry, what year is it? And what country is this again?
And also: We know that lung cancer is the number one of all cancer killers among women. Lung cancer kills more women than breast cancer. More women than cervical cancer, uterine cancer, ovarian cancer, and on and on and on. And lemme tell ya - if you've ever seen someone die of lung cancer (which, sadly, I have), you know that it's enough to make you think Jack Kavorkian was on to something. Anyway. Let's pretend I smoke. (I do not.) I would hope that my physician would encourage, cajole, and push me to quit smoking for me. And not because my physician is worried about how my smoking might affect the fetus that does not yet exist. (Or in my case, will likely never exist.) Let's worry about the people who are already here, eh?
The CDC's recent pronouncement inspired me to finally read The Handmaid's Tale. (Ironically, I saw it sitting in an empty cubicle in the advising center on Thursday. I finished it late Friday night. It's a very quick read.) If you haven't read it yet, please do so. It's terrifying on so many levels, which is also part of its genius. Margaret Atwood wrote it in 1985 and personally? I think that woman is either psychic or hiding a crystal ball somewhere, because damn. She saw the future and she was afraid. Rightly so.