Written by Leigh Griffin. Published 2019.
Treating women of childbearing age in a manner that is consistent with prenatal care is a good idea in theory, at first glance. The most important aspect of prenatal care is maintaining a healthy lifestyle through proper diet, exercise and nutritional supplements--a goal that doctors should recommend for any patient. There’s also significant benefit to ongoing prenatal care in the case of an unplanned pregnancy to prevent birth defects and ensure that the fetus develops properly. According to the CDC, over half of all pregnancies in the United States are unplanned. This is a solid case for arguing that all fertile women should be treated as though they may conceive a child, as basic prenatal care is beneficial to the mother regardless of their pregnancy status in the future. However, the good intentions behind the CDC’s recommendation to treat all potentially-fertile women with prenatal care become murkier on an individual doctor-patient level. There is a fine line between considering pregnancy as a medical possibility when recommending a course of treatment and prioritizing a woman’s potential pregnancy over her health and well-being.
Despite the potential health benefits to mothers and children during unplanned pregnancies, the notion of treating all potentially fertile women as though they are “pre-pregnant” has some insidious implications about how healthcare professionals should view their patients. Doctors may neglect the patient’s health as an individual to focus on their potential to have a child in the future. Treating a patient as though they may become pregnant is also often insulting and unnecessary, especially if the patient is in an exclusive same-sex couple, not sexually active, or simply not interested in having children. Treating these women as pre-pregnant “just in case” they might become pregnant in the future prioritizes the health of a child who may or may not ever exist over the values and wishes of the actual patient.
The healthcare field has an unfortunately long history of valuing women’s fertility over their health. Many doctors have denied their patients permanent birth control (sterilization) because they believed that the women might change their minds in the future and decide to have children. Doctors have also denied women certain treatments and medications due to possible side effects of birth defects, even when the women are not pregnant or trying to become pregnant.
I asked Reddit users to share their stories being treated as pre-pregnant by medical professionals. Quotes from Reddit users describing how they were denied medication and treatment, forced to pay for unnecessary tests, and much worse are below.
Reddit user /u/violettepetrichor: “I became dizzy at work ... I’m epileptic. I was a virgin. I was on my period. The doctor wanted to run a pregnancy test. I told her that it was impossible for the reasons I listed so please don’t run it, I know my body, I know what happened. She didn’t believe me … I didn’t have insurance so guess who had to pay out of pocket for a stupid test I didn’t need?”
Reddit user /u/sassylildame: “I have cystic acne, PCOS and PMDD that has cost me jobs. Spironolactone would save my life. Unfortunately, one of my symptoms of PMDD is 12-hour menstrual migraines that get worse when I'm on birth control. Unfortunately, in every state, you can't be on spironolactone unless you're on birth control. Why? Because spironolactone can cause harm to a male fetus. I told my doctor that I practice safe sex, that I don't ever want kids and that if, god forbid, I became pregnant I would abort it immediately. I still can't get spironolactone.”
Reddit user /u/Verusak: “[I] was refused dental x-ray as there is no way to eliminate the possibility of me being pregnant at the moment as I am older than 10 and younger than 50.”
Reddit user /u/YouGotAte: “My gf had some issues changing medications for her ulcerative colitis because the new one would interfere with her fertility.She told her doc ‘that’s a bonus for me’ and that just made him more firm on his stance to refuse medication that would immensely improve her quality of life.”
Reddit user /u/SeeSaraRun86: “I had appendicitis a few years back, and they had to rule out pregnancy, ectopic pregnancy, etc. before finally determining it was indeed, appendicitis. I was even told if I was male they would have jumped right to that conclusion. Thank god for insurance, bc I got charged for all of those other tests. Oh, and of course, a pregnancy test before they could administer pain meds. And each time I was moved to a separate room, I had to either wait for the chart to come before I could get more pain meds, OR take another pee test (as I was on no foods or liquids to prep for surgery at this time). It was great. I was also charged for each of the pee tests.”
Reddit user /u/Frolic-A-holic: “I have an old injury from falling down some stairs which herniated a disk in my lower back. When I was 27 I coughed while standing and jerked my back just the wrong way and threw it out. I mean I crumpled to the floor kind of bad and could barely walk. I needed my bf to help me get dressed so I could go to the emergency clinic. They forced me to undergo a pregnancy test despite telling them that I coughed and threw my back out before proceeding to "other causes for such large amounts of pain." … It's like they couldn't believe anything else aside from being in labor could cause me to be in such misery. I don't have insurance so I was already in tears from the pain and expenses. Of course I had to pay for the unnecessary pregnancy test on top of everything else. The pregnancy test just made everything take longer before I could get painkillers to make me comfortable enough to proceed with actually trying to figure out what happened in my back. I had to sit in pain while they determined if I was pregnant or not. Which felt like an eternity. Thanks for making me suffer longer than needed for a baby that didn't exist.”
Despite the ostensibly well-intentioned CDC recommendation to treat all women as pre-pregnant, these testimonies from women whose medical care suffered as a result of this line of thinking is enough to make anyone question whether the benefits outweigh the consequences.