Bringing Up Baby: Is Pregnancy A Disease?

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:

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:

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