Is pregnancy is a disease?
There are some who argue that pregnancy should be classified as a disease.
Arguments for this proposal vary, but the most common ones seem to be analogies. Like many diseases, pregnancy causes varying degrees of multiple different symptoms: nausea, headache, back pain, stomach pain, swelling among others.
Likewise, pregnancy, as do most diseases, proceeds if not treated, and usually resolves itself after a typical time period but can be fatal similarly to pneumonia, for example.
There is also a specific pathogen that causes the "disease" - sperm.
Another line of argument in support of classifying pregnancy as a disease relies upon a certain definition of health, much debated in itself.
This definition construes health as an overall wellbeing of an individual, rather than the more common, and traditional definition of health, which sees it as "normally" functioning body. If we embrace the former, it turns out that all suffering has to be a disease - that is, abscence of overall wellbeing. Pregnancy causes suffering, and therefore it has to be a disease.
Despite the latter two and other lines of argument have been presented, the core of the proposal seems to be pragmatic.
It is a widely accepted fact that all kinds of symptoms in women have been historically, and even now, downplayed and dismissed as "normal" and just a part of life. Such is definitely the case with pregnancy also.
Classifying pregnancy as a disease would make it harder for professionals to dismiss the symptoms and suffering experienced by pregnant women. It would probably also enhance the research efforts to come up with better treatment for pregnancy related symptoms. Maybe we would even come up with a treatment for migraine during pregnancy!
I am to argue here that despite the merits of the aforementioned arguments, pregnancy should not be classified as a disease.
1. Whatever kinds of analogies may be used to argue for the similarity of pregnancy and diseases, there is a problem. There are other biological states that could be similarly equated - puberty, old age and sorrow, for example, all cause many different symptoms and suffering, which, albeit usually less sevear than those caused by pregnancy, do not differ from pregnancy symptoms in qualitative way. Therefore such analogy as a base for this argument can only be used if at the same time one accepts classifying old age as a disease as well.
2. Definition of health as a state of overall wellbeing is precisely what leads to patients feeling dissapointed and medical professionals being exhausted. If health means that one feels good, than all suffering should be examined and treated. We can only treat a small proportion of things that cause suffering to humans. This leads to patients inevitably feeling disappointed, and that their suffering - "disease" - is not taken seriously.
This definition also turns the field of medicine into an all encompassing study of human existence. Whatever the problem may be, medicine is responsible for trying to fix it.
Physicians, moreover, are then transformed into technicians. The job of the physicians is to operate the enourmous machinery of medical knowledge and technology to produce whatever kind of value to each patient, regardless of whether the problem has anything to with biology or even psychology. That is exhausting. Health should thus be connected to some form of baseline normalcy regarding human biology. Critics argue that we are well passed teleological explanations, so such "normalcy" is impossible to define. That is a topic of another discussion. I am not making definite positive claims about health here - just refuting the one proposed by the proponents of the original argument.
3. However well-intentioned, pragmatism is ill-suited as a base for this argument.
The argument is of the form of: "historically downplayed, suffering causing X has to be classified as a disease, so that downplaying of X stops, and treatment of X is enhanced". Note that adding the term "biological" or "physiological" in front of "suffering" would evoke difficult questions of "normalcy" and essential characteristics of the human body - questions which are hard to answer for the proponents of the original argument for the aforementioned reasons.
Well and good, then, but insert "poverty" in the place of X, and ask yourself: are you willing to call poor people sick just because they are poor?
Arguments for this proposal vary, but the most common ones seem to be analogies. Like many diseases, pregnancy causes varying degrees of multiple different symptoms: nausea, headache, back pain, stomach pain, swelling among others.
Likewise, pregnancy, as do most diseases, proceeds if not treated, and usually resolves itself after a typical time period but can be fatal similarly to pneumonia, for example.
There is also a specific pathogen that causes the "disease" - sperm.
Another line of argument in support of classifying pregnancy as a disease relies upon a certain definition of health, much debated in itself.
This definition construes health as an overall wellbeing of an individual, rather than the more common, and traditional definition of health, which sees it as "normally" functioning body. If we embrace the former, it turns out that all suffering has to be a disease - that is, abscence of overall wellbeing. Pregnancy causes suffering, and therefore it has to be a disease.
Despite the latter two and other lines of argument have been presented, the core of the proposal seems to be pragmatic.
It is a widely accepted fact that all kinds of symptoms in women have been historically, and even now, downplayed and dismissed as "normal" and just a part of life. Such is definitely the case with pregnancy also.
Classifying pregnancy as a disease would make it harder for professionals to dismiss the symptoms and suffering experienced by pregnant women. It would probably also enhance the research efforts to come up with better treatment for pregnancy related symptoms. Maybe we would even come up with a treatment for migraine during pregnancy!
I am to argue here that despite the merits of the aforementioned arguments, pregnancy should not be classified as a disease.
1. Whatever kinds of analogies may be used to argue for the similarity of pregnancy and diseases, there is a problem. There are other biological states that could be similarly equated - puberty, old age and sorrow, for example, all cause many different symptoms and suffering, which, albeit usually less sevear than those caused by pregnancy, do not differ from pregnancy symptoms in qualitative way. Therefore such analogy as a base for this argument can only be used if at the same time one accepts classifying old age as a disease as well.
2. Definition of health as a state of overall wellbeing is precisely what leads to patients feeling dissapointed and medical professionals being exhausted. If health means that one feels good, than all suffering should be examined and treated. We can only treat a small proportion of things that cause suffering to humans. This leads to patients inevitably feeling disappointed, and that their suffering - "disease" - is not taken seriously.
This definition also turns the field of medicine into an all encompassing study of human existence. Whatever the problem may be, medicine is responsible for trying to fix it.
Physicians, moreover, are then transformed into technicians. The job of the physicians is to operate the enourmous machinery of medical knowledge and technology to produce whatever kind of value to each patient, regardless of whether the problem has anything to with biology or even psychology. That is exhausting. Health should thus be connected to some form of baseline normalcy regarding human biology. Critics argue that we are well passed teleological explanations, so such "normalcy" is impossible to define. That is a topic of another discussion. I am not making definite positive claims about health here - just refuting the one proposed by the proponents of the original argument.
3. However well-intentioned, pragmatism is ill-suited as a base for this argument.
The argument is of the form of: "historically downplayed, suffering causing X has to be classified as a disease, so that downplaying of X stops, and treatment of X is enhanced". Note that adding the term "biological" or "physiological" in front of "suffering" would evoke difficult questions of "normalcy" and essential characteristics of the human body - questions which are hard to answer for the proponents of the original argument for the aforementioned reasons.
Well and good, then, but insert "poverty" in the place of X, and ask yourself: are you willing to call poor people sick just because they are poor?
Comments (35)
There are some who argue that the moon is made of blue cheese. Just say "NO".
https://en.wikipedia.org/wiki/Turtles_all_the_way_down
But this does suggest a somewhat interesting question:
How are medical conditions classified?
How are 'illness', 'disease', 'malady', 'affliction' and 'disorder' different? How are the words used in medical science? Generally, anything that presents with symptoms of pain, abnormal expulsion of biomass, elevated temperature, etc. is an illness or sickness. The word disease usually denotes an illness, usually contagious, caused by pathogens. Malady and affliction are usually applied to chronic, non-life-threatening conditions, such as allergy or migraine. A disorder may be a genetic or developed condition that presents as non-lethal malfunction or disability.
Obviously, pregnancy is a naturally occurring condition which can be healthy and normal or abnormal and unhealthy. In the first case, it requires no medical intervention to run its course and have a successful result. We humans intervene anyway, because our evolutionary path has complicated the human reproductive functions with this bipedal innovation; pregnancy and birth are more difficult than they were for our ancestors. In that sense dis ease could apply.
Smajdor A & Räsänen J. 2024. Is pregnancy a disease? A normative approach. Journal of Medical Ethics. https://doi.org/10.1136/jme-2023-109651
Here!
Hi, here is a reference for you! An article concerning this was recently posted on a Finnish journal for physicians. Thats how i heard of the debate.
Smajdor A & Räsänen J. 2024. Is pregnancy a disease? A normative approach. Journal of Medical Ethics. https://doi.org/10.1136/jme-2023-109651
Wow, very interesting, thanks! Will definitely have a look.
Thanks.
Those who want to construe things like abortion and contraception as forms of traditional healthcare are eventually forced to claim that pregnancy is a disease.
Not true. Ideally, medicine is about keeping people from getting sick and helping them to be healthier. The fact that I'm overweight and out of shape is not a disease, but it could lead to one.
I'm not sure what you mean. Are you suggesting that pregnant women shouldn't go to Ob/Gyns for care while they're pregnant or that the care shouldn't be covered by insurance? What about my annual physical? What about well-baby checkups?
For example, doctors would be able to prescribe birth control pills or morning after pills "for the prevention of disease", the same as they prescribe medication for [other] STD's.
Diseases are cured or prevented, not carried to term. You are here speaking about accepting pregnancy and carrying it to term, which is incompatible with the idea that pregnancy is a disease. Traditionally, care for pregnant women has been ordered towards the natural term of the pregnancy: birth. Those who wish to construe pregnancy as a disease are those who do not wish to carry pregnancy to term. We do not carry diseases to term.
And I think the some people who argue this should be classified as diseases.
I'll say it one more time, then I'm done. Medical care does not include only treatment or prevention of disease or damage. It also includes promotion of health. Pregnant women are not sick, but they still need care. I think it makes sense that that care is provided through the medical care system.
I'll give you the last word.
What makes sense to a normal person may not make cents to an insurance company.
No one is questioning the idea that traditional healthcare includes prenatal care. You are missing the point. I am explaining why some people are motivated to try to classify pregnancy as a disease. As noted in my first post to you, what are at stake are things like abortion and contraception, not prenatal care.
To take the proposition,
Quoting Hanover
I'm glad that there is some room to argue and try to make sense of the question.
The act of analogizing a pregnancy with a disease -- which actually, on paper, looks persuasive -- is similar to the act of analogizing going-through-puberty with mental illness. Both phases of life present a condition that could be called suffering within the afflicted person. (Let's not forget that a woman who is growing a baby in the womb would have to sacrifice a lot of her calcium deposits in her bones and teeth because that is the source of the baby's development).
But we would be horrified in believing that the body of a pregnant woman is undergoing an intense beating, the way we would be horrified at saying that the growing pubertal teen's mind is inhabited by a demon (unless of course they are mentally ill).
I'm just content that the human lexicon is intelligent. And by intelligent, I mean that there is no actual confusion in what we mean. What we have, instead, in moments like this OP, is the ability to entertain a foreign object that has managed to invade our organically grown knowledge.
I am glad that this part of the human lexicon is still intelligent at this point in history, and I am pleasantly surprised that the argument does not seem to have have purchase on TPF. At the same time, I do not want to take such intelligence for granted.
True.
This is actually a startling point.
Because, yes!, there comes a time when our intelligence undergoes a "mutation". Here I meander to some wider perception. We might have actually already lost the ability to perceive the curvature of the earth (without the aid of a device). Some philosopher said that the reason for this is our insistence on having flatness, wide space, and no height, depth, and tall columns.
I know, too much to unpack here and at the moment I cannot fully explain this idea.
All ACA (affordable care act) plans require prenatal coverage even when coverage is sought while pregnant.
You're fighting a battle that was won in 2014.
That's 40 million people, of whom how many are women of reproductive age? I don't know the particulars of employee health coverage, but it's probably worth closing any potential loopholes.
Quoting Hanover
The 'conservative' states are still fighting battles that were won in the 1960's. African Americans are still fighting battles that were supposedly won in the 1860's. Can't take our eyes off the ball for a minute!
I think this is the crux of the issue.
There's considerable ambiguity in the concept of functional impairment. 40 weeks of tiredness, nausea, coordination issues, disrupted appetite, interrupted sleep, rapid changes in temperature could count as one. I had those symptoms with COVID. If you end up defining a disease just by the presence of functional impairment relative to a person's baseline, you can probably conclude pregnancy is a disease on that basis.
It can join happiness, which perhaps should be a psychiatric disorder.
You can construe the (sometimes reported) presence of functional impairment as necessary but not sufficient for being diagnosed as diseased. If you universalise that you end up not being able to diagnose many mental health conditions or migraines (and some people will bite that bullet).
If you insist that functional impairment is necessary but not sufficient for counting as a disease, there needs to be something which stops pregnancy from being diagnosable as a disease. Presumably that's where, at base, "it just does, it's life, nerd" comes in.
I could imagine a society where an unplanned pregnancy of an unwanted (future) child is treated as a disease, whereas a planned pregnancy of a wanted (future) child is not treated as a disease. The former suggestion seems to cut through the idea that someone's well reasoned desire to be in a state of functional impairment stops any warrant for calling it a disease.
Perhaps also functional impairment itself is full of expectations of normality - maybe something which is sufficiently expected and "seen as commonplace and necessary for the average person" cannot be seen as a functional impairment. In that case, only above average severity period symptoms, despite how debilitating even relatively below average ones can be, could count as functional impairment. Even if you're weak and in constant pain for a week.
I do think that's the juicy bit. The norms inherent in diagnosing a disease, the norms inherent in counting as a disease, and the constitutive norms of functional impairment which facilitate both definition and diagnosis.
The fact of the matter is that there are a lot of very goofy people at large who ought to be apprehended and returned to school for the basic education they missed during the first round (assuming, of course, that goofy people aren't running the schools).
The National Lampoon used to call them "vagino-Americans."
I first read that in about 1974 and I still laugh every time I say, or write, it.
Aha, that actually made me laugh out loud for several minutes.
As I noted, that was written in about 1974. They probably wouldn't have been able to print it now. For that matter, very little of what was in the National Lampoon would be suitable for 2024.