Pregnancy can be a challenging experience, and it is an even more complicated issue for women of color who are more likely to experience maternal mortality. While the physical discomforts of pregnancy are well-known, the lack of research in obstetric medicine and the exclusion of pregnant women from clinical trials make it challenging for women to get access to safe medication during pregnancy. Furthermore, pregnant women with pre-existing health conditions or disabilities are left with little to no options for medical treatment. Cultural perceptions around motherhood and pain have contributed to the stigma against using pain relief during pregnancy and childbirth. Changing the way medical schools approach reproductive healthcare could be one way to address the issues surrounding pregnancy and childbirth. Finally, studies have shown that pregnancy increases the risk of developing infectious diseases, and a new study aims to understand how changes in immunity during pregnancy increase the risk of tuberculosis in pregnant and postpartum women.
Pregnancy: An Uncomfortable Experience Neglected by Medical Science
Pregnancy is a significant physiological change that brings many symptoms, such as back pain, increased urination frequency, trapped gas, morning sickness, and even mental health conditions. Despite the numerous anecdotal remedies and a list of things to avoid, pregnancy is still portrayed as an uncomfortable yet bearable experience. However, there is no cure for morning sickness, a common symptom, raising the question of why science has not paid attention to it.
Lack of Research on Pregnancy
Dr. Aaron Caughey, chair of the department of obstetrics and gynecology at Oregon Health Science University, expressed that there is not enough research on pregnancy. During the first trimester of pregnancy, embryogenesis occurs when pregnancy nausea is often the worst. Therefore, medication that could treat nausea in pregnancy requires many animal studies to show that the effect on embryogenesis was nonexistent. Although there are over 13,000 studies on the subject, JAMA reviewers found only 35 to be robust.
Exclusion of Pregnant Women from Clinical Trials
Clinical trials for medications that can alleviate pains do not include pregnant women, fearing potential harm to fetuses. However, a National Library of Medicine article showed that there is a greater danger in exclusion altogether. Some conditions require urgent intervention, like preeclampsia – a life-threatening pregnancy complication. Still, investors shy away from focusing on it, assuming that pregnancy is a time-limited experience and does not require significant investment.
Perception of Pregnancy in Culture
Research has excluded pregnant women from clinical trials, adding to cultural perceptions around pain and motherhood being natural allies. Many people consider pregnancy a “natural” part of a woman’s life, along with eventual marriage and motherhood. However, science has not paid enough attention to pregnancy. Diana Bianchi, director of the Eunice Kennedy Shriver National Institute of Child Health and Human Development, stressed that pregnancy is a stress test for a woman.
In conclusion, pregnancy is an uncomfortable experience that has been neglected by medical science. Despite the many symptoms that women face during pregnancy, there is a lack of research on the subject. Additionally, clinical trials for medication that could alleviate pain and symptoms do not include pregnant women, and investors shy away from focusing on urgent conditions. Cultural perceptions around pain and motherhood have added to this neglect. Thus, medical science needs to focus more on pregnancy to provide women with a comfortable and safe pregnancy experience.
Lack of Research and Approved Drugs for Pregnancy-Related Issues
Pregnancy is a nearly ubiquitous experience in most societies, yet science has remained largely mum about common medical problems during pregnancy, including full body pains and abdominal cramps. A lack of research activity and exclusion from clinical trials have resulted in little to no approved drugs for pregnancy-related issues. Within the past 40 years, only two new drugs have been approved for use during pregnancy. This “profound lack of research activity” and outdated information, combined with a fear of litigation, have halted progress. Peter Brocklehurst, co-author of the “Healthy Mum, Healthy Baby, Healthy Future” report, stresses the need to mobilize enthusiasm and investment towards pregnancy to develop effective medications. In most societies, going child-free is the exception rather than the norm, making the dearth of research on pregnancy discomfort even more magnified.
Cultural Factors at Play
The desire to feel the whole experience of childbirth and be connected to the primal experience of birth is an important driver for some women, according to Julie Jomeen, professor of midwifery at Hull University. However, the fact remains that a birth with pain relief and medical or surgical interventions is not an inferior outcome for the mother or child. This is more related to the sociological discourse of good mothering. In the 1960s and 70s, with the second wave of feminism, the natural birthing movement emerged. Feminists saw birth as a site for feminist empowerment and for liberating women’s bodies from the surveillance of male obstetricians.
In conclusion, the combination of a shortage of research and exclusion from clinical trials has ensured that little to no approved drugs exist for common medical problems during pregnancy. Additionally, cultural factors such as the natural birthing movement contribute to the dearth of research on pregnancy discomfort. The need for more enthusiasm and investment towards pregnancy to develop effective medications is necessary to provide women with safe and comfortable pregnancies.
Pregnancy Vulnerability and Pre-Existing Health Conditions
Pregnancy is a vulnerable time for infectious diseases, with pregnant women being more prone to developing serious COVID-19 infections. A new study at BJ Government Medical College aims to assess tuberculosis, HIV, and diabetes among pregnant women to understand how changes in immunity due to pregnancy and Gestational Diabetes Mellitus (GDM) increase the risk of TB in pregnant and postpartum women. Although studies like this seek to lessen the deficiencies in obstetric medicine, there is still a chasm, especially in regards to the pain women experience during pregnancy.
Pre-Existing Health Conditions
Pregnant people who deal with pre-existing health conditions and disabilities face additional challenges. For most drugs, clinical trials exclude pregnant women as a “vulnerable” category, making their impact on pregnancies unclear. Many have had to stop taking important medication, such as psychotropic drugs, during pregnancies. However, recent research shows that most psychotropic drugs are safe for use in pregnancy, for both mother and child.
In conclusion, pregnancy is a vulnerable time for infectious diseases, and studies seek to understand the risks associated with pregnancy and pre-existing health conditions. Pregnant women face additional challenges, as clinical trials exclude them as a vulnerable category, making their impact on pregnancies unclear. However, recent research shows that most psychotropic drugs are safe for use in pregnancy.
The Racial Implications of Pregnancy and Childbirth
Pregnancy and childbirth come with numerous physical discomforts, but women of color often have to deal with the additional burden of institutional racism. Research has shown that maternal mortality rates among women of color are significantly higher than those of their white counterparts. This is partly due to the undervaluation and underdiagnosis of their health conditions by doctors, which can lead to the symptoms of comorbid cardiovascular diseases being ignored or overlooked. Dr. Alicia D Bonaparte, co-editor of Birthing Justice: Black Women, Pregnancy, and Childbirth, cites institutional racism alongside classism, ageism, ableism, and heterosexism as contributors to these alarming statistics.
The Cultural Glorification of Female Pain
The societal glorification of maternal sacrifice has normalized the pain associated with pregnancy and childbirth. This is perpetuated by the cultural narrative that mothers must endure the pain of birth without painkillers. University of Oslo philosophy professor Anna Smajdor suggests that this attitude is due to the social and moral currency attached to enduring the pain of birth without painkillers. However, this mindset is highly inaccessible to a disproportionate number of women.
Conclusion
The physical discomforts and complications of pregnancy and childbirth are exacerbated by social and racial factors. The underdiagnosis and undervaluation of health conditions among women of color contribute to the high maternal mortality rates among this demographic. Moreover, the glorification of maternal sacrifice perpetuates the cultural narrative of women enduring the pain of childbirth without painkillers, which is highly inaccessible to many women. Addressing these issues requires a systemic change that recognizes the diversity of experiences and challenges that women face during pregnancy and childbirth.
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