July 31, 2012 | Posted By Lisa Campo-Engelstein, PhD

The Huffington Post recently published a blog by bioethicist and philosopher Rory E. Kraft, Jr. titled “Pregnancy as Harm?” As a friend and former colleague of Dr. Kraft, he and I have had numerous conversations about pregnancy as harm and we have presented on a conference panel together on this very topic. However, it seems—based in part on my students’ reactions and discussions I’ve had with people who don’t work in the field of reproduction—that most people find the idea of pregnancy as harm as counterintuitive or oxymoronic. 

Pregnancy is generally understood as a beautiful, special, and maybe even magical time in a woman’s life. And while it no doubt is for many women, it can simultaneously be harmful. For example, pregnancy can entail various nontrivial, though not life-threatening, discomforts, such as weight gain, back pain, edema, and morning sickness. Furthermore, pregnancy can lead to life threatening conditions, such as gestational diabetes and hypertension, and in many parts of the developing world pregnancy related complications are the leading cause of death for women in their prime. In addition to being painful, giving birth can also cause harms, like hemorrhaging, internal tearing, placental abruption, and nerve damage to the pelvic structures. In addition to physical harms, pregnancy and childbirth also have the potential to lead to mental health problems. Since being pregnant changes women’s hormone levels, it can affect women’s emotional well-being and their overall psychological balance. 

Claiming that pregnancy is inherently physically (and perhaps mentally) damaging is controversial. It is this sort of thinking that is often behind the treatment of pregnancy as a disease or disability—classifications which are both problematic. Yet, minimizing or ignoring any aspects of pregnancy that could be considered negative in favor of a romanticized view of it is equally problematic. As Dr. Kraft eloquently points out in his piece, as a society we respond differently to non-reproductive bodily harms like a fracture than we do to pregnancy related harms. We even respond differently to the same harm—including whether we label it a harm—depending on whether it is caused by pregnancy or not. 

In our pronatalist culture, the dominant cultural view of pregnancy is that it is a positive event, and so many, including pregnant women themselves, rarely classify the manifestations of pregnancy as harm. Yet, failing to acknowledge that pregnancy can entail harm, as well as wonder, is an important first step in helping to meet the medical and pyscho-social needs of pregnant women. Indeed, Dr. Kraft asserts, “As we focus more on the various aspects of life that are changed by pregnancy, we should come to an understanding of the vulnerabilities of the woman and act on a social responsibility to address these vulnerabilities exposed by the harm of pregnancy.”

The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our website.
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BIOETHICS TODAY is the blog of the Alden March Bioethics Institute, presenting topical and timely commentary on issues, trends, and breaking news in the broad arena of bioethics. BIOETHICS TODAY presents interviews, opinion pieces, and ongoing articles on health care policy, end-of-life decision making, emerging issues in genetics and genomics, procreative liberty and reproductive health, ethics in clinical trials, medicine and the media, distributive justice and health care delivery in developing nations, and the intersection of environmental conservation and bioethics.