Pregnant people’s preferences are often not respected during childbirth, which is a primary cause of birth trauma. In their recent article Is pregnancy a disease? A normative approach, Smajdor and Räsänen claim that classifying pregnancy as a disease would improve the respect given to pregnant people’s preferences.
Focusing on normative arguments rather than conceptual, I critique Smajdor and Räsänen’s claim in two ways.
Firstly, I argue that Smajdor and Räsänen put too much emphasis on pregnancy’s lack of disease-status to explain why pregnant people’s preferences are not respected – misogyny, the dual-patient model, medicalisation, issues regarding competency are some of the factors that also play a role.
Secondly, I argue that while, in practice (cf. in law) giving pregnancy disease-status could increase the respect given to those pregnant people who desire pain relief and other interventions, it may also encourage a more medicalised, expert-centred model and so will not help those who do not want intervention.
If we are concerned about pregnant people having their preferences respected, then this must apply equally to both those who prefer interventions and those who do not. Thus, I conclude that there seems to be insufficient normative reason to classify pregnancy as a disease.
Smajdor A, Räsänen J. Is pregnancy a disease? A normative approach. J Med Ethics. Published online 2023:jme-2023-109651. doi:10.1136/jme-2023-109651