We Are More Than Our Future Children

From testing for the onset of menopause to drinking while pregnant, the focus--at least in the media--is on those aspects of research that affect women's fertility, more than women's health and more than similar effects on men's fertility.

It’s a sign of how pervasive “woman as incubator” thinking is that even in the world of medical science coverage—where reporters have to deal with doctors and researchers have to think of human beings in complicated, interconnected ways—you will see a tendency to reduce women to their ability to reproduce.  And sadly, all too often, you see doctors and researchers making the same kind of mistake. 

Case in point: the possibility of a new blood test that can accurately predict when a woman will hit menopause.  It appears that research on the test, developed by Iranian researchers, is still in the preliminary stage, but if it is proven to work, this discovery could be of great benefit to women and their doctors everywhere.  Setting aside debates about hormone replacement therapy and whether or not menopause’s natural state should dictate our understanding of it, it’s still an often miserable time for many women, and it’s made more complicated and miserable by not knowing when it starts and when it will end.  Think of all the various ways this could help gynecologists determine treatment for women with the painful or irregular periods that often mark the period before and during your transition.  Knowing when the end is coming could influence choices on things like whether to relieve symptoms with hormones or take more drastic surgical measures.  I imagine that the treatment of uterine fibroids could be influenced dramatically by knowing how much longer a woman will continue to build menstrual tissue every cycle.  Plus, knowing when the onset of menopause will begin may simply reduce the amount of testing that a doctor has to do to determine if you’re beginning to show symptoms of menopause that could also be symptoms of something else.  As an added bonus, I imagine many women would like to know exactly when they can stop using contraception.

These are the concerns of the majority of women with concerns about menopause.  A smaller group of women have additional concerns about declining fertility, and this test can help them best decide how long they can put off child-bearing before it’s likely too late.  This is an extremely important, life-altering concern.  However, it’s not really a concern for most women, who deliberately stop reproducing long before nature takes care of it for them.  (Indeed, concerns about infertility don’t even rate a mention on the Mayo Clinic’s webpage about menopause.) Since pretty much all women have a lot of concerns about menopause, why is that the coverage of this potential test focused solely on fertility issues, instead of simply including concerns about fertility along with others of importance to women?

Reading the story from the Associated Press makes me even more skeptical, because there’s nothing in the story to indicate that the researchers were interested solely in telling women how long they had to have babies.  The fertility-centric quotes were strictly from British fertility experts and obstetricians, who may not be in a position to offer insights that focus on the whole woman’s overall health, which includes but isn’t limited to her ability to make more babies. I have a funny feeling the reporter didn’t even stop to think about the bigger picture here, because we’re so used to thinking of women’s sexual health in such reproduction-centric terms.

Better, but still worrying, is the coverage of this study showing that sons of women who consumed 4 to 5 alcoholic beverages a week while pregnant have a 32 percent lower sperm count than the sons of the control group of mothers who didn’t drink alcohol.  Taken on its own, it’s a useful study and a useful report, and it’s nice for once to have the focus on men’s baby-making capabilities instead of women’s. And the possibility of adverse effects on a developing fetus at lower levels of alcohol consumption than you usually see with more serious problems, such as fetal alcohol syndrome, is useful information to have. If this was one study in a sea of generally responsible, non-sexist reporting, this study wouldn’t be a reason to worry.

My concern isn’t with this study or the reporting so much as the hyper-focus on pregnant women’s behavior and choices over all other influences on fetal health, particularly environmental ones pregnant women have no control over. Robin rounded up some of the coverage, and the Time wellness blog got close to seeing that it’s possible way more is going on here than a strict “alcohol lowers sperm count” causation chain. 

In other words, could it be, for example, that women who drink during pregnancy might be more likely to expose their sons to other potential hazards — or be exposed to such hazards themselves — that could impact testicle development or fertility?

What if higher alcohol consumption is linked, in Denmark where the study was conducted, with other factors?  Do the different groups of women have different stress levels, different environments, diverse levels of access to medical care, different nutritional levels?  Why someone chooses to drink more than someone else, especially when we’re talking about the difference between 2 and 5 drinks a week, can depend on many different factors. 

When it comes to male fertility, this question isn’t an idle one or an attempt to get people to avoid inquiring into what pregnant mothers can do to improve the health of their future children.  It’s well-known that our environment is awash in pollutants, mostly pesticides, that quite possibly alter sex hormone levels.  Which, in turn, could be influencing male fertility.  If we spend all our time interrogating women’s habits, and no time looking into these environmental factors, we run the high risk of wasting time and energy guilt-tripping women for no real reason. And still facing an epidemic of male infertility. 

Above all, when crafting medical coverage and public health policy, we must avoid hysterical models that imagine wombs as entities separate from women, or imagine women as somehow pitted against their fetuses.  Interesting studies pop up here and there, but one thing we do know for sure, and that’s when women do better, children do better.