References

Baron T Pregnancy, pain and pathology: a reply to Smajdor and Räsänen. J Med Ethics. 2024; https://doi.org/10.1136/jme-2024-109921

Gerber A, Hentzelt F, Lauterbach KW Can evidence-based medicine implicitly rely on current concepts of disease, or does it have to develop its own definition?. J Med Ethics. 2007; 33:394-399

Greer G Sex and destiny: the politics of human fertility.London: Picador; 1985

Kukla R Infertility, epistemic risk, and disease definitions. Synthese. 2019; 196:4409-4428 https://doi.org/10.1007/s11229-017-1405-0

Shermak J Obesity as disease: definition by desperation. Narrative Inq Bioeth. 2014; 4:(2)114-116 https://doi.org/10.1353/nib.2014.0049

Smajdor A, Räsänen J Is pregnancy a disease? A normative approach. J Med Ethics. 2024; 0:1-8 https://doi.org/10.1136/jme-2023-109651

Is pregnancy a disease?

02 October 2024
Volume 32 · Issue 10

Abstract

George F Winter explores the rationale behind treating pregnancy as a disease, and whether it is useful to do so

What is a disease? To what extent can ‘disease’ be defined, given views in relation to terms like ‘illness’ and ‘sickness’? In considering disease in the context of evidence-based medicine (where emerging scientific data are under continuous re-evaluation and revision), Gerber et al (2007) noted evidence-based medicine itself ‘is not able to form a single universal, or rather, general definition of disease’.

Taking obesity as an example, Shermak (2014) suggested that calling obesity a disease fuels prejudice of those critical of people who are obese. Shermak (2014) also detected ‘an assumption that by designating obesity as a disease, many folks with weight issues will fall back on this as an excuse … [yet] for those like me, who do fight obesity and continue to fight obesity, declaring it a disease does not make the battle any easier’.

Kukla (2019) highlighted groups who frame infertility as a problem that demands social and medical action, insisting that it is a legitimate disease, ‘but they cannot agree on which disease it is’. The World Health Organization offers eight definitions of fertility, with definitions of infertility including a failure to achieve pregnancy after 12 months or more of regular unprotected sexual intercourse, and the failure of a sexually active, non-contracepting couple to achieve pregnancy in 1 year. But both definitions imply that those with same-sex partners are infertile, ‘so the definitions either pathologize all homosexuals, or accidentally erase their existence altogether’ (Kukla, 2019). Kukla (2019) asserted that where the first definition describes an individual's reproductive system as having the ‘disease’ of infertility, ‘according to the second, it is a couple that has the disease’.

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