Discussions of this bit of misongyny have surfaced on the web. What. utter. crap. Apparently all women who are menstruating (ie fertile) should consider themselves "prepregnant" and exercise great care and caution and engage in preconception self care. And sure, the concept is good: don't drink excessively, stop smoking, take folic acid, eat well, exercise regularly, but some fucktard at the CDC seems to have missed the picture issue here: NOT ALL WOMEN HAVE BABIES. Even if they can, even if they get pregnant and well, we're more than just Wombs with legs.
I see two kinds of ways to refute this notion of "prepregnant". The first is a more health-based argument. We can discuss the epidemiological evidence on women's behaviours and birth defects/illnesses and prevention as Bitch PhD does. These are good arguments. It is difficult to extract from population based data down to individual women. While your odds of having a "good" pregnancy (more on that in a minute) go up if you engage in the behaviours they recommend, they are not assured. You can do everything right and things can still go wrong. And do everything wrong and have a healthy baby. The CDC guidelines turn pregnancy into a risky state from a natural one, making it fraught with perils. Make you wonder how women managed to have babies before those in public health decided to step in with their pre-pregnant care or how women who are not reading these guidelines manage.
Which brings me to the other way to argue this, the moral, social stuff. Examining that crazy assumption that women are just incubators, that we have a responsibility to always care for our bodies, just in case we get pregnant. That our ability to reproduce means we have a moral obligation as citizens to engage in practices determined by the state to ensure a healthy populace. I don't tend to see the power as being repressive and dictatorial since we do not have to follow these guidelines, but reports like this one contribute to a long-standing notion that women are ultimately responsible for the outcomes of their pregnancies and that they live in some statistical bubble which only measures practices like smoking and prenatal vitamin doses which are under a woman's control.
This completely neglects a whole bunch of factors which likely determine the outcomes of pregnancy:
1. Pregnancy is often a trigger for intimate partner violence
2. Poverty. Can a woman afford the nutritious foods, vitamins, classes and in the US medical insurance. Does she live in adequate housing? Is there access to clean water? Poverty is probably the biggest determinant of a healthy pregnancy.
3. Addictions. They are not a personal moral failing but a complex social and psychological state. Stop smoking/drinking/using drugs is not going to help women with addictions pregnant or NOT.
4. Safe working conditions. Are women handling toxic chemicals, working long hours, in poor conditions?
5. The environment. But no one in public health likes to discuss that whole mess. Too messy epidemiologically because you can't run randomized trials. So it's neglected.
This new state of "prepregnancy" adds to the already growing trend toward blaming women for health concerns in their children and put them under the microscope for what they could/should have done. We see instances of this with women who are portrayed as Bad (smoke, consume drugs/alcohol while pregnant) and ideas that they should be incarcerated/treated because their fetus takes priority over the woman.
And it further marginalizes people with disabilities, since a non-perfect pregnancy (whatever the hell that means) is seen as a failing, again of women.
If you look at the report, you can see the CDC means well but they privilege personal individualized solutions over social change which would benefit the populace, avoid placing blame on women (because people will use this report to do that) and which treat women as more than baby vessels who treat health (as conceived by the CDC) as their main priority.