An article in the Washington Post ("Forever Pregnant Guidelines: Treat Nearly All Women as Pre-Pregnant" by January W. Payne May 16, 2006; Page HE01) and a similar article in the Wall Street Journal have caused a stir by recommending that physicians encourage all women of child bearing years to consider themselves "pre-pregnant."
Among other things, this means all women between first menstrual period and menopause should take folic acid supplements, refrain from smoking, maintain a healthy weight and keep chronic conditions such as asthma and diabetes under control.
Generally, this seems to be good overall medical advice and, other than the folic acid part, would be applicable to men as well. Yet it has caused some concern in the blogosphere. I have a hard time getting too upset about it, in part because of this statistic:
The U.S. infant mortality rate is higher than those of most other industrialized nations -- it's three times that of Japan and 2.5 times those of Norway, Finland and Iceland, according to a report released last week by Save the Children, an advocacy group.
Better preconception and early pregnancy care could decrease the infant mortality rate. Susie over at the Suburban Guerilla has some stories about her experiences as a midwife and the lack of knowledge she encountered. I was at the other end of the spectrum. I had pre-conception checkups before each pregnancy, and a full quota of prenatal medical visits. At no point did anyone discuss nutrition with me, other than to ask if I understand what a good diet was. I said yes, and that answer was accepted without question. I learned more from reading the "What To Expect" book than I did from the docs.
The general state of health knowledge, especially where reproduction is concerned, is poor in this country. If you ever want to have some really wicked fun, talk to a group of high school or college women and casually mention that many standard antiobiotics will interfere with birth control pills and anyone who uses the pill for contraception should use an alternative method while taking antibiotics and for some weeks afterward (ask your doc for details). Every time I've done this at least 3/4 of the women will be so startled they nearly fall out of their chair.
Any kind of life planning that would include some basic health information could only be an improvement.