How is being pregnant like having measles? That sounds like a way to set up a punchline, but that’s the serious question two Finnish philosophers use to set up their argument that pregnancy should be viewed as a disease.
Their open-access article, published online in January 2024 by the Journal of Medical Ethics, makes the sort of claim that’s easy to dismiss as “ivory tower logic” disconnected from real life. However, arguments like this made in academic journals eventually affect the way ordinary people think and talk, as we’ve seen through the transformation of the sexual revolution from a university ideal into a destructive everyday reality. As Richard Weaver argues, “Ideas have consequences.”
Everyone is a hero in his own eyes. The authors justify their quest to define pregnancy as a disease because “pathologising pregnancy could, in fact, lead to better treatment for women.” Those treatments, of course, include a broader range of contraceptives and the promotion of elective abortion as the most effective “cure.” This is the sort of argument that may grow wings amid the deathworks of modernity, so it’s worth considering how they arrive at their conclusions and where their argument falls apart.
Redefine ‘Disease’
According to the authors, Anna Smajdor and Joona Räsänen, for a condition (they call it P) to be classified as a disease, it has to meet three criteria:
1. P is bad for the person who suffers from it.
2. The sufferer is unlucky to suffer from P.
3. P can be treated medically.
Criterion 1 is met, they argue, because some pregnancies end in death, because of the normal discomfort of a full-term pregnancy like “stretch marks and nausea,” and because of the acute pain associated with childbirth. These factors, they argue, mean pregnancy is bad for women even if they desire to be pregnant.
According to Smajdor and Räsänen, although “many people regard themselves as fortunate when they become pregnant,” they describe this as being “the lesser of two evils,” with the greater evil being childlessness. Thus, even in a “wanted pregnancy, the ‘sufferer’ is unlucky insofar as she is obliged to undergo the associate risks in order to achieve the good she seeks.” Therefore, they believe criterion 2 is met in all cases of pregnancy.
Arguments made in academic journals eventually affect the way ordinary people think and talk.
Criterion 3 seems to be a slam dunk, given the amount of time most women in the industrialized world spend visiting doctors’ offices even during healthy pregnancies. The authors don’t define “medical” in this context, which allows them to assume elective abortion, sterilization, and the application of artificial reproductive technologies are also simply “medical” in nature.
According to their three criteria, pregnancy meets the definition of a disease, which they feel should open up new options for “treatments” that increase funding for prevention and “cure” of the alleged disease.
Broken Logic
Christians will have several ready objections to this viewpoint, such as the psalmist’s declaration that “children are a heritage from the LORD, the fruit of the womb a reward” (Ps. 127:3). The goodness of having and bearing children is plain in Scripture.
However, the argument in the paper also falls apart under its own weight. It’s worth examining on its own terms. There are at least three problems that undermine the paper’s argument.
1. The three criteria for identifying a disease require rejecting dysfunction as a necessary characteristic.
Smajdor and Räsänen argue against disease as dysfunction because it’s “subjective” and they claim it relies on the naturalistic fallacy—an incorrect appeal to a moral “ought” based on an “is” observed in nature. “This leap from the descriptive to the normative,” they argue, “is highly problematic.” Their assertion is, however, an unforced error of reasoning.
No moral claim is made in the observation that pregnancy is a natural outcome of sexual intercourse between a male and a female with healthy, functioning reproductive systems. This is simply understanding “the birds and the bees.” To my knowledge, no one seriously argues based on observation of mammalian reproduction that a woman should get pregnant merely because she can physically do so. That would be like arguing that if the elevator stops at the fifth floor when I push the “5” button, I must go to the fifth floor when I’m in an elevator—or that I have to take the elevator at all.
The authors are incorrect when they argue that “the notion of proper functioning borrows from a teleological view of biological organisms, or alternatively, from the belief that there is indeed a designer.” Determining the proper functioning of an organism assumes regularity in the natural world, which doesn’t require religious reasoning or moral claims.
2. Everyone doesn’t have to be pregnant all the time for pregnancy to be normal.
Smajdor and Räsänen begin with the recognition that biological males cannot get pregnant. (A good start these days.) Additionally, prepubescent girls and postmenopausal women cannot get pregnant. And some women are infertile for various natural reasons. Finally, they argue, most of those females aged 15–49 who have healthy reproductive systems aren’t pregnant at a given point in time. Thus, “Based purely on numbers, pregnancy is abnormal, even within the narrowest target group we can define.” This is a shell game.
Let common sense prevail. The question isn’t whether the condition (pregnancy) is universal among a given population but rather whether a given condition (pregnancy) is likely to be caused by a given event (sexual intercourse) in a healthy woman of reproductive age. By sleight of hand, these philosophers confuse the audience in an attempt to obscure generations of observed reality. They’re essentially saying, “Who are you going to trust: me or your lying eyes?”
3. ‘Medical treatment’ has too broad a definition.
The paper’s authors don’t define or defend the term, but they seem to assume things that are “medical” are those done by people with white coats (or scrubs) who work in a hospital or a doctor’s office. This assumption is common in Western culture.
“Not until recently,” Oliver O’Donovan argues in Begotten or Made?, “has society ventured to think that medical technique ought to be used to overcome not only the necessities of disease but also the necessities of health (such as pregnancy).” Western medicine, he notes, until recently “differentiated sharply between interfering in a healthy body and curing a sick one.” Abortion has been normalized in society because it’s done in operating rooms by those in sterilized garb who, at one point, took oaths to help and not harm. However, the second patient in a pregnancy is ignored or dehumanized.
Words Matter
The dehumanization of preborn children is a feature and not a bug in arguments for elective abortion. Thus it’s no surprise when the paper’s authors state that “sperm could be seen as a pathogen in the same way that the measles virus is.” Or when they lament that “the gestating fetus . . . is regarded as being exquisitely vulnerable.” In Less than Human, David Livingstone Smith notes the power of such dehumanizing rhetoric:
Sometimes this sort of language is metaphorical—but it’s foolish to think of it as just metaphorical. Describing beings as rats or cockroaches [or diseases] is a symptom of something more powerful and more dangerous—something that’s vitally important for us to understand. It reflects how one thinks about them.
Reducing the existence of a preborn child to a disease makes the extermination of a child sound no different than taking antibiotics to cure strep throat. That attitude is already prevalent in society, with a case coming before the U.S. Supreme Court about the legality of restrictions on mail-order abortion drugs.
Abortion has been normalized in society because it’s done in operating rooms by those in sterilized garb who, at one point, took oaths to help and not harm.
Additionally, as Smajdor and Räsänen note, classifying pregnancy as a disease will encourage support for “human trials in ‘extracorporeal uteruses’—or artificial wombs,” which are currently in planning stages. This classification is another step toward Huxley’s Brave New World where being a mother is stigmatized. It treats babies as products to be manufactured via technology rather than as people to be begotten by permanently committed, complementary couples through natural relations. It’s a way of alienating humans from our humanity.
Words matter. As Jesus reminds us, we’ll give an account for “every careless word” we speak (Matt. 12:36). Christians mustn’t adopt language that treats pregnancy like a disease. And we should be ready to graciously explain to others why we resist that language. Pregnancy isn’t like measles, and any “victory” over the “disease” of pregnancy is simply another stage of our culture’s conquest over the goodness of humanity itself.
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