Tuesday, February 3, 2015

"Nine months of inconvenience."

In the abortion debate, sometimes people describe pregnancy as “nine months of inconvenience” or a “temporary donation of the uterus” or other similar terms. Usually they use these descriptions because they are trying to show that, relative to abortion, unwanted pregnancy is not a very severe situation to endure.

I do agree that abortion (in which a human life is taken) is much more severe than a healthy pregnancy (in which a woman’s body is drastically affected). Even so, I don’t like it when people use descriptions like “temporary donation of the uterus” because such descriptions belittle pregnancy, underplaying how physically and emotionally difficult the process can be. Just because abortion is worse doesn't mean pregnancy isn't a big deal. The process can be difficult even for planned, healthy pregnancies, much less unplanned or medically complicated ones.

Below I describe how even healthy pregnancies affect basically every major body system. I’m only describing issues common in healthy pregnancies; I’m leaving out the more severe but less common pregnancy risks, such as gestational diabetes, pre-eclampsia, hyperemesis gravidarum, etc. Some pregnancies are much more dangerous and debilitating than others. We can talk about how the more severe situations compare to abortion, but my point in this blog post is to illustrate that even healthy pregnancies involve a good deal more than simply “donating the uterus.”

Integumentary System – The skin stretches to accommodate the growing fetus. Many women experience acne, darkened blotches of skin on the face (“melasma”), and itchy skin, especially around the abdomen. Many women lose chunks of their hair or start growing more hair in unusual places (face, arms, legs, or back). Some women experience increased nail brittleness, breakage, and grooves. Many women end up sweating more as their core body temperature increases and their increased weight makes everyday activities more difficult. Postpartum, many women sweat extensively as their bodies try to get rid of the fluids built up during the pregnancy. Both the physical expansion of the uterus and the hormonal changes that affect skin elasticity can cause permanent stretch marks.

Skeletal System – The bones carry more and more weight as the pregnancy progresses. If the fetus does not get enough calcium during the pregnancy, she starts leeching calcium from the woman’s bones, increasing the woman’s risk of osteoporosis and related problems. The expanding uterus compresses the ribs, causing rib pain later in pregnancy.

Nervous System – There are many pregnancy issues that can affect the nerves. Women can get pregnancy-induced carpal tunnel syndrome as fluids build up and press on the nerves in the wrists leading to numb or sore fingers and thumbs, sometimes to the point where it’s difficult for a woman to use her hands. Many women get sciatica as the extra weight, fluids, and the baby herself press against the sciatic nerve, causing sharp shooting pains down the legs. Some women also experience nearsightedness and an increase in intraocular pressure.

Cardiovascular System – A woman’s blood supply can increase in volume by almost 50% as she provides nutrients to the fetus. The increase in blood increases stress on her heart. By the 2nd trimester, the woman’s resting heart rate is 30% higher than her non-pregnant rate. Pregnancy hormones can decrease blood vessel tone, making it more difficult to get blood to the brain and central nervous system and increasing the chances of dizziness or perhaps even loss of consciousness. Women more than 24 weeks pregnant are advised against lying on their backs because of the pressure on the vena cava – the large blood vessel leading from the lower body to the heart. This increased pressure can make it difficult for blood to flow to and from the heart. The enlarged uterus can also interfere with blood returning to the heart, which makes swelling in the legs and feet (edema) common. Pregnant women also have an increased risk of swollen blood vessels in the rectal area (hemorrhoids), which can be itchy and painful. The increased blood supply can also put more pressure on the more delicate vessels in the woman’s nose, causing nosebleeds.

Endocrine System – Pregnant women experience major increases in progesterone and especially estrogen. The estrogen increase may be why women experience nausea and vomiting in the first trimester (or, in some cases, for the duration of the pregnancy). Increased estrogen also makes it easier for higher levels of yeast to grow, increasing the woman’s chances of a yeast infection. Estrogen levels may also be the cause of restless leg syndrome, an “itching,” “burning,” or “creepy-crawly” feeling that gives pregnant women an overwhelming urge to move their legs, making sleep difficult. The progesterone increase causes a loosening of ligaments or joints throughout the body. Hormonal changes are also thought to be responsible for the “baby blues,” a collection of symptoms involving irritability, anxiety, and sadness (but not full-blown postpartum depression) that the majority of women experience in the first few weeks after giving birth.

Muscular System – Many women feel stitch-like pains along their abdomens as the uterus expands. Meanwhile, the increase in progesterone causes a loosening of ligaments throughout the body, which can decrease women’s grasping reflexes and general coordination. The loose ligaments and the woman’s rapidly changing center-of-gravity are two reasons doctors believe pregnant women are at an increased risk of tripping or falling and recommend women avoid standing on stools or ladders or the like. Many women experience intense leg cramps, especially at night, as the pregnancy progresses. In the later parts of the pregnancy the lower abdominal muscles can feel pulled from the extra weight. Postpartum the abdomen is usually sore and tender as the woman’s body starts to take back its shape.

Respiratory System - Many women struggle to catch their breath as the fetus pushes up against the diaphragm, leaving less room for the lungs to expand. Additionally, the higher levels of progesterone signal the brain to lower the levels of carbon dioxide in the blood; pregnant women breathe slightly faster to exhale more carbon dioxide. And because the heart is pumping more blood, the lining of the airways receives more blood and swells a bit, which can lead to stuffy noses and possibly blocked Eustachian tubes (tubes connecting ear and nose).

Excretory System – As the fetus grows, the uterus takes up more and more space, leaving less room for other major organs such as the bladder. The bladder’s compression, along with the body’s general increase in blood supply and other fluids, causes women to need to urinate more and more frequently. If a woman tries not to use the bathroom so often, she has an increased risk of urinary tract infections. Many women also experience incontinence during pregnancy.

Reproductive System – The woman’s uterus expands extensively (obviously). Labor may cause tears in the woman’s cervix or vagina, and postpartum she experiences a lot of bleeding and cramping as her uterus contracts back to its non-pregnant state. The woman’s breasts are often tender and sore, sometimes throbbing, as they increase in size to prepare for milk production. Near the end of the pregnancy and for awhile after giving birth, she may experience “leakage” of colostrum, a thick, yellowish precursor to the milk she will produce. She also needs to keep an eye on clogged milk ducts in case they don’t resolve themselves.

Digestive System – Most women endure nausea and vomiting in the first trimester, although for some women these problems last for the whole pregnancy. Hormonal changes increase gum swelling, tenderness, and bleeding. In some cases women produce excess saliva, so much so that they need to spit regularly (swallowing spit can increase nausea). Meanwhile, as the fetus grows, the uterus pushes against the diaphragm which pushes against the stomach, making acid reflux more common. Plus increases in progesterone cause muscles, including the esophagus, to relax, which can make it difficult to keep food flowing in the correct direction, leading to heartburn and acid reflux as well. The intestines also have more limited room than before, and the change in space and the increased relaxation can lead to slow and improper digestion, causing constipation.

I think we tend to be somewhat dismissive of the levels of frustration and discomfort women feel with months of these symptoms, because we know these symptoms are normal and are part of a very common bodily process meant to result in a newborn baby. But imagine instead if all the issues I describe here were symptoms of some sort of illness, rather than symptoms of pregnancy. How would you react to a person going through most (or all) of the above in that case? I doubt we’d glibly summarize such an illness as “nine months of inconvenience.”

Of course pregnancy isn’t an illness. It even has some long-term health benefits. But it still can be a very trying situation, even for women with planned, wanted pregnancies. Please keep that in mind as you talk about pregnancy in the context of the abortion debate--or in any context, really.

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