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Aug. 8, 2003
Is there anything about the
human body that medicine should not try to alter? When it
comes to women’s
bodies the answer apparently is no. Medicine is more than ready
to fool with Mother Nature.
A new study reports that there has been a 20 percent jump in
elective Caesarean sections. These are not C-sections chosen
by women when natural childbirth proves too difficult. Rather,
these are surgeries for women who are scheduling them simply
for the sake of convenience.
As one mother-to-be told one of the researchers, “Our
vacation is important to the entire family and I would rather
have the birth over with than ruin that for everybody.”
Elective C-sections are not the only recent example of medicine
being used to undermine the natural. The Food and Drug Administration
is expected to rule in the next few weeks on whether to allow
a new pill to be put on the market that will reduce the number
of menstrual cycles women experience. Instead of having their
periods once a month, women who take Seasonale would have only
four periods a year — one in the spring, summer, fall
and winter. Get it? Seasonale!
Doctors have long known that women who take birth control hormones
do not menstruate. The reason that birth control pills are
supposed to be taken for 21 days with a break for a period
is that the original manufacturers wanted to make birth control
pills seem more “natural.” They also knew that
having a period allows a woman who is trying to avoid pregnancy
know that she is not pregnant. But today birth control pills
already seem “natural.” And there are easy-to-use
While many women would like to be rid of the inconvenience
of periods, should it be part of medicine’s job to help
women time their births to fit a busy schedule or to get rid
of a messy and sometimes painful monthly experience?
Like it or not, the answer seems clear: Say goodbye to menstruation.
Most doctors would agree that C-sections are worse for moms
and babies than natural childbirth. But that concern has not
slowed the explosion of elective C-sections. And, despite the
fact that there are no long-term studies on the side effects
of suppressing menstruation, it is very likely that Seasonale
will soon be approved by the FDA.
Just as elective C-sections become the norm, the advent of
Seasonale illustrates how medicine is increasingly willing
to let the patient decide what is and is not appropriate when
it comes to taking health risks.
And it’s not just about patient’s choice. As long
as there is big money to be made doing elective surgeries,
the rate of elective C-sections is likely to continue to climb.
Similarly, you can bet there will be a big market for Seasonale.
There is a lot of money to be made selling it — and few
women are going to wax nostalgic about missing their period.
Medicine is poised to change the very nature of what is natural.
When money and convenience are allied with what medicine can
offer, Mother Nature does not stand a chance.
Arthur Caplan, Ph.D., is director of the Center
for Bioethics at the University of Pennsylvania in Philadelphia.
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Contraception