Week 4

An Illness of Nine Months’ Duration”: Pregnancy and Thalidomide Use in Canada and the United States
Barbara Clow
Based on the information I could find on the effects that thalidomide had in this article in Canada, I couldn’t believe the that doctors “…tended to prescribe tranquilizers on the grounds that many of the common ‘complaints’ of pregnancy could be attributed to psychological disturbance[s].” (49 Clow) while the encouragement and “Medical enthusiasm for sedatives and tranquilizers also led hundreds of American doctors to participate in clinical trials of thalidomide; some physicians even imported private supplies of the drug while it was still under review by the Food and Drug Administration.” (49 Clow). With this “push” or “medical enthusiasm” by pharmaceutical manufacturers “On 1 April 1961 Richardson-Merrell’s brand of thalidomide, Kevadon, went on sale in Canada…” (47 Clow) although clinical trials as early as 1956 spotted “dizziness and loss of balance among elderly patients treated with Contergan.” (48), but the big red flags didn’t go up until reports of undesirable side effects skyrocketed including: “…severe constipation, hangover, loss of memory, hypotension, petechial hemorrhages, trembling, incoordination, numb- ness, and even partial paralysis.” (48) but this was only the beginning. The occurrence of phocomelia being known to be onset by thalidomide wouldn’t be noted until 1961, which is when countries would begin to withdraw and recall the product from circulation, yet was not recalled in Canada until 1962 (48). The information that I find the most troubling (aside from all the children that faced life-altering handicaps) is that thalidomide which was used as a sedative and tranquilizer, was given to for pregnant women for morning sickness as “Many practitioners relied on sedatives and tranquilizers specifically because they regarded pregnancy as a time of emotional instability and morning sickness as a psychosomatic symptom” (54) really showing how medical professionals saw women at this time. While thalidomide was prescribed to pregnant women it was not yet tested “properly”, as U.S. officials even refused to approve thalidomide as “…they were dissatisfied with the details of toxicity studies, [yet] Canadian regulators apparently felt that the safety of thalidomide had been well established by European experience and the five hundred pages of documentation submitted by the company.” (47) which in my opinion is not sufficient evidence concerning what the future health and wellbeing of the population will look like. This article really allowed me as a reader to see what types of impacts doctors and pharmaceutical manufacturers have on us, and allowed me to notice that as a population we should really put more effort into looking at what we are being prescribed (or even what we “self-prescribe” ourselves), and allow ourselves to ask questions on what we are being given from physicians, and what kind of medical research is behind it.

Exercising Caution: The Production of Medical Knowledge about Physical Exertion during Pregnancy
Shannon Jette
While looking at the risks of exercising while pregnant in the second half of the 20th century, and an editorial piece was published regarding guidelines that pregnant women should as “It was postulated that maternal exercise would result in a redistribution of blood flow to the woman’s working muscles and away from the pregnant uterus.” (300 Jette) which doctors at this time believed would cause competition between the fetus and mother for oxygenated blood, substrates including glucose, and heat dissipation. As it was agreed upon that more research needed to be done on if pregnant women should do physical activity, it was tested whether or not “The effect on [a] fetal outcome of a single factor such as exercise,’” (301) was even possible to test, as all other risk factors of pregnancy would have to be controlled to ensure it was the physical exercise that would or would not affect these children/mothers. As low levels of physical activity were still encouraged to pregnant women, walking was an encouraged form of exercises but heart rates of expecting mothers “’…should not exceed 140-150 bpm’” 3-5 times per week for only 15 minutes (303). It was only in the 1990s and obstetricians/gynecologists and phycologists “…weighted the potential risks and benefits of prenatal exercise…” (307) and came to the conclusion that “moderate exercise was safe from healthy pregnant women” (307) which was very shocking to me, I couldn’t imagine my mother being pregnant with me and the doctors telling her “well we’ve weighted the odds, and you should be fine”, which is when I found the information about how there are still ”substantial gaps and limitations” in the research regarding the “appropriate exercise limit for [pregnant] women” (308) although less conservative practices are being pushed on women today, and women are now encouraged to do moderate exercise while pregnant!

Gender Expectations: Natural Bodies and Natural Births in the New Midwifery in Canada
Margaret Macdonald

While looking at the “natural births” thanks to contemporary midwifery in Canada, as we have looked at previously, the medicalization of many “natural” practices (in this case pregnancy) has been questioned by “…critiques of the cultural construction of the female body and medicalized birth[s] arose [due to] a certain romantic bias toward non-Western birthing systems.” (239), allowing us as readers to question once again if we should continue to allow medicalized birthing methods, or if we should look closer at “more natural” practices of giving birth. Has this cultural construction of medicalized birthing become hurtful among mothers? As perhaps many expectant mothers see natural birthing options as “…the nostalgic desire for birth as a natural event that takes place in the home…” (239), but what about the mothers that are compelling, excited, and only comfortable giving birth in a medicalized facility? I’ve seen evidence of “mother-shaming” online, in TV shows, and even in person of mothers being shamed for “taking the drugs” and countless other decision that mothers have to make when they are expecting a baby. While many women wish to go through midwives and doulas as a way that can help “…discursively to affect women’s knowledge and experience of labor pain and [show] how this becomes central (and indeed desirable) to having a natural birth.” (246), that’s not to say that women need to “embrace” the pain as their womanly responsibility and even “…achieve some sort of womanhood.”(243). I enjoyed the information regarding women who do decide to give natural birth, and “…if an intervention is done because it is absolutely necessary, and not simply convenient or expedient, then the birth could still be considered natural.” (249) is very interesting to me because it made it seem (in my interpretation) that it was the coined phrase “natural birth” more than the true experience of having a natural birth. While this pressure the expecting mothers have is very alarming to me, I can also appreciate many of the reasons for home births, including being in a comfortable home setting, less possible stress and not having your baby “taken” away from the mother immediately after giving birth (242), and to me, these are all very understandable and positive reasons on having a midwife/ homebirth and how this profession has expanded so much in recent years due to way that midwifery culture has influenced so many individual cultures (242). While having natural pregnancies shown and talked about so much more than ever before has allowed for many women to weigh their options more than ever before, and allow the mothers to decide what feels better for them as an individual (242), do we want to replace all medicalization? Or do we just want more options and give more of a choice. I think it’s vital to give the options and allow the family to choose whether or not they would like to have a midwife, home birth, birth at a hospital, or even anesthesia rather than trying to “replace” cultural visions. I’m assuming that there are people currently living in Canada that find a lot more comfort in giving birth in a hospital with doctors, and women being left full of shame if they had given birth in a hospital, or god forbid they had to have a C-section (463). Overall, I believe this article had a lot of great information, especially for people looking to find alternative birth methods rather than the typical medicalized version, with that being said, I do believe that “shaming” a way that any given mother chooses to give birth may only worsen the social construction, I believe that it’s important to listen to what some individual wants, not what “most people” want, which i believe all 3 of these articles showcase very well- a direct view of how every individual should have a voice and be able to speak freely and ask questions about their heath/health concerns with a variety of people (doctors, natural paths, doulas, etc)!

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