The XX Factor

Study on Women’s Painkiller Use Causes Concern Over Hypothetical Embryos, Not Actual Women

How much should we worry about prescription painkillers hurting hypothetical embryos?

Photo by Darren McCollester/Getty Images

The Centers for Disease Control and Prevention released a report Thursday showing that opioid painkiller prescription use is really high among women. Analyzing health insurance data claims, researchers found that an average of 39 percent of the women on Medicaid and 28 percent of the women on private health insurance filled opioid prescriptions every year from 2008 to 2012. These numbers raise a lot of important questions: How many of these women have a pill problem? Are doctors prescribing hard drugs too quickly when aspirin would suffice? How much of this opioid use is due to chronic pain? Is opioid overuse more common in women than men?

Unfortunately, the media coverage of this report has focused primarily on the fortunes of hypothetical embryos that might be lurking in the wombs of the women taking these pills. This NBC News headline is a good example: “Pill-Popping Mommas: ‘Many’ Pregnant Women Take Opioids, CDC Finds.” The story comes complete with a photo of a heavily pregnant woman who is smoking, even though the report is not about smoking and focuses on women between the ages of 15 and 44, not pregnant women specifically. Why does coverage of an important women’s health study ignore actual women and their health problems to instead zero in on how women are treating the pregnancies that may not even exist in their bodies? Even the New York Times headline is: “High Rates of Opioid Prescriptions Among Women Raise Birth Defect Fears.”

We’ve been down this road before. In 2006, the CDC drew criticism when it released a report calling on doctors to treat all female patients of reproductive age like they are “pre-pregnant,” whether they are planning on having children or not. The rationale for this was that half of all pregnancies are unplanned—though it’s worth noting that 40 percent of those end in abortion—so the safest bet is to assume any woman who can give birth is likely to do so soon. But, as University of South Florida philosophy and internal medicine professor Rebecca Kukla told Ms magazine in 2011, treating all women like they might as well be pregnant sends the message that “the ‘purpose’ of women’s health care is the protection of babies and society.”

This idea comes across in the coverage of the new CDC report. While opioids are overprescribed in this country, there is no indication from this report of how many of the women who use them need them, how many of the women are abusing them, or how many of the women counted in the study were actually pregnant or planned to be. Alarmism over birth defects could subordinate the very real needs of actual women to the needs of hypothetical embryos women may not even want in their bodies.

Reducing women’s health care to womb management has real-world effects. As Libby Copeland wrote for Slate in December, concern about painkiller use during pregnancy is blowing up to hysterical proportions, reminiscent of the “crack baby” panic of the 1980s. It turned out that the so-called crack babies were not actually the misshapen monsters that many in the media breathlessly predicted back then. Similarly, while opioid use in pregnancy can cause birth defects and other problems, fear-mongering over opioid addiction is being used to harass and jail pregnant women, often with little to no evidence that the babies are suffering long-term damage.