The recent headline at CBS news stating “pregnancy is not a disease” has compelled me to resurrect the Best. Opinion. Ever. Unfortunately, it was overturned on appeal, but that takes nothing away from its eloquence. The Honorable Laurie Smith Camp describes pregnancy in gender neutral terms, leaving little doubt that if men suffered the following, no one would be making the “oh, it’s so natural and beautiful” argument. I cut out the footnotes that were in the opinion to make for easier reading, but you legal geeks can find In re Union Pacific R.R. Employment Practices Litigation, 378 F.Supp.2d 1139 (D. Neb. 2005).
Our typical patient becomes aware that he has contracted the disease when he experiences extreme fatigue, accompanied by nausea and vomiting. These symptoms diminish after a few months, as his abdomen begins to distend. Pressure on his bladder requires that he urinate frequently. He feels hot and sweaty, and has headaches and dizziness. As his digestive tract slows, he becomes constipated and suffers heartburn and hemorrhoidal symptoms. His weight increases by twenty per cent, with most of the gain centered in his abdomen, altering his balance and causing strain and discomfort in his lower back. His breasts, ankles, and feet swell, and his legs cramp. His mobility, his sleep, and even his breathing are impaired as his abdomen expands to twice its normal circumference. Stretch marks appear on his thighs, chest and abdomen. The ligaments in his hips and pelvis soften, and he develops sciatica, causing tingling and numbness. After nine months, he feels the onset of intense, intermittent pain, accompanied by diarrhea and nausea. His pain increases and accelerates over approximately 15 hours as his genital opening, usually the size of a pencil lead, is stretched to a diameter of 10 centimeters. Surgical incisions are used to facilitate the opening of his genitals. His pain may require general anesthesia, but usually can be managed through other methods, such as injections in the fluid surrounding his spinal cord. He is encouraged to reject pain medication entirely so he can remain alert to assist in the treatment of his disease. The incisions and tears in his genitalia are closed with internal and external sutures. His breasts continue to swell, and his nipples become sore. Healing of his genitals takes about six weeks, during which time his pain may be relieved by sitz baths, heat lamps, ice packs, and anesthetic sprays. Finally, he has a heavy bloody discharge from his genitals, lasting several weeks.
Results may vary. Our typical patient is fortunate that he does not develop diabetes (a risk of about 3 per cent); dangerously high blood pressure (a risk of about 7%); clinical depression (a risk of about 15%); or require open abdominal surgery (a risk of about 25%). Even with abdominal surgery, he runs only a minor risk of death (.02%).
Thank you to the IOM for recognizing the importance of contraception to women’s health.