Politics & Policy

“Don’T You Want to Be Prepared?”

I don’t want to sound unpatriotic, and I realize that this is not a wildly original point, but there is something creepy about how risk aversion has become a kind of unofficial American creed.

It’s creepy in the way that it has crept stealthily into our national life, and creepier still in its sinister, innumerate, fear-fanning, joy-squashing effects. There have been days lately when I have caught myself wondering aloud, “Can we really be the people who settled the Great Plains?”

Spend a few hours at the park and you’ll hear the endless gull-like cries of fretful parents and nannies: “Don’t climb so high! Watch out with that stick! No running! No pushing! Don’t get on the slide until everyone’s off it!” Of course children can get hurt, but really, they usually bounce. Go to a swimming pool and it’s all, “No running! No diving! No jumping! Stop splashing!”

When Paris went recently to his pal Emma’s 8th birthday party–”Laser tag, wow!”–he came out cheerful and sweaty but slightly crestfallen. “It was fun,” he told me, “but not as exciting as I expected. We weren’t allowed to run or jump, so everyone just walked around slowly, shooting each other with beams of light.”

The next day Molly returned from a field trip to a D.C government office and informed us that a new municipal regulation requires children to wear protective headgear when…sledding! To grasp the full craziness of this rule, you must understand that we get sled-worthy snow maybe three times a winter–at which point school is invariably cancelled due to the peril of slippage–and that Washington, D.C. is not exactly Alpine. Them thar hillocks is hazardous, m’am! Them moguls is downright deadly!

It seems a no-fun approach to life to me, but then I come from a generation that knew not the steel-reinforced child car seat, the bicycle helmet, or that antibiotic gel that conscientious mothers rub on their toddlers’ hands when they’ve been playing in a sandbox.

Or take the business of having babies here in the United States, which is a particularly joyless one, I’m finding, at least in the first two trimesters of pregnancy, and when compared to my own experiences in other countries.

“Congratulations!” said my doctor in Japan, when I was in the early stages of expecting Molly.

“Lovely!” applauded my doctor in England, when Paris was on the way.

“Hurrah, another one!” beamed my Canadian ob/gyn first with Violet, then with Phoebe.

Here in the States? Oh, my goodness. First you get asked what insurance coverage you have. Then they calculate your due date, ask your age (and sound alarmed when you tell them what it is, if you are me), then the very next line of inquiry is about testing for abnormalities.

“Oh,” I said deprecatingly, waving a hand, and sitting down on the examining table during my first visit to the doctor’s office. “No thanks. I don’t want genetic testing. I’ll just have the baby I get.”

The nurse practitioner looked concerned. “But don’t you want to be prepared?”

“Be prepared for what?” I said, trying to shrug nonchalantly. I could feel my smile faltering under the force of her worried gaze. “I mean, I’d rather just assume all is well and deal with something awful if it happens.”

The nurse frowned. “Most couples prefer nowadays to know. Then you’d have a chance to…” she paused. “Be prepared.”

I don’t know why I felt compelled to discuss this on her level, but some situations just bring out one’s inner coward. “You mean, like reading up on my baby’s condition, or organizing special equipment or something?” I said. As the words left my mouth I knew I had conceded something I hadn’t intended to concede.

“Yes,” she said. “Like that.”

A flunky approached with a syringe and vast number of empty glass vials. “Wow,” I remarked, pulling up my sleeve, “that’s a lot of blood you’re taking. What’s it all for?”

The nurse smiled reassuringly. “Just a few tests. The usual.”

A few days later, a welcome-to-our-medical-practice folder arrived at our house. I remember when this happened in England: I got a fat file full of advice about sleeping enough, eating a varied diet, and getting exercise, with lists of semi-socialist organizations I could phone if I needed “family support” or felt “social exclusion.” I opened the pamphlet from the American practice expecting some of the same pleasantries and was dismayed to find it almost entirely concerned with… genetic testing!

AFP Tetra: What You Should Know,” read the first pamphlet to hit my eye. It listed the birth defects this particular test could detect: Open Neural Tube Defects, Down Syndrome, and Trisomy 18. The second one was all about amniocentesis (“An Important Procedure in Prenatal Diagnosis“) and the third, which showed a smiling family of four, wanted to tell me about the risk of cystic fibrosis. For no particular reason, I flipped this one open and read: What can a couple do if there is a risk of having affected children The answer was that there are options: “Many include personal choices that are best discussed in private by the couple had health care provider(s).”

“Yikes,” I muttered, “bad juju,” but like a motorist passing a grisly pile-up, I couldn’t help leafing through the rest of the folder: Parvovirus, Tay Sachs, sickle trait, toxoplasmosis–My heart was pounding, and I pushed the folder into the middle of a pile of papers on my desk where, as far as I am concerned, it will stay. Has this grim focus on What May Go Wrong scared me? Why yes! It has!

In no other country have I come across this–and it is not merely a function of my extreme old age. Ask around: Alarmism is the American way of birth. Pregnant French women sip wine with their meals, expectant Japanese eat sushi for the full nine months; American women daren’t even risk a second cup of coffee, for fear of something awful transpiring within. (You know why? Because of a study that found that pregnant laboratory rats given huge doses of caffeine had offspring with toes missing. Large studies of actual women have come up with, ahem, zero risk of toelessness.)

No doubt many families are grateful for the medical advances that allow them to “be prepared,” or worse, for a faulty child. But in ten years of having babies myself and of hearing other women’s war stories, from what I can see the chief effect of the extravagant testing that has become routine is that it pointlessly stokes the anxiety of expectant parents.

I’ve lost count of the stories I’ve heard about women who spent months in terrified apprehension because some obscure test came back positive–only to find, in the delivery room, a perfectly healthy baby. One close friend of mine was told her son’s brain wasn’t developing properly and was urged to consider termination. “Nah,” said her husband, as he supported her collapsing weight, “If he turns out to be a little guy with problems, well, he’s still our little guy.” Their little guy’s brain, it turns out, works almost too well; eleven years later, his teachers are hard-pressed to keep him challenged at school.

As Andrew Stuttaford likes to point out, the hemming-in of cheery freedoms like bicycling without a helmet and the incessant government nannying to which we are all subjected has the noblest of reasons: It is, of course, “for the children.”

“The children,” politicians will tell you, “are our future.” They will inherit “our world.” Actuarially, that is an unavoidable fact. What strikes me as a shame is that the world we Americans are bequeathing our children is no longer a juicy oyster for them to wrench open and devour with gusto, but a timid, blood-test-taking, bran-muffin-eating, strapped-in world of worry. You have to ask: If we had to do it again, could we still settle the Great Plains?


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