{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T05:35:39Z","timestamp":1789191339941,"version":"build-2803163510"},"reference-count":46,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2024,1,29]],"date-time":"2024-01-29T00:00:00Z","timestamp":1706486400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J Med Ethics"],"accepted":{"date-parts":[[2023,11,19]]},"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:p>In this paper, we identify some key features of what makes something a disease, and consider whether these apply to pregnancy. We argue that there are some compelling grounds for regarding pregnancy as a disease. Like a disease, pregnancy affects the health of the pregnant person, causing a range of symptoms from discomfort to death. Like a disease, pregnancy can be treated medically. Like a disease, pregnancy is caused by a pathogen, an external organism invading the host\u2019s body. Like a disease, the risk of getting pregnant can be reduced by using prophylactic measures. We address the question of whether the \u2018normality\u2019 of pregnancy, its current necessity for human survival, or the value often attached to it are reasons to reject the view that pregnancy is a disease. We point out that applying theories of disease to the case of pregnancy, can in many cases illuminate inconsistencies and problems within these theories. Finally, we show that it is difficult to find one theory of disease that captures all paradigm cases of diseases, while convincingly excluding pregnancy. We conclude that there are both normative and pragmatic reasons to consider pregnancy a disease.<\/jats:p>","DOI":"10.1136\/jme-2023-109651","type":"journal-article","created":{"date-parts":[[2024,1,29]],"date-time":"2024-01-29T18:20:24Z","timestamp":1706552424000},"page":"37-44","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":23,"title":["Is pregnancy a disease? A normative approach"],"prefix":"10.1136","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9752-6302","authenticated-orcid":false,"given":"Anna","family":"Smajdor","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7383-6138","authenticated-orcid":false,"given":"Joona","family":"R\u00e4s\u00e4nen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,1,29]]},"reference":[{"key":"2024122604551874000_51.1.37.1","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2012-001632","article-title":"What is a disease? Perspectives of the public, health professionals and legislators","volume":"2","author":"Tikkinen","year":"2012","journal-title":"BMJ Open"},{"key":"2024122604551874000_51.1.37.2","doi-asserted-by":"publisher","DOI":"10.1515\/jpm-2016-0282"},{"key":"2024122604551874000_51.1.37.3","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.180226"},{"key":"2024122604551874000_51.1.37.4","unstructured":"NHS . Common health problems in pregnancy. 2018. Available: https:\/\/www.nhs.uk\/conditions\/pregnancy-and-baby\/common-pregnancy-problems\/ [Accessed 31 Aug 2023]."},{"key":"2024122604551874000_51.1.37.5","unstructured":"European Centre for Disease Prevention and Control . Factsheet about measles. In: European Centre for Disease Prevention and Control. European Union, 2022. Available: https:\/\/www.ecdc.europa.eu\/en\/measles\/facts [accessed 31 Aug 2023]."},{"key":"2024122604551874000_51.1.37.6","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0234320","article-title":"Effectiveness of utilizing the WHO safe childbirth checklist on improving essential childbirth practices and maternal and perinatal outcome: A systematic review and meta-analysis","volume":"15","author":"Tolu","year":"2020","journal-title":"PLoS One"},{"key":"2024122604551874000_51.1.37.7","unstructured":"World Health Organisation . Maternal mortality evidence brief. World Health Organisation Department of Reproductive Health and Research; 2019. Available: https:\/\/apps.who.int\/iris\/bitstream\/handle\/10665\/329886\/WHO-RHR-19.20-eng.pdf?sequence=1 [Accessed 31 Aug 2023]."},{"key":"2024122604551874000_51.1.37.8","unstructured":"Paul A G , Susan B R , Nakia S C , et al . Chapter 7: measles. In: Sandra W R , Linda M B , eds. Manual for the Surveillance of Vaccine-Preventable Diseases. 2019. Available: https:\/\/www.cdc.gov\/vaccines\/pubs\/surv-manual\/chpt07-measles.html"},{"key":"2024122604551874000_51.1.37.9","doi-asserted-by":"publisher","DOI":"10.1007\/s11673-019-09922-4"},{"key":"2024122604551874000_51.1.37.10","doi-asserted-by":"crossref","unstructured":"Young IM . Pregnant embodiment: subjectivity and alienation. In: On Female Body Experience:\u2018Throwing Like a Girl\u2019 and Other Essays. New York: Studies in Feminist Philosophy, 2005. doi:10.1093\/0195161920.001.0001","DOI":"10.1093\/0195161920.001.0001"},{"key":"2024122604551874000_51.1.37.11","doi-asserted-by":"publisher","DOI":"10.1016\/S0039-3681(02)00018-3"},{"key":"2024122604551874000_51.1.37.12","doi-asserted-by":"crossref","DOI":"10.1111\/ecc.12841","article-title":"Finding meaning in Suffering?\u2014Meaning making and psychological adjustment over the course of a breast cancer disease","volume":"27","author":"Loeffler","year":"2018","journal-title":"Eur J Cancer Care (Engl)"},{"key":"2024122604551874000_51.1.37.13","doi-asserted-by":"publisher","DOI":"10.1002\/pon.671"},{"key":"2024122604551874000_51.1.37.14","doi-asserted-by":"publisher","DOI":"10.1080\/08870440512331317634"},{"key":"2024122604551874000_51.1.37.15","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2008-2572"},{"key":"2024122604551874000_51.1.37.16","doi-asserted-by":"crossref","unstructured":"Hambleton S , Arvin AM . Chickenpox party or Varicella vaccine? In: Hot Topics in Infection and Immunity in Children II. 2005: 11\u201324. doi:10.1007\/b107202","DOI":"10.1007\/0-387-25342-4_2"},{"key":"2024122604551874000_51.1.37.17","doi-asserted-by":"publisher","DOI":"10.1111\/jcpt.13614"},{"key":"2024122604551874000_51.1.37.18","doi-asserted-by":"crossref","unstructured":"Matthews J . Reluctant warriors: Republican popular army and nationalist army conscripts in the Spanish Civil War, 1936-1939. Oxford Historical Monographs July 12, 2012. doi:10.1093\/acprof:oso\/9780199655748.001.0001","DOI":"10.1093\/acprof:oso\/9780199655748.001.0001"},{"key":"2024122604551874000_51.1.37.19","doi-asserted-by":"crossref","unstructured":"Smajdor A . The moral imperative for Ectogenesis. Cambridge Q Healthcare Ethics 2007;16. doi:10.1017\/S0963180107070405","DOI":"10.1017\/S0963180107070405"},{"key":"2024122604551874000_51.1.37.20","doi-asserted-by":"publisher","DOI":"10.1093\/jmp\/11.3.215"},{"key":"2024122604551874000_51.1.37.21","doi-asserted-by":"publisher","DOI":"10.1136\/jme-2022-108601"},{"key":"2024122604551874000_51.1.37.22","doi-asserted-by":"publisher","DOI":"10.1136\/jme-2023-109156"},{"key":"2024122604551874000_51.1.37.23","doi-asserted-by":"publisher","DOI":"10.1080\/07399332.2018.1442838"},{"key":"2024122604551874000_51.1.37.24","doi-asserted-by":"publisher","DOI":"10.1080\/02646838.2018.1540863"},{"key":"2024122604551874000_51.1.37.25","doi-asserted-by":"publisher","DOI":"10.1080\/13698575.2013.876191"},{"key":"2024122604551874000_51.1.37.26","first-page":"1","article-title":"Surrogacy and the fiction of medical necessity","volume":"12","author":"Baron","year":"2023","journal-title":"Camb Q Healthc Ethics"},{"key":"2024122604551874000_51.1.37.27","doi-asserted-by":"crossref","first-page":"1615","DOI":"10.1016\/S0140-6736(05)74468-8","article-title":"Discarded diagnoses","volume":"356","author":"Bynum","year":"2000","journal-title":"The Lancet"},{"key":"2024122604551874000_51.1.37.28","doi-asserted-by":"publisher","DOI":"10.1093\/jmp\/jhu038"},{"key":"2024122604551874000_51.1.37.29","unstructured":"Cohon R , Edward NZ . The Stanford encyclopedia of philosophy (fall 2018 edition). In: Hume\u2019s Moral Philosophy. Available: https:\/\/plato.stanford.edu\/archives\/fall2018\/entries\/hume-moral\/"},{"key":"2024122604551874000_51.1.37.30","doi-asserted-by":"crossref","unstructured":"Daniels N . Just health care. Cambridge, New York: Cambridge University Press, 1985. doi:10.1017\/CBO9780511624971","DOI":"10.1017\/CBO9780511624971"},{"key":"2024122604551874000_51.1.37.31","unstructured":"Bage B . Biological exuberance: animal homosexuality and natural diversity. St Martin\u2019s Press, 1999: 196."},{"key":"2024122604551874000_51.1.37.32","unstructured":"Elflein J . Population of women aged 15-49 in the U.S. and worldwide in 2013 and 2025. Statista, 2019. Available: https:\/\/www.statista.com\/statistics\/654630\/female-population-aged-15-49-us-worldwide\/ [accessed 13 May 2022]."},{"key":"2024122604551874000_51.1.37.33","doi-asserted-by":"crossref","unstructured":"Bigna JJ , Tochie JN , Tounouga DN , et al . Global, regional, and country Seroprevalence of Toxoplasma Gondii in pregnant women: a systematic review, Modelling and meta-analysis. Sci Rep 2020. doi:10.1038\/s41598-020-69078-9","DOI":"10.1038\/s41598-020-69078-9"},{"key":"2024122604551874000_51.1.37.34","doi-asserted-by":"publisher","DOI":"10.1086\/288768"},{"key":"2024122604551874000_51.1.37.35","doi-asserted-by":"publisher","DOI":"10.1093\/jmp\/jhu035"},{"key":"2024122604551874000_51.1.37.36","first-page":"222","article-title":"A theory for the origin of human Menopause","volume":"7","author":"Takahashi","year":"2016","journal-title":"Front Genet"},{"key":"2024122604551874000_51.1.37.37","doi-asserted-by":"publisher","DOI":"10.1007\/s10508-020-01749-0"},{"key":"2024122604551874000_51.1.37.38","doi-asserted-by":"publisher","DOI":"10.1111\/j.1467-8284.2007.00662.x"},{"key":"2024122604551874000_51.1.37.39","doi-asserted-by":"publisher","DOI":"10.1111\/bioe.12745"},{"key":"2024122604551874000_51.1.37.40","doi-asserted-by":"publisher","DOI":"10.1186\/s12910-021-00630-6"},{"key":"2024122604551874000_51.1.37.41","doi-asserted-by":"publisher","DOI":"10.1177\/10935266211067110"},{"key":"2024122604551874000_51.1.37.42","unstructured":"Kokko H , Brooks R . Annales Zoologici Fennicni. Finnish Zoological and Botanical Publishing Board, 2003: 207\u201319."},{"key":"2024122604551874000_51.1.37.43","doi-asserted-by":"publisher","DOI":"10.1007\/s11229-017-1405-0"},{"key":"2024122604551874000_51.1.37.44","doi-asserted-by":"publisher","DOI":"10.1136\/medethics-2020-106160"},{"key":"2024122604551874000_51.1.37.45","doi-asserted-by":"crossref","unstructured":"Jauniaux E , Grobman W . Editorial caesarean section: introduction to the \u2018world\u2019s No.1\u2019 surgical procedure. In: Jauniaux E , Grobman W , eds. Textbook of Caesarean Section. Oxford, UK: Oxford University Press, 2016. doi:10.1093\/med\/9780198758563.001.0001","DOI":"10.1093\/med\/9780198758563.003.0001"},{"key":"2024122604551874000_51.1.37.46","unstructured":"Canadian Institute for Health Information . Hospital stays in Canada. 2019. Available: https:\/\/www.cihi.ca\/en\/hospital-stays-in-canada [Accessed 13 May 2022]."}],"container-title":["Journal of Medical Ethics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/jme-2023-109651","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,26]],"date-time":"2024-12-26T12:56:15Z","timestamp":1735217775000},"score":1,"resource":{"primary":{"URL":"https:\/\/jme.bmj.com\/lookup\/doi\/10.1136\/jme-2023-109651"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,29]]},"references-count":46,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12,23]]},"published-print":{"date-parts":[[2025,1]]}},"alternative-id":["10.1136\/jme-2023-109651"],"URL":"https:\/\/doi.org\/10.1136\/jme-2023-109651","relation":{},"ISSN":["0306-6800","1473-4257"],"issn-type":[{"value":"0306-6800","type":"print"},{"value":"1473-4257","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,29]]}}}