In Florida, A Pregnant Woman is Nothing But A Womb Pod

I encourage people to follow this case in Florida, where a woman was court-ordered to be held against her will on hospital bedrest. She was 25 weeks pregnant and having some issues in her pregnancy, so it was recommended she remain on bedrest. However, with a job and two other young children at home, she did not feel that would be possible. So the hospital sought a court order to keep her hospitalized, claiming it was in the "best interests of the fetus." Never mind what might be in the best interests of her other two children! The court order required her to submit to any and all treatments during her stay. Three days later, she had no choice but to undergo a c-section, and during the surgery it was determined that the fetus had already died. (Which, as an aside, could have easily been determined by an ultrasound rather than major abdominal surgery.)

In the past, courts have always upheld patient autonomy in making medical decisions, even for pregnant women, even when it might endanger a fetus. The Florida courts, however, have summarily stripped this woman of her constitutional rights. Fortunately, a lawyer has agreed to appeal her case pro bono, and the ACLU has (rightfully) stepped in as well.

Let this case be a warning to women everywhere: The Pregnancy Police are watching. You think it's bad that people give you the stinkeye in Starbucks when you don't order a decaf latte? Just wait til they imprison you in the hospital until delivery for it.

A Bit of History That Gives Me Chills

Yesterday one of my favorite bloggers, The Unnecesarean, posted an excerpt from a history text about birth in the early 20th century. The excerpt presents the practice of putting women under "twilight sleep" for labor and delivery as a way to convince WASP women to have more babies because "modern" birth practices render it painless-- or at least without the memory of pain. I had never heard of this racist/classist perspective of twilight sleep before. But it got me thinking, especially since I recently read that the tv show Mad Men featured a character giving birth within the haze of twilight sleep.

I can't remember the first time I heard about women being "put under" to have their babies- it was probably as a child or teen. Until a few years ago, I guess I thought it was a benign but clumsy attempt to spare women the pain of birth. No big deal. But then I happened to see "The Business of Being Born, " a documentary by Ricki Lake that covers a little bit of the history of birth in the US. The historical aspect was eye-opening, to say the least. When you start to think about the fact that this is the way many of our parents came into the world (and maybe even some of us, considering twilight sleep was prevalent well into the 60s and even the 70s in some hospitals), it can be downright scary.

Beginning in the 1900s, a combination of scopolamine and morphine was administered to all women entering the hospital for birth. Women had no recollection of the birth, and certainly no recollection of any pain. Feminists heralded this as a fantastic medical breakthrough, and demanded its widespread availability for birthing women. As word spread of this wonderful new pain-free way to give birth, women across the country chose to deliver in hospitals offering twilight sleep. In fact, there are reports of women being put under for delivery whether they wanted it or not, even against their own explicit refusal. But since women had no recollection what actually happened during their births, and husbands at that time were not part of the birth process, it was years before the true horror of twilight sleep was exposed.

Since the women were not fully sedated, and not fully relieved of the pain of labor, they had to be placed in restraints in their hospital beds so as not to thrash themselves onto the floor. When husbands started questioning the marks on their wives' wrists and ankles left behind by the leather restraints, the practice of restraining was not abandoned. Instead new restraints made of lambswool were designed so as not to leave any marks. Women were left, tied down, to writhe through their labors until the doctor arrived with forceps to extract the baby. (See photo at top.)

When the effects of the medicine wore off, women were presented with a freshly bathed, blanketed bundle of baby. Some women complained of feeling detached from their babies, like they weren't even sure it was their own child. The drugs also crossed the placenta and often sedated the baby, resulting in breathing problems. Over time the method was eventually abandoned, as a result of the negative side effects and the second wave of feminism. As women reclaimed control of their reproductive lives, including access to birth control pills, they also began increasingly demanding unmedicated births and fathers' involvement in births. The development of epidural anesthesia also played a role in the demise of twilight sleep.

Maybe it's my own personal bias against hospitals, but the thought of literally being dropped at the door of the maternity ward by my husband and literally having no recollection of anything else until being handed a baby two days later utterly horrifies me. I don't think the method would have taken off if husbands had been allowed in- I cannot imagine any man permitting such barbaric practices to be visited upon his wife. But they didn't know, so they couldn't help.

There was (and I think there still is) a certain mystique around birth: We don't know exactly how labor starts, and can't predict when it will happen. Regardless of a mother's weight gain or belly size, we don't know the size of the baby until it's born-- even ultrasound measurement can be off by a pound or more in either direction. This mystique allowed generations past, and still allows many people today, to maintain a certain degree of ignorance about birth. It's very easy to assume that the doctor has all the knowledge, the hospital has all the equipment, so all the expectant parents need to do is show up when it's time. I think that is a dangerous attitude. The same people who wouldn't hesitate to seek a second opinion from a doctor who said they need a heart transplant... the same people who would consult with three different orthopedic surgeons about a knee replacement... don't think twice about their choice of care provider, birth place, or pain management options. I could write a whole other post on the topic of informed birth choices... But suffice to say for now, If you don't know your options, you don't have any.

Are Motherhood and Feminism Incompatible?

I have never considered myself a feminist. I'm not "anti-feminist." I support many of the aims of feminism, such as gender equality in the workplace and advocacy for victims of discrimination, violence, and sexism. But I just haven't felt like I fully identified with the socio-political group of "feminists."

What comes to mind when you think of the feminist movement? Maybe it's women like Gloria Steinem and Betty Friedan. Maybe it's politics, like the Equal Rights Amendment and Roe v. Wade. Perhaps it's social issues, such as sexual harassment, domestic violence, or rape. Or maybe it's just Girl!!! Power!!! I'd say all of those are pretty valid answers.

But when you think of feminism, do you think of moms? Probably not. Do you know why? Because the feminist movement doesn't think about moms either.

In the United States, something like 80% of women will have at least one child. That's more than the number of women who obtain bachelor's degrees (26%) and more than the number of women participating in the workforce (60%). But where is the feminist activism on behalf of mothers?

I started with perhaps the most well-known feminist group, the National Organization for Women (NOW). The "Top Priority" issues that NOW works with are listed on the front page of their site: Abortion and Reproductive Rights, Economic Justice, Ending Sex Discrimination, Lesbian Rights, Promoting Diversity and Ending Racism, and Stopping Violence Against Women. Worthy causes, all. When I clicked on "Many more" at the bottom of the list, I found, way down on the list of "Other Important Issues" a link to the Mothers [sic] and Caregivers [sic] Economic Rights page. The issue as NOW sees it is paid parental leave. Their action plan on this issue consists of.... a petition. Oh, and encouragement for women to contact their Senators. Wow, great plan. Things weren't any more promising on the Abortion and Reproductive Rights page. Apparently, the only reproductive rights that NOW supports are the ones that assist women who DON'T want to be mothers. The agenda is abortion, emergency contraception, and birth control access for all women. These are important issues, but do nothing for the women who choose to carry a pregnancy to term.

I next decided to head over to NARAL Pro Choice America. This was another bust, as their platform of issues encompasses only abortion rights, birth control access, sex education, and "Women of Color." Nothing about being pro-choice for women's childbearing options as opposed to pregnancy prevention and termination options.

Surely the ACLU must be working on behalf of mother's rights, right? Wrong. While they have a Women's Rights Project (started by Ruth Bader Ginsburg), the project only focuses on four areas: Employment, Violence Against Women, Criminal Justice, and Education. Again, all important issues, but nothing that directly advances the position of mothers.

I wandered over to the Obama Administration site, Change.org. There is a Women's Rights page, but it looks like news stories, blog entries, and job postings. Nothing resembling any kind of national movement of any type.

This is getting discouraging.

Isn't anyone fighting for better maternity leave policies? For breastfeeding women who are returning to work and need time and a place to pump breastmilk? For women who want to be attended by a homebirth midwife (still illegal in 10 states)? For women who want options other than a court-ordered cesarean section?

Well, how about the National Advocates for Pregnant Women (NAPW)? Now we're getting somewhere! The NAPW includes the following in its mission:

• By focusing on the rights of pregnant women, including those who are continuing their pregnancies to term, we hope to broaden and strengthen the women’s rights and progressive movements in America today... While it is generally recognized that people have a right to bodily integrity and the right to procreate, women face an array of restrictions on their reproductive decision-making, from restriction on access to abortion services, to restrictions on alternative birthing practices to a wide variety of health and welfare polices that devalue and undermine motherhood for some women, including low income and women of color. Although it is generally accepted that adults can decide what medical treatment they will or will not have - once a woman becomes pregnant others may be able to make that decision for her.

Now that's what I'm talking about. While the NAPW doesn't address issues beyond pregnancy (such as maternity leave and breastfeeding rights), it's still a great agenda. However, they do not specifically bill themselves specifically as a "feminist" or "women's rights" organization. They consider themselves a reproductive and human rights organization.

The National Partnership of Women and Families works toward family-friendly employment policies, such as flexibility in the workplace and paid sick leave. In fact, the National Partnership helped draft the Family Medical Leave Act legislation. Their agenda is great for working mothers, though I would like to see them go even further by adding support for breastfeeding/pumping moms. And in the reproductive health arena, they only scratch the surface, by supporting general ideas of affordability, quality, evidence-based and patient-centered care. It would be good to see

The other problem: Have you ever heard of the National Partnership and/or NAPW? Most people probably have not. They don't have the prominence of (and the political weight that goes along with) larger organizations like NOW and the ACLU. Women (and men too!) need to know about the NAPW and the National Partnership in order to give the organization a broader base of support and more political sway.

To be fair, there is a patchwork of different groups that support specific mothers' rights issues. For example, The MAMA Campaign and The Big Push for Midwives support choices for birthing mothers and pro-midwifery laws. First Right works to end breastfeeding discrimination. Over the past few decades the feminist agenda has not adequately included the rights of mothers. As it stands now, there isn't one umbrella organization to encompass ALL of the personal, political, social, and economic issues mothers face. Maybe some would say it's not necessary, that the other groups, small and large, that have a piece of the "mommy agenda" will be able to get the job done. I wonder, though, if it's an idea whose time has come.