Womb Versus Woman

...Hence, it is hardly fair to assume that poor women are not motivated to take care of themselves during pregnancy and then of their babies...

...A San Diego resident, Pamela Rae Stewart Monson, was charged with criminal negligence because she gave birth to a "brain dead" infant son, who died three months later...

...Although the miracle of birth may still be a miracle, we have changed its meaning...

...We may assume that their inducement stemmed from good intentions...

...Obviously, twisting protective legislation for women into a tool of discrimination is not SUMMER • 1991 • 397 Women and Rights something new...

...She did not receive prenatal medical care until the seventh month of her pregnancy...

...It is far too simplistic to assert that any and all intrusion is, by its nature, onerous or evil...

...In the last part of the twentieth century, birth research has kept pace with other medical advancements...

...I would argue, however, that the distaste that many others have for abortion stems from the notion that to be a mother is to enter into a secular form of a sacred covenant with a society...

...Does it then follow that expectant mothers should be monitored to be sure their behavior or habits do not harm the fetuses they are carrying...

...A California case in 1986 brought to light the issue of fetal neglect, illustrating in the process the vulnerability of women, especially poor women...

...Those women who chose to quit smoking were rewarded by a discount...

...We are one of the richest countries in the world, but we increasingly cut back on our welfare services for children, and are still unable to come to grips with an almost Third World ranking in infant mortality...

...In attempting to provide assistance to pregnant women, we cannot avoid opening the door to control and regulation...

...Yet it is easy to understand how things get muddied once the state becomes involved in the "well-being" of pregnant women...

...With such regulation, the privacy of pregnancy is further jeopardized and the autonomy of women eroded...

...Once the business of minding the health of pregnant women and their potential offspring is placed outside their own purview, an ideological free-for-all ensues, with each side choosing their weapons and shields...

...We are still searching for programs that signify we are equally worried about the lives of women, pregnant or not...

...To honor the sanctity of fetal life while government and its policies ignore the needs of its existing women citizens and already-born children constitutes a national betrayal...

...Such cases invest in the doctor a kind of judicial power closer to tyranny than to the sage advice of a trusted family "medical friend...

...Other such laws are designed to force fathers of illegitimate children to support their pregnant partners...

...One unintended consequence of this elevation is to diminish the public's approval of the abortion choice, and thus perhaps contribute to the lack of available, affordable abortions for many women...

...The infant died almost instantly, and the cancer-patient mother within a few days...

...According to the prosecution, Monson failed to behave in a manner that would have provided maximum safety for her unborn child...

...Two obstetricians in a Philadelphia suburb provided a small discount to pregnant women who quit smoking...

...With the United States already ranked an incredible nineteenth among industrialized nations in infant mortality, would less autonomy in pregnancy cause any fewer deaths of infants...

...After all, whom would one prosecute—the dead man...

...For poor women, quality and availability of prenatal care are seriously deficient...

...This idealization of motherhood is paradoxical in a country that has such a high infant mortality rate, provides no national guarantee of parental leave, and has no policy for child care...

...The lawsuit alleged that she had been warned not to take drugs, not to have sexual intercourse, and to seek medical attention immediately if she began to hemorrhage...

...Ironically, once a child is born, they act as though the state should drop its "compelling interest in preserving life...

...Yet one cannot doubt that motherhood, like the flag, has become an icon...

...The 396 • DISSENT Women and Rights consumption of alcohol is another...

...Underlying the Monson case is the question of social class in America...

...Yet from there we move to the reality of addicted women giving birth to addicted babies and to desperately ill AIDS– infected babies...

...Because they are generally perceived as a wonderful thing for women, advances in reproductive technology like artificial insemination and fetal surgery have elevated the notion of motherhood...

...And can we devise a benign control that would afford a smaller loss of personal freedom...

...Does a pregnant woman have the right to live autonomously with the full complement of her liberties protected, or does she, by virtue of her pregnancy, become another kind of citizen, a citizen whose obligations to the society are such that her rights and liberties become secondary, or, at worst, temporarily suspended...

...For if a society chooses to rationalize the invasion of privacy in order to help ensure the health of its future generations, then it can also move to a rationalization of pregnancy monitoring that would, over time, redefine and extend the meaning of "high-risk pregnancy...

...There is, needless to say, a substantial difference between voluntary nutritional and educational programs and other forms of aid for impoverished pregnant women and the demand that women behave in certain ways in order to protect their unborn...

...Until we find a way to protect unborn life, without a complete disregard for the integrity of the life of the already existing woman, we will run eternally into the wall of personal freedom and privacy, and we will find many casualties as a result...

...In America, the flag has become the repository of great emotion, in far greater measure than its simple cloth as a symbol of a country's identity would suggest...

...With both the womb and the birth process in the public eye, protecting a woman's rights and privacy becomes a tougher job...

...It is specifically the pregnant woman, entrusted with the next generation, who is most vulnerable to this kind of invasion and intimidation...

...Her infant presumably had barbiturates and amphetamines in his blood...

...choose to smoke or choose to quit...

...Following from the notion of fetal neglect is public regulation of pregnancy...

...They had observed the differences in the health of smoking and nonsmoking women and the consequent results on babies they delivered...

...While technology has revealed some of the mystery of life, this revelation has been politically distorted by the pro-lifers, who believe they know the exact second when life begins, notwithstanding scientific debate...

...But no one is likely to advocate prosecution for not taking the doctor seriously...

...Which is the more important value: to safeguard the individual autonomy and personal privacy of pregnant women or to make sure the society gets healthier, chubbier babies—babies less likely, by the way, to need state care or aid...

...Despite the problem with fixing blame for "neglect," the feticide laws are the opening wedge for a serious invasion of privacy...

...The Monson precedent could, for instance, be used for a myriad of public policies to monitor and control pregnant citizens...

...The reality instead is that poverty and the lack of consistently good prenatal care prevent many from acting in ways we have come to define as responsible...

...In another case, a woman dying of cancer was forced by a hospital-secured court order to undergo a cesarean section after her husband, her parents, and her personal physician said no...

...In this case, the feticide laws provide the right-to-life movement with a legal foundation for the persecution and prosecution of women...

...This would-be benign regulation of pregnancy was coopted by the political forces of the New Right and its allied groups...

...Obviously, this law was supposed to be used not against women, but for their protection...

...The concerns of those living and in need have traditionally been left to the liberals, who are most likely to honor the right to reproductive choice and the right to die...

...For some the flag is not just a symbol of national identity alone but evokes a feeling of patriotism deserving of religious protection...

...Certainly, programs monitoring a poor woman's nutritional needs are humanitarian...

...The case does, however, raise the seemingly simple but desperately complex question: should privacy in pregnancy be protected if it could mean that some babies will not be as healthy as other babies...

...Thus, to abort is to diminish one's status as a woman because it precludes one's identity as a mother...

...The Reproductive Rights Project of the American Civil Liberties Union reports that fetal neglect and fetal abuse charges are occurring on a regular basis...

...The notion of that guarded thing called "pregnancy" is no longer part of our vernacular...

...Miraculous births are now documented because of sophisticated and technically assisted pregnancies...

...Even during periods of primitive, or what moderns would call "barbarian," birthing practices, there prevailed the notion and the reality of the "mother's child" inside her womb...

...Sue Monson, the first woman whose case brought national attention to fetal neglect, was charged under a California law that was originally intended to force fathers of illegitimate children to support the women during pregnancy...

...These advocates argue always on the side of preserving life at any level, and at any cost...

...And more important, whose responsibility is it to assure, insofar as possible, the delivery of healthy babies...

...this is not a recent development...

...We have seen the limiting effects of "protective" measures for women in employment practices for a long time...

...Government nutritional programs and federally funded prenatal programs tell us that we do believe that the life of the unborn is worthy of public attention and care...

...The abortion struggle is only part of the story of woman's fight for bodily autonomy and full citizenship...

...This is, of course, precisely the kind of sentiment utilized by the pro-life groups, which believe that the fetus is a full-blown human life, that civil liberties begin in the womb, and that there is nothing fundamentally frightening or dangerous about the wholesale monitoring of pregnant women through state or federally controlled programs...

...A friend has said these events have ushered in the age of "kangaroo pregnancies" —we carry our young in observable, almost external "birth pockets...

...Smoking is just one example of a private behavior known to be unhealthy to a fetus...

...It is the notion of the fetus as a person that most complicates the issue...

...The neglectful mother, the abusing mother— these are powerful and incriminating labels...

...But the notion that a woman can be accused of child abuse or neglect before the birth of her child is a fairly recent phenomenon...

...Specifically, one downside of the now open womb is the opportunity it gives anti-abortionists to conjure up the image and the accusation of the "BAD MOTHER...

...In the words of the lawyer Lynn Paltrow, where will we stop?—perhaps we "should prosecute women who stand on their feet too long...

...If he refuses and then dies of cardiac arrest or lung cancer, it is a tragedy for the man, his family, and his friends...

...The choice appears to be stark...

...The bitterness of the contemporary struggle for reproductive freedom has its antecedents throughout the course of history...

...According to the prosecution, the child's condition and subsequent death were a result of the mother's fetal neglect...

...The mother's child-of-her-womb has increasingly been replaced by the fetal citizen...

...Artists' images of women with little children have universal appeal, and, of course, the Christian image of the Madonna with the infant Jesus has provided a great precedent for a mythological view of motherhood...

...At the very least, technology has added to the complexity of the fight for a reasonable balance between the values of woman's life and those of fetal life...

...Although the Monson case was eventually dismissed by a California court, it exists as a cold and stark reminder...

...One such example would be the ghastly murder of the pregnant actress Sharon Tate at the hands of the Charles Manson gang...

...Right-to-life supporters who are absolutely unrelated to families often believe they can and must make decisions not just for fetuses but increasingly for comatose patients in righttodie cases...

...It also suggests that the refusal to follow your doctor's advice, should he or she be of a different political stripe, might find you reported to the authorities...

...They are human issues, and not until they are moved from an exclusively female agenda will women also move away from an arena where they come under such intensive attack...

...Clearly, there must be a way to get beyond the specter of millions of pregnant women lined up to get their blood and urine tested at neighborhood or community "Pregnancy Monitoring Centers," probably euphemistically renamed something like Maternal Health Centers...

...However, the doctrine of fetal neglect says all women are potentially accountable for the outcome of their pregnancy and the condition of their offspring at birth...

...The Roe v. Wade decision gave women, of the appropriate age and financial means, the ability to claim their guarantee of privacy in decisions to terminate pregnancies...

...It is one thing to entrust a medical doctor with the power to help a woman decide on an abortion, but it paves the way for the kind of grotesque abuse evidenced in the Monson case...

...Childlessness need no longer be permanent...

...In the case of insurance rates, the person involved is responsible only for him- or herself...

...Perhaps these forms of life are a much less threatening reality than the survival needs of living, thinking, conscious, and fully formed children and adults...

...The dark mystery of life's beginning is now quite in the open, never to be returned to the shadows and whispers of the past...

...Thus, the high-risk pregnant and poor drug-abusing woman, hoping to break out of her habit to protect herself and her fetus, usually finds no welcome in programs that might help her and her fetus...

...The seeming grounds for such cases stem from a variety of state laws, of which California has one...

...What is the appeal for the right-to-life forces of the desperately damaged infant, the unformed fetus, the comatose patient...

...The delivery of social services to pregnant women poses a dilemma because it is both a form of protection and a form of intrusion...

...On one level we might justifiably ask what kind of a callous society could say: "Too bad these little infants will have to suffer because we must not monitor the behavior or intervene in the lives of the mothers...

...Some "feticide" laws permit prosecution for murder when a fetus is killed during a fatal or near fatal attack on a pregnant woman...

...In fairness, the doctors in question did not pry into the lives of their patients...

...q SKIMMER • 1991 • 399...

...And sadly, women—mothers—are sometimes the culprits...

...The category might easily come to include mothers or potential mothers who are "sick" women with kidney diseases, arthritis, diabetes, the panoply of auto-immune connective tissue disorders like lupus, and the virtually limitless array of diseases that have hereditary factors...

...They elevate medical counsel to law...

...Further pain is added to this already tragic scenario because so few drug rehabilitation centers or detox clinics are willing to take pregnant women because of liability and insurance problems...

...So, also, the notion of motherhood has been imbued in the United States with a symbolic power to define, to elevate, and for some, to consecrate the image of woman as mother...

...In the case of the doctors, the discount offered was based on medical evidence that healthier babies are born to women who do not smoke...

...Laws to protect women from brutal attacks that in turn might harm their pregnancies were originally well-intentioned...

...At the same time, this has made autonomy in SUMMER • 1991 • 395 Women and Rights pregnancy problematic indeed...

...With the creation of this preborn, presentient, and invisible citizenry, a woman's quite legitimate expectation of privacy and control in pregnancy is being obliterated...

...Doctors who wanted their pregnant patients to stop smoking were also probably well-intentioned...

...Is it the responsibility of mature, responsible women (with the aid of their families and at the suggestions of their doctors), or is it the responsibility of law, public policy, or, in the extreme case, religious zealots who place the rights of the unborn above the rights of the living...

...But child care, pregnancy, and the attendant cares of bringing up the next generation cannot be only women's issues or feminist issues...

...Some children are indeed mercilessly pummeled by disturbed parents, left to fend for themselves in abandoned houses, scalded in hot water, and thrown from apartment windows...

...The politics of the womb have once again forced a notion that motherhood is a woman's chief goal or primary definition...

...In the past, infertile women who craved the joys and satisfactions of motherhood had few options, other than to adopt...

...the growing use of drugs constitutes the most striking danger...

...The question is begged: what is a woman, Private Citizen or Pregnant Subject...

...Yet now the privacy of pregnancy, long understood as a common right, is a phenomenon of times gone by...

...There is the undeniable reality that babies are born, many thousands each year, 398 • DISSENT Women and Rights who suffer, from the very moment of their birth, from serious, sometimes fatal, health problems due to the drug use of their mothers...

...Yet many thousands of Americans work up more than a little protective sympathy for fetuses, and even for bunches of frozen cells—much more, at times, than for babies once they are born and in dire need of assistance...

...Yet there is a darker side to this tale, which makes their offer substantially different from the discounts offered to nonsmokers by health or life insurance companies...

...Yet our current battle raises the most potent danger to women's autonomy because now the womb has been pitted against the woman...

...As happens too often, whatever the motivation for enacting a law, any group can try to make that law serve its own ends...

...A doctor might tell a middle-aged man to stop smoking...

...A large part of the anti-abortion movement is fueled by a religious opposition to abortion as a mortal sin...

...Obviously drug-addicted women need help, but is criminal prosecution of their pregnant selves the most appropriate remedy...

...Liberal social welfare programs sponsored by those in favor of choice might unwittingly provide a kind of precedent for fetal neglect cases, which are popular among anti-abortion crusaders...

...Women who cannot have babies often want to have them...

...A fairly innocent story illustrates the complexity of intervention aimed at pregnant women...

...In other legal cases, the refusal of women to consent to cesarean section deliveries has prompted similar public and legal reactions from hospitals, doctors, and right-to-life advocates...