Politics – Page 2

With eight states (so far) passing laws that effectively ban abortion, including some laws that criminally punish both women and doctors for having or performing an abortion, it is beyond time for us to stand up and speak out. Preaching to the choir is nice, but won’t make change. So, here I write for those who are opposed to abortion.

On Proper Terminology

**Note: I use the correct medical term fetus instead of baby, with good reason. When sperm meets egg, the cluster of cells is called a zygote. Then it becomes an embryo. It remains an embryo till week 11 (date from last menstrual period). Afterwards, it becomes a fetus. It is a fetus until it is born and a valve in its heart closes so it can circulate oxygen through the lungs as opposed to receiving it through the umbilical cord. The physiology of a fetus is not the same as a baby after birth.

Pro-Life Beliefs, or Valuing the Fetus over the Woman

The pro-life belief presumes to value the life of the fetus and in doing so, determines that abortion is taking a life. In that, the belief is that taking a life is morally wrong and therefore abortion should not be an option for pregnant people.

Fundamentally, this belief values the life of the embryo or fetus over that of the woman. It values the potentiality of that life over the realized life of the woman. It values a maybe over what is.

I had a social media discussion, in the context of the abortion debate, with a man this week in which he said that he values the lives of both his wife and his children equally. Yet, what he could not see is that those are realized children, not potential children. When I mentioned a litany of pregnancy complications, including stroke, hemorrhage and death that a woman may suffer, he still insisted that the life of the fetus was valued as much as that of the woman so the woman should take the risk of pregnancy… yet, he values his wife? Do you see the problem here? This is him valuing the fetus over the mother, unarguably.

The pro-life beliefs are not that they value the life of the fetus and the woman equally, though they say that often. The pro-life beliefs value the fetus over the mother, no matter the cost to the pregnant person. The costs to her are physical, emotional, economic, social, relational, and temporal. When we value a fetus, an unrealized potentiality, over a fully realized woman, we place her status as second class. She is demoted.

Anti-Abortion Feminists?

To those who claim to be feminists and anti-abortion, you find yourselves in a paradoxical state. Feminism is equality for all genders in all matters
physical, emotional, economic, social, relational, and temporal. By demoting a woman’s value to below that of an unrealized potential you have stripped her of her equality. You can not claim to be a feminist while decreasing a woman’s value at the same time.

The Question of Bodily Autonomy

Ok, so what about the question of bodily autonomy? A zygote, embryo and fetus are only sustained because of the woman’s body. Without the woman’s uterus the fetus has no nutrients, oxygen, water or anything else it needs to grow and develop. If you remove it from the uterus it is incompatible with life. As such, its body is not in any way separate from the woman’s body. It shares blood circulation through the placenta. The woman’s heart beats therefore so does the fetus’s. If the woman dies, her heart stops, so does that of the fetus. Given that, the fetus is thus part of a woman’s body and therefore is under her dominion. The realized woman has autonomy. The potentiality of a fetus does not.

Autonomy also assumes the ability to make decisions about one’s own body. A fetus has no decision making capability. A newborn baby, 2 weeks old, has no decision making capability. All decisions for and about the baby are made by its parent(s). Neither the fetus nor the baby have autonomy. They are incapable of such a thing. They have no ability to govern their body of their beliefs. A realized person does. The pregnant person, being realized, has autonomy. Therefore, the decision as to how she handles her body and everything contained within is solely up to her.

The pregnant woman is stripped of her human rights and of her autonomy by anti-abortion legislation. By valuing a fetus, a potentiality, over the reality of a woman it thus demotes her to below the level of men do who have full dominion over their bodies. She and her body are put under the control of the state.

The issue has never been about fetus’s lives or the question thereof. If you believe that you have fallen for a red herring. The issue, is and always will be, controlling women and their bodies. Pro-life isn’t pro-life. It is pro-birth, pro-control and pro-women-as-second-class-citizens.

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Truly, I do like Elizabeth Warren as a Democratic candidate for president in 2020. She’s said a number of things that jive with the direction I’d like to see this country move. However, upon reading this article from CNN this morning, I find that she’s made a statement that sounds really great on paper about reducing maternal mortality among black women. However, when you look at the high level, talking points plan, it falls very short of the mark and smacks of a lack of in depth understanding of the issue of why black mothers die at a rate of four times higher than the rate of their white counterparts.

Her approach, according the article is to reward hospitals financially for reducing rates of black maternal mortality while reducing funding and financially penalizing hospitals that don’t reduce rates of black maternal mortality.

This sounds an awful lot like “No Child Left Behind” where failing schools are penalized financially and the best schools are rewarded. This cycle perpetuates the poor schools by not granting them the resources needed to do better. It’s no different with her hospital plan.

Penalizing hospitals will mean they may close their maternity units, thus reducing access to care. Most maternity units cost hospitals money, they aren’t money makers. Many rural hospitals have closed or consolidated their maternity units to urban centers, leaving women with drive times of an hour or more for prenatal care, let alone for birth. Better access to care is imperative.

This country is also short about 100,000 obstetricians. We would do well to have thousands more midwives in this country too, to provide care. Midwives are lower cost and have a different model of care for their patients with better outcomes. More providers isn’t enough of a solution. We need to work with the providers we have currently too.

Warren is correct in that we need better education for all medical providers on the issues of race and medical care. However, this is much deeper than cultural competency. Competency is what Warren showed us – she understands there is an issue and it needs to be fixed. Cultural humility is what is truly needed to cover the complexity of human identity and experience. It includes life long learning, mitigating the power imbalances between patient and provider and the institution needs to change. (credit to Melanie Tervalon and Jann Murray-Garcia) For more information please do watch their video on the topic.

This issue of systemic racism starts well before black women are pregnant and in need of prenatal care and care during childbirth. Our medical system has erroneous beliefs about black women’s bodies that go back generations. Please do read “Medical Bondage: Race, Gender, and the Origins of American Gynecology” by Deirdre Cooper Owens if you’d like an in depth, academic history of why and how these beliefs came about and the impact they have currently on black women’s healthcare.

Warren’s response is a gross oversimplification of a problem of endemic racism and weathering in the black community. This penalizing of hospitals won’t solve it. Quite frankly its a panacea. It sounds great, but won’t make the change she’s seeking.

Warren needs to look to the places like the CMQCC and other similar state programs to see what’s working and what’s not. The March for Moms and their team of experts, who have a much deeper understanding of the issues than I do, should be consulted as well. She needs a panel of people who are experts in their fields to consult with and who will initiate evidence based plans to combat maternal mortality specifically among black women.

This issue isn’t as simple as “we’ll charge them money for not making improvements.” See how well that works for the EPA and big polluters. It’s cheaper to pay the fine than to make the change. Making real change, with a multi-factor, nuanced issue like this isn’t easy or straightforward. It will take time, expertise, education and a whole lot of people to admit they have racial biases and are willing to make the change needed.

Warren’s acknowledgement of the issue of black maternal mortality is a good start. However, humility is knowing what you don’t know and where and from whom to seek help. Warren needs help to make real change. I hope she asks for it from the right people.