The Silent Mother

Esoteric & Historical Gravidity & Parturition

A Dead Woman, Pronatalism, and the Enlightenment

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Yesterday, I had a conversation with my 16 year old daughter about college. I told her in no uncertain terms, that she should not apply for colleges in states with abortion bans and that the minute she thinks about sex with a boy, we should get her on birth control. She agreed, without any argument. My daughter should not have to limit herself because of fear, or because of laws that might harm or kill her, yet here we are.

The latest story out of Georgia, about Adriana Smith, who has been brain dead and kept on life support to be used as an incubator for a baby that may not be compatible with life, since the pregnancy was 9 weeks along, has shaken American women, myself and my daughter included, to the core. Ms. Smith had provided no consent for her body to be kept alive like this. Her family, her legal decision makers, do not consent to having her body used like this. Nor do they consent to burying a baby that didn’t need to suffer or consent to the astronomical medical bills. Informed consent and bodily autonomy are central to medical ethics. What the state of Georgia is doing is not only unethical, it is amoral, and cruel.

Ms. Smith’s story is straight out of Brave New World‘s hatchery, and it’s author, Aldous Huxley, was a lifelong eugenicist. Viewing or using women as “breeders” is pronatalism. Pronatalism, or natalism, is the belief that making more babies, typically of a specific kind, to increase the population is not only good, but a necessity. The online dictionaries and encyclopedias vary in their definitions. Some of them include anti-immigrant references, others touch on legal, or political references. Some places attempt to spin the definition into something positive including supports for families, daycare, financial incentives, etc. We can have additional social supports without pronatalism or pronatalist laws or policies.

What these definitions lack is historical context. That context includes the eugenics inherent in the term itself. The most directly relevant historical period is the interwar period in both Europe and the US. Which, as it happens, is when Brave New World was published. Before we get to that, we need to roll the clock back a bit further. The roots of eugenics, or proto-eugenics, began during the Enlightenment period, the late 17th and early 18th centuries, when there was little differentiation between science and philosophy. I’ll leave this as a teaser for the next post. Suffice it to say, what is happening now, to Adriana Smith, is part of a long thread anchored in history, but which runs through our modern laws, policies, and beliefs about women, pregnancy, and ethics.

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On the Failures of SCOTUS, the fall of Roe, and the Silence of Childbirth Education Organizations and Doula Organizations with Regards to Abortion Rights

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I’ll preface this by saying that SCOTUS’s decision on Dobbs vs. Jackson, to strike down Roe vs. Wade and ending almost 50 years of abortion access in the US, is an affront to human rights. Restricting access to abortion will only result in harm to both the pregnant person and to the baby they are forced to carry to term. I will add to this that I write using multiple terms (women, pregnant person, person with a uterus, etc.), depending on context.

That said, this will become a broader series of blog posts because there is too much to unpack for one post. Really, this series started a while back with my series on Dr. Grantly Dick-Read and his pronatalist, eugenicist, Christian beliefs about women, birth, and the “right” kind of babies. I’d encourage you to go back in this blog and read more.

My trigger for writing was not the Dobbs decision, per se. You all already know my feelings about abortion and the right to make decisions over one’s own body. My trigger was the absolutely deafening silence of both the childbirth education and the doula organizations in the wake of Dobbs. Yet, while I am severely dissapointed, I am wholly unsurprised. The sheer hypocrisy of the organizations that claim to support women’s choices in pregnancy and birth, yet who say nothing in support of the first choice a pregnant person must make – the decision to terminate or continue the pregnancy, is distressing.

If we are to say we support choice, then we must, support all choices, not just the ones we like or the ones that suit our biases. Staying neutral and trying not to offend anyone is being complicit.

A failure of this kind, from all of the childbirth education organizations and doula organizations, is a failure to support human rights, women's rights, public health, and evidence-based medicine.

Let’s talk first about who does support choice, bodily autonomy, and evidence-based healthcare. That’s at least 75 professional organizations, and counting. The link has the list of organizations and the full statement.

ACOG released a statement on the day of the SCOTUS decision.

“While the Supreme Court’s decision today is a significant and destructive setback, ACOG’s resolve is unwavering: we will continue to support our members, our community partners, and all people in the ongoing struggle against laws and regulations that violate and interfere with the patient–physician relationship and block access to essential, evidence-based health care.”

ACOG

ACNM released a statement as well.

“ACNM maintains the right to access to abortion care as an essential right of those capable of pregnancy. ACNM affirms that everyone has the right to decide what is best for their health, bodies, lives, and families. As such, we adamantly oppose all legal opinions and legislative policy that blatantly or surreptitiously seek to restrict or ban the provision of abortion care, as well as any efforts at any level to render it less accessible. ACNM will continue to support efforts to increase access to midwives as abortion providers and engage with stakeholders to make abortion care accessible to the people and communities midwives serve.”

ACNM statement
PA chapter of ACNM’s statement

Childbirth Education and Doula Organizations did NOT release public statements about the Dobbs Decision.

At the time of writing (7/11/2022), no childbirth education organization or doula certifying body has released a public statement regarding the Dobbs decision. These organizations include Lamaze International, ICEA, CAPPA, and DONA. No public statement from any of them appears on their websites or social media. Their silence speaks volumes.

Lamaze did send a letter to the membership (i.e. the certified childbirth educators) via email on July 7, 2022. This was internal only and not designed for the general public. A fellow educator called the letter, “wishy washy,” which I think is a kindness Lamaze does not deserve for it’s failure to support it’s stated mission. The letter, in the image below, falls intentionally short of supporting abortion and human rights. While it acknowledges that a lack of abortion access will cause harm, it does not even use the word abortion in it’s letter. Noting that an issue is “highly politically charged and polarizing” directly shows that Lamaze intentionally will not take a stand to support pregnant people. By not taking a stand, like almost every other maternal-child health organization in the country, Lamaze lays their cards on the table. They chose not to advocate for women, not to support bodily autonomy, not to support evidence-based medicine, and not to support normal healthcare.

Letter from Lamaze International to the membership 7/7/2022

For as long as I’ve been teaching Lamaze classes, since late 2010, I have been told by the organization that they support women’s birthing choices. I’ve been told that they support evidence-based medicine. I’ve been told they support women’s autonomy in decision making regarding their bodies and their births. I’ve been to DC to lobby lawmakers with Lamaze for laws to improve maternal health, reduce maternal mortality, and support breastfeeding initiatives.

As a Lamaze educator, I have taught the people with whom I’ve worked that their choices about their bodies matter and they they should advocate not only for themselves, but also for the next pregnant person to improve the quality and accessibility of healthcare.

A failure of this kind, from all of the childbirth education organizations and doula organizations, is a failure to support human rights, women’s rights, public health, and evidence-based medicine.

I am so disappointed in my organization. Even though I no longer teach childbirth classes or attend births as a doula, I still have an affinity for the group that shaped my life for 12 years. I feel somewhat like a child, who has learned that their parent is flawed and not what they had believed. Let’s explore the details of Lamaze’s failure and the failure of the other organizations in not joining the other 75+ maternal health organizations in condemning Dobbs and supporting the right to abortion.

Breaking Down the Failures of the Childbirth Education and Doula Organizations

  • These organizations say they support evidence-based medicine and information.
  • These organizations say they want to reduce maternal mortality and morbidity
  • These organizations say they support women’s choices and autonomy in all things pregnancy, birth, and parenthood.
    • Except, apparently, for the first choice, to continue or to terminate the pregnancy. If this first choice is not supported, then are women’s other choices truly supported or is it dogma? How can you claim to support women’s choices, but not for abortion? Simple, you don’t support women’s choices.
  • These organizations say they support shared decision making with a medical provider.
    • When the law disallows abortion, shared decision making with a medical provider is squashed.
    • How can a person even have the conversation with their doctor or midwife in a state where abortion is outlawed and it becomes a crime to even help a person by driving them to have an abortion or telling them how to order medication online? Women many skip the doctor entirely and choose online resources that may cause her harm or be ineffective because abortion isn’t legal in their state.
    • Abortion must be legal and accessible for shared decision making to take place.
  • These organizations say they have a mission to advance safe and healthy pregnancy.
    • Safe and healthy pregnancies are had when abortions are accessible. Safe and healthy includes mental and emotional wellbeing in addition to physical. Without abortion, many unhealthy (for adult or fetus) pregnancies will be forced to continue.
    • Pregnancy is a huge drain on the body’s resources, and can cause permanent harm or death. The risks of pregnancy on the body must be entered into with open eyes, evidence-based information, and proper prenatal care which includes access to abortion.
    • Emotional wellbeing is essential to being a successful parent. Not everyone is emotionally ready, nor is everyone financially ready, nor do they have proper social and familial support.
    • Poverty and the social determinants of health play a huge role in how safe an healthy a pregnancy will be.
  • Advocacy
    • This is a rough one for me. I’ve been to DC to lobby with Lamaze. I’ve written letters, I’ve spoken with local, state, and federal legislators on maternal health issues.
    • Abortion is the one topic Lamaze and the other organizations won’t touch with their advocacy.
  • These organizations have chosen the feelings of some of the membership over the reality facing pregnant people. (note: I haven’t seen a poll as to whether or not doulas and childbirth educators support abortion rights. Do we have data on that?)
    • By Lamaze choosing not to make a public statement to pregnant people and those outside of the organization, Lamaze ignores those who matter most. The people we serve.
    • Noting that this is a controversial issue sidesteps the real, direct issue of human rights and women’s health.
    • Taking a firm and direct stance like the 75+ other maternal-child health organizations would send a direct message in support of all people who have the ability to become pregnant. It would support human rights, women’s rights, public health, and most importantly, it supports the health, wellbeing, and autonomy of those people who own a uterus.
    • Noncommittal responses are the same as supporting anti-abortion legislation. It’s like voting 3rd party and therefore helping a reasonable candidate lose because your vote didn’t count.
    • Being “wishy washy,” staying out of politics, trying not to hurt someone’s feelings is doing direct, irreparable harm.
    • Silence is doing direct irreparable harm.

Our local Midwife Center for Birth and Women’s Health also released a statement. So did Healthy Start.

“This includes the belief that our clients are the experts in their health care choices, social environment, and influences, including when and if they choose to become parents. In the United States, the maternal mortality rates and economic disparities currently affecting women and families of color, especially Black women and birthing people, are already at a crisis level, which means that access to comprehensive reproductive services is more critical than ever.”

Midwife Center for Birth and Women’s Health

“As a community that is focused on public health, health equity and centering the lived experiences of marginalized people—in particular Black women—this decision presents an affront to our safety, security and bodily autonomy. What is at stake is bigger than the perceived morality of a personal decision about pregnancy; but the duality of a society where women, children, poor people, people of color, people who are disabled and people of nonconforming gender and sexual identities are oppressed through policy and legislated hatred. In particular, this ruling will have a disproportionate impact on Black women.”

Heathy Start

Ok, but why are these organizations silent?

I’ll give you a hint.

The two major flavors of childbirth education, Lamaze and ICEA, have their historical origins firmly planted in eugenics, pronatalism, politics, and Christianity.

I’ll leave off on today’s post with this: While on one hand, I expected better of the childbirth education and doula organizations, on the other hand, I’ve been in this world of birth professionals long enough to be a realist. There was never any way they could come our and possibly offend someone by speaking out against the Dobbs decision and in support of the human right of abortion access. Their silence is enough to make them complicit.

Expect the first post digging into the history of why in the coming days. In the meantime, go back and read the dozen posts on Dr. Grantly Dick-Read. You’ll find them a good foundation for what’s to come.

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On the Potentiality of a Fetus vs. the Realized Woman

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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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