Why Childbirth and Abortion Are Not Separate Issues

Abortion could soon be a crime. That’s not hyperbole, but a legitimate concern among advocates grappling with the possible appointment of Brett M. Kavanaugh to the US Supreme Court. Public support for Kavanaugh is the lowest for a court nominee since 1987, according to a CNN poll. But even if he fails to be confirmed, a long line of other conservative judges are waiting to join the bench and overturn Roe v. Wade.

And by overturn, I mean begin the systematic dismantling of dire medical care for millions of women and gender-variant folks, resulting in more violence against them that is both direct, such as anti-abortion terrorism, and indirect, such as restriction to access and further criminalization of poverty.

But another experience of reproductive health has been missing from public debate. Like abortion, it also affects women of all ages, backgrounds, and ethnicities; their health, relationships, and self-identity. Like abortion, it can be hugely relieving or deeply traumatizing. Like abortion, it’s an issue of reproductive rights. It’s pregnancy and childbirth, and it’s been left out of the conversation for far too long.

A government that allows employers to deny contraception and abortion coverage while exempting so-called pregnancy centers from providing accurate medical information is essentially trying to control and coerce most reproductive women, those who want children and those who don’t. Whether we’re seeking contraceptives, pregnancy termination, or pregnancy care, our decisions are judged and our bodies treated as property of the patriarchy. Pregnancy and childbirth may seem more ideologically embraced than abortion, especially among conservatives and anti-choice activists, but data indicates otherwise.

Every year, 3.9 million women give birth in the United States. And every year, 700 to 900 women die from pregnancy or childbirth-related causes, the highest rate of maternal mortality among wealthy nations. In comparison, US women are more than three times as likely as Canadian women and six times as likely as Scandinavian women to die in the maternal period. Of the women who survive, about 65,000 barely do. For African American women, the mortality rate is even higher.

The risk of dying from childbirth or related complications is about 14 times higher than dying from legal abortion, according to a report published in the journal Obstetrics & Gynecology. That’s not because childbirth is inherently fatal; after all, a recent report from the Centers for Disease Control suggests that as many as 60 percent of those aforementioned deaths are preventable.

It’s because women’s health has been maligned and subjugated for a very long time and science and technology have done little to understand and competently care for female bodies.

My story in the reproductive rights conversation is a mixed narrative of empowerment and victimization. In other words, it’s pretty common.

At 25, I had an abortion. Despite identifying as a proud feminist, I felt ashamed about “letting myself get pregnant” — and then doubly ashamed about feeling ashamed, for experiencing ostensibly unliberated emotions such as self-doubt and fear. Misogyny is partly to blame for this reaction. But the women’s movement is also partly to blame, for perpetuating the myth that women are morally superior to men, and therefore are obligated to try to dispel misogyny and prove our intrinsic value by accomplishing everything, everywhere, all the time while looking good and acting cheery. No complaining or protesting, lest we seem ungrateful for the opportunity to work ourselves to death.

I’m now expecting my second child. Since having my first, I’ve seen more clearly how women are harmed by this internalized belief that our health should be invisible because our bodies are repulsive to society.

YES! Media, my nonprofit employer, offers me six weeks of paid maternity leave, and if I piece together the sick and vacation hours I’ve been banking all year long, I’ll get just over three months off to bond with my infant, establish breastfeeding, and (partially) recover from childbirth. I hear all the time that I should be grateful for that, that it’s something, that my three months is better than the two weeks taken by 1 out of 4 employed mothers. But medical research suggests that a minimum of six months is necessary for healing and adjustment. Sure, some tech companies offer that to stay competitive, but the United States still remains the only country among 41 nations that does not mandate any paid leave for new parents.

American women need to stop being told their resentment is unjustified, that their criticism of poor, even risky health care is a failure in gratitude. Furthermore, we should stop telling ourselves that. It’s not women who should be silenced. It’s the systems — economic, political, and social — that need to stop silencing women and start looking at solutions to these problems. We all can’t go work at Netflix.

Because I’ve been banking my sick and vacation hours to total at least three months of paid leave, I’ve had to work longer days to compensate for the missing hours in productivity from weekly prenatal appointments (and post-baby couple’s counseling) plus travel. I have done this not just because I need the income during those three months to support my family — in 40 percent of all families with children, the mother is the sole or primary breadwinner — but because taking off more than that puts me at risk of losing my insurance benefits and my job protections.

The challenges of abortion and pregnancy are profoundly similar, although the circumstances might look different: Many women struggle to coordinate child care, shift coverage, or travel to obtain abortions, but they also struggle to find similar resources to attend pre- and postnatal visits and recover after childbirth.

The Pregnancy Discrimination Act was enacted in 1978, five years after Roe v. Wade was decided by the Supreme Court. Culturally, some changes have occurred, but women are still infantilized by the law and by society. Every time our baby bumps are caressed without consent and every time our decision to terminate a pregnancy is challenged legally or philosophically, the message essentially is, Your body is not your own.

I’m not arguing that abortion rights should be discussed exclusively in the context of pregnancy and birth. But that shift would more clearly, more powerfully serve most women: those needing access to terminate pregnancy and those needing care during and after pregnancy. Both deserve as much public understanding and support as possible.