Protecting pregnant women is part of reproductive rights too

The war on reproductive rights is a complicated and seemingly endless one; just when I think I know what’s coming next, some clever legislator comes up with a new way to attack the rights of people with the capacity to carry children. Since the vast majority of those who meet that qualification are cis women, such laws disproportionately affect them, creating considerable social disadvantages for cis women of childbearing age, which is to say a very sizable percentage of the population. Such laws limit freedom, and sometimes even put babies at risk, in direct contradiction of their stated function.

Advocates for reproductive rights sometimes get extremely reductionist, focusing on abortion to the exclusion of almost all other considerations — including those of pregnant women who need social supports. In the hurry to defend the right to abort, some overlook the need to pay attention to what is happening to pregnant women in the United States right now, and they should be looking closely, because it matters.

Take the rash of foetal homicide laws, which essentially want to make miscarriages illegal in the name of restricting abortion. While those focused on the right to terminate pregnancies rightly identify such laws as very damaging when it comes to the right to choose, they’re also damaging and dangerous to people who are trying to carry pregnancies to term. If miscarrying becomes illegal, there’s a heavy incentive to conceal miscarriages, especially after witnessing other people being prosecuted for them, which has already started to happen in several states.

Covering up a miscarriage can have serious implications. It’s not uncommon for some material to be left behind, which can create a risk of continued bleeding and infections that could ultimately lead to septicaemia. It’s imperative that the patient receive a thorough evaluation and, likely, a D&C to address lingering health concerns. If patients cannot go to the doctor for fear of being identifying as murderers because their bodies did something entirely out of their control, that leads to putting lives at risk. It also endangers future fertility — if a patient survives lack of treatment or gets treatment late, it may be harder or impossible to get pregnant again.

Moreover, if a miscarriage can be stopped and managed, it may be possible for the parent to carry the fetus to term or at least closer to viability, which could result in the birth of a live infant. Depending on the condition that led to the miscarriage and when the baby is born, the baby might well be born at full term, healthy, and with no medical complications — or could need treatment in NICU for several weeks before going home with loving parents — but if the pregnant parent feared getting treatment, the outcome might not be so good.

Such laws, of course, spell terrible news for people who need or want abortions. When the state indicates that the termination of pregnancy by natural or other means amounts to homicide, it endangers patients and the doctors who treat them. That equates to restricted access to abortion providers and the need to resort to unqualified care providers or to travel to receive care, neither of which is a good thing. The problem is compounded by bizarre machinations of law that not only outlaw ‘foetal homicide’ but also charge people with neglect for miscarrying — a sort of Shrödinger’s foetus, as it were, both dead and alive.

Other laws of concern surround the truly bizarre appointment of attorneys for foetuses, with some states requiring a sort of ‘abortion trial’ for minors who want abortions, and others considering similar measures for people of all ages. At said trials, people advocating for abortion have to face off against an attorney appointed to represent the foetus, with arbiters determining which party is more important. The very fact that the foetus has an ‘attorney’ suggests that the court seriously wants to consider a living pregnant human being with a cluster of cells at some stage of development.

Such laws similarly have the effect not just of criminalising abortion, but also miscarriage. Furthermore, they contribute to existing dangerous precedents involving pregnant women who are using, or getting treatment for, drugs and other addictive substances. When their foetuses are treated like living children who need to be defended from neglect and abuse, it makes it harder for them to access care, because they may be too frightened to come forward in search of treatment. Instead of facilitating treatment, such laws actually increase the risk to pregnant women and foetuses, which goes directly contrary to their stated purpose.

We need to be concerned about the welfare of pregnant people on its face, because pregnant people deserve access to social supports and excellent health care just like everyone else. They have a variety of health needs and some are quite unique due to the fact that another human being is developing inside them. As we advocate for better health care for all, we must make sure that treatment for pregnant people is included in that and that pregnancy is included in the comprehensive list of issues to address as we move forward on health care reform; for example, pregnant people should have more medical autonomy, including the ability to make decisions about when and how they deliver, and the ability to make delivery plans that are respected and adhered to.

However, this is also a pressing reproductive rights issue that sometimes seems to get short shrift. Pregnancy is one aspect of a complicated interwoven network of reproductive rights issues, and it’s critical to make sure it gets attention. We must protect the right of people to carry children safely, and to access care when something is going wrong and they need help, whether it’s a substance abuse problem, a miscarriage, or a routine and unrelated medical matter. If we don’t, we’re not honestly advocating for better reproductive rights for all — and that speaks ill of a social movement that claims to care about health and welfare across the board.

Image: Pregnant, Marcelo Cantarela Junior, Flickr