Where do we come from? There are many ways to answer this, but most of us come from a womb inside of a person we think of as “Mom.” As we look ahead to Mother’s Day and Sunday’s March for Moms, we wonder: to what extent do we really celebrate the pregnant women our mothers once were? How much does our existence and our well-being trace back solely to this one person, this one nine-month period? We give moms a lot of credit. We also assign a lot of blame. So we pause here to explore here some of the things we could fix by recognizing the problems pregnant women face and by taking some collective responsibility for improving the health and well-being of women and babies in the United States.
For example, despite having the costliest maternity care in the world, pregnancy and birth remain health- and life-risking events in the U.S. Each year, an estimated 800-1,200 women die from complications related to pregnancy or childbirth in the United States. Another 55,000-60,000 women suffer near-fatal close calls. Deaths and near-misses are both on the rise. Globally, maternal deaths have dropped by nearly 50 percent since 1990; the United States is the rare wealthy country in which these deaths have increased. Since 1950, black mothers have had maternal death rates at least three times higher than those of white women. Many of these deaths are preventable, too. For example, after a woman gives birth (when most pregnancy-related deaths actually occur), the focus is often on the baby’s health. Giving more postpartum attention to the mother would reduce her risk of dying due to hemorrhage, infection, eclampsia or suicide.
Moreover, contrary to what advice books lead people to expect when they’re expecting, people don’t have complete control over their pregnancies. Pregnancy losses are common. Each year, 26,000 women in the United States will experience a stillbirth and approximately one-third of all pregnant women will have a miscarriage, usually due to a deadly chromosomal abnormality unrelated to the parents. As many as half of these miscarriages will occur before a woman even realizes she is pregnant. Those women who experience pregnancy losses still often find that they do not get the support they need or—worse still—may be accused of a crime for that pregnancy outcome. Indeed, it is all too common for everyone, including the pregnant woman herself, to assume she did something wrong if she experiences a loss or gives birth to a baby with any kind of health problem.
But babies not only grow in the wombs of the people who carry them. They also develop in the “societal womb”—from the places where “their mothers eat, breathe and live.” As sociologist Barbara Katz Rothman explains, “the biggest determinants of the health of that baby are done deals, most of them written in by the time the mother herself was born. Race, class, neighborhood–where that mother herself grew up, where she is living in this pregnancy–those are the biggest determinants of infant outcome.”
One might expect that we would provide social supports and safe physical environments. In reality, the societal womb is often an unfriendly and threatening place. Women continue to be pilloried and punished for being pregnant and using certain drugs despite scientific evidence that claims of harm from the criminalized ones are exaggerated and unfounded, that virtually no drugs prescribed to and taken by pregnant women have been tested for safety on them and even though social and environmental hazards pose far more of a risk to a woman’s health and pregnancy than her use of controlled substances.
Though we espouse concern for expectant and new mothers, our actions shout volumes to the contrary. The societal womb is a place where the deaths of pregnant women from accidents, homicide and suicide continue to go unrecorded and undercounted. It is located in a country where once again we face the prospect that insurers will be allowed to treat postpartum depression and cesarean surgeries—which account for 1 in 3 births—as grounds for denying insurance coverage or charging higher premiums. Pregnant women face the prospect of arrest and the possibility that their health care providers will report them to the police. Tens of thousands of mothers of young children are incarcerated. The societal womb is also a place particularly hostile to Black women and their babies—because the chronic “weathering” stress of poverty and racism has longstanding and multigenerational consequences.
We expect pregnant women to guarantee their babies will be born alive and healthy when such a guarantee is impossible to achieve under any circumstance—and when we offer no guarantee of life and health to women themselves. In the absence of government supports and buffers that make good maternal and infant outcomes more likely, this is just plain wrong.
Pregnant women and new mothers deserve better than our greeting cards. They deserve safe and secure physical and social environments and lives free of racism and violence. This Mother’s Day—and every day—let’s show some love by helping to free the mothers who are locked up because they are too poor to post bail, fighting to preserve universal health care and access to patient-centered health care, and, yes, defending Mother Nature against fracking, pollution and other assaults on the environmen.