Glossary Term: Pregnancy / Childbirth, The United States
Definition of the Term and Background
The Encyclopædia Britannica defines obstetrics and gynecology as the, “Medical/surgical specialty concerned with the care of women from pregnancy until after delivery and with the diagnosis and treatment of disorders of the female reproductive tract” (“Obstetrics and gynecology”, 2017). The process of pregnancy has changed over the course of history. In the beginning, midwifery had been the common practice of attending to childbirths. This began to change in the 17th century with the onset of physician-assisted births but was marked by social division. At the beginning of this practice, only aristocratic women were afforded the benefit of a doctor. However, over time the custom expanded to encompass those of lower class standing (“Obstetrics and gynecology”, 2017) Today, pregnancy and childbirth is filled with options that have arisen due to medical advancement, such as the possibility of in vitro fertilization and cesarean section births. In American society today, pregnancy and child birth involve contrasting issues. The politics and social norms surrounding teen pregnancy stand in opposition to the potential dangers of geriatric pregnancy, highlighting how society holds certain ideas about ideal pregnancies.
More information on geriatric pregnancy can be found here: https://www.healthline.com/health/pregnancy/geriatric-pregnancy
And more information on teen pregnancy can be found here:
https://www.cdc.gov/teenpregnancy/about/index.htm
Medical support through pregnancy and child birth varies greatly between countries depending on the structure of the health care system and the social norms that surround the biological process (Sedgh, 2015). Statistics concerning maternal mortality, child mortality, attending physicians, and other aspects of the pregnancy and childbirth process vary country to country, but it is clear that a disparity remains concerning maternal healthcare both internationally and domestically. Recently, the idea of a clear linkage between pregnancy itself and issues of female rights has been increasingly explored (Vogel, 1990). There are many different ways to approach this field of medicine, but this encyclopedia entry will examine pregnancy and child birth from the mother’s experience, and how this plays a role in the issue of gender equality in the United States of America. Pregnancy impacts a woman’s ability to participate in the workforce fully, particularly relative to their male counterparts. Reconciling feminism, “the belief in the social, economic, and political equality of the sexes” (“Feminism”), with the complex nature of maternal health is a challenge to American lawmakers and society as a whole. Feminism, furthermore, plays a role in the debate over a woman’s right to terminate her pregnancy, calling into question reproductive rights and access to abortions. All these issues are inexorably linked to pregnancy and child birth in the United States and are only a small piece of the complex nature of pregnancy and childbirth.
Image 1: “Dr. Frankenstein Reading a Pregnancy Book with Frankenstein’s Monster on the Lab Table” (Sipress). In this image from The New Yorker, a political cartoonists pokes fun at the process of pregnancy as being similar to the creation of Frankenstein.
Historical Context
Protecting the mother and the child throughout pregnancy and child birth is a challenge that many healthcare systems around the world are working to achieve (Wall, 1995). L. Lewis Wall, Associate Professor and Director of the Fellowship Program in Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics and Gynecology, Louisiana State University, writes that, “The transcendent objective of obstetrics is that every pregnancy be wanted and that it culminates in a healthy mother and a healthy baby” (Wall, 1995). However, this is far from the reality of many women, both in America and all over the world. Prenatal care only began in the 1900’s (“Obstetrics and gynecology”, 2017). Maternal care has advanced greatly since then, but maternal death rates remain high in the United States and across the globe. Additionally, the issue of individual control over one’s own body has been hotly debated in America, whether concerning access to contraceptives or legal right to abortion. The right to control one’s own body is inextricably linked to pregnancy and childbirth, particularly from the point of view of the mother as a patient in the American healthcare system. As discussed further later in this entry, the health of the fetus can be viewed as holding more importance than the health of the mother, thus complicating the process of contraception and abortion in the States. A series of court cases that have established legal precedent, but this is continuously challenged. Since the landmark Supreme Court Decision of Roe v. Wade in 1973, a woman’s ability to receive an abortion has increased dramatically (Schoen, 2015). However, the debate endures as individuals continue to challenge the healthcare system.
Image 2: “An unexpected child can really rock the cradle” (Planned Parenthood Association of America). In this Planned Parenthood poster, women are encouraged to consider all the consequences of having an unplanned child, thus encouraging the use of methods of family planning, such as contraception.
Perspectives
Accordingly, pregnancy and childbirth have become inextricably tied to feminism and equal treatment, regardless of gender. Health systems all over the world wrestle with how to optimize women’s health. Interestingly, research has shown that the medical community often does not describe female health problems, such as smoking or diabetes, in the same way that women define their own problems (Inhorn, 2006). This discrepancy puts undue strain on the woman during any health process, particularly pregnancy and childbirth. The article from the Medical Anthropology Quarterly goes on to explain that during pregnancy, certain accommodations are afforded to the mother, solely with the child in mind. This view, focusing on females as exclusively mothers, has resulted in a narrower approach to obstetrics (Inhorn, 2006). This disconnect further challenges pregnant women and makes the process more emotionally challenging. The focus on reproduction, from an ethnographic standpoint, casts other women’s health issues as less significant. These issues include serious topics, like female circumcision and HIV/AIDS. Yet, despite their seriousness, they are viewed as less important in the face of infertility and reproduction. This framing is particularly stark when examining the value placed on the mother versus her fetus throughout the pregnancy. As Marcia C. Inhorn, Department of Health Behavior and Health Education Program in Women’s Studies at the University of Michigan points out, women are put in impossible positions when deciding to terminate pregnancies due to diagnoses of birth defects. The mother is thrust into a near impossible moral problem and she alone must make a decision, which is especially challenging in light of the emphasis on reproduction in society (Inhorn, 2006).
In the United States, questions concerning the quality and availability of maternity care have also been raised. According to the Guttmacher Institute, “More that 23,000 U.S. infants die each year in their first 12 months,” and the rate of maternal mortality, especially in the black community, in the United States remains high (Sonfield, 2017). These mortality rates pose a threat to the nation. Improving the quality of pre-natal and post-natal care would cause a decrease in infant and maternal death rates. How exactly to improve pregnancy and maternity support is an enduring challenge that country continues to face.
These issues, such as the framing of the mother’s body in the pregnancy process and the quality of her healthcare throughout the maternity period, are only a few of the points of conflict surrounding pregnancy and child birth in the United States.
Relation to Politics of Health
Pregnancy and child birth, as well as maternal health in general, is deeply tied to the study of politics of health in a variety of ways. As explored throughout this entry, the pregnancy process brings about issues of personal agency and individual control over one’s own body.
As discussed in class in relation to the Michel Foucault’s chapter, “Right of Death and Power over Life”, from his book, The History of Sexuality, the idea of biopower continues to apply to governance of the human body (Foucault, 1985). The regulation of bodies by societal norms and institutions, particularly by healthcare officials, is evident in the conflict surrounding women’s health and pregnancy. In American society, questions of authority and the ability to regulate biological health circulate among the discussion of pregnancy and childbirth. In the book, Blood Sugar: Racial Pharmacology and Food Justice in Black America, author Anthony Ryan Hatch defines Foucault’s idea of biopower as, “the relationships through which the life and health of bodies and populations become the objects of scientific discourse and institutional regulation by governments and corporations” (Hatch, 2016). Thus, the current debate concerning female agency over one’s own body and pregnancy is closely linked to the opposing institutional and societal regulation.
Ultimately, the conflict surrounding pregnancy is multifaceted and often tied to politics. The divergence over reproductive rights continues to play out in American society, while the stereotypes concerning the female body remains influential over medical care in the United States.
Additional resources
https://www.ted.com/talks/sofia_jawed_wessel_the_lies_we_tell_pregnant_women/transcript
In this TED Talk, Sofia Jawed-Wessel, a sex researcher, explores the shift in how women are viewed and thought of once they become pregnant. She explains how the loss of individuality that comes with carrying a child impacts the way that women are seen and objectified in society.
https://www.ncbi.nlm.nih.gov/pubmed/26967357
This article, “The Stigmatization of Pregnancy”, explores the ways in which society influences pregnant women, particularly in the realm of physical activity. The study conducted looks at how women’s exercise is impacted by society throughout the course of their pregnancy.
http://www.thejournal.ie/readme/debate-drinking-during-pregnancy-3193080-Jan2017/
This piece, “Debate: We need to tell pregnant women not to drink alcohol”, examines the discussion surrounding what pregnant women are advised to do and not do. The article, written from two different contrasting opinions, further supports the link between pregnancy and the idea of biopower.
This article from the Guttmacher Institute, an American reproductive health nonprofit organization, highlights the connection between declining rates of unintended pregnancy and therefore dropping abortion rates.
References
“Feminism.” Britannica Academic, Encyclopædia Britannica, 28 Dec. 2017. academic.eb.com/levels/collegiate/article/feminism/343946. Accessed 16 Feb. 2018.
“The Framework of Biopower.” Blood Sugar: Racial Pharmacology and Food Justice in Black America, by Anthony Ryan Hatch, University of Minnesota Press, 2016.
“Geriatric Pregnancy: Is Getting Pregnant After 35 Risky?” Healthline, Healthline Media, www.healthline.com/health/pregnancy/geriatric-pregnancy.
Inhorn, Marcia C. “Defining Women’s Health: A Dozen Messages from More than 150 Ethnographies.” Medical Anthropology Quarterly, vol. 20, no. 3, 2006, pp. 345–378. My Library, onlinelibrary.wiley.com/doi/10.1525/maq.2006.20.3.345/epdf.
“Obstetrics and Gynecology.” The Editors of Encyclopædia Britannica, Encyclopædia Britannica, Encyclopædia Britannica, Inc., 28 Apr. 2017, www.britannica.com/science/obstetrics.
Planned Parenthood Association of America. Advertising Council. “An Unexpected Child Can Really Rock the Cradle.” U.S. National Library of Medicine, New York, NY: Planned Parenthood, 1972.
“Reproductive Health: Teen Pregnancy.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 9 May 2017, www.cdc.gov/teenpregnancy/about/index.htm.
“Right of Death and Power over Life.” The History of Sexuality, by Michel Foucault, Pantheon Books, 1985.
Schoen, Johanna. “Living through Some Giant Change: The Establishment of Abortion Services.” Abortion after Roe: Abortion after Legalization, University of North Carolina Press, Chapel Hill, 2015, pp. 23–60. JSTOR, www.jstor.org/stable/10.5149/9781469621197_schoen.6.
Sedgh, Gilda et al. “Adolescent Pregnancy, Birth, and Abortion Rates Across Countries: Levels and Recent Trends.” The Journal of adolescent health: official publication of the Society for Adolescent Medicine 56.2 (2015): 223–230. PMC. Web.
Sonfield, Adam. “No One Benefits If Women Lose Coverage for Maternity Care.” Guttmacher Institute, 27 July 2017, www.guttmacher.org/gpr/2017/06/no-one-benefits-if-women-lose-coverage-maternity-care.
Sipress, David. Dr. Frankenstein reading a pregnancy book with Frankenstein’s monster on the lab table. Publication: New Yorker. http://library.artstor.org/asset/AWSS35953_35953_29923764. Web. 16 Feb 2018.
Wall, L. Lewis. “The Anthropologist as Obstetrician: Childbirth Observed and Childbirth Experienced.” Anthropology Today, vol. 11, no. 6, 1995, pp. 12–15. JSTOR, JSTOR, www.jstor.org/stable/2783519.
Vogel, Lise. “Debating Difference: Feminism, Pregnancy, and the Workplace.” Feminist Studies, vol. 16, no. 1, 1990, pp. 9–32. JSTOR, JSTOR, www.jstor.org/stable/3177954.
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