On being black and pregnant in America

Via Bean comes both some good and some bad news for African American women of childbearing age. The good news is that they’re still legally allowed to become pregnant. The bad news is that, if they do, they are four times more likely to die in childbirth than white American women.

Nicole Black at Sui Generis covers the case of a homeless African American woman who is struggling from drug addiction and has more than one child in foster care who was ordered by a court to not become pregnant until she gained custody.

At issue in the case was the legality of Monroe County Family Court Judge Marilyn O’Connor’s order requiring the appellant, a homeless African-American struggling with drug addiction, to refrain from becoming pregnant “until she has actually obtained custody and care of (her child) Bobbijean P. and every other child of hers who is in foster care or has not been adopted or institutionalized.”

This case garnered national media attention and an amicus curiae brief was filed by the New York Civil Liberties Union and the National Advocates for Pregnant Women on behalf of more than 40 leading medical professionals and child welfare and public health organizations. The brief alleged, in part, that the order violated public policy considerations and infringed on the appellant’s fundamental constitutional right to privacy.

The ruling, thankfully, was struck down. However, it was unfortunately struck down on the basis that the court that made the ruling did not have the authority to do so — not that the ruling was unconstitutional. The constitutionality of such a ruling was not covered in this decision.

Basic and critical constitutional rights were at stake. The case revolved around issues of self-determination and self-control. Does the government or the individual decide when, where and how a person may or may not procreate?

Do our federal and state constitutions permit the government to prevent drug addicts from engaging in one of the most intimate and personal acts in order to avoid the risk of a governmentally mandated abortion should birth control fail?

Is a person under the influence of drugs capable of making rational decisions regarding sexual activity and birth control? If not, then is forced sterilization the only option available to relieve them of making such a choice?

Is forced sterilization an alternative that we, as a civilized and democratic society, should consider even if it turns out to be constitutionally permissible?

Another important and difficult to answer question at stake in this case is just what makes a “good” parent? How do we, as a society, come to an agreement as to what qualities a “good” parent should exhibit?

It’s unclear to me whether Black thinks that these are good questions, or whether they are simply ones that she thinks the court may have or should have dealt with. It seems to me that the clear answer to most of them is “no.”

I will reluctantly admit that a couple of years ago, though I would have been uncomfortable with the ruling, I would have also kind of seen a point. And I may have thought that some of the above questions were genuinely good ones. I mean, I think that we can still agree that homelessness and drug addiction are not the best circumstances under which to become pregnant. And becoming pregnant while you have other children in foster care is also probably not a good idea. The difference, however, is that I now realize that the government should never, ever be able to make that decision.

The book Killing the Black Body helped me to understand this. It also taught me to recognize that we cannot ignore the impact of race in this situation. The woman in this case is apparently addicted to crack. She is also black. These are two circumstances under which the U.S. government has historically usurped a woman’s right to procreate. They have been used to both permanently and temporarily sterilize primarily women of color, particularly black women. It’s not that white women are never addicted while pregnant — it’s that they are treated differently. Since they are less likely to be addicted to crack, they are treated differently by the (racist) law. In addition, they are less likely to be poor and more likely to have a network of support that can take care of the child while they get well. They are more likely to be sent to rehab instead of being ordered to not become pregnant.

Do we want more children in foster care? Of course not. Is it the government’s job to prevent children needlessly ending up in foster care? Actually, I would say that it is — but not by tying chains around a woman’s uterus, and instead providing free public housing and treatment for addiction for mothers in this situation, by providing job training and a stable environment in which to make a living and raise a child (and hey, finally instituting a living wage). In very many cases, we can in fact prevent children going into foster care — and if that was our concern, it would be our focus, not trying to mandate who can and cannot become pregnant.

And if we think that it’s a coincidence that black women in America have such a higher rate of mortality in childbirth than white women, it’s certainly not. Interestingly enough, though it clearly plays some sort of role, access to health care coverage does not seem to be the deciding factor. We know this because the same study showed that not only has the black life expectancy risen, it has narrowed the gap with the white life expectancy rate.

But the equally signifcant explanation for American maternal mortality is probably under-treatment. Perhaps the most notable fact in the CDC’s new report is that African American women are nearly four times as likely as white women to die in child-birth. That is, while 9.3 white women per 100,000 died in childbirth, 34.7 African American women died. And this is a criminal disparity, one that is all the more shocking given that other racial disparities in the report were narrowing. Whether the causes are poor health, poor health care, poor insurance coverage, or — likely — all of the above, there is no excuse for the injustice that being black is a risk factor putting some pregnant women at death’s door.

I’d like to add another potential factor to that list: society’s devaluation and sometimes downright scorn for black mothers. First, we have a situation in this country where many falsely see pregnancy as something that we have 100% control over, and failing to control pregnancy is your own fault. Secondly, we also view motherhood as something earned. Women who bear children in all but the most ideal situations are looked down upon. Thirdly, this is especially true for poor women, and black women are more likely to be poor.

Just look at our public debates — particularly on the Republican side — the openly include disdain for “single mothers,” particularly “poor single mothers” and “welfare queens.” Even though the welfare demographics do not show that black women make up a majority of those receiving benefits, they are in fact disproportionately represented and this is well known political and racist “code” to mean “poor black mothers.”

In this way, poor black women are portrayed as to blame for their own poverty. Fertility is made into the problem, instead of lack of birth control, lack of education, lack of jobs and lack of living wages. Because it’s “our tax dollars paying for those women to have children,” large portions of society feel the right to judge them and yes, to try to control their right to become pregnant.

Are we meant to think that this is wholly unrelated to the fact that black women are four times more likely to die in childbirth? Are we meant to ignore the fact that black women giving birth is often seen as a burden, where as white women giving birth is generally seen as a “miracle?” Of course health insurance is a huge part, but so is the quality of care. It has been proven time and time again that patients medical staff like are likely to receive better medical care. And so are women who have health insurance. Tie this into the fact that, for many of the reasons listed above, women are color are more likely to be distrustful of medical establishments, and you’ve got yourself a recipe for disaster.

Under these circumstances, I think that only talking about health insurance and access to medical care, while avoiding the far more difficult conversation about how we, as a society, truly see black mothers and the right to reproduce, is quite a big mistake. And it’s one that could cost a lot of lives.

0 thoughts on “On being black and pregnant in America

  1. Nicole Black

    I absolutely think that the ruling was unconstitutional, as indicated in my article where I state:

    ***

    In mid-August I wrote about this case (“No pregnancy for you,” Aug. 13) and at the conclusion of my article, I wondered: “Will the court conclude that the right to procreate without interference from the state is a constitutional guarantee, or simply a guideline that can be altered with the stroke of a pen?

    “Will the court’s decision take us one step closer to making governmental regulation of procreation as perceived by Margaret Atwood in the novel ‘The Handmaid’s Tale’ a reality? I certainly hope not.” …

    America is a melting pot of cultures, religions and beliefs. Absent a consensus as to which ideals are “correct,” I simply don’t see how governmental interference with an individual’s ability to procreate would be constitutionally permissible.

    This was a constitutional issue ripe for judicial determination. It’s unfortunate the Fourth Department declined to address it.

    *****

    Reply
  2. Redstar

    I’m reading Flat Broke with Children right now, by Sociologist/Women Studies feminist professor Sharon Hays. I’d love to get a blog book club going about this book. You should check it out; it’s highly relevant to this issue you’re discussing here.

    It focuses on the 1996 welfare reform legislation (PWORA), the benefits now known as TANF. In the legislation, there is this thing known as the “family cap,” under which women who become pregnant while on welfare are denied benefits for that new child. It’s unconstitutional and written right into the legislation.

    The book lays out clearly the cultural conflicts we have in this country re: women, motherhood, work v. family balance/resposibility, etc.

    The major irony to me is that though there are about 35M people at any given time living in poverty, there are only about 1M or so on “the rolls” by now. Yet, we make these mothers and children our obsession, acting as if they’re some enormous drain on the system deserving of punishment for their irresponsibility.

    As for TANF recipients, I think that the recipients are disproportionately women and children of color, following on their disproportionately high rates of poverty that you mention above.

    Reply

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