Of Mothers & Morality

Sui Generis has been following the case of Bobbijean P., the child taken away from her parents – two homeless people struggling with crack addictions. In the neglect proceeding regarding custody over the girl (initiated wholly on the basis of the child’s positive drug screen at birth), her mother was told by a New York family court judge that she must not become 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.” Two weeks ago, a mid-level appellate court unanimously threw out the judge’s order, holding that the family court judge had “no authority to impose the ‘no-pregnancy’ condition.”

Unfortunately, the appellate court did not address the constitutional issues at stake — most centrally, who gets to decide whether, when, and how a woman will bear a child? I’m willing to venture that the state should play no role in that decision — and most certainly should not impose a bar to it.

It seems to me that the U.S. has especially little to say about when and how women can become parents (this applies both to abortion rights and to the rights at stake in this case), when it does so little to support women who do choose to become parents and when it seems to care so little about their health and humanity. Not sure what I mean. Take this excerpt from Sarah Blustain’s recent TAP piece, “No Country for Mothers”:

According to new government numbers, the rate of Americans dying in 2004 (the most recent year to be calculated) hit a record low, while life expectancy — for blacks and whites, men and women — hit a record high. Men were closing their historic life-expectancy gap with women, and African Americans were closing their life-expectancy gap with whites. Even the babies were doing well: The infant mortality rate dropped, too.

Sadly, however, if you are a pregnant mortal living in the United States today, your chances of dying appear to be greater than ever. Yes, the total number of women who die in childbirth in America is low. But according to the Centers for Disease Control’s new “National Vital Statistics Report,” the number of women dying in or around childbirth has risen — putting the United States behind some unsurprising countries, like Switzerland and Sweden, and some surprising ones, like Serbia and Macedonia, Qatar and Kuwait, in its rate of maternal mortality. In rankings calculated on 2000 numbers, the World Health Organization (WHO) ranked the United States at No. 29 on the list, even though, according to the most recent statistics, there is only one country, Tuvalu, that spends more on health care as a percentage of gross domestic product than the United States.

Blustain identifies undertreatment as a central cause of this high mortality rate. Undertreatment because so many millions of pregnant women lack healthcare, especially poor women who most desperately need prenatal care to up the chances that they will give birth to healthy children. How much of a difference does care make? Well, a lot.

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.

Admittedly, race is not necessarily a proxy for the level of care. But it’s undeniable that there remains in the US a correlation between race and poverty, and it’s equally uncontrovertible that poverty is linked to lack of access to prenatal care.

To me, the connections seem clear: women like Bobbijean’s mother are punished for being unable to simultaneously carry a pregnancy to term and kick a drug habit. And the state spends plenty of time meddling in her carrying out of her reproductive life. But when it comes to providing affirmative support to pregnant women (drug treatment, prenatal care, whatever), the state just can’t be bothered.

(Sui Generis via Michelle M.)