In this episode of “Kat and Liz Talk About…” we discuss pregnancy and paternalism. As Kat and Liz have both been learning firsthand, becoming pregnant can mean losing a lot of autonomy. Suddenly, everyone from doctors to strangers to the state starts treating women like interchangeable baby incubators instead of individuals.
Alas, this sometime starts even before pregnancy (remember when the CDC classified everyone of reproductive age as “pre-pregnant” in order to advise them not to drink?). It extends to atrocious advice from media “experts” about what pregnant women should and shouldn’t eat, drink, etc. And it’s led to some seriously suspect policies.
Whether it’s coffee consumption, treating pregnancy symptoms with cannabis, or simply wanting to schedule with a specialist, women are frequently given misinformation or refused adequate medical care—simply because they’re pregnant.
Join us for a libertarian feminist look at cultural perceptions and government reactions surrounding pregnancy. And, if you like this episode, make sure to subscribe to our YouTube channel, and join the conversation by tweeting us (@feministliberty) with #KatandLiz.
Produced by Addyson Garner
TRANSCRIPT:
Kat: So I’m pregnant
Liz: And I am also pregnant.
Kat: We’re both pregnant during the pandemic.
Liz: Take that COVID-19 baby bust!
Kat: So being pregnant and a feminist is a really interesting experience because it really puts a lot of the more abstract things that we talk about and think about into sharp focus.
Liz: Right? In a lot of ways, society has really progressed with gender equality in the past few decades, but then you get into pregnancy and parenting, and a lot of that falls apart.
Kat: And it really ranges in the ways that it affects you. So it’s everything from the gender wage gap where millennial women actually often make more than their male peers, 8 to 20% more, according to one 2010 study, until they get married and have kids—
Liz: —to division of labor within the home with a lot of studies showing that women often end up taking on more work once they have kids.. which my husband should know is not going to happen in our household!
Kat: Or mine. To just like basic ownership of your body from strangers, trying to touch you and your belly and decide for you what you’re allowed to eat or drink or do, to actual laws that in many ways treat you as less of a person just because you’re growing another person inside of you. Having babies just changes a lot.
Liz: One thing that’s been really weird to me is suddenly all of my doctors want to get approval from my obstetrician before they’ll do anything. I needed dental work and the dentist was like, okay, we need to get approval from your OB first. My psychiatrist would not prescribe me this anti-depressant that I’ve been on for more than a decade until he talked to my psychiatrist first, even though I told him, you know, I talked to my OB about it and they said it was totally fine. And he was like, no, no, no, no; my word was not good enough. They needed to hear from them, which is just really weird. I know it’s a liability issue, but also… I’m still your patient, not my OB, and not the fetus growing inside me, and it’s really weird to feel like my consent in this doesn’t matter anymore.
Kat: Yeah. My OB GYN straight up told me not to bother going to any urgent care clinics and just to call the OB GYN for anything I needed, even if it wasn’t related to the pregnancy, just because the minute they saw me and my belly, they would refuse to treat me. And I experienced this because I had an allergic reaction to inhaling way too much dust when vacuuming. I’m always allergic to dust, but pregnancy makes you more allergic to things you’re already allergic to. And I ended up coughing up blood for a week. I’m fine now, don’t worry, but I couldn’t get a single pulmonologist to make sure that that was the only issue and there’s nothing else going on. Even though I had a referral simply because they all refused to see me. As soon as I told them I was pregnant.
Liz: It’s like as soon as you’re carrying a baby, a lot of people start acting like you as an independent or an actual person just don’t exist and you’re just this incubator for another life. And also that you cannot be trusted to have your own opinions on what’s in the best interest for that life.
Kat: It’s weirdly dehumanizing
Liz: The advice given to pregnant women on what to consume or not to consume can also be crazy paternalistic. A lot of it on health websites or in the media is just like, “Don’t do this, do this,” without saying why. And I’m a “why” person. I want the data behind recommendations. I want to make an informed decision for myself, not just listen to the conventional wisdom that may be out of date or, you know, some potentially shitty study that’s filtered down through this totally bastardized reading by a health journalist.
Kat: And the fact of the matter is they actually don’t often have the data. And even when they do, the powers that be might just decide that women, especially pregnant women apparently, are just too stupid to figure it out for themselves. For example, pregnant women are often told never, ever, ever to even dream of smelling coffee or touching a drop of alcohol, unless they’re just terrible people who want horrible things to happen to their children. In 2016, the CDC even told pre-pregnant women (Yeah, that’s right. Not pregnant women, just women who possibly could be fertile. So like, I don’t know what, like every American female from like 10 to 60?) not to drink alcohol at any time, just in case they were to become pregnant. “Why Take the chance?” the CDC principal deputy director at the time actually said in the press release.
Liz: That advisory in particular, I remember it got a lot of ridicule with good reason, but that was far from the first time that the CDC suggested that all women of childbearing age should be treated as, you know, pre-pregnant. They’ve issued guidelines, saying women shouldn’t have the same access to painkillers or anti-depressants or other life-saving drugs or life-improving drugs as men simply because they could potentially get pregnant and that maybe might have a small impact on the fetus.
Kat: And that’s the thing, the actual science itself, including the CDC’s own research shows that drinking small amounts of alcohol is unlikely to have any actual impact on the child. And similarly, despite the many scares about how caffeine can cause infertility or miscarriages or birth defects, study after study tells us that your morning cup of coffee won’t kill your baby.
Liz: I’ve learned that they can’t do randomized controlled trials on pregnant women with most things—because it would be unethical to give pregnant women something that could be potentially harm a developing fetus, or to withhold a substance that could be good. So there’s just not a lot of good science out there. It leads to a lot of super cautious statements from government health bodies like “this isn’t proven to be safe,” or “there’s no amount of this substance that is known to be safe in pregnancy,” which makes it seem like these things are known to be harmful. But that’s not the case. It’s just unknown. And then they’ll still just say, “Well, just stay away from it out of an abundance of caution”—like any amounts of alcohol whatsoever, any amount of coffee whatsoever, lunch meat, sushi, you know, the whole list.
Kat: Yeah. There’s this attitude that pregnant women are merely a vessel and any amount of sacrifice on the woman’s part should be worth it and done without any questions if people say it might be better for the baby, and most moms actually would and do make these sacrifices when there’s good reason. But when you look at some of the recommendations, it’s based on things that actually have a really, really minuscule or negligible impact on fetal outcomes, or are based on outdated science or an overabundance caution, or, you know, someone just made up.
Liz: You really have to do a lot of your own reading and research to find out what’s real. I highly recommend reading Expecting Better by Emily Oster or reading her newsletter. She’s an economist who really digs into the data behind a lot of advice that’s given to pregnant women and to parents with the aim of helping them have good information so that they can actually make decisions, informed decisions for themselves based on their own particular circumstances and values and risk tolerance levels and things like that.
Kat: Yeah, so like with everything else, what’s right for one person during pregnancy, isn’t always best for the next person. And while most expecting moms want to do what’s right for their future kids and have the healthiest pregnancy possible, there are other constraints and issues that people are dealing with. Everything from poverty, mental health problems, addiction. And we have to think in trade-offs like “Maybe this person can’t do everything perfectly. How do we still help them have the healthiest pregnancy possible? And like, is there such thing as being perfectly pregnant anyway?”
Liz: I mentioned cannabis before because I’ve been researching an article for Reason on drug testing of pregnant women. And it’s shocking how common it is to do this the first place. And then second, how they keep women in the dark about it? Keep everyone sort of in the dark about what their policies are. It really varies by state, by city, by county, by hospital system. And, you know, pregnant women have to give urine samples or blood samples so often for any number of reasons during their pregnancy, they’re often just not told why and what’s being done with them. And it’s really hard for them to get answers about why.
Kat: Yeah. And again, a lot of this just isn’t based on science or what’s best for either mom or baby, like we talked about. Take cannabis—decades of data on cannabis usage and pregnancy all show that prenatal exposure to cannabis does not lead to cognitive impairment in children. And that’s not based on some flimsy study done by someone with an industry bias or I don’t know, High Times Magazine, but by researchers at places like the New York State Psychiatric Institute and Columbia University. And yet women around the country are routinely incarcerated or lose custody of their children simply for testing positive for drugs, including marijuana, before or after giving birth, even though some women actually find that cannabis usage can help them with conditions that occur during pregnancy.
Liz: Some places leave drug testing up to the discretion of doctors or medical staff on who to test, which can lead to a lot of bias based on, you know, race or class or other, just sort of preconceived notions that staff have. Other places do universal testing, which can also be very problematic though, because, you know, there’s a lot of false positives with these things. And also just a lot of people aren’t clear on what is going to happen. If someone has a positive drug test you know, are they going to just, you know, use that for medical reasons to talk to their mother, to look and make sure the baby’s okay. Are they going to do a confirmatory test before they actually alert some sort of state authorities? Not always. I was reading about a lot of cases around where I live now in Cincinnati and Kentucky, where there’s been lawsuits because they have not waited until they got a second test on the baby to alert CPS. And then the baby comes back negative and it turns out it was a false positive test on the mom’s part. This stuff is happening without a lot of people’s consent entirely. The Supreme court said that pregnant women, you must have consent of a pregnant woman before doing a drug test on her, but there’s been a lot of investigations by people like ProPublica and other outlets that just show that that hasn’t happened. And meanwhile, if a woman refuses, they could test newborns without her consent.
Kat: Yeah. And the people that pass these laws and policies say that they’re trying to protect babies and protect women and get women the help they need. But evidence suggests that they do the exact opposite. They push women who are struggling with substance abuse issues and addiction to forego appointments, be dishonest with doctors or even forego prenatal care whatsoever. So really they tend to push pregnant drug users, underground, prevent them from getting any help, even if that’s help that they want, they want to seek out. And they create a potentially more dangerous situation for both them and their children, rather than, you know, actually protecting life and ensuring healthy pregnancies. It’s not so dissimilar from any other drug war policies. The people who pass these laws are way more focused on incarcerating and punishing women than they are on helping them get the help that they need.
Liz: Then you have a lot of cases too, where if something, God forbid does happen to a baby, then they look for reasons a lot of times to blame the woman, especially if it seems like there are other reasons to have a bias against her. Like a lot of times women with mental health issues or just women that are already regarded as suspect classes—they might miscarry or give birth to a stillborn and you’ll have people looking to blame them. Which is just nuts because of course, even if you do everything right, there’s still so much that can go wrong.
It’s really scary. I had a miscarriage previously. I know a lot of women who have had miscarriages. And on top of the sadness about losing your pregnancy, there’s this irrational guilt, like, was I too stressed? Did I not do this or this right? And just sort of blaming yourself and thinking, you know, what could I have done better? Would it have been different? Even though the vast majority of miscarriages are caused by genetic abnormalities and things that no one could actually help.
Kat: Yeah, I think one of the things that our generation does bit better than our parents’ generation is be more open about this stuff like miscarriages, fertility issues, and try to de-stigmatize it. It’s crazy how people used to consider things like that to be too shameful to talk about. And it’s sad because these are things that women and couples shouldn’t have to go through alone if they don’t want to, and often feel like they have to still. Fertility and infertility in general is another huge topic we plan to touch on in future videos.
There’s really just so many issues surrounding pregnancy that we want to talk about, like abortion and the treatment of pregnant women in prison and the act of childbirth itself and issues like birth freedom and medical consent and there’s just a lot of important decisions about prenatal care and especially labor and the birthing process that women aren’t asked about or given choices on, or even when they do make choices, they’ve done their own research, they know what they want, they’re just ignored.
Liz: A lot of times, this comes down to (surprise, surprise) government regulations. I’ve written some about regulations surrounding, for instance, doulas and midwives and home births and things like that. And this is an area that is really ripe for occupational licensing reform—which as we know, is a perennial favorite topic for libertarians, with good reason, and something that I wish more libertarians would get invested in when it comes to birthing issues.
Kat: Yeah, people just really want to slot pregnant women and the birth process into a one-size-fits-all experience. And it’s just not, we’re all so different. Our bodies are different. Each pregnancy is different. You know, between one pregnancy and the next, women have completely different experiences, and they really need to have that individual experience which our whole system is set up to discourage.
Liz: It’s interesting because even though reproductive decisions and pregnancy and childbirth are such intensely personal experiences, they’re also intensely and inherently political ones in our society. The most politicized part of a lot of women’s experience is going to be decisions related to reproductive freedom, whether that’s, you know, about birth control or just the decision whether or not to have kids, to decisions around childbirth and pregnancy and parenting and things like that. It all kind of makes being pregnant an astoundingly joyful experience, but also a very scary one. Like, at this point, I know how to deal with societal expectations for being a woman—but I do not know about being A Mother, and all the things that come with that in terms of a whole new set of expectations.
Kat: Yeah. I think “scary” is a good word for it. It’s very exciting, but it’s also life changing in a very real way and for a lot of people, a lot of women, pregnancy is the first time that the state really gets involved in their own personal decisions. All of which I’m sure people will find us talking about a lot in the future, you know, maybe as we’re going through it, something like that.
Liz: So stay tuned!
Kat: And please like this video, subscribe to our YouTube channel, follow Feminists for Liberty across social media, and share this with your friends.
Liz: And tell us what you think, and what you’d like to see us talk about in the future.
Kat: But until next time, thanks for watching!
Liz: Bye!
