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The pregnancy police are watching you

In the US, women of child-bearing age are being advised to consider themselves 'pre-pregnant' at all times, by giving up smoking, drinking and drugs. What are the implications of treating people as glorified incubators, asks Diane Taylor

Diane Taylor
Monday September 4, 2006


When Regina McKnight, of South Carolina, went to her local hospital to give birth in May 1999, she prayed that the baby would be healthy. She had good reason to worry. Since her mother had been killed by a hit-and-run driver the previous year McKnight had begun smoking crack. She was naturally devastated when the baby was stillborn - and shocked, five months later, to be charged with homicide. Prosecutors argued that smoking crack had caused the stillbirth and that McKnight should therefore be classed as a murderer.

Despite medically disputed evidence about the role cocaine had played in the tragedy, McKnight went on to become the first woman in US history to be convicted of foetal homicide by child abuse. An appeal to the US Supreme Court failed and she is serving a 12-year jail term.

In the US, more than 20 states now define drug use by an expectant mother as child abuse, neglect or even torture, while The Unborn Victims of Violence Act, passed by Congress in 2004, argues that foetuses are separate persons under the law, with rights independent of the pregnant woman. Any aspect of a pregnant woman's behaviour that might risk foetal health - except of course abortion - is therefore open to punishment in the courts. And last May, legislators in Arkansas proposed making it, not just a matter of social and moral oppobrium, but an offence worthy of prosecution for a pregnant woman to smoke a single cigarette.

New federal guidelines issued this year ask any woman capable of conceiving to treat themselves - and to be treated by their health-care provider - as "pre-pregnant" at all times. Women between their first menstrual period and the menopause are told to take folic acid supplements, stop smoking, stop drinking regularly, maintain a healthy weight and keep chronic conditions such as asthma and diabetes under control; not primarily for their own health but to protect any baby that they may or may not be planning to have. They're also advised to steer clear of lead-based paint and cat faeces - a problem for any "pre-pregnant" folk whose household chores include cleaning the litter tray. There is no mention of "pre- fertilisers", ie, fathers, taking similar steps to ensure their sperm are healthy, despite studies that suggest male alcoholism can cause birth defects in children.

The rationale for the guidelines is that half of all pregnancies are unplanned and that the US has a higher infant mortality rate than most other industrialised nations. At the moment there is no talk of criminal sanctions against women who fail to comply with the pre-pregnancy guidance but it's another worrying sign that US women are expected to treat themselves as incubators first, individuals second. And the onward march of foetal harm legislation suggests that it's not entirely Orwellian to suspect that women might, in future, be criminalised for any indulgent behaviour before a pregnancy - as well as during - that ends up harming their child.

Lynn Paltrow, executive director of the New York-based group, National Advocates for Pregnant Women, believes that hatred of women is at the root of the trend. "It's linked to 30 years of vicious anti-abortion rhetoric that describes women who terminate pregnancies as murderers," she says. "You can't have that level of hateful rhetoric and just limit it to abortion. Once pregnant women are seen as capable of heinous crimes like murder, they are dehumanised."

Of course, it's obviously far better for a developing foetus if an expectant mother gives up drinking, smoking and taking drugs. But while it seems no expense is spared to prosecute and jail women addicts, far too little is spent on getting them appropriate treatment. And the women involved in these cases are almost always those most in need of support - there have been no stories of children dragged from rich Manhattan mothers who choose to snort a few lines of coke before breakfast. Those targeted are disproportionately black and poor. And all the sound and fury about the highly prized foetus evaporates once it is no longer in utero: children of drug-addicted mothers are often dumped in foster placements, where study after study has shown they have little chance of thriving.

This attitude to pregnant women shows signs of crossing the Atlantic. The behaviour of expectant mothers has never been more closely scrutinised or criticised, with both Kate Garraway and Kerry Katona having been attacked by the tabloids in recent months after being pictured with a cigarette plus baby bump. And some sources have proposed measures that aim to ensure that transgressive women can't conceive. In a recent paper, Professor Neil McKeganey of Glasgow University, a specialist in the social effects of drug misuse, suggested that "paying female drug users to use long-term contraception is one ... incentive that we may need to consider if we fail to reduce the level of unwanted pregnancies by drug users by other means". In a separate development, Labour MSP Duncan McNeil has proposed adding oral contraceptive to prescription methadone.

Dr Mary Hepburn, who runs the Glasgow Women's Reproductive Health Service supports women with social problems during pregnancy and after birth. What she finds most disturbing is the blanket condemnation applied to drug-using mothers.

"The gap between the rich and the poor is growing," she says, "and so is the gap between the poor and the very poor. A lot of the problems the women I work with experience are caused by poverty rather than by drugs in isolation. A punitive approach towards them will drive them underground, which won't be good for them or their babies."

When it comes to drug- or alcohol-addicted expectant mothers, obviously the ideal way forward is for them to seek treatment. Even for the richest people, addiction is supremely difficult to tackle, but for those from the lowest socio-economic groups the depredations that have led to them becoming drug-users generally make it extremely hard for them to give up. In the current US climate, though, the punitive approach towards pregnant women - in which women have been dragged to prison cells, hours after giving birth to a healthy baby, still haemorrhaging but having tested positive for drugs - means that few are likely to seek treatment. Who would take that risk if it meant the possibility of prosecution, a jail term and your child being removed from your care?

As Paltrow says: "The US has a phenomenal disregard for the wellbeing of families. Almost every problem is seen as one of personal responsibility rather than social or community responsibility." And the punitive approach to pregnant mothers emphasises this, legislating against women who might otherwise seek help for their personal problems.

In the last couple of decades laws targeting some of the US's most vulnerable women have crept inexorably, state by state, across the country, and now the institution of pre-pregnancy guidelines brings the spectre of women facing even wider punishment. In the UK we need to be vigilant to ensure that, in similar situations, pregnant women receive support - rather than a prison sentence.

Date: 2006-09-09 10:20 am (UTC)
From: [identity profile] babelmira.livejournal.com
Being Honest? I've expected something like this for years. Pretty soon they'll find a guy wanking and a woman ovulating and charge them with attempted abortion.

Did you know that in Scotland you can be charged with causing the birth and death of a baby? That one's been on the books for years.

Date: 2006-09-09 10:29 am (UTC)
From: [identity profile] unwillinggal.livejournal.com
No, I'd never heard of that one. Presumably it's not a law that's used a lot?

I'm constantly surprised that Real Life (whatever that means anyway) is becoming more and more like a work of fiction - the ideas in that article remind me of the Handmaid's Tale.

Date: 2006-09-09 10:36 am (UTC)
From: [identity profile] babelmira.livejournal.com
They already did that in Argentina early 1980s.

I first read The Handmaids Tale when I first found out I was pregnant with Stewart. It was the scariest thing I had ever, ever read or watched.

That law tends to get used when women who are pregnant go into early labour through the fault of others and the child dies as a result. Last exaple I heard of was adrunk driver smacked into the car of a 5 month gone woman. She went into labour, baby died within minutes. Guy got two years,causing the birth and death of a baby.

The real battle of the sexes is fertility, isn't it?

Date: 2006-09-09 01:41 pm (UTC)
From: [identity profile] unwillinggal.livejournal.com
Did what in Argentina?

Amazon reviews of The Handmaid's Tale reckon it's an unbelievable set up, but I think they're wrong. Very chilling, from the removal of individual identity onwards.

Perhaps it's control of fertility that's the issue. Then that sort of leads on to property, in patriarchal culture it's paramount to the males to know it's their offspring(sons) who inherit, after all, so to ensure that they want a tight grip of female fertility. I'm still puzzling over what happened in history that women allowed themselves to be controlled in this way on such a wide scale.

Date: 2006-09-09 07:07 pm (UTC)
From: [identity profile] babelmira.livejournal.com
The children of political dissidents were given to the childless party members

Date: 2006-09-09 07:24 pm (UTC)

Date: 2006-09-10 10:49 am (UTC)
From: [identity profile] korenwolf.livejournal.com
Amazon reviews of The Handmaid's Tale reckon it's an unbelievable set up, but I think they're wrong.

Given recent US history I find it very very believable, it's been moving further and further to the religious right and "keeping women in their proper place" (barefoot, pregnant and in the kitchen) has always been on their agenda.

Date: 2006-09-10 11:03 am (UTC)
From: [identity profile] unwillinggal.livejournal.com
I still don't understand how being a fanatic of pretty much any religion makes people think they have the right to oppress women. Seems like a convenient excuse for men (and women too, I suppose) who *already* hate women.

Date: 2006-09-09 02:24 pm (UTC)
From: [identity profile] http://users.livejournal.com/_pyromancer_/
The history of this goes back at least 5000 years, probably much further. As you say, it's about property. Marriage in the traditional sense has absolutely nothing to do with love or any of the other stuff that gets attached to it - it's a property transaction that should properly be negotiated between the parents of the parties involved - in fact the ideal set up is one where the parents tell their offspring who they will marry, to further the family fortune, connections, etc. Love is an irrelevance, property and money are what matter.

Yes, I'm a bit of a cynic. :-)

Date: 2006-09-09 07:29 pm (UTC)
From: [identity profile] unwillinggal.livejournal.com
Well, so am I - although some of the traditions still associated with it all are now not viewed by participants in the same manner. I had a bit of a quandary about my dad walking me down the registery office aisle, but he would have been so crushed if I'd said he wasn't allowed, and he has no other daughters (or sons, for that matter - unless of course he's kept them awful quiet all these years). I don't like the whole 'giving away' thing though.

Having said that - why is/was it that the parents of a female had to give assurances that *she* was of good breeding stock, and apparently no such problems were thought of from the male side? Or is it just that more modern literature mentioning these things is biased and/or innacurate?

Date: 2006-09-10 02:39 am (UTC)
From: [identity profile] almagill.livejournal.com
"why is/was it that the parents of a female had to give assurances that *she* was of good breeding stock " They do/did?

One of the things that struck me when I was transcribing Kirk Session records from the 1700's - 1800's was the comparatively even handed way that both male and female congregation members who were accused of, say, sex outside marriage, getting married 'irregularly' etc, were punished. Both parties would be expected to come to the church and sit up front on the 'cutty stool', they'd both be chastised (verbally) by the Minister and so on.

Where a girl was accused of sleeping with a soldier it was pretty common for her to be punished but it was generally the head of the family who'd be fined (if she was still living at home) and bound over to ensure her future good behaviour. There are instances on record of the soldiers being recalled from wherever they'd moved on to from the parish to answer to the Kirk fo rtheir behaviour, be fined, etc. But frequently it was down to the Kirk Session to send somebody after them to see that an officer handed down an appropriate punishment.

Generally this was seen as a way of maintaining stability in the local community and where both males and females were involved, in general, both were equally punished. Oblviously, get into schtuck with the Kirk and you're going to have problems marrying....

"and apparently no such problems were thought of from the male side?"

Other than the fact that bankrupts couldn't marry (ok, not gender specific but more prevalent for males than females due to the way finance was handled) . A man who was apprenticed couldn't marry (without permission of his master) until his apprenticeship was served and he could present his debeture papers to the Clerk to show that he was now a Journeyman / Tradesman. While this practise died out in the late 19th early 20th century it was still the norm for couples to wait until the groom was at least 21 before marrying (historically a boy could be endentured from the age of 12 or 14 for up to (but not always limited to) a period of seven years).

As has already been said, much of this goes back to property. If a man married a girl and she was carrying another mans child there was, before the C20th, no way to prove who the biological father was. However, once the child gained it's majority and could inherit property there could be serious ramifications if the biological father was identified.

For example, Mr Smith marries Ms Brown, she is carrying Mr Jones' baby. Years later Mr Smith, an elderly and well set up old landowner, pegs out. Mrs Smith later pops her clogs and the now grown up child inherits the property as oldest child. (Assuming there was a will to that effect, otherwise under Scots law the eldest child merely inherits an equal share of the property with any siblings).

Up pops Mr Jones who identifies young Smith as his child, points out a birthmark or two, shows some old letters and claims the right to act as the childs guardian, effectively taking control of the property / share of the property.

Question is, did it ever happen? Chances are "probably" but it's late and my books are well locked away ;)

Oh, and another instance where a minor, frequently the male heir of a family, could be prevented from marrying. Where a guardian had been appointed on the death or imprisonment of a parent and the Court saw fit to put somebody, often a relative but sometimes just a neighbouring landowner, in charge of the minor's affairs, up to and including the "gift of their hand in marriage". There are cases in the Register of the Great Seal (or might be Privy Seal) of minors petitioning to have control of their own affairs transferred back to them as, amongst other things, they can't get married without the say so of the guardian.

... just off the top of my head.... ;)

Date: 2006-09-10 11:01 am (UTC)
From: [identity profile] unwillinggal.livejournal.com
Wow. :-) See, good to have folk who know what they're on about.

From this modern and jaded eye it's also odd to think that the Kirk could be responsible and fair in dealing with the flock. :-)

Date: 2006-09-10 03:31 pm (UTC)
From: [identity profile] almagill.livejournal.com
That's not to say that there weren't some seriously small minded, petty, vindictive chunts. ;)

Date: 2006-09-10 09:54 pm (UTC)
From: [identity profile] unwillinggal.livejournal.com
But of course. :-)

Date: 2006-09-10 10:50 am (UTC)
From: [identity profile] korenwolf.livejournal.com
Certainly within the classes with property or power (or those on the fringes trying to move in) that's true, it's historically been less so for the poor / serf classes.


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