Can We Stop Penalizing Pregnancy Already?

I’ve got to disagree with Clarissa on this one: It’s not fair to equate pregnancy with a hangover (even if the nausea can be similarly overwhelming). Specifically, a student who misses class for pregnancy-related disability should not be treated the same as one who misses due to oversleeping or a hangover.

But let’s back up. Clarissa was responding to a post by The Feminist Breeder on prodromal labor, in which TFB also mentioned that she was feeling crappy enough in her 40th week of gestation that she just couldn’t hang with her college-degree program. Here’s the bit that set Clarissa off:

I have to keep going to class until I’m really in labor, and school is pretty far away.  My Tuesday class is a reasonable half hour away, but my Wednesday class is 90 minutes away in traffic.  If I started hard, active labor at school, I have no idea what I would do.  Also – get this – I left class early last Tuesday because I was so sick I couldn’t see straight, and my professor actually had the balls to dock me 20 out of 25 possible Participation points just because I had to leave.  Clearly she’ll be docking me ALL 25 Participation points for each class I miss while I’m doing a silly little thing like trying to have a baby, so I cannot take off a single extra day other than what is absolutely necessary.  (And yes, I am SOOO writing a letter about that.)

Now, I think jumping straight to a letter to college administrators, rather than trying so say, talk to her prof, is pouring gas on the flames. If a student has a beef – especially an adult student like TBF who’s got the cojones and verbal skills – she should first talk to the the instructor, preferably when she doesn’t feel on the verge of hurling. Personally, I would be much more receptive to a conversation than a formal complaint. Going slow offers a chance to preserve the student-teacher relationship as a collaborative one. Going directly to the administration strikes most teachers as an act of aggression (which is why I’ve never done that to my kids’ teachers, even when it might have been warranted). Often, too, the instructor will cool down and reassess a rash decision, opening the gate to a reasonable compromise. If not, there’s still time to write a scathing letter, though I suspect TBF, who could very well be in labor as I write this, felt the hourglass was empty (prodromal labor has a way of remininding one of the clock). And so I understand perfectly why she might skip negotiating and just lodge a formal complaint.

That said, I just can’t sign on to Clarissa’s reaction:

There is no doubt in my mind that her pregnancy is very special to this woman. It must also be very special to her relatives and friends. For strangers, however, of which her professor is one, it is neither more nor less special than another student’s hangover. Both the pregnancy and the hangover are the results of the choices these students made as adults. In my capacity as an educator, I don’t think it’s my place to judge whose choices are more legitimate and deserve of greater consideration. All I need to know is that the student wasn’t there and, as a result, didn’t manage to participate.

This is a false conception of “fairness.” As my friend Moonglow (who just happens to be the mother of a brand-new daughter, yippee!!!) told me today: “I never promise my kids that I’ll treat them all equally. But I do commit to treating them all fairly. That means knowing what each of them needs and when they need it.” (And if I misquoted you, my dear, please blame it on the delectable distraction of brie with fig jam.)

Much the same goes for my students. Last spring, a student of mine landed in the ER with appendicitis and only appeared two weeks later (full documentation in hand). I’ve had multiple students felled by mono, over the years. I’ve had students come to me with serious mental health issues (sometimes exacerbated by the portion of my syllabus dealing with sexual violence). I’ve had students totter to class on crutches due to slippery messes in the dorms. I’ve had students with arms in casts due to (ahem) barroom brawls.

I am not happy about the last category of problem – injuries that result from drunken stupidity – but I am grateful for those students’ frankness. And once a student acquires a disability, don’t I have an obligation – both human and feminist – to accommodate it? Would I not be a monster to mark down a student on participation just because his appendix tried to kill him? How could I live with myself if a student went into a spiral of depression, and I exacerbated it with rigid expectations of attending every single class meeting?

Last year, I had a graduate student announce to me that she was likely to give birth within the next couple of weeks. I was dumbfounded. I hadn’t even noticed she was pregnant, only that she’d put on a few pounds. (That alone should’ve given me pause, because I tend not to notice even major changes in people’s shapes. I’m obtuse that way.) The very next class meeting, she was absent, because she’d just come through labor. A week later, she showed up for class, her iPhone brimming with baby pictures. She worked very hard not to let her pregnancy interfere with her coursework, but I certainly could have found ways to accommodate her if she’d asked for more time off.

There’s an easy, pragmatic, fair solution to most of these situations. Exempt the student from work missed (as long as it’s not a major project) and weight the rest of their grade more heavily. This little trick works as well for a pregnant student as for anyone else struck by unexpected disability. The student does pay a small price, in that there’s more pressure on the rest of their work and less opportunity to dilute a crummy grade. But it’s a fair price that makes allowances for the fallibility and vulnerability of our flesh. However much a university might pretend that we’re all disembodied brains, in the end those brains still rely pretty heavily on their whole-body support systems.

I guess I’m a bit of a feminist-Marxist on these issues: from each according to hir ability, to each according to hir needs. That doesn’t mean abandoning all standards. It simply means realizing that life intervenes. Death intervenes. And all kinds of other shit – good, bad, and ugly – intervenes, too. Students are whole people, often needy people, coping with lives more complicated than we instructors often know. They cannot be reduced to their throbbing-in-a-petri-dish brains (or pickled-in-a-game-of-beer-pong brains, either).

This isn’t a matter of trusting my students. (Mostly they deserve my trust; sometimes they prove that they don’t.) It’s a matter of trusting my own judgment. I trust myself to distinguish between the student who couldn’t turn in her final paper on time due to strep and the one who added my class late, then fell asleep in the back row after a mere three minutes! Hey, at least he zonked out so fast I couldn’t take it personally; there was no time for me to bore him to sleep.

This is also an arena where I have to live true to my principles. Any feminist ought to be committed to disability rights. Heck, even Sarah Palin (a nightmare feminist, but a feminist nonetheless, in my book) at least pays lip service to disability rights. You cannot honor human rights without acknowledging that most of us, if we live long enough, will eventually live with a disability. You cannot work toward gender justice but then insist it’s only for those of completely able bodies and minds. What does that mean for me, practically speaking? If a student is struggling to achieve with a disability – of any sort, be it a physical, mental-health, or learning-style condition – it’s my job as an educator, feminist, and mensch to help them perform at their peak, on as level a playing field as I can cobble together.

But hey – isn’t pregnancy a natural, healthy condition? Well, for all the work that women’s health educators, natural childbirth advocates, and feminist historians have done to unseat the idea that pregnancy = disability, we do childbearing women an awful disservice if we insist that pregnancy never spawns disability. Most of us suffer at least debilitating fatigue. Most of us have stories about how we nearly ralphed at work. My students from fall 2002 and winter 2003 – when I was gestating the Tiger – can consider themselves lucky that I maintained a barf-free classroom. And I got off easy, compared to my friends who landed in the hospital, hitched to an IV, after weeks of incessant vomiting.

If you care about women, you must care about mothers, and thus you must be willing to honor pregnancy-related disability as real disability. And yes, pregnancy usually results from a planned, voluntary choice, these days, but not always; women still find themselves pregnant against their will, and they still sometimes decide to carry out a surprise pregnancy, even with the option to terminate. Anyway: Should I only make allowances for students’ injuries if they can prove that, say, the other guy started the fight, or the other driver broke the law? And do I really want to start interrogating a pregnant student about why she and her partner didn’t both get sterilized before they ever had sex (after all, every other contraceptive is fallible), or why she didn’t terminate the pregnanacy early on? That way lies fascism.

To be crystal clear – and fair! – Clarissa doesn’t advocate bare-bulb interrogations. She instead argues that one should never cut students slack when their free will contributed to their inability to participate; that a class missed due to a hangover is no different than one missed due to pregnancy symptoms, because in both cases, “choice” was involved. I trust Clarissa enough to believe her when she says she’s a good teacher – and actually, I trust that in a few more years, because she’s smart and tuned in to her students, she may very well trust herself to draw finer-grained judgments, which just might put the pregnant students in a different category from the hardcore imbibers.

But this other extreme – harshly penalizing pregnant women for making a “lifestyle choice” that most couples eventually make (but predominantly women  pay for) – sets feminism back a couple of generations. It tells women, “It’s fine if you want to compete with the men – as long as you’re just like the men!” Didn’t we leave that trap behind us in the ’80s, along with big hair, shoulder pads, and Tears for Fears?

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Defunding Title X: What Goes Around, Comes Around

This week I’m reading Michelle Goldberg’s masterful The Means of Reproduction: Sex, Power, and the Future of the World with one of my classes. In it, Goldberg traces the history of foreign aid for women’s health – especially reproductive health – from its Cold War, Rockefeller/Ford/Guttmacher beginnings to the present era.

In 2011, well into the second decade after the UN International Conference on Population and Development in Cairo, you’d think we’d be well along the path blazed there: foregrounding women’s need for education and autonomy. Nuh-unh!! Instead, the proponents of women’s reproductive autonomy in developing nations and the Global South face constant friction and opposition from groups funded by the Radical Christian Right in the U.S. This trajectory toward radical rightwing interference is lucidly, chillingly described in Goldberg’s book. It’s as though women’s bodies became a proxy war for the tensions over reproductive rights and justice back here in the U.S.

And now, with the House of Representatives today voting to defund Title X funding, that proxy war has come home. For details, see excellent recaps by Lindsay Beyerstein and Jill Filipovic. The legislation wouldn’t affect abortions – except to inflate their numbers by making birth control less accessible to poor women and young women. No, the target here is broader. It’s a war against all women, but especially those who are poor.

When I was young and underinsured, I too turned to Planned Parenthood, and I’m forever grateful for their services. Some women are transiently poor, like I was. Many struggle with poverty throughout their childbearing years. All of us deserve affordable access to basic services like a Pap test.

I believe this even though – or especially because! – I had a few dodgy Pap test results in my early twenties. Those diagnoses of “cervical dysplasia” scared me. Cone biopsies were threatened. The cellular abnormalities resolved on their own, as HPV usually does. Had I progressed toward cervical cancer, Planned Parenthood might well have saved my life.

All women deserve preventive care, and that includes the prevention of pregnancy. This is sooo not rocket science.

Odds are good that the Senate won’t stand for the House’s crap. Still, I’m appalled that a majority in the House signed onto it. While some members may try to hide behind a figleaf of fiscal responsibility, that’s balderdash, as Amanda Marcotte argues:

Of course, rhetoric that attacks federal funding for contraception as a state-subsidy for promiscuity obscures the fact that continuing Title X is one of the more fiscally sound things the government can do: Research from the Guttmacher Institute demonstrates that every dollar spent on family planning saves the government four dollars down the road.

(Read her whole piece – it’s excellent.)

No, this is strictly culture war ammo, just as the Mexico City rule and all the other right-wing meddling into brown and black women’s bodies has to do with ideology and misogyny – not fiscal soundness.

This is merely the continuation of funding politics imposed on the “Third World” – now aimed at women that Chandra Mohanty once called the “Third World” in the United States. This is the redirection of contempt for brown and black women’s bodies to those women living within U.S. borders. Women like me – white, securely middle-class, employed, insured, and slouching toward the end of my reproductive years – will be just fine. It’s poor women of color who will suffer. College students who can’t tell their conservative parents that they’re on the pill. Appalachian women lacking any form of health insurance.

Senate? The ball’s in your court. Please show us that you consider women human beings whose health is as important as men’s – who should have a chance to participate fully in society – and who should not be written off if they lack racial or class privilege.

In the clip below, Michelle Goldberg suggests that the U.S. culture wars have affected women outside the U.S. more profoundly than women here at home. Up until now, she’s been right. As to the future? Well, that might just be up to the Senate.

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An Unsentimental Post about Love

With my partner a whole ocean away from me, I’m not in a very lovey-dovey mood for Valentine’s Day. That leaves plenty of time to think about what allowed Love to sneak out of courtly ballads and Shakespearean plays and into the hearts of average Americans. And no, it’s not chick lit or rom-coms.

The long answer would involve reading Stephanie Coontz’s Marriage, a History: How Love Conquered Marriage – the story of how marriage made the historical shift from an economic arrangement to a partnership from which we expect love and companionship..

Oh, and by now we also expect hot sex for more years than humans used to live, period, from birth to death. Nearly 500 years ago, Martin Luther set us down this road when he rejected the Catholic insistence on procreative sex, and instead embraced pleasure in marriage. Luther liked marriage. He termed it a “hospital for lust.” Bear in mind that in those days, hospitals weren’t in the business of curing; they took the poor and the insane and the unwed-but-pregnant off the streets. They were a way of containing social problems. Bear in mind, too, that Luther thought women’s lot was to be wives and mothers, undoing some of Eve’s screw-up in the garden. Still, there’s a solid though wavy line from Luther to Susie Bright.

The short answer: If we feel free to love today – or to lust outside of of the old “hospital” – we can thank two things: 1) the right to say no to sex, the key prerequisite for sighing a breathy, enthusiastic YES, and 2) reliable birth control with legal abortion as a safe backup. From the Ohio Statehouse to the House of Representatives, these rights are under more ferocious fire than I can recall in the post-Roe era.

But it’s a holiday, and so instead of gloom, let there be satire! It’s the more festive response – and maybe more effective , too. Here’s Kristen Schaal of the Daily Show, mocking the piss out of the “No Taxpayer Money for Abortions” crowd.

I used this in class last week to illuminate rape myths, and students got it like never before. (Does this mean college administrators will one day replace me with a semi-random mix off the tubes?)

And I knew I liked Felicity Huffman anyway (Lynnette is my favorite housewife, of course) but now I’m besotted:

(Via Rachel at Women’s Health News – If you can’t see either clip from your blog reader, click on through and say hey while you’re here.)

Take that to your next Tea Party, and sip it!

Happy Valentine’s Day to all, especially to those of you who are celebrating it alone with chocolate, champagne, or blogging. (I’ve only got two out of three but am wondering why I am too cheap to open the champagne sans partner. Wandering off to the kitchen now to rectify what I can …)

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Blog for Choice Day: The Dire State of the States

This year’s Blog for Choice Day theme is to contemplate what the electoral gains of the anti-choicers will mean for “choice” this year. I’m sure other bloggers will ponder the damage liable to be wrought by our virulently anti-choice new Congress. For my part? I think most of the mischief will occur at the state level, where a new crop of reactionary leaders will exploit the abortion issue to pander to their base.

Take Ohio. (Please! Or at least, deliver me from our new “leadership.”) With John Kasich, we now have a blithering idiot as a governor. He’s so far right that if the earth were flat, he’d tumble off  its right edge. We have a completely Republican legislature. The anti-choicers are emboldened. And they’ve already made their first move.

Modernesquire at Plunderbund reports that one of our Democratic (!) legislators, Lorraine Fende, has introduced a bill that she and the media are framing as a ban on all late-term abortions. As Modernesquire notes, Ohio already has a law in place that prohibits “partial-birth abortions”: Ohio Revised Code 2919.151.

Modernesquire (who unlike me, is an actual lawyer) suggests that the late-term ban is redundant with ORC 2919.151, except in one crucial respect:

It potentially criminalizes all abortions.  H.B. 7 enacts a new section 2929.17 that makes the performance of any abortion in which the fetus is arguably “viable” a fourth-degree felony.  “Viable” is defined under the bill as:

“the stage of development of a human fetus at which in the determination of a physician, based on the particular facts of a woman’s pregnancy that are known to the physician and in light of medical technology and information reasonably available to the physician, there is a realistic possibility of the maintaining and nourishing of a life outside of the womb with or without temporary artificial life-sustaining support.”

The statute also creates a rebuttable presumption that any fetus at 24-weeks gestational age is viable.  But note that the statute does not create a converse rebuttable presumption that any fetus before 24-weeks ISN’T viable.  The bill declares the issue of the viability of the fetus to be an affirmative defense.  What does that mean?  It means that the State has no burden to proof that a fetus was viable to criminally prosecute a doctor under this provision, even in instances that don’t involve a late-term abortion.  Instead, the doctor has the burden at trial to convince a criminal jury unanimously that the fetus was not viable, or that the abortion was necessary to protect the life of the mother, or to protect from serious and irreversible impairment of the pregnant woman’s medical health.

If a doctor carries the burden of proof to show that the fetus was not viable, this bill would surely have a chilling effect. It would be still be pointless for a prosecutor to pursue first trimester abortions, but what’s to stop him from questioning the viability of a 20-week-old fetus? An 18-week-old fetus? Second-trimester abortions.

In criminal cases the burden typically falls on the state to prove the defendant’s guilt beyond a reasonable doubt. Here, the burden of proof is reversed in a stunning disregard for basic principles of jurisprudence. Modernesquire again:

Normally, affirmative defenses are things in the criminal law in which the law recognizes that the Defendant committed a crime, but holds that certain factors require the Defendant to not be held culpable for the crime such as insanity and self-defense.  In this instance, however, it takes what should be a major element for the State to have to prove beyond a reasonable doubt and forces the accused to prove the negative instead.  Such element shifting can only be by design to encourage prosecutions against any abortion provider.

Yes. Furthermore, this “element shifting” constructs second-trimester abortions as presumptively illegal. It essentially says that any abortion within the latter part of the second trimester is assumed to be a crime – unless proven otherwise.

With all due respect to Modernesquire’s legal smarts, I do notice a difference between the proposed bill (House Bill 7) and the existing law. They don’t appear to be entirely redundant, because existing law is limited to a single procedure (which it charmingly terms “feticide.”) ORC 2919.151 explicitly distinguishes between dilation and extraction (aka “partial-birth abortion”) and other techniques; it explicitly exempts dilation and evacuation, another late-term technique that is often an implicit target of restrictions on “partial-birth abortions”:

This section does not prohibit the suction curettage procedure of abortion, the suction aspiration procedure of abortion, or the dilation and evacuation procedure of abortion.

House Bill 7 is silent on these other procedures. It does not exempt any particular procedures. It appears to broaden the scope of the earlier “partial-birth” ban to any technique used in the second trimester – and even to those, like suction curettage, which are used only for early abortions!

Fende’s bill contains another little bombshell: it significantly narrows the health exemption for late-term abortions. Where the law previously included multiple sclerosis and diabetes as conditions that impose a “serious risk of the substantial and irreversible impairment of a major bodily function” and thus permit abortion late in pregnancy, now those two diseases are downgraded: they may be included among such conditions, but they’re clearly ranked lower than preeclampsia, which isn’t saddled with such a qualifier:

A medically diagnosed condition that constitutes a “serious risk of the substantial and irreversible impairment of a major bodily function” includes pre-eclampsia, inevitable abortion, and premature rupture of the membranes, may include, but is not limited to, diabetes and multiple sclerosis, and does not include a condition related to the woman’s mental health. [my emphasis]

In what appears to be a very substantial change, mental health would never qualify as a reason for late-term abortion. Where Fende invokes the image of a woman cavalierly choosing to abort at 8 1/2 months, my imagination conjures up a woman struggling with psychosis – a woman in acute danger of ending her own life. We are not talking about a woman who’s having a lousy day, feeling a tad blue, and flips a coin: an abortion or a pedicure as a quick pick-me-up? Hmm, if I get the abortion, I can paint my own toes??

Oh, and in any case where the fetus could be remotely considered viable, H.B. 7 mandates that the doctor performing the termination get a written certification from a second physician that abortion was medically necessary. The only exception would be for dire, acute emergencies.

The Columbus Dispatch reports that some Ohio lawmakers want to tinker with H.B. 7 to define a fetus as potentially viable all the way back to 20 weeks. As far as I know, no fetus born at 20 weeks has yet survived. For those of us who get ambiguous test results during the 19th week (as I did in my second pregnancy) and need to pursue further testing to learn what we’re up against, a 20-week deadline would be a nightmare. It would trigger precipitous decisions to abort in some instances, while potentially criminalizing those who choose termination after additional tests.

I’d like to close with some comforting words about how this bill doesn’t stand a chance. But you know, the Statehouse leadership saw fit to introduce this bill among its first ten. The Repubs are making it a priority. It’s sponsored by a Democrat. And Governor Kasich is shaping up as the kind of guy who’ll make G.W. Bush appear intelligent, humane, and pro-feminist.

If by some miracle this bill flounders, it’ll only be a matter of weeks before the anti-choicers launch their next salvo.

And that’s just my adopted state of Ohio. My purportedly purple state. I cringe to think of what will happen in those states that are even more retrograde.

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The Bush Fetus Anecdote: Even More Jarring Than Before!

You probably caught the story a couple of weeks ago about Dubya seeing the remains of his mothers’ miscarriage in a jar. As New York Magazine reported:

After Barbara Bush suffered a devastating miscarriage, “she said to her teenage kid, ‘Here’s the fetus,’” [George W.] Bush told [interviewer Matt] Lauer, “gesturing as if he were holding the jar.” According to the Post, Bush says he got special permission from his mom to recount the private incident in print. Lauer reads an excerpt from the memoir where Bush, who had to drive his mother to the hospital, wrote, “I never expected to see the remains of the fetus, which she had saved in a jar to bring to the hospital.” In the interview, he tells Lauer, “There’s no question that affected me, a philosophy that we should respect life,” adding that, “[The anecdote] was really to show how my mom and I developed a relationship.”

As Knitting Clio explains, it’s actually not surprising that Bush mère and père were pro-choice, like other Republicans of their day. Dubya thus couldn’t claim a lifelong affinity for the anti-choicers. Given his fondness for conversion stories (e.g., the tale of how he was saved from alcoholism), it makes perfect sense that Dubya would present a dramatic tale to explain his departure from the family’s pro-choice legacy. Bush Jr. has denied that it was meant as a political morality tale, but it’s been received as one anyway.

What I originally found astonishing about the story was Barbara Bush’s apparent presence of mind. How many of us, in the midst of a miscarriage, would think to catch the fetal remains and put them in a jar? Grisly as it may sound, the remains might have been medically useful, indicating whether the miscarriage was complete, though I imagine her doctor performed a D&C regardless. I thought this was mildly strange but also strangely admirable.

Showing the remains to her son was a bit odder. Dubya offering this story to illustrate an evolving relationship? Well, that’s a whole ‘nother dimension of weird. Once upon a time, my mom showed me her gallstones in a jar. (Said jar resided in her medicine chest for at least decade, and might still be there.) Even accounting for the difference between gallstones and a miscarried fetus, I wouldn’t consider my mother sharing her gallstones a key event in our relationship. Frankly, I thought Dubya would’ve been well advised to just let the story stand as his anti-abortion conversion tale – full stop.

Today, the fetus-in-a-jar story took a turn for the outright bizarre. Here’s Politico’s transcript of Larry King interviewing Barbara Bush (via Shakesville):

KING: You also disclose, Barbara — George discloses something very personal about you, which he says you gave him special permission to write about. He wrote that when you once had a miscarriage, you showed him the fetus in the jar.

BARBARA BUSH: No, really, the truth is …

KING: We touched on it before. But we didn’t elaborate.

BARBARA BUSH: I didn’t put it in the jar.

KING: What?

BARBARA BUSH: It’s not in the library. No …

KING: I know.

BARBARA BUSH: George — Paula put it in the jar. And I was shocked when she gave it to him to. But, you know, memories dim a little bit.

“Paula” is evidently their long-time housekeeper. Why, for heaven’s sake, would Dubya tell the story differently after checking with his mother before publishing it? Barbara says memories dim, but why present this as the truth if they have two different recollections? Methinks her son is just in the habit of truthiness.

But the oddest thing of all is that Barbara Bush’s housekeeper would be handling a miscarried fetus. This raises all sorts of unsavory questions, such as where the fetus resided before it was placed in the jar. Did Paula handle the fetus on her own initiative, or did Barbara ask her to package it? And why would Paula give the fetus to Dubya?

Still left unanswered: the burning question of where that jar is now. I’d originally thought it went to the hospital with Dubya and Barbara – end of story. Now, all we know is “it’s not in the library.” Perhaps in the conservatory? With Professor Plum and a candlestick?

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On “Birth Rape”

(TMI alert, especially for the medically squeamish, and trigger alert for medical violence.)

The story of how I birthed my first child is a far cry from the dimly-lit, romantic scenarios pictured in hospital brochures and natural birth guides alike.

The Bear got stuck before his head was even properly engaged. I was in Germany, so you can’t blame what happened next on medicalized childbirth, American-style. I did have an epidural (at my own request, nay, demand!) and enough Pitocin to deliver a small elephant. My midwife tried acupuncture. We tried every possible position: all fours, squatting, draped over an elevated bed with my head hanging down. I even swallowed some homeopathic remedy. This was Germany, after all.

Still, he was stuck. After seven hours (!) of being fully dilated – which is four or five hours longer than a U.S. ob/gyn would tolerate without a c-section – my midwife had to turn me over to a doctor. Even then, he didn’t go straight for the knife. He proposed trying vacuum extraction, with a c-section as backup. Three tugs, three giant pushes, and three mighty shoves on the top of my uterus – out came the Bear.

I was grateful my son was healthy, and glad I’d avoided a cesarean. I thought I’d gotten off easy. The recovery proved me wrong. I’d lost a lot of blood and my healing was difficult and incomplete. In the long run, I probably would have been far better off with a c-section. The pushing on my uterus (“fundal pressure”) did a lot of damage to my pelvic floor, which persists a decade later. I was given a lengthy consent form that explained the risks of a potential c-section, but it said nothing about the risks of fundal pressure and vacuum extraction, particularly an extraction from so high in the pelvis.

In other words, I had no crack at informed consent for what was actually done to me. And I don’t want to hear that none of it matters since my baby was healthy. The violence of my delivery severely affected my ability to be an effective mother. Try hauling around a 13-pound infant six weeks postpartum, feeling as though your viscera are about to fall out. Then try it again with a 19-pounder at four months. The Bear was not a sleepy, contented baby. He was irked at the world. He needed to be walked around. I couldn’t do it. Not on the scale he demanded. For optimal healing, I shouldn’t have been lifting anything heavier than ten pounds. I felt utterly trapped.

Many women have traumatic childbirth stories. Many are uglier than mine and revolve around disrespect by medical personnel, which sometimes edges into outright violation. Over the past few years, some birth activists and feminists have started to label such stories “birth rape.” The term struck me as wrong when I first saw it (which I’m pretty sure was this post at the F Word). So I was glad to see a flurry of criticism ripple through the feminist blogosphere over the past few days, starting with Irin Carmon at Jezebel and then spreading to Amanda Marcotte at XX, Tracy Clark-Flory at Broadsheet, and Lindsay Beyerstein at Big Think. Even my friend figleaf has weighed in against using “rape” to characterize traumatic birth experiences.

In discussions of sexual violence, it’s not unusual for women who’ve actually experienced the trauma in question to use their experience as a trump card against anyone who disagrees with them. Ditto for childbirth experiences. In actuality, experiences vary, as do our interpretations of them. One woman may feel violated by a c-section, while another might feel relief.

So far, none of the feminist bloggers who’ve criticized “birth rape” have actually experienced childbirth in their own flesh. Their opponents may well say that this disqualifies them. I’m weighing in to support them, partly as a mother (and partly as a professional historian of childbirth and critic of medicalizaiton) who has in fact experienced a failure of informed consent and a traumatic birth (and who has studied some truly egregious instances of it in the past). Of course, my labor experiences don’t give me the right to trivialize other women’s feelings of violations, and I would never want to do that. At the same time, the trauma women experience doesn’t justify the inflationary and misleading use of “rape” to describe violations of medical consent.

It’s important that we can talk about birth trauma. We need a language of childbirth that will help us protect women’s autonomy. But it’s hyperbolic to call incidents of unwanted vaginal exams or artificial rupture of the membranes “rape.” It does an injustice to victims of actual rape by conflating two different phenomena, thus watering down the meaning of “rape.” It’s not as bad as the trivialization that goes along with saying, “Man, that test really raped me,” but both uses are on a continuum, because they’re both metaphorical, not literal.

I realize that proponents of the term say that a speculum is no different than a penis. Here’s how Amity Reed expressed it at the F Word:

A woman who is raped while giving birth does not experience the assault in a way that fits neatly within the typical definitions we hold true in civilised society. A penis is usually nowhere to be found in the story and the perpetrator may not even possess one. But fingers, hands, suction cups, forceps, needles and scissors… these are the tools of birth rape and they are wielded with as much force and as little consent as if a stranger grabbed a passer-by off the street and tied her up before having his way with her. Women are slapped, told to shut up, stop making noise and a nuisance of themselves, that they deserve this, that they shouldn’t have opened their legs nine months ago if they didn’t want to open them now. They are threatened, intimidated and bullied into submitting to procedures they do not need and interventions they do not want. Some are physically restrained from moving, their legs held open or their stomachs pushed on.

These things happened commonly in the past, and they still occur today. A commenter at Salon wrote:

Once, while still a nursing student, I heard a nursing supervisor inform a screaming patient in labor – “maybe you should have yelled like that 9 months ago and you wouldnt be here”. Later, during my own labors, I remembered her remark and it made me smile.

She smiled? Boy, I’m glad she didn’t attend one of my births. And it gets worse. A self-identified midwife commented at Salon:

The quickest example I can come up with is the time a doula friend of mine heard the OB say while a VBAC mom was pushing (pretty much under his breath, I don’t even think the mom heard this): “It’s the LEAST you can do for your VBAC” and he put one end of the scissors in her vagina and one in her anus and cut her a 4th degree episiotomy. No fetal distress, no reason beyond what I guess was his irritation at not just doing a repeat cesarean?

(Her whole comment was terrific, if you can stand to wade through the morass of misogyny that is Salon’s comment section.)

Stories like these are appalling. I feel sick and angry when I read them.

And yet, this is not rape. There’s nothing sexual about it, even though the assault is perpetrated on a woman’s genitals.

Let’s take a look at the legal definition of “rape.” It requires, as Amanda Marcotte points out, intent to violate someone sexually against her will. This is what the law calls “mens rea,” or awareness that one is committing a crime. If a prosecutor fails to demonstrate mens rea in a rape case, it’s still possible to convict on a lesser count of sexual assault (e.g., gross sexual imposition). “Rape,” however, is off the table.

The intent of this OB was to hurry the birth along. I don’t think it’s a stretch to say that he was also high on his own power, getting off on his dominance. But he wasn’t getting off sexually. Nor was he intending to commit a sexual act. What he perpetrated was neither rape nor a lesser form of sexual assault.

“Birth rape” is not just an exaggeration, though. It also does not say enough. It fails to specify what makes such violations of autonomy in labor reprehensible in their own awful way. First, doctors and nurses enjoy a high degree of trust. The minority of them who break our trust deserve contempt. Similarly, the discourse on medical ethics has been hammering on the importance of informed consent for the past few decades. We rightly expect medical professionals to have internalized this. Most of all, a woman in labor is extremely vulnerable. I don’t know of any situation where I’ve felt comparably exposed, defenseless, and liminal. To receive abuse from the very person charged with expecting you and your child has got to leave emotional scars.

What should we call these violations, then, if not “rape”? Well, “medical battery” works for me. (“Medical assault” would be more satisfying because of the parallel to “sexual assault,” but legally the correct category, as far as I understand, is battery, not assault.) I would also distinguish between situations where real bodily harm is perpetrated, as opposed to assholish behavior such as slut-shaming women in labor, and also as opposed to neglect of informed consent, such as I experienced. (I’m not speaking here of outright malpractice, though some cases of abuse may also constitute malpractice too.)

Medical battery in childbirth ought to be treated as a criminal offense. That’s not a stretch, legally. For instance, except in an emergency, a physician who performs surgery against the patient’s will is guilty of battery, and is subject to both criminal and civil law. Even failure to obtain informed consent is already subject to criminal penalties. In cases of assholish behavior or flawed consent (as in my own experience), medical professionals should be sanctioned by their peers. In those cases where professionals protect their own and refuse to discipline offenders, patients should go public with their stories.

The law already supports a woman’s right to autonomy in labor, just like it does for any other patient. Actually enforcing that right in court is tricky. Doctors may argue that they were forced to act due to an emergency. Proving otherwise may be difficult. But just the awareness that medical battery carries penalties could work as a deterrent to battery and lesser forms of abuse. In addition, it might serve as a counterweight to the pressure OBs often feel to take action – any action, even if it’s not supported by evidence – to avoid a later malpractice suit.

To avoid failures of informed consent, obstetrical doctors and nurses could do much more to enlighten expectant mothers on possible interventions, their justifications, and their risks. I would have been better off if I’d been provided any information on the risks of vacuum extraction. I knew a lot about forceps because they were used in the period of history I study. Vacuum extractors are newer, and so I was flying blind, even though I was an exceptionally well-educated parturient. I didn’t even know that vacuum extraction carries a significant risk of damage to the baby’s brachial nerves. Most women would’ve known less. This is just not necessary in childbirth, where there’s usually nine months to prepare and become truly informed. And yet, neither doctors nor nurses nor midwives nor childbirth educators are really preparing the women whose bodies and children are at stake.

I don’t imagine that these potential solutions would be a panacea. I do think, though, that they’re closer to the mark than the tactics that a notion of “birth rape” would suggest.

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