Michele Bratcher Goodwin,
"Reproductive Carrots and Sticks"
(page 3 of 9)
Part I: The Stick Effect: Pressure, Pain, and Punishment
Across the United States, a revived form of womb policing has led to
an intensified state focus on women's reproduction. In Utah for
example, Governor Gary Herbert recently signed into law the Criminal
Homicide and Abortion Revisions Act, which specifically applies to
miscarriages and other fetal harms resulting from "knowing acts"
committed by women. A prior version of the bill, drafted by state
legislator Carl Wimmer, failed to win the support of the Governor, as
it called for up to life imprisonment for women who engage in reckless
behavior during pregnancy that could result in miscarriage and
stillbirth. Absent from most of the new wave of legislation penalizing
pregnant women are considerations about men's conduct. For example, a
2006 peer-reviewed study published in the Journal of Obstetrics and
Gynecology points out that pregnancies from men older than forty are
60% more likely to terminate in a miscarriage than those from men
between the ages of twenty-five and
twenty-nine.[4] Does this mean
that a woman who intentionally decides to copulate with a man over forty
exposes herself to the risk of criminal prosecution if a miscarriage
results?
That the scope of such a law potentially extends beyond illicit drug
use during pregnancy, encompassing activities ranging from consumption
of alcoholic beverages and smoking, to the more innocuous, but equally
dangerous, such as overeating, living near environmental hazards, or
using ART, should raise concerns. How are prosecutors to decide which
cases to pursue? And should miscarriages, which are issues of medical
concern, now be the domain of police and prosecutors?
Ironically, the intensified interest in policing women's reproduction
by states like Utah, South Carolina, Kentucky, and others, does not
translate economically or structurally into better prenatal services,
maternal counseling, drug addiction rehabilitation, or social services.
Rather, the effort is decisively "stick" driven; its fundamental aim is
to punish without regard for the economic costs to the state, the
long-term emotional and health impacts on the babies, or the
psychological toll imposed on the pregnant women. Consider the
following cases:
Tara Keil
"I was screaming; I needed help, and I even pounded on the door a
few times, but nobody came .... And that's when it hit me—I'm going to have
this baby on my own."[5]
In May 2009, Tara Keil (TK) screamed for help from her jail cell.
The nineteen-year-old inmate's contractions indicated the imminence of
her son's birth. Blood covered her hands and thighs. Amniotic fluid
was on the floor of her cell. Despite her screams and pleas for help no
one came to render aid. The day before, Keil was pulled over while
walking to a friend's home. Within minutes the nine-month pregnant
teenager was arrested and whisked to the Dubuke County Jail, charged
with violating parole conditions for a prior drug charge. A warrant
had been issued for Keil after she stopped meeting regularly with her
parole officer.
Despite TK indicating the nearness of her delivery on question 53 of
her intake medical questionnaire, staff paid no particular attention to
the pregnant girl. According to TK, after pleading to one of the
guards that he call a nurse, his response was to ask whether she wanted
breakfast or not. With no other options, TK sat on the metal toilet
located in her cell and gave birth to her son. By the time of the
nurse's arrival, the cell, sink, toilet and other areas were covered in
TK's blood, and according to reports, the new mother was visibly shaking
and crying. Two days later, the baby was placed in foster care, and TK
was given a three-month sentence.
Ambrett Spencer
"I kept praying that she would just open her eyes because she
looked like she was alive."[6]
Studies indicate that African American women's pain is usually
misdiagnosed or treated with some skepticism on the part of
doctors.[7]
Ambrett Spencer's (AS) story fits that paradigm. In April 2006,
Ambrett, a pregnant inmate at the Maricopa County Estrella Jail in
Phoenix, called for assistance at 3 AM, indicating a pain level of 10
based on a scale from 1-10. She alerted jail staff that her medical
condition was painful and urgent.
In her case, the nurse ordered immediate action, but the sergeant on
duty declined to follow the nurse's order. Instead, AS was shuttled to
the infirmary an hour later. But there too, Ambrett, who was
incarcerated for driving while intoxicated, was ignored. Her pain was
not treated, nor was she taken to a hospital. Her blood pressure
decreased, the pain intensified, she grew pale. An hour passed before
the nurse on duty decided to call an ambulance. By that time, AS had
collapsed, and the nurse was unable to get an intravenous drip into her
arm. On arrival, the emergency medical technician noted, "If you are
turning that color, you're not getting enough blood to your organs and
skin." He was right. AS's baby, Ambria, was born dead.
AS suffered from placental abruption, a condition in which fetuses
have a promising rate of survival, but only if the patient receives
timely treatment. The nearly four-hour wait for appropriate medical
attention may have caused the baby's death. According to John
Dickerson, a reporter for an Arizona newspaper, while the number of
women in Maricopa jails is relatively low, the complaints made by these
women about jail conditions, including water contamination and other
matters, should not be dismissed. After all, the local environmental
agency found mice fecal matter in the drinking
water.[8]
Paula Hale
Paula Hale (PH) was a rape victim and a drug
addict.[9] She
informed hospital officials about her rape. But she never received rape
counseling for the trauma and, like other women and girls with histories
of sexual violence in their lives, she treated her depression and
anxiety with illegal drugs.[10]
Hale's rape resulted in a pregnancy.
By deciding to carry her pregnancy to term, she ruled out an abortion
and pursued prenatal care for the baby she was carrying. For her, it
was a rational decision to seek treatment at the Medical University of
South Carolina (MUSC), the only hospital she knew to serve poor black women
like her. But, "no one bothered to link her with an appropriate drug
treatment program or a trauma institute."[11]
PH did receive prenatal care, but she did not anticipate how
dramatically her life and that of her baby would change by making that
decision. PH did not realize that by seeking prenatal treatment she
would surrender privacy and provide presumptive consent for her medical
personnel to waive confidentiality. More specifically, PH did not
anticipate that MUSC nurses and doctors would test her and the baby for
the presence of illicit drugs. Nor did she foresee that the medical
test would become "evidence" of her drug use or turned over to police
and prosecutors. As with the twenty-eight other black women snagged by
the MUSC, PH was "dragged out of the hospital in chains and
shackles."[12]
To Lynn Paltrow, Executive Director of National
Advocates for Pregnant Women, these haunting episodes conjured images of
slavery.[13]
Indeed, race seemed to dominate every aspect of pregnant
patients' treatment at MUSC. All of the women who were turned over to
police for using illegal drugs during pregnancy were black, with only
one exception.[14]
In the case of the one lone white woman surrendered
to police, hospital officials made sure to note on her chart that the
white patient "lives with her boyfriend who is a
Negro."[15]
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