America Has Embraced Forced Pregnancy

Nine months of physical and hormonal trauma to your body—with permanent and sometimes lethal consequences—is no longer your choice.

Miriam Markowitz


In this era, when women are supposedly freer than ever, my peers and I have found the opposite. Our options have diminished without our even knowing it. Now, with the overturn of Roe v. Wade, we find that they have grown even fewer. 

Most of the childless women I know my age did not decide deliberately not to have babies. We found that the decision, like so many others, was made for us: by society, by economics, by time, and by the one factor society refuses to understand as the crucial determinant of motherhood — our own bodies. Childcare has become prohibitively expensive, especially for single mothers. Women are increasingly delaying and then abandoning their plans to have children as life becomes more financially precarious. And as mothers get older, having a baby doesn’t get physically easier. 

Pregnancy has never been a risk-free endeavor, but in recent decades it has become significantly more dangerous for women in the U.S. due to our abysmal healthcare system. More women die in childbirth or shortly after than in any other wealthy nation on Earth and these women, like their peers in the developing world, are disproportionately poor and non-white.

At this age I have watched most of my female peers go through multiple years of pregnancy, because that’s what it is on a basic physical level: a year or two or three of life where your body is fundamentally not yours and pays the price for hosting a parasite that grows larger and more uncomfortable until it is cut or heaved out. This is not a process to be taken lightly, in particular if you are older or have health issues. 

While some extoll the joys of pregnancy (yes, your hair and nails grow faster), your body mostly doesn’t feel the same way. To your body, a fetus is not a blessing but an antigen the immune system must train itself not to attack. Your body does not think pregnancy is a beautiful, glowing experience that every woman should have. It thinks a baby is an alien organism that probably shouldn’t be there very long and then happily, or less so, is finally expelled.

Nearly everyone I know who has carried a baby to term has experienced considerable difficulty and often serious, long-term effects to their health that don’t necessarily resolve over time, and certainly not soon after birth. There are the obvious adverse effects, such as weight gain and hypertension, as well as preterm birth and ectopic pregnancies. Gestational diabetes is likely to reappear as regular diabetes later in life. Preeclampsia brings increased risk of kidney disease, heart disease, thromboembolism, hypothyroidism and impaired memory. A pregnant person should prepare for the possibility of anemia, urinary tract infections and mood disorders before and after birth. This list is far from comprehensive and likely to grow longer: Severe maternal morbidity is rising along with mortality, and now affects between 50,000 and 60,000 people in the U.S. each year. In other words, going into labor carries a 1 in 60 risk of a health effect as serious as a heart attack or a hysterectomy. 

All of these friends have also told me about the surreal experience of being, to the doctors who are supposed to be helping them, just a baby incubator. Doctors are concerned about their physical and mental health insofar as it affects the load they are carrying. The person carrying that load is a vessel to be coached through and sewed up after and otherwise largely ignored, except when she is doing something that might be bad for the baby. One woman I know asked for a cesarean a week early after a horrific pregnancy from which she is still recovering. She was suffering from debilitating nausea that the doctors told her was normal but turned out to be a severe hernia that required surgery only months after she had given birth. The doctors refused her until she told them she was worried she would become a danger to the baby. Those were the magic words, apparently the only ones that would sway her captors.

The Christian Right has successfully made choosing the woman anathema in America. In Judaism, women are prioritized over fetuses. Rabbinic law dictates that if there is a choice between a woman and the child she is bearing, the choice must be the woman. The best argument against the Christian fanaticism against women is the Jewish priority of our safety. To this end, perhaps women and babies should have different doctors, one for each party. This does not create a conflict between mother and child. It is normal for a patient to have multiple specialists on one team that work together for her holistic health. Acknowledging the disparate interests of mother and fetus does not mean the fetus is a child. It means that the mother is a person. 

It’s against all of our rhetoric and idealization of motherhood to treat fetus and mother as separate, not necessarily compatible entities, much like a woman and her cancer. The reality of pregnancy is that the interests of your body and the baby-to-be’s development are often at odds. Birth is, was, and always will be a perilous undertaking. There is no such thing as a safe pregnancy, physically or existentially, only degrees of risk.

Can you force someone to do something that risks their life? Because that’s what abortion bans entail: forced pregnancy. The Christian Right of 2022 is more ambitious than Margaret Atwood’s villains in 1985 The Handmaid’s Tale. Instead of assigning women to bear children for select wealthy, powerful men, the Christian Right wants us to serve all men, even poor ones, and even those who don’t want children or haven’t thought much about it either way. This is the essence of patriarchy. Natalism denies individual freedom. It is performed on a population who cannot even give consent, whether they are male, female, or other. Every individual in forced pregnancy is a victim, including, and perhaps most especially, children.

Until we codify pregnancy as the ordeal it is, and adequately care for mothers during and after pregnancy, including those that terminate, women will always be baby boarding houses rather than people. That shift means de-romanticizing pregnancy and childbirth and recognizing the physical and hormonal trauma that change our bodies in ways we are not even supposed to talk about.

It also means understanding that many women choose not to have children not because they can’t but because it’s fundamentally against our interests. There’s nothing selfish about survival; what’s selfish is demonizing women who choose themselves.

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Miriam Markowitz is an American writer and performer living in Lisbon, Portugal.

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