The Complex Landscape of Pregnancy in America
A new book dives into what the experience is like—and why
By Rebecca Carroll
If you’ve ever been pregnant (to term or not), you know that suddenly your choices are of public interest, and sometimes outright judgment. Pregnancy is a deeply personal experience that also inescapably involves power, vulnerability, politics, and a litany of unjust systems built for only certain beneficiaries. In her latest book, Unbearable: Five Women and the Perils of Pregnancy in America, journalist Irin Carmon weaves together narrative stories and reporting to create a lucid, sometimes heartbreaking, chronicle of how pregnant people are guided, or too often misguided, to navigate the experience in America.
Rebecca Carroll: I want to start by asking about something you wrote in the book’s introduction, which is that “being pregnant in America means bearing the consequences of separating one form of reproductive care, abortion, from everything else.” What is “everything else,” and what do you mean?
Irin Carmon: All other forms of reproductive medicine—prenatal care, birth, infertility, pregnancy loss—or even gynecological care in general. Before the white male takeover of medicine [in the mid-19th century], all reproductive care [including abortion] was more integrated into communal life, really across cultures. It was a group of women who were surrounding somebody at different stages of their reproductive life, from the onset of menarche through pregnancy and childbearing. I’m not saying that that system was perfect or that the old way was the right way, but I was really struck reading the history of the first abortion bans—as we live under the yoke of the new abortion bans, which are even more draconian and enforced with much more efficacy—that abortion bans and the white male medical establishment takeover of medicine were inextricably linked to each other.
It struck me as one of the many original sins of [modern] medical care. The other one being that the foundation of contemporary gynecology and obstetrics was American enslavement, and the unjust experimentation on enslaved women.
The part about experimenting on enslaved Black women was really hard to read—I actually physically winced. I think the narrative around childbearing and -rearing for Black women in America is so fraught, from the brutal, harrowing reality of how it all started with enslaved Black women, to the way that Toni Morrison used to talk about mothering as this gift of being able to keep and mother our children. How did you reconcile the different ways that Black women and white women experience pregnancy care?
Dr. Yashica Robinson [an Alabama-based OBGYN and former abortion care provider] was actually one of the starting points for me wanting to write this book. In so many ways, the work that she does is the embodiment of what could be a better way. I first met her in 2014 when I was reporting for MSNBC, and I had come to interview [her husband], who ran the only Black-owned clinic in Alabama. Dr. Robinson walked into the room, and when she started talking, I thought, “Who is this? Did I come to interview the wrong person?” I thought, this is the person who I want to learn from, and to help me understand the truly bifurcated, painful dichotomy you are talking about. Another Black woman I write about in the book, Christine Fields, died in the same hospital as Maggie Boyd, a white woman I also write about. They were both harmed by the same doctor. But…Maggie was able to come home and raise her son because when her husband screamed for help, he was listened to. And when Jose [Christine’s husband] screamed for help, they called security on him, and wouldn’t let him be in the room.
They left Christine alone, maybe because she was being treated like a problem, [and] we know from the research that Black women are much more likely to be treated in medical settings as a problem when they question the treatment or the care that they’re getting.
When I had an abortion in the 90s, even though I didn’t hesitate, I still felt so much shame, in no small part because of the picketers outside the clinic calling me a murderer. Where do you think shame falls today in the broader conversation?
The shame of being a “bad mother,” whatever that means to the person uttering it, is very powerful. And the anti-abortion movement has done a very effective job in making people—even when they’re feeling a sense of relief, which is the most commonly cited feeling around an abortion—feel shame for being a “bad mother.” I write about the work of Lynn Paltrow [founder and executive director of Pregnancy Justice] and Dorothy Roberts [civil rights scholar and author of Killing the Black Body] in the book, and I think they have so powerfully shown how this shaming of pregnant people’s very existence is so malleable that it can encompass somebody with a substance abuse problem, as well as somebody who drinks a glass of wine. Everybody thinks, “I won’t be the person whose behavior is scrutinized.” [But] the post-Dobbs era has made clear just how broad the tentacles of policing pregnancy can be.
How has your own pregnancy experience been impacted by the stories and experiences you write about in the book?
I was postpartum when I read about Hali Burns getting arrested six days after her son was born; she was arrested in her son’s hospital room. And so I’m mindful of the fact that I’ve been incredibly lucky, but that I feel a sense of deep connection to these women [in the book]. The work of this book was in trying to go deeper to understand the factors in the systems that led us to any given situation, because I’ve been the recipient of some low-key shitty pregnancy care, and I’ve had some incredible pregnancy care. For people who choose to go down this path, everybody deserves to have access to what I had access to.