In the midst of life ...

I should say at the outset that this pregnancy-related post is quite a solemn one (don’t worry, I’m fine!), and even though it is firmly grounded in my own experience may act as a trigger for some readers. 

* * * * *

This is a tale of two pregnancies.

During my first pregnancy, I began to bleed at seven weeks. As I’m sure you can imagine it was a startling and unexpected sight. Given that I was still in my first trimester, I worried that I might be about to miscarry and quickly made an appointment with the nearest GP that I could find. After a check-up, he seemed fairly relaxed that my fears were not about to be realised, but sent me for a scan just to be on the safe side. I felt calmer, but was eager to see what was going on in my otherwise-much-as-usual abdomen.

I don’t think that I really expected to see much at this scan. After all, the scans where you can discern faces and legs and hands come later, at 12 and then 20 weeks. I guess I thought the radiologist would have a quick look and reassure me that everything was just fine (well, fingers crossed anyway).

After consuming practically my own body weight in water in the hour before my appointment, I propped myself up on the bed and gel was smeared across my tummy. Using my inflated bladder as a guide, the radiologist soon found what he was looking for. There, magnified several times, was a small shadowy circle: that, he said, is the remainder of the egg sac, the proof we sought that my pregnancy was still viable. Phew!

But there was something else there too. Something I had not expected to see.

It was like a tiny flickering light, a candle buffeted by a draft. 

As we looked at it, the radiologist turned on the sound. Clear, regular thuds turned the flickering candle into a sure sign of life: a heartbeat. Along the bottom of the screen, we could see the jagged lines graphically representing that heartbeat. This fetal heartbeat, much faster than ours, pushed the lines close together, into steep, high peaks, and deep, narrow valleys.

I watched, speechless, unexpectedly moved by this testament to a life that was still going strong, despite what I feared. Whatever the reason for my bleeding, it was clear that the foetus and I were still in this together.

Afterwards, I couldn’t stop thinking about this moment. It got me thinking about, of all things given my very recent fears, abortion. I was and am firmly pro-choice, believing that it is a woman’s right to control her own fertility. But my experience at the seven-week scan had given me a different perspective. I didn’t agree with pro-life advocates, but I could understand better where they were coming from. It was hard to deny the life-force of that tiny but steady beating heart, that palpable assurance that ‘yes, I’m still here.’

It reminded me of the anti-abortion sign parked by the side of the road of State Highway 2, which infuriated me every time I drove past it: ‘abortion stops a beating heart.’ Designed to guilt-trip, it now seemed like they might have a point.

I’m not the only expectant pro-choice mother who has been given pause by an early scan. In Misconceptions, Naomi Wolf wrote of her reaction to her three-month scan:

As I saw that hand and foot, something irrational happened: a lifetime’s orientation toward maternal rights over fetal rights lurched out of kilter. Some voice from the most primitive core of my brain - the voice of the species? - said: You must protect that little hand at all costs; no harm can come to it or its owner. That little hand, that small human signature, is more important now than you are. The message was unambivalent. (Misconceptions, chapter 5)

While I did not share many of Wolf’s sentiments - ‘voice of the species?’, ‘more important now than you are’? Jeez, Naomi! - I related to her altered perception. And how it led her to question her basic notions of identity and politics. She comments further:

I was still passionately pro-choice. But I was beginning to wonder if a pregnant woman was an implicit challenge to the autonomous ‘individual’ upon which basic Western notions of law, of rights, even of selfhood were based. There are two people inside me now, I thought. Everything is different. Pregnancy, it seemed required a different kind of philosophy; even a better pro-choice language. (Misconceptions, chapter 5, extracted here)

In a previous article in New Republic, Wolf opined that the pro-choice movement had "developed a lexicon of dehumanization" and urged feminists to accept abortion as a form of homicide and defend the procedure within the ambiguity of this moral conundrum. She continues, "Abortion should be legal; it is sometimes even necessary. Sometimes the mother must be able to decide that the fetus, in its full humanity, must die."  Wolf concluded by speculating that in a world of "real gender equality," passionate feminists "might well hold candlelight vigils at abortion clinics, standing shoulder to shoulder with the doctors who work there, commemorating and saying goodbye to the dead."

I don’t think she’s on the right track here, but Wolf does have a point. Trans-historically, cross-culturally, and among other animal species, reproductive control - whether through abortion or, more troublingly, infanticide - is the dark other side of the story of women’s ability to bring forth life. 

My own reflections on this topic didn’t end with my first pregnancy, however.

In this, my second pregnancy, I also had a seven-week scan. This one was simply ordered as a ‘dating scan’ to establish an estimated due date, rather than to confirm the viability of the pregnancy. Again, I sloshed into the radiologist’s room, had the gel put on my tummy, and looked expectantly at the monitor. This time my fear was not that I might have lost the baby, but that there might be more than one heartbeat in there. 

Again, we saw the shadowy egg-sac - just the one, thank goodness - appear on the screen. Again, we saw the candle-flame flickering. Again, we saw the jagged heart-rate and heard the quick rhythmical beat. 

This time, however, my emotional response to the scan was quite different. 

This time, I was more matter-of-fact, less surprised: ‘There it is’, I thought to myself, as if I had just found a lost set of car-keys. I watched the monitor and was only surprised by the fact that I was not really surprised.  What had changed since my previous first scan and this one?

In a word, experience.

While I still remembered my sense of wonder from the first scan, I was also somewhat older and wiser about what it takes to bear and raise a child. I remembered feeling sick as a dog during my previous first trimester. I remembered nearly dying after giving birth, and the long process of recovery from that. I remembered the sleep deprivation, near-constant breast-feeding, isolation, and marginalisation that counter-balanced the marvel of a new baby and the joy of her every movement. I remembered that there are emotional, financial and social costs in having a baby, just as there are incalculable gains. 

More importantly, I knew that I had wanted my first baby and I wanted this one. But I also knew that not every woman who finds herself pregnant does (for whatever reason that may be). I found myself agreeing wholeheartedly with pregnant Guardian columnist Tanya Gold, who recently wrote: “Pregnancy has made me more pro-choice, not less; an unwanted pregnancy, I now know for certain, is too much to ask, here or anywhere.”  Similarly, journalist Caitlin Moran powerfully narrates her own experience of abortion, after already suffering a miscarriage and giving birth to two children, in How to Be A Woman. Her conclusion? That women know best about what’s best for them.

But, as my reaction to my first scan attests, this is a complex area.  

While I remain pro-choice, I cannot un-remember the flickering light of life I first saw approximately three years ago. Nor can I ignore the fact that, for some groups of women, the right to have children is threatened by things I am extremely unlikely to experience, such as forced sterilisation (see examples here and here). Nor that some groups of women are stereotyped as ‘bludging breeders’ and are on the receiving end of social censure for having or wanting to have children. But in every circumstance, when it comes to fertility, women are often positioned as less than human, their right to control their own fertility - be it having children or deciding not to have them - is seen as a matter for others to determine. 

Knowing now what I was yet to learn then, I am more convinced than ever that it is the state’s responsibility to provide women with access to legal and safe abortion, not only in cases of rape, incest, threat to the mother’s life, or for medical reasons, but also in cases where a potential mother does not want to carry a child to term for whatever reason that may be. Anything less would be, ironically, to infantilise women, to treat them as if the state - and, by that, let’s face it, I really mean patriarchal ideology - knew better than women themselves about what is best for them.

This is not an abstract or settled issue, either. 

Just this week, Texas senator Wendy Davis filibustered for 11 hours to stall proposed legislation that would have limited Texan women’s right to exercise control over their own fertility. The proposals she took a stand against called for abortions to be banned after 20 weeks, clinics to upgrade their facilities to be classed as surgical centres and doctors to have admitting privileges at a hospital within 30 miles. They would have forced 37 of the state's 42 clinics to close, making it very difficult for women in rural areas to obtain an abortion if they needed one. 

Since her actions, and those of her supporters, succeeded in over-turning the vote, Davis has been attacked by male politicians for being a teenage mother of a teenage mother, someone who should know better than anyone what the value of a life is. 

Given that Davis was a divorced single mother, working two jobs to support her family, and living in a trailer park by the age of 19, I think she, far better than her male critics, probably does know what the value of a life is and what it takes to make and raise one. She did not choose to end her own pregnancy, but she knows enough to know that not all women would make the same choice she did.

review: Origins

It was with some trepidation that I picked up this book. 

Written by science journalist Annie Murphy Paul, Origins: How the nine months before birth shape the rest of our lives (2010) threatened to be another ‘blame the mother’ - even before she’s given birth! - tome, this time in the guise of a popular overview of the latest developments in the study of fetal origins of adult disease. ‘Fetal origins’ is a burgeoning field of scientific research, as more and more studies have produced suggestive - but not necessarily conclusive - findings that indicate that some diseases such as diabetes, heart disease, as well as mental health problems, may get their start in utero. Other research has suggested that other aspects of our lives may also be affected by our pre-natal life, including educational attainment and material wellbeing. These are novel - and potentially controversial - claims. 

Intrigued, but with spider senses heightened for anti-feminist or overly deterministic polemic, I decided to delve in and see what the boffins were saying.  I was relieved to discover that Paul shared some of my concerns, and gestured to them in various parts of the book. Moreover, her narrative style was personal and accessible. 

Pregnant with her second child at the time of writing the book, Paul, preoccupied with the usual pregnancy concerns (‘what should I eat?’ ‘will this affect the baby?’) decided to explore further into what really happens in the those first nine months. The book, structured into nine month chapters each exploring a different field of research, also traces her own altered feelings and perceptions as she passes through the stages of her pregnancy: how she (secretly) wishes for another boy; how she starts to see everyone around her in a doubled way as both person and fetus simultaneously; how she experiences ‘Mommy Despair’ (not quite ante-natal depression but in the same spectrum). We also follow her to obstetric appointments, and hear her try and explain to her three-year old son about the new baby inside her tummy (his reaction: ‘that’s silly, mummy’). 

Going through the experience of pregnancy herself as she researches and writes this book enables Paul to steer a middle ground between interest in the research and a slightly distancing skepticism (does fetal origins research equal determinism?). She writes:

But science can’t tell us everything we need to know about this new perspective; there’s always a gap where the hard evidence of the laboratory meets the soft flesh of our bodies. So I’ll also embark on this exploration as a pregnant woman, someone who is living what she’s learning about. (pp 9-10)

Among the topics she covers are: the effects of both traumatic and everyday stress (three months); the effect of chemicals and pollution in the environment on a developing fetus (four months) the impact of environment on sex preference (five months); and the impact of diet and lifestyle in the context of concerns about determinism (seven months).  

In the course of exploring the latest research in these areas she muses that the difference between nature and nurture is not as simple nor as binary as people think: poor health may not only be a result of genes and/or environment, but also a result of the complex interplay of developing fetal biology and the intra-uterine environment (also biological). For example, some researchers have studied data from such ‘natural experiments’ as the Dutch Hunger Winter of 1944-45 or the famines caused by the Great Leap Forward in China to explore the impact of maternal malnutrition on babies born after the time period. In each case, researchers found evidence that infants born after these events had higher rates of still births, birth defects, low birth weights, and infant mortality. Furthermore, these infants grew up to have higher rates of obesity and heart disease than those born under ‘normal conditions’ (pp 23-4). These findings seem a little counter-intuitive to the lay reader: why would the effects of malnutrition - caused by deprivation - lead to poorer health outcomes that are more commonly thought to be the result of affluence?

This was a question that bothered British doctor David Barker, one of the earliest of the current wave of fetal origins researchers. In his own research into birth records in the UK, and the subsequent lives of these infants, he found similar patterns in some of the poorest areas of the country, and was led to the inescapable conclusion that low birth weights meant a higher risk of heart disease in middle age (p 25). Barker explained what he thinks these findings mean:  ‘I think the fetuses are actually taking cues from the intrauterine environment and tailoring their physiology accordingly. They’re preparing themselves for the kind of life they will encounter on the other side of the womb.’ (p 27)

When Barker’s findings were first published in 1989, they were not well-received - even ridiculed - as researchers at the time were focussed on the environmental and lifestyle factors in disease. Since then, however, fetal origins research has taken off in a number of different fields, including the medical, psychological, and economic. 

The results of the research Paul summarises are very interesting, but also alarming, particularly given that I am also pregnant with a second child. I’m already conscious of the slightly sanctimonious lists of things I should and shouldn’t be doing, and still can’t quite over the feeling that the aggregate of all this fetal origins research may be to position the rights of a fetus over the rights of a pregnant woman in a more coercive way. Some medical researchers have also sounded a similar note of caution. Physician Darshak Sanghavi, for example, is concerned that if people become convinced that destiny is determined in the womb, societies will no longer invest in the welfare of individuals: ‘why bother funding children’s health initiatives or universal preschool, if physical and cognitive functioning have been set in utero?’ (p 195). 

Nowhere is this concern about the possible ends to which fetal origins research could be put more palpable than in the contentious area of abortion. In one chapter, Paul cites evidence of the impact of ‘wantedness’ on a baby’s post-natal life: one study found that an ‘unwanted’ child born due to abortion restrictions was as much as 50 per cent less likely to survive into old age than the average child born in the same era (p 219).

Paul, to her credit, does address the minefield of abortion,  She asks all the researchers she interviews about the impact of their research on debates over the legality and morality of abortion, and notes that virtually all of them are uneasy about this topic:

They grow uneasy, shifting in their chairs and hesitating over their words. Fetal origins is concerned with the relationship between prenatal experience and postnatal life, they say at last, leaving me to complete the thought. For the aborted fetus, there is no postnatal life, so the matter of fetal origins is moot. (p 217)

Paul, rightly I think, believes this response side-steps the issue of the political ends to which fetal origins research could be put, not least in the United States where there have been some high-profile court-cases that have upheld the right to life of the fetus over the wishes of the mother.  In societies still dominated by patriarchal values, fetal origins research could well be pressed into service in future court proceedings of this nature. 

As a result, I’m not so convinced by Paul’s assertion that fetal origins research discomfits both sides of the abortion debate:

Advocates of the right to abortion, for example, have at times portrayed the fetus as no more than an inert blob of tissue. Fetal origins research, with its emerging picture of a learning, adapting, responding fetus, makes that evasion less tenable. For their part, opponents of abortion have sometimes preferred to consider the fetus in splendid isolation, relegating the pregnant woman to the role of human incubator. Fetal origins research, with its elaboration of the intimate interplay between pregnant woman and fetus, does away with the imaginary separation (218).

In this effort to strike a middle path between two extremes, I think Paul creates a false dichotomy. While some advocates for a woman’s right to bodily autonomy and control of her own fertility (whether that means access to legal and safe abortion, or the ability to have children without being coerced into an unwanted abortion or sterilisation) may have represented the fetus in this way, I think the larger issues in feminist discourse on abortion have been both ‘choice’ (in the sense of self-determination, a fundamental human right) and the notion that ‘every child be a wanted child.’ I do not see how learning more about fetal origins undermines those basic principles. Far from it, the importance of fetal origins could be held up as further underscoring the importance of women being able to fully control their own fertility, of ensuring that every child they have is wanted, and will receive the best care - both pre- and post-natally - they can provide.

In framing the issue this way, I think Paul inadvertently reproduces (pardon the pun) the notion that abortion is an easy and frivolous ‘lifestyle’ choice for promiscuous women. By contrast, I can easily see how fetal origins research could be high-jacked by conservative opponents of women’s rights: already, the ability to detect fetal heartbeats at just seven week’s gestation has led to emotive anti-abortion slogans like ‘abortion stops a beating heart’. When there have not only been cases of women forced by court order to have children against their will - and what will the health outcomes of those children be like? - and, recently, a woman left to die because her rights were seen as secondary to that of her dying fetus, I think there are some serious ethical and political questions that need to be asked about the implications of this research. To be clear, I am not at all suggesting an anti-science approach and the abandoning of these research lines. Rather, I am suggesting that such research take place in the context of enhanced and protected women’s rights.

Paul may say all the right things about avoiding fetal determinism by ensuring programmes to address pre-natal risk indicators (like low birth-weight) are meant to support women and their children, rather than co-erce or label them. I’m a little more cynical, however, about the ways such programmes might be targeted and deployed in societies still dominated by patriarchal values. 

And, of course, much of the fetal origins research Paul highlights could lead to policy changes that would benefit everyone, not just pregnant women: in these cases, fetal origins research could lead to greater regulation of pollutants, toxic environments, food additives and so on. Paul also looks at the most recent work of economist Amartya Sen (already famous for his work on global poverty and the positive impact women’s empowerment has on children, families and communities). Sen’s latest work has focussed on the ‘hidden penalties of gender inequality’: the effects of pregnant women’s disadvantage on their fetuses. Sen argues that ‘women’s deprivation in terms of nutrition and healthcare rebounds on the society in the form of ill-health of their offspring - males and females alike.’  He comments further on the ironic implications of this: ‘We in India treat ... women so badly that most are undernourished and give birth to underweight babies. It is known that cardiovascular diseases hit men much more than women. So when you mistreat ... women, the men eventually suffer.’ (p 222)

So what I am left with at the end of this by turns fascinating and frustrating, but always compelling, book, is that motherhood is crucially important right from the moment of conception, whether one is a man or a woman; a mother or a child-free woman; a fetus, child or adult. This means that everyone has a stake in better supporting mothers and families: protecting women’s rights only threatens ideology not people.

review: How To Be A Woman

Newsflash! Feminism is not fusty, fussy and frowny.  It’s fun, funny and frivolous. After all, ‘it’s a good time to be a woman: we have the vote and the Pill and we haven’t been burnt as witches since 1727.’ But, as Caitlin Moran, concedes ‘a few nagging questions do remain.’

Indeed.

If the blurb on the back of the book is to be believed, Moran has the answers to the questions that every modern woman is asking. 

After finishing it, I’m not quite so sure. Some of the questions about botox and brazilians seem less like the concerns of ‘every modern woman’ and more like the kind of things you might find posited as ‘issues’ in Cosmo. 

Having said that, I do think it’s great that this book has struck a chord with many girls and women, who have found something of value in it, and have, hopefully, taken up Moran’s call to re-define themselves as ‘strident feminists.’ And if it then encourages them to take a deeper look at the serious, momentous and urgent stuff rather than simply guffawing at an anecdote about getting really drunk with Lady Gaga, then Moran will have achieved a great deal. Several reviews have already welcomed the book in this way, and I think it’s difficult to argue with the positive impact a best-selling book about feminism can have. I myself was interested in her insider's take on how the media construct representations of female celebrities as 'everywomen' (basically, by asking when they're going to have a baby all the time).

Other reviewers have, however, criticised this book because of what they perceive as its inherent snobbery and focus on the mores of a particular social set, likening it to a Victorian etiquette book in the process. More broadly, I think the book reveals the limits of individual memoir as a ground for political action. Memoir gives a writer license to retreat into the authority of subjectivity, so, in Moran’s case, one could be forgiven for thinking that brazilians appear to rate more highly than rape as a feminist issue (although I realise it’s not a zero-sum game and there is a relationship between the two). I found myself torn between interest in Moran’s memoirs - she’s lived an interesting life and spins many a funny yarn about it - frustration at her wanting to make a joke of everything all the time, and exasperation at some of the supposedly empowering solutions she trumpets (burlesque and female-centric porn will set us free apparently. Um, really?) 

Yes, the personal is  political, and (paraphrasing bell hooks) ‘there is no joy in appropriating someone else’s oppression’. The power of consciousness-raising rooted in personal experience is then to elevate it to the structural: ‘I’m only earning half as much as that doofus of guy doing the same job as me’ - ‘me too’ - ‘let’s start a revolution!’ The idea is that even those not directly affected will recognise that ‘there but for the grace of God ...’ 

All the amusing anecdotes and hilarious romps involving lots of booze, Lady Gaga and so on got a bit wearing after a while. I couldn’t help but think that while there was a lot of strategic mileage to be had out of the ‘feminism is fun, dontcha know’ schtick that there was also a disavowal of some righteous anger as well. Women aren’t meant to be angry, so it was disappointing to see Moran, in interviews promoting the book, quickly pointing out that she’s a funny feminist not a scary or awful one. 

Sure, pioneering feminists like the suffragettes might’ve shared some laughs over a gin or three, but they went on hunger strikes, chained themselves to railings, lobbied politicians, and even threw themselves under horses because they were bloody well PISSED OFF at not having the vote and not having the right to own property. Similarly, second wave feminists probably had a rollicking good time at consciousness-raising sessions, protest marches, and speculum parties. But they were also pretty incensed at being poorly paid for their work, being stuck at home with small kids all day while being treated as little more than children themselves, needing male relatives to sign documents for them, being subject to overt sexual harassment as part of daily working life, being unable to decide their own reproductive futures, and, in some cases, being legally raped by their husbands. 

Pretty hilarious stuff, when you get down to it.

And yet, there are other moments when Moran drops the quips that have a quiet power. In the book’s postscript she poses herself the rhetorical question ‘so do I know how to be a woman now?’  Instead of the expected self-deprecation, she writes ‘I distrust this female habit of reflexively flagging up your own shortcomings ... I’m talking abut the common attitudinal habit in women that we’re kind of ... failing if we’re not a bit neurotic.’ Her response to the question instead? ‘Kind of yes, really, to be honest (pp 297-8).’ Not exactly strident, maybe still a little neurotic, but progress nonetheless. 

Where the book is most powerful - and given its theme - most pertinent to this blog, is in the chapters on birth, mothering, not-mothering, and abortion. These chapters are the strongest because the amusing anecdotes and wry asides retreated - but, you’ll be relieved to know, didn’t disappear entirely - to include moments where, to put it bluntly, shit gets real. Particularly confronting was her chapter on abortion, which aimed to show that deciding one’s own reproductive fate is about more than what happens in cases of rape and incest. 

Here are a couple of selections from these chapters:

(on birth): of course, I haven’t told you the half of it. I haven’t told you about Pete crying, or the shit, or vomiting three feet up a wall, or gasping ‘mouth!’ for the gas and air, as I’d forgotten all the words. Or the nerve that Lizzie damaged with her face and how, ten years later, my right leg is still numb and cold. Of the four failed epidurals, which left each vertebra smashed and bruised, and the fluid between them feeling like hot, rotting vinegar. And the most important thing - the shock, the shock that Lizzie’s birth would hurt me so much; would make me an animal with my leg caught in a trap of my own bones, and leave me begging for the doctors to take a knife and cut me free. // For the next year, every Monday at 7.48am, I would look at the clock and remember the birth, and tremble and give thanks it was all over, and marvel that we both survived. (pp 221-2)

(on deciding to have an abortion) This isn’t who I’m going to be again: another three years of being life support to someone who weeps for me, and rages against me, and who knows, when they’re ill, can only be relieved by resting their head on my belly, and dreaming they’re back inside. My two girls ... are all I want .. I’ll do anything for those girls. // But I will only do one thing for this baby - as quickly as I can before it goes any further (p 271)

To me, these stories offer a much more powerful version of the personal is political than the chapters which preceded it. By putting herself out there in this way, Moran really has the potential to speak to other women’s experience and effect change. But that's all a bit po-faced and serious, innit?