Gratuitous Woman-Blaming: Even Progressives Do It

As I am likely to be moving to Tennessee in the not-too-distant future, I read this guest post at Shakesville with particular alarm. (Cross-posted from here).

Apparently there is a bill working its way through the Tennessee state legislature that would require all pregnant women who aren't seeing an OB/GYN for prenatal care all throughout their pregnancy, or whose pregnancies are "abnormal" in some way, to undergo drug testing.

Here's Aunt B's take on the bill's implications:

This bill would make mandatory drug testing for women who don't act right during pregnancy. If you don't get pre-natal care, the State [of Tennessee --- not the entire US, international readers!] wants the right to drug test you. If you don't come in for prenatal care promptly once the fetus is viable, they want the right to drug test you. If you don't get the right kind of prenatal care, they want the right to drug test you. In other words, if you act in any way "abnormal," the going assumption is going to be that you must be on drugs.

But here's the best part. If your pregnancy just isn't going right --- the placenta comes open or the fetus dies or you go into labor early for no discernible reason, or the fetus isn't growing fast enough, or the fetus has congenital anomalies --- and let me remind you that these are all things that just happen during pregnancies; things go wrong, for no reason, all the time --- the State wants to drug test you.
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In other words, the precedent they're setting is that, once you are pregnant, your body is not your own. You no longer know what's best for you. Your doctor no longer knows what's best for you. You are not allowed to not realize you're pregnant. You're not allowed to be afraid. You're not allowed to be too poor to go to the doctor. You have to do what the State tells you to do while you're
pregnant, because, while you're pregnant, your body is not your own.

Here, from the text of the bill itself, is the list of "indications of the necessity for drug and alcohol testing":

(1) No prenatal care;
(2) Late prenatal care after twenty-four (24) weeks gestation;
(3) Incomplete prenatal care;
(4) Abruptio placentae;
(5) Intrauterine fetal death;
(6) Preterm labor of no obvious cause;
(7) Intrauterine growth retardation of no obvious cause;
(8) Previously known alcohol or drug abuse; or
(9) Unexplained congenital anomalies.

(I took #3, "Incomplete prenatal care," to encompass not only failing to see an OB/GYN all the way up to the birth, but also getting prenatal care from anyone who is not an OB/GYN --- like if you had decided to give birth at home with the help of a midwife or doula).

What's particularly mind-bending about this bill is that its sponsors --- Sen. Beverly Marrero (D-Memphis) and Rep. Jim Hackworth (D-Clinton) --- actually seem to be fairly progressive.

From a statement Marrero made on human rights:

As a Democrat, I support women being allowed to make choices about their own lives and bodies. These are painful and difficult choices. I support these women. I stand beside them in their struggle for self-determination.

As a Democrat, I am concerned about all children being nurtured and supported by a loving and compassionate community.

Aunt B mentioned in her post the likely reasoning behind someone like Marrero proposing this act: Memphis --- Marrero's home district of Shelby County in particular --- has appalling rates of infant mortality and premature birth.

Lack of access to prenatal care has a lot to do with it:

Prematurity is the No. 1 baby killer in Memphis and nationwide, accounting for at least 60 percent of the deaths.

In half those cases doctors don't know why the babies came early.

Poor women are more likely to deliver too early - between 20 and 37 weeks - and lose their babies. The odds are against them.

Their lives too often reflect the long list of risk factors.

Poor mothers are less likely to get prenatal care, less likely to eat right and get vitamins they need.

They're more likely to smoke, drink, use drugs, and suffer mental and physical abuse.

They're more likely to have unplanned or back-to-back pregnancies.

Poor mothers are more often high school dropouts and teenagers, more likely to live near toxic streams and dumping grounds.
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"We've medicalized a social problem," [Nancy Lawhead, health policy assistant to Shelby County Mayor A C Wharton] said.

Memphis must find a way to infuse in its culture that teen pregnancy is a shackle to poverty, she said. That the surest way to freedom is family planning; that low education levels and no prenatal care can literally kill your baby.

In light of that, I can understand Marrero and Hackworth's desperation. But the way to combat the profound systemic inequalities at work here is not to penalize poor women for failing to get themselves into doctors' offices in spite of all the factors that work to keep them out. As Aunt B mentions in her post, this bill is not likely to get more drug-using moms-to-be to see doctors; if anything, it will keep them away for fear of testing positive and facing drug charges. (Also, as one of the commenters at Shakesville noted, opiate withdrawal is hell on even a nonpregnant body, so going into treatment to break the addiction --- which is what the law would mandate for women testing positive --- could actually jeopardize more pregnancies).

No, I think legislators like Marrero and Hackworth would be better served by putting their funding behind existing volunteer organizations that educate and advocate for pregnant women, or by beefing up state-funded healthcare. Using the law to make more choices available to poor women makes a lot more sense than using it to restrict their choices even further.