Belabored

INTRODUCTION

Who Gets to Be a Mother?

In a poem attributed to Herbert Farnham, a mother is described as a flower, majestic as a tree, gentle as the dew, calm as the quiet sea. She is as graceful as a bird and as beautiful as twilight. God, Farnham wrote, pulled all these elements together and called them simply “Mother.”

I read Farnham’s poem on a card that I received from my mother-in-law on my first Mother’s Day in 2011. I was still sixty pounds over my pre-baby weight and constipated from the iron pills I had to take because I lost so much blood during labor. Every time I went to the bathroom, my bowel movement pressed against my stitches and made me cry. The only thing dewy about me was the noxious stew of postpartum juices in my underwear. My vagina looked like raw ground beef.

I tossed that card and all its treacle in the trash. What did those words mean, anyway? Dew, sea, brook, flight. None of them had any relation to my life as a mother. The fragrance of the flower had nothing to do with the deep darkness into which I stumbled every three hours each night to stuff my bleeding nipple into a screaming baby. With the way my boobs, once A cups and now E cups, hung like balloons full of sand from my body. The rippling brook sounded nothing like the womp womp womp of the breast pump, which in my exhaustion-induced hallucinations I thought was saying, “Bob Hope, Bob Hope, Bob Hope,” over and over. The majesty of the tree spoke to no part of my hormonal acne or the way I’d stare out the front door and imagine myself running away.

“How does it feel to be a mom?” my own mother had asked me.

“Like myself, but fatter and more tired and with weird shit coming out of my vagina,” I said.

My mom has eight children. By the time she was the age I was when my daughter was born, she was already five kids deep. I don’t think she’d forgotten what it felt like to be in my position. But she had done it all alone. Her own mother absent. My father working all the time. The burning pain of mastitis, the exhaustion, the times she must have sobbed in the bathroom because we wouldn’t stop crying—it all had to be for something more than our fat upper pubic area.

A video from 2014 that went viral shows clips of job interviews for a position called Director of Operations. The applicants are told the job involves long hours, no pay, no sitting, no breaks and requires expertise in the culinary arts, medicine, and finance. The job, they are told at the end of the interview, is Mom.

The video, titled #WorldsToughestJob, has been viewed over twenty-eight million times. It is meant to be a celebration of motherhood. Of the pain and the struggle. A glorification of the brutalization of our bodies and the lack of help we get from our own partners and government. It says to women that this, this is the greatest thing you can be: a martyr, a mother.

The pedestal on top of which sits the perfect mother appears in our creation myths. There is Gaia, Mother Earth from Greek mythology, who bore the powerful monstrous children of the god Uranus, the Titans. An Algonquian legend tells of the Mother of Life, who feeds plants, animals, and humans at her bosom. The Inca mythology includes Mama Pacha, fertility goddess of planting and harvesting. Christians have Eve, who failed in her first task—not to eat—and was given a second: bear children. Each creation story ties together the concepts of the worldly and the otherworldly. The flesh and the myth.

Not all creation stories begin with a mother. Not all of them involve a woman’s body given up for the good of—as it’s often phrased—mankind. But in America, to be a mother is to become a myth. To be a mother is to step into a role of someone else’s invention, to cosplay a character who exists at the intersection of race, class, gender, and religion. Stepping into this role, a woman is no longer a human. (But then, was she ever truly seen as human?) She is now a river, she is dew, she is a majestic tree, she is earth and wind and magic and mama.

But not all mothers are permitted to embody this hallowed, all-consuming role. And who our culture sees as not succeeding in the role of mother says even more about how we conceive of mothers, than who we laud as perfect exemplars.

In our cultural imagination the perfect mother is a white, middle-class, straight, cisgender, married woman. She announces her pregnancy on social media with a photo in which she’s smiling, draped in a gauzy dress, framing an almost nonexistent bump with her hands, wedding band glinting in the light. We are happy for her. We say, “Congrats,” over and over in the comments. Her hair is perfectly curled. Her husband smiles benignly behind her. She is the modern-day Virgin Mary.

This mother doesn’t force us to think of the complications of sperm and egg. With the focus on her glowing skin and hair, we get to skip that part. The perfect mother would never force us to think about sex.

Imagine if that woman had conceived before she was married, perhaps as a teenager. She announces she’s pregnant and we whisper: “What happened? Couldn’t she keep her legs closed? What went wrong?” We think of the darkness. We picture the wet-stained sheets. The tearful acceptance. Her parents. We blame her—her cavernous need. Her cavernous stupidity. We blame her, for her failure to live up to an arbitrary moral code. We don’t reckon with the societal conditions. What we told (or didn’t tell) her about conception. (After all, Texas, with its focus on abstinence-only education, has one of the highest teen pregnancy rates in the nation.¹) We excuse the boy who refused to wear a condom, but not the girl who didn’t push back and insist he wear it. The girl who didn’t have access to birth control or who was too ashamed to seek it because of her religion, her family, her lack of money or adequate sex ed or both. No, in those moments we think only of the girl, of her sex.

Imagine she’s black. (Why did we imagine her white in the first place?) Then our whispers silence and in their place are wry smiles. “Of course,” we nod. “Of course she’s pregnant.” And, no, no, no, no, that nod doesn’t make us racist. It’s just statistics. It’s not racist if it’s a fact, right?

Imagine she has no husband. Imagine her husband is her wife. Imagine she has no uterus. Imagine her husband has a uterus and is carrying their child.

Imagine mothers.

America scorns a fat mother. In 2019, writer Virginia Sole-Smith reported in a story for New York Times Magazine that fertility clinics will refuse to work with women if they deem their body mass index (BMI) is too high. The science behind that reasoning is based on a 1952 study that associated obesity with “menstrual disturbances,” a broad descriptor. Recent studies seem to back up the finding that women with higher weights have a harder time conceiving. But being “overweight” alone does not preclude conception or childbirth, and weight loss doesn’t always guarantee success.²

In 2018, Dr. Mark Turrentine, chair of the committee that produced the American College of Obstetricians and Gynecologists’ guidance on obesity and pregnancy, told the Huffington Post that the statistics surrounding pregnancy and weight need context to be fully understood. Although increased weight can be a complicating factor, the majority of overweight women have very healthy pregnancies. “Some of those potential risks, although they’re increased compared to normal-weight women, they’re still at a lower percentage,” Turrentine said. “We’re not saying there’s this great high rate of complications.”³

Roughly, over half of pregnant women in America are classified as obese.⁴ When a woman the medical establishment determines is obese becomes pregnant, the risk we should be concerned about is not the risk to the fetus but the risk that the mother won’t be treated as fully human. Study after study shows that doctors routinely discriminate against overweight women. A doctor’s inability to see the woman for the weight means they often miss warning signs, which increases the risk of complications. What we should be asking is, What if it’s not the woman and her weight that are the problem but the way she’s seen by her doctors?

Our society refuses to see a fat person as anything other than someone who is selfish and depraved, lost to the sins of laziness and overeating. Media stories take a condescending, lecturing overtone. Mothers who are overweight are depicted as gross food addicts who risk their babies’ lives with their refusal to lose weight. A fat mother who faces poor birth outcomes is held up as a cautionary tale for women who dare to be fat.

If a fat woman is allowed to become a mother, we certainly don’t allow her to be a good mother. Her food choices and the food choices of her children are scrutinized, examined, silently judged. If she is a mother, she mustn’t be a happy mother. She must always be trying to lose weight, always be struggling to model “healthy” behavior to her children, which is coded language for not eating, for not enjoying herself or her body.

America has a problem with fat mothers.

When Diane Delgado gave birth to her daughter in prison, she was shackled to the bed. Her legs and arms were immobilized. She couldn’t move, even as the labor pains crashed over her. The metal cuffs cut into her skin, leaving her with bruises that lasted for three weeks. Even when she was given an epidural, no one loosened her restraints. She had to twist her body and hope she could hold still in that unnatural position while the anesthesiologist pushed the needle into her spine.

Even when the doctor asked the guards to remove her chains, they refused. “It’s procedure and policy,” she recalls them insisting. “Can’t do it.”⁵

In 2017, around 225,060 women in the United States were imprisoned in state and federal prisons and jails, and over a million more were on probation or parole.⁶ In 2019, approximately 1,400 incarcerated women were pregnant.⁷ Giving birth in prison is a horrific experience, both physically and emotionally. Prisoners have recounted being shackled to the bed, and many say they weren’t allowed to have anyone in the room with them other than the hospital staff. One in eight incarcerated parents will lose their parental rights. And incarcerated mothers are the most likely to lose their children to foster care.⁸

The 1997 Adoption and Safe Families Act (ASFA) requires states to terminate parental rights for children who have been in foster care for fifteen of the last twenty-two months. According to the American Medical Association’s Journal of Ethics, “Because the average sentence for women in prison is 18 months, by the time parents are released it is likely they will no longer have custody of their children. Thus, a sentence as short as 15 months can result in the lifelong separation of a mother and her children.”⁹

Most of these women are not violent offenders. They are often in jail for petty theft or issues relating to mental health or addiction. As a by-product of the institutionalized racism, including generational wealth gaps, the black-coded “welfare queen” myth used to justify cutting social services, and the prejudiced policing and justice systems, these women are more likely to be women of color. Over 60 percent of women in state prisons have children younger than the age of eighteen.¹⁰

America does not allow women in jail to be mothers.

Shalon Irving was thirty-six when she had her first baby. Irving worked as an epidemiologist for the Centers for Disease Control and Prevention (CDC) and had a dual doctorate in sociology and gerontology. Her family described her as “an accomplished author and talented chef; skilled photographer and inveterate world traveler; and an ecstatic mother-to-be.”¹¹

Throughout her pregnancy, Irving, according to her mother Wanda, did everything right. When she found out she was pregnant while in Puerto Rico working to combat the Zika outbreak, she immediately got tested and confirmed she was negative for the virus. Over the course of her pregnancy, she was careful to take medication for a genetic condition she had that increased her risk of blood clots, and she never missed a doctor appointment. Irving had a detailed birth plan, down to who could be in the room, what conversations they could have, and what music could be played. That is the kind of woman Irving was: smart, detail-oriented, organized. And that was the kind of mother she would have been, had she been allowed to live. Irving gave birth to her baby, Soleil, in January 2017, via cesarean section. Everything was perfect, until Irving went home.

At home, Irving had trouble with her bladder, and though most mothers lose weight postpartum, Irving gained weight. She also had headaches and swollen legs. Again and again, she went back to the doctor, who—again and again—told her she was fine and this was normal. On January 21, only five hours after seeing her doctor and being told to “give it more time,” Irving collapsed.¹² She was taken to the hospital, where, one week later, she was removed from life support. Despite having known risk factors that warranted a high level of care and attention, she died of preventable complications of high blood pressure.¹³

Maternal death is on the rise in the United States. The CDC estimates that 700 to 900 new and expectant mothers die in this nation each year, with an additional 500,000 women experiencing life-threatening postpartum complications. The risk of death is more than triple for black women compared to white women. Between 2011 and 2013, the mortality rate for black women was 43.5 in every 100,000 births compared to 12.7 per 100,000 births for non-Hispanic white women.¹⁴

Neel Shah, an obstetrician-gynecologist at Beth Israel Deaconess Medical Center in Boston and director of the Delivery Decisions Initiative at Ariadne Labs, notes, “The common thread is that when black women expressed concern about their symptoms, clinicians were more delayed and seemed to believe them less.… There is a very fine line between clinical intuition and unconscious bias.”¹⁵

America is killing black mothers.

Black mothers who survive face discrimination and challenges to their maternal rights. America was founded on a system that required the surrender and oppression of black female bodies. In The Negro Family in the United States, historian and sociologist E. Franklin Frazier details the systematic oppression and sexual assault of enslaved black mothers. Raped and assaulted, enslaved mothers were usually forced to abandon their own children to take care of the white children of their oppressors in the often-romanticized “Mammy” role. In When Momma Speaks, black theologian Stephanie Buckhanon Crowder explains, “Mammy epitomized the mind versus body, culture versus nature, dichotomy that would distinguish her from other African American enslaved women. While on the same continuum as more youthful, light-skinned childbearing slaves, mammy became the fulfillment of what a loyal oppressed woman should be: the blissful, asexual mother to children not her own.”¹⁶

The experience of motherhood in America is a political question just as much as it’s a question of flesh.

For decades, American doctors forcibly sterilized black, Hispanic, and Native American women and women who were poor or disabled to stop them from reproducing. Many women had no idea they were being sterilized.

“In the South,” Ms. magazine reports, “it was such a widespread practice that it had a euphemism: a ‘Mississippi appendectomy.’”¹⁷

In total, up through the 1960s, it’s estimated that more than sixty thousand women were forcibly sterilized.¹⁸ And America didn’t stop regulating the right to be a mother with the surgical knife in that decade. In the 1970s and 1980s, doctors sterilized 25 to 30 percent of Native American women without their consent.¹⁹ More recently, the Center for Investigative Reporting found that between 2006 and 2010, 148 women in California prisons were forced to undergo tubal ligations.²⁰

As I wrote this chapter, Marshae Jones, a pregnant woman in Alabama, was shot in the stomach. Her fetus was killed. And though the woman who shot Jones walked free because she “acted out of self-defense,” Jones faced charges of manslaughter for her fetus’s death. She was being charged because she started it.²¹ “It” is presumably the fight that preceded the shooting. But it is a loaded word in America. “It” could be rape. “It” could be domestic violence. “It” is what women deserve when we deem them deviant. The state of Alabama decided not to prosecute Jones after she was indicted for the crime by a grand jury.

In 2014, The Root, an online magazine, profiled three black women who had lost their children due to the simple act of trying to survive. The first, thirty-five-year-old homeless Air Force veteran Shanesha Taylor, was arrested and held in jail for ten days on two counts of felony child abuse because she left her children in the car during a job interview. She was able to reach a plea deal in her case, but others have gotten stuck in this catch-22.²² Betty Brunson, was charged with child neglect after leaving her five children in the car while she retrieved a job application. Moshimalee Johnson, a mother of four, lost custody of her children after placing a Craigslist ad looking for housing.²³

America does not allow black, or brown, or Native women to become mothers.

In a 2018 article for the magazine Them, Lara Americo, a trans woman, recounts the harrowing process of detransitioning so that she and her partner, a cis woman, could have a baby. The pain of being misgendered coupled with the societal misunderstanding and transphobia was crippling. She writes, “There is no version of ‘What to Expect When You’re Expecting’ for transgender femmes trying to reinvigorate their penis.”²⁴ Americo and her partner eventually conceived and had a child in 2019. Their story of motherhood is one rarely told, or considered.²⁵

Transphobia, homophobia, and a lack of understanding about queer bodies’ are rampant in our healthcare system. A 2018 article that examined a series of studies about the maternity experiences of lesbians who became mothers found that the women experienced heteronormativity or homophobia (or both) when seeking maternity care. This ranged from paper forms that assumed a heteronormative family structure, with a mother and a father; to difficulty accessing fertility specialists to help couples conceive without having a diagnosis of infertility (as evidenced by repeated failure to conceive through penis-in-vagina sex); to staff at the hospital barring the nonbirthing partner from the recovery room, even in instances when a male partner would be permitted; to refusal of care entirely.²⁶

The Williams Institute at UCLA School of Law found that, in 2016, 114,000 same-sex couples in the United States had children. These couples, many of whom became parents through adoption or fostering, are challenging traditional ideas about what it means to be a parent, or a family, and because of that, they often face prejudice and discrimination.²⁷ Most recently, in 2018 Republican congressman Robert Aderholt added the Aderholt Amendment to the 2019 fiscal spending bill. The amendment would have allowed child welfare and adoption agencies to turn away families based on religion, sexual orientation, gender identity, and family structure. Although Congress stripped the amendment from the bill before it was passed, legal discrimination on the state level is still common. LGBTQ couples in America who wish to become parents face a complex legal system that often denies them their rights.

In 2019, the American Bar Association (ABA) attested: “State-sanctioned discrimination against LGBTQ individuals who wish to raise children has dramatically increased in recent years.” As examples, the ABA highlighted ten states that give state-licensed welfare agencies the right to refuse to place children with LGBTQ couples. Many of these laws were passed after the United States Supreme Court legalized gay marriage in Obergefell v. Hodges in 2015.

America does not let queer people become parents.

The question of who gets to be a mother, and further, who is a good mother, cuts to the heart of our cultural biases and systemic inequalities. So, when we think of mother, we need to consider who we don’t see represented.

Motherhood should be a choice—not compulsory, not restricted, but a choice allowed to everyone. However motherhood is chosen, it ought to be just that—chosen. For all the people stripped of the right to be mothers, more are forced into this role through abuse, rape, inadequate education or health care, and lack of access to birth control or abortion providers. So, when we talk about mothers, more than pregnancy photos and birth plans and which car seats to install in our minivans, we need to talk about choice. We need to talk about who is allowed in the delivery room and who is forced out. Who is killed in the delivery room. Who is forced in. We have to talk about the violence of the term mother. The way it cuts across and through our bodies. The story of motherhood is in so many ways the story of the female body. And what happens in and on this flesh is just as much massacre as it is miracle.

Throughout this book, I primarily use the terms mother and motherhood and female pronouns, in part because much of the culture surrounding pregnancy in America reflects and amplifies the misogyny our larger culture is steeped in. So, to talk about our cultural narratives of pregnancy is in many ways to talk about our cultural narratives of women. But I am also defaulting to this gendered lexicon because of the limitations of our culture and the English language. Although not all mothers give birth to their children and not all people who give birth to their children are mothers, mother and motherhood evoke the childbearing parent with a clarity, however illusory, that parent and parenthood do not, for instance. And because mothers continue to face higher standards and more judgment for their parenting than fathers do, parent alone doesn’t capture the full weight of the cultural expectations placed on mothers. I try to use more inclusive and accurate alternatives where they exist, but I am sure I will fail in this. And my failures will feel constricting and limiting to mothers who don’t identify with the words used. My failures are my own. And I hope that where I fail, others will succeed, showing us ways to better reflect the breadth and complexity of our reality.

This book is about pregnancy, but it is not a guide to your swollen boobs. This book is not a how-to for a gender reveal party. This book is an attempt to midrash the experience of motherhood. To plumb the depths and meaning of the text of our bodies. To look at the stories we have been told and to create new ones and better ones.

In her 1792 groundbreaking feminist treatise, Mary Wollstonecraft wrote, “I do not wish [women] to have power over men; but over themselves.”²⁸ Like Wollstonecraft, I wish the same for all pregnant people. I wish for all people to be given the radical opportunity to have power over themselves. To have that power, we need to be able to choose freely whether to become pregnant or not. To bear—and to raise—a child is a radical choice that can reduce us to poverty, ruin our bodies, and compromise our employment, our earning potential, our lives, and our relationships. To become pregnant and to have children is to wade deeper into a world where your body is no longer yours, your body is debated by politicians, your body is manhandled by medical practitioners who won’t listen, your body is a thing people in the Target checkout line and on the school playground and around a holiday table have opinions about.

To be pregnant, to be a mother, is to occupy a political space where your body is fought over and you feel powerless to control the conversation that rages around you. Power over our bodies begins with consent and consent begins with choice and choice is the primary right that is often stripped from people in their journeys to and through pregnancy.

Not long after I announced my second pregnancy, I was hired to be part of a team of mom bloggers paid by our local hospital system to blog about mothers and motherhood and pregnancy on its site. We earned fifty dollars a post, which, at the time, felt like a lot of money. The blog was called “The Real Moms of Eastern Iowa”—a send-up of the “Real Housewives” series. The hospital commissioned a glamorous photoshoot of us posing with our bumps and our babies. The pictures were published in a full-page ad in the hospital magazine and on mall kiosks, print mailers, even a billboard. We were beautiful, we were middle class, we were white, we were “The Real Moms of Eastern Iowa.”

Less than a year into the project, one woman quit when she got divorced. I, too, quit, as my marriage grew more and more strained and the labor of the writing exceeded the pay. We were replaced by other smiling white ladies with children. It was like we’d never left, like we’d never been there at all. We were just placeholders for an ideal. The blog drew criticism from other mothers, who rightfully took issue with this vision of white, cisgender, heterosexual motherhood being cast as “real.” The defense the hospital’s marketing team offered was the same excuse you hear repeated in these situations: these are the mothers we found, they are the ones who’d write, we’d love to have diverse mothers, but they are hard to find. The reality was we were the women who could afford to take such low pay to write. We were the women who had the time to write.

Eventually, the project ended. The blog still exists but hasn’t been updated since 2016; it remains on the Web as a clutter of broken images, broken links, and incomplete HTML tags. It’s an online monument to a pervasive cultural ideal about what constitutes a real mother. An ideal that is shaped by class, patriarchy, and white supremacy.

To be a real mother is just to be a mother. And to be a mother is both a personal and political reckoning, a negotiation of culture and myth and science, an enterprise based more on survival than on who breastfeeds the best or the longest. But whatever else it is, it ought to be a choice.

Part I

FIRST TRIMESTER

Congratulations, you are pregnant.

Those two lines that appear on the plastic stick you peed on tell you with 99 percent accuracy that you are fucked.

Congratulations.

From this moment on, your body is no longer yours. Already you have Google-searched your symptoms and already you have typed “what should I do if I am pregnant?” Already you have ceded autonomy. It’s not your fault; you’ve been trained to submit your body to the greater authority. Soon your obstetrician will weigh in. They’ll give you a list of acceptable foods and medicines. Mothers will stroke your stomach. Strangers will comment.

You are used to being told how to carry yourself. How to dress yourself. How to be yourself. But this is different. Whatever little was yours is now gone. Lost to the life inside you.

Do it for the baby. Don’t do that! You’ll hurt the baby.