America is killing its mothers

Motherhood doesn’t have a marketing problem. It has a mortality problem.

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In Ohio, a woman is being charged with a felony after suffering from a miscarriage. Brittany Watts, a 33-year-old Black woman, had a miscarriage at week 22 of her pregnancy. The fetus came out through the birth canal and into the toilet. Despite medical evidence that the fetus was non-viable, prosecutors still pressed for the felony “abuse of a corpse” charge.

At the hearing, forensic pathologist Dr. George Sterbenz testified, “This fetus was going to be non-viable. It was going to be non-viable because she had premature ruptured membranes — her water had broken early — and the fetus was too young to be delivered.” Despite that evidence, assistant prosecutor for Warren County Lewis Guarnieri argued that because Watts left the fetus in the toilet she should be charged with felony abuse of a corpse. On November 2, a judge allowed that charge to move forward, saying, “There are better scholars than I am to determine the exact legal status of this fetus/corpse/body/birthing tissue/whatever it is.”

Watts is just one of many mothers fighting for their right to autonomy under a spate of new abortion restrictions.

In Texas, Kate Cox has been fighting the courts for the right to terminate her pregnancy after her fetus was diagnosed with Trisomy 18 — a genetic abnormality that results in stillbirth or miscarriage. Despite assurances from Texas politicians that their abortion restrictions have exceptions for the life and health of the mother, in practice those exceptions have proven to be nothing more than empty words. On Monday, Cox, a white mother of two, announced that rather than sit in Texas and play Russian roulette with her life, she’s leaving the state for an abortion. And it’s a good thing she did. The same day, the Texas Supreme Court overturned a lower court’s order ruling that  Cox was entitled to a medical exception to the state’s abortion ban.

Even before the Dobbs decision, motherhood was a gamble. In 2018, a ProPublica investigation looked at the maternal mortality rate in America, which is the highest among developed nations. According to the CDC, that rate has gotten worse. In 2021, 1,205 women died from causes related to pregnancy, compared to 754 in 2019. Abortion bans are making this problem even worse. A recent report found that in states with abortion bans, women are three times more likely to die of maternal causes than in states without them.

In her new book, Failing Moms, sociologist Caitlin Killian examines the devastating impact that the choice (if it is even a choice) to become a mother has on the lives of women. She details many stories of women who faced jail time for taking prescribed painkillers during their pregnancies or for having a miscarriage. In one instance, a woman named Regina McKnight, served 10 years in prison after suffering a stillbirth. Prosecutors charged that McKnight had killed her child by using cocaine. The ruling was overturned after no evidence was found linking her actions to the stillbirth of the fetus.

Killian’s book is filled with such stories and analysis. She notes, “Moms of color, poor moms, disabled moms, very young moms, and parents who are queer and/or non-binary have always been disproportionately surveilled and punished — as well as denied adequate health care and social support. The offenses for which mothers tangle with the law still affect women in these categories at greater rates, but the total number of prosecutable offenses is mushrooming and reaching mothers across the class, racial, and gender spectrums. All moms are in jeopardy, whether they realize it or not.”

Earlier this month, Vox published an essay titled “How millennials learned to dread motherhood.” In the essay, journalist Rachel M. Cohen talks about motherhood’s marketing problem, pointing to books and movies that depict middle-class white women struggling with the ennui of parenthood. She writes. “It is hard to shake the feeling that all these “honest and unflinching” portrayals are driving people like me away from having kids at all. Is it even possible anymore to find perspectives that are both credible and bright?”

While the essay does mention maternal mortality rates, a lack of healthcare, and a dearth of paid parental leave, these structural issues are brushed aside in favor of a more determined look at the “marketing” problem of parenthood. Motherhood just needs a better pitch to women. “In response to attacks on abortion rights, most progressive politicians, writers, and activists stress the real risks of pregnancy and the toll of parenting that no one should be forced to experience against their will, rather than any upsides to having children,” Cohen writes. “This makes sense, but the result is that for many, the very act of becoming pregnant sounds harrowing, and giving birth less a choice than a potential punishment.”

I understand the impulse to ask where the happy mothers are. We are here. But our happiness has nothing to do with the daily Rube-Golbergian-herculean task of simply finding someone to care for our kids while we work. In an era where our rights to bodily autonomy are being taken away and mothers are facing jail time for stillbirths — and only a few years out from historic shutdowns that crippled mothers by forcing them to be the social safety net — branding the life-threatening decision that motherhood has become as a marketing problem is missing the forest for the cute baby snuggles.

Another issue not mentioned in that story was the childcare cliff, which America has driven off. A recent US Treasury report shows more than 60 percent of American families cannot afford childcare.. “Meanwhile,” as NPR puts it, “day care providers can barely afford to stay open.” I deeply love my children and love being their mother. But no amount of love can overcome the intentional structural barriers that make raising them a monumental task.

When I was doing an interview for my second book, Belabored, which looks at the cultural forces behind our maternity crisis, an interviewee told me that perhaps I was exaggerating the problem. After all, she had had a great birth at the local university hospital. I pointed out that being a white woman with access to health care and a maternity ward was the exception, not the rule. While I was glad she was happy with her motherhood experience, structural problems have criminalized pregnancy and motherhood, making it expensive, inaccessible, and in some cases deadly. Just because our skin color or wealth or access to health care insulates some of us from the worst of the problems doesn’t mean these problems are not real. And it doesn’t mean that the luckier among us will be safe for long.

And it has been this way for decades. But those problems were easier to ignore in an era before the pandemic, before Dobbs, before the bottom dropped out and we all stumbled through the subflooring of American society.

The story of Kate Cox highlights important issues about maternal care, reproductive rights, and the right of women to live, thrive and make the decisions that are best for them and their families. But Cox is a middle-class white woman with two children — she’s the model of a perfect victim. Her story is garnering more headlines than that of Brittany Watts. But there have been hundreds of women just like Watts, criminalized for the accidents of their bodies and nature and whose lives we do not get up in arms over, because they were poor, they did drugs once, or they otherwise fall outside of our restrictive cultural ideas of what a “good mother” is. 

Recently, in a moment of frustration, I texted a friend who works in healthcare to ask, “Do women have to die for people to care about how bad it’s getting?” And my friend responded, “Women are already dying, but they’re the lives we are okay with overlooking.”

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Further reading: You can buy Caitlin Killian’s book here. You can also pre-order Jessica Calarco’s new book Holding It Together, which offers a detailed and meticulously reported look at how difficult motherhood has become.