I just knew that this book would be fascinating and educational, even considering that I work in reproductive health for a living and keep up with reproductive justice work on my own time as well. I also knew, not due to the book itself, but due to my feelings on the topic under the microscope, it would be infuriating. And it met my expectations on all those fronts. This book is a lot, informative and upsetting in equal measure, and absolutely timely and necessary and, as I always say when it comes to knowledge on women's/female-bodied health, filling in gaps that are sadly rampant for everyone, in ways both scientific/medical and individual.
I took so many notes while reading this. And I'm hella behind on reviews and pretty tired. So. This is going to be a bullet point review situation. But again, I took a lot of notes, so maybe that'll be an easier way to read through all my thoughts (if you are inclined to) for you anyways...
- They say it in the “author’s note on word choice,” and it worked for me, but they aren’t wrong about the dark humor as a coping mechanism. There are a couple very dark humor moments. (And ok, but that intro list of women across the history of pregnancy/miscarriage/birth in the style of American Girl Doll bios was on point and hilarious.) But overall, it helped create the super relatable narrative tone, at least for me. Please be very aware of that coming in, if this is a topic that you already know is potentially a difficult one for you.
- Obviously, I’m pro-choice no matter the situation, but this phrasing of how it especially affects those who wanted the pregnancy hit particularly hard…that’s who these anti-choice protestors are professing to protect, yet they are hurt at least as badly as anyone else.
- Connected reading! Alua Arthur’s death doula memoir, Briefly Perfectly Human. The ways we do not handle death/grief well in our toxic positivity culture, and how that ties in here, is a fantastic nonfiction combo.
- The weight of the lack of clear language for discussing pregnancy and pregnancy loss (legally, emotionally, medically, societally), and the impact of that on connotation and moral hierarchy of termination...what devastating (and life threatening!) impacts on individuals. In fact, across the board, the linguistic discussions in this book were so interesting. Like: how successful reframing anti-abortion as pro-life/family was, and how the way it’s easy slogan-ing like “save babies” paints the pro-choice group into a corner because their stance is inherently not that simple/straightforward (they want people to choose whatever option, of limitless possibilities, works best for them).
- This book started with an absolutely fascinating rapid overview of the history/development of access and outlooks on pregnancy/contraception/abortion in the US. And with that grew an unflinching calling out of the role that patriarchy, racism, and capitalism have played in the dire/worsening outlook of reproductive health that we’re living in today. Depressing and upsetting AF, but I was engrossed in the development.
- Whoa. Mind-blowing perspective/interpretative shift on the reframing of miscarriage after 2000: since two thirds of abortions take place before 8th week (thanks to at home pregnancy tests and Plan B), it means that miscarriages that happen by course of nature (which you'll see are quite common, if you read this and get through the "history of pregnancy" loss opening sections) are happening in much higher proportion to those “wanted” pregnancies, because unwanted are already ended by the time they would have been miscarried. That change has led to the shift of miscarriage into something that is mourned and grief-filled in a way that it wasn't historically, changing the sociocultural views and responses to it.
- After Roe - so recently - legal abortions before 16 weeks were safer than continued pregnancy and childbirth... Are you kidding me?! Whose lives matter here?!
- The way that scientific advances, allowing us to see just the fetus and therefore detach its existence from the mother and her experiences, and how that’s shaped contemporary reactions to it as a being on its own (even if it couldn’t legit survive without the mother) is so fascinating. And, on theme, depressing and upsetting to see laid out. But there is something to be said for having a better idea how we got to this point.
- Speaking of, though, as a reproductive health (puberty and sex ed) educator, I still have to wonder... How did we go from watching “the miracle of life” in school in the 80s to the travesty that is puberty and sex ed today, where we can't show/talk about anything, SO quickly?!
- Pro-choice and pro-life are not semantically opposite, and yet somehow are diametrically opposed in abortion policy. Again, the conversation about language options/use in this book is so good.
- Stigma has been such a powerful and masterfully used tool of social control by the anti abortion side. We all know the narrative of the “bad” mothers who voluntarily cause fetal death and “good” mothers who grieve pregnancy loss and that ubiquity is such a damaging and stigmatizing narrative, unevenly and unclearly assigned. I mean, OH THE HARM. Ughh, I wish pro-choice could figure their shit out better.
- This concept came up in a favorite read of mine from last year too, Period, but there is just so little knowledge available on thse topics because women have been so dis-included and uncentered in medicine and medical research for….ever (and, of course, still today). And while there are ethical considerations in studying pregnant women, there are also ethical implications in *not* studying them, and “the absence of information breeds superstition and misinformation.”
- Another common concept: we put mothers on a pedestal in America, but don’t do anything for or to support them.
- I loved this giving a name (“relational model”) to the idea that every pregnancy means something different to the pregnant person - a meaning they get to set and decide on their own, and react to the ending of (from miscarriage to TFMR to still birth to birth) in their different and self/determined way as well. I mean, I have always felt this, but it's so great to have language for it now.
- Part 4 ("Making Meaning" - the capitalism-making of grief and mourning and remembering and social media aspects of loss) was, for me, the weakest part. I think in part it almost felt like a different book/message. I mean it fits here too, but felt a little tangential perhaps? I don't know. Maybe this was a "me" problem. I did like the point out of how ridiculous it is that abortion is against law/religion/morality, but grieving a pregnancy loss (at any stage) isn’t given as much weight as after a baby is “born” (not to mention the lack of help for those who are unable to fully parent, for whatever reason, after forced to have the baby). Like, where’s the cognitive dissonance??
- I SUPER appreciated the appendix with the info about what to do/say and not to do/say when trying to comfort/help someone experiencing pregnancy loss. I absolutely took pictures of those pages for later reference.
Silence. Stigma. Shame. (And the fallacy of control.) It all turns people into failures (whether it was a wanted pregnancy or not) instead of someone needing support. It's heartbreaking. And yet this book was something good, despite the difficulty of reading it. I appreciate how woven in all the different types of loss are here - this isn’t necessarily a book focusing on one or the other (though it does lean into wanted pregnancy losses). I don’t see a lot of trying to bring this sector all together like this, but I think it’s an incredibly useful start in trying to combat the current unhealthy cultural conceptualizations and morality conflicts about it. The inconsistency and confusion and ambiguity and arbitrariness in everything from definitions of these stages/milestones of pregnancy to what qualifies as life-threatening/life-saving to whose personhood gets prioritized to enforcement of laws supposedly set to protect pregnancy women/babies (that more often end in their own prosecution) to dictating who/how people can grieve. This book was, like I said, a lot. But I also learned a lot. And felt like it was a really useful read. I recommend it.
“…what it’s like to feel the weight of a political movement against a palliative choice.”
“These losses [ectopic pregnancy, miscarriage, stillbirth, TFMR, selective reduction, abortion] are all part of the same medical universe. The body doesn’t distinguish between them. It’s American culture that puts a premium on the intention behind it.”
“You cannot feel empathy for people whose stories you never hear.”
“Abortion laws have usually rested on a cultural ideal of who is deserving of this care, whose tragedies matter."
“…because the narrative around pregnancy is increasingly focused on the fetus, the pregnant person matters less and less.”
“This notion of control and choice has made society more suspicious of miscarriage, judgemental about pregnancy and abortion, and more perverse and inconsistent about who "matters" in a pregnancy. And as parents on individual levels try to control fertility and parenthood, the government has also sought to exercise control over who will give birth and under what circumstances."
“But the fall of Roe has, for better or worse, brought to light the connectedness of all forms of pregnancy loss and the concept that it can be downright hazardous to ascribe blanket morality to difficult and highly specific medical choices.”