Intentional Motherhood: Connecting Abortion, Pregnancy, and Birth

by Jill Morrison, Senior Counsel
National Women’s Law Center

For those who are used to me keeping it short and (not too) sweet, sorry for the length of this one. This entry is from a talk I gave at a fundraiser for the DC Abortion Fund. Abortion funds are volunteer-run organizations that raise and distribute money to women who want to get abortions but can’t afford them.  Really-try to think of yourself or someone you love being in that situation, and tell me if there is a worthier cause. If you’d prefer to give to one in your area, visit the National Network of Abortion Funds.

The event was also a book-signing for Our Bodies Ourselves: Pregnancy and Birth. The book provides great scientifically-based advice, and encourages women to fight back against the pregnancy police and listen to their own bodies. Very cool. My talk was on making the connection between abortion rights and birthing rights: the right to use a midwife, or give birth at home, or skip the “medically advised” cesarean section. 

I am thrilled that the DC Abortion Fund is hosting an event to celebrate a book that enhances women’s ability to make pregnancy and birthing decisions.  Let’s face it, some don’t think that abortion supporters can be all rah-rah about the childbirth thing, but we really are. But this isn’t just because we think pregnant women are incredibly gorgeous and we’re the first in line to coochie-coo. It’s because we share common goals with those who support a woman’s pregnancy and birthing choices. Sometimes it is really difficult to make the connection between abortion, pregnancy and birth, but I think one case really brings home the point.

Angela Carder struggled with cancer since the age of 13. After years of remission, in 1987 she decided to get married and have a baby. From conception, Ms. Carder made it perfectly clear to her treating obstetrician at George Washington University Hospital: she wanted to be sure her own health was not compromised because of her pregnancy. Sadly, during the 25th week of her pregnancy, she was diagnosed with a lung tumor. Her doctors said that the baby was too premature to have a good chance of survival, and that she would have to wait until her 28th week.  Fully knowing the increased risks to her pregnancy, they agreed on a treatment schedule of chemotherapy and radiation to prolong her life.

When her condition deteriorated the next day, it never even occurred to her doctors to intervene in an attempt to save the fetus. Ms. Carder lapsed into unconsciousness. Her parents, husband and medical team all agreed that she would not have wanted any intervention, but the hospital administrators disagreed. The hospital was concerned because the fetus was potentially viable, so it petitioned the court for an order to determine what was best for the fetus. 

The hasty hearing at the hospital focused only on the fetus’ chance of survival. The court ordered that she be given a Caesarean section and a staff obstetrician grudgingly agreed to perform the surgery, because her treating doctors refused. In the meantime, Ms. Carder came to and was informed of the court ordered cesarean by the staff obstetrician. When she was told that she might die from surgery, Angela Carder said over and over, “I don't want it done.” Despite this, a quickly assembled panel of the appeals court upheld the lower court’s decision, and the hospital charged forward with surgery, against the patient’s clearly expressed wishes.

The baby died within two hours of delivery, and Angela Carder lasted another two days. There is no doubt that the surgery hastened her death. 

Her family requested a rehearing from the court of appeals, hoping to honor her fight for her life and to make sure no woman ever again had to be subjected to such treatment.  The question was simply this: does a woman have a constitutional right to make her own health care decisions even when the state has an interest in protecting a viable fetus?  On April 26, 1990 the D.C. Court of Appeals answered yes: your body is your own, even when you are pregnant.

While everyone knows Roe v. Wade supports women’s rights to bodily autonomy and integrity, the language reversing the court’s decision is pretty powerful: “[C]ourts do not compel one person to permit a significant intrusion upon his or her bodily integrity for the benefit of another person’s health.” The court reviews other decisions that have refused to require organ donations between relatives, and concludes, “[A] fetus cannot have rights in this respect superior to those of a person who has already been born.”
Since this case, virtually every court has supported a pregnant woman’s right to make medical decisions that may endanger the fetus, or to refuse treatment for the fetus’s benefit. Indeed, the one reported case to the contrary, graphically illustrates the incredible violation that occurs when the government oversteps its bounds. Laura Pemberton had previously had a cesarean, and wanted to give birth vaginally. Her doctor thought it was too dangerous, so she decided to have home birth instead. During her home birth, she became dehydrated and went to the hospital for I.V. fluids. The doctor on duty refused to give her fluids, and instead called the hospital administration, which called their lawyer, who called the state’s attorney and all hell broke loose. In the meantime, Laura Pemberton (remember she’s at full term!) “slipped” out of the hospital.

What followed (as reported in the eventual court opinion) is almost unbelievable: a woman in labor was taken from her home by a police officer, taken to the hospital, and forced to submit to surgery. She sued alleging a violation of her rights to bodily integrity and to refuse medical treatment, and negligence and false imprisonment.

She lost. The court ruled that the “potentially deadly” nature of a vaginal delivery completely justified the hospital’s actions. Interestingly enough, after this debacle, Ms. Pemberton went on to deliver four children vaginally, including a set of twins. I know this because she told a large pro-choice crowd of her experiences at a conference hosted by the National Advocates for Pregnant Women in January 2007.

And irony of all ironies-Ms. Pemberton was also quite vocal in her opposition to a woman’s right to terminate a pregnancy. She doesn’t get what should be apparent from her own story. Only an individual woman knows in her heart and mind and soul what is best for her.  No one else can make that decision. The right to decide to terminate a pregnancy, and the right to decide how to be pregnant and how to give birth are merely points on the continuum of reproductive choice. If you start looking at the efforts of some doctors, some law enforcement officials and some judges to control women’s bodies, our unity of interests becomes painfully clear. 

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[Jill]

ah-I think I've got it. Please drop me a line and let me know if there are other topics you think we should be covering on womenstake.org. Hope the weather's fine where you are. [email protected]

[Guess Who]

Tsk Tsk..Good commentary by the way, I read the rest of your articles. You have very salient points. Arrrgh..I am devasted I did not make a sound impression. Greensboro NC, I believe you were visiting a friend at our apartment who attended a nearby HBCU? I am trying to discreetly avoid divulging any unnecessary information to 150 million internet users..lol..oh well if it does not jog the old memory c'est la vie..!

[Jill]

Thanks so much for your kind words "Guess Who," but I am drawing a blank!

[Guess Who]

Hello Ms. Morrison, excellent commentary. I see the years have not diminished your fire or elocution. Just reading some academic articles and was suprised to see a name I recognized. Greensboro, roomate, "middle name" references, card games,..lol.
Glad too see you have risen though the ranks of your chosen field. I am suitably impressed.