Pregnancy: Policies, Policing, and Protection

Debbie says:


In November, it seems lots of people in my feeds were writing about or linking to articles about pregnancy. Let’s start with the unalloyed good news, from Remy Tumin, writing at TakePart:

… many new moms in developing countries … suffer from postpartum hemorrhage, the leading cause of maternal mortality. Now the LifeWrap is making great strides in reversing the mortality rate in these countries.

Made of neoprene and Velcro, the wet-suit-like garment is cut into segments. The LifeWrap acts as a first-aid device to stabilize women like Aisha who don’t have access to resources to stop the bleeding immediately. The low technology keeps women alive while they travel to a hospital for surgery or wait for treatment.

To date, LifeWraps have been used on more than 10,000 women in 33 countries. According to the American Congress of Obstetricians and Gynecologists, a woman dies every four minutes from postpartum hemorrhage.

According to Tumin, the LifeWrap was developed by Suellen Miller, a nurse-midwife and a professor at the University of California San Francisco. Miller based the design on a garment developed by a female U.S. astronaut; earlier more complicated versions were used on soldiers in Vietnam.

In a recent study in the International Journal of Reproduction, Contraception, Obstetrics and Gynecology it was recommended that the garment be made available by governments and included in all health care centers as a management protocol for postpartum hemorrhage. LifeWrap is on internationally approved lists from the World Health Organization, International Organization of Obstetrics and Gynecologists, and the United Nations Commission on Life-Saving Commodities…

Miller and her team train clinicians around the world on how to use the garment and give presentations to departments of health and professional associations.

One of the most heartening trends in the world today is the continuing development of low-tech medical, communications, and other solutions that serve the poorest people on the globe, including this one.


The next piece of pregnancy news is also good, despite the qualifiers at the beginning of the article. Miriam Zoila Pérez at Our Bodies, Ourselves, writes about a movement to change the common U.S. policy requiring women to fast during labor.

The logic behind requiring women in labor to fast is thus: If the labor changed course, and a c-section was needed, a patient who had eaten recently was at risk of aspirating her own vomit if given general anesthesia.

It is a policy predicated on a lot of if/then scenarios, and applied incredibly widely (to pretty much everyone giving birth in a hospital setting) despite a relatively low risk and changes in practice. Most c-section anesthesia is provided in a similar fashion to an epidural (through a spinal block) and not through a mask over the nose and mouth, where the potential aspiration risk came in.

According to the article, in the eight years between 2005 and 2013 there was only one recorded U.S. case of aspiration related to labor, and the article doesn’t say whether or not the patient died. It certainly seems that the risk is vanishingly small.

Midwives and home birth advocates have been encouraging light meals during labor for years; “labor” is well-named, and doing heavy work while fasting is (in most circumstances) an unnecessary burden. The medical establishment in the U.S. is wending its slow, ponderous way toward making these changes, while miidwives have been encouraging their clients to eat light meals for years (and centuries).


Supermodel Christine Teigen posted an Instagram photo of her bowl of Fruity Pebbles cereal combined with Captain Crunch cereal. I can’t say I’d eat it, but I’m not a supermodel, I’m not newly pregnant, and I’m not Christine Teigen. Many commenters appreciated it, but some took her to task, and a Twitter-battle ensued. Tracy Moore at Jezebel has the story, and also misses the point.

Moore says:

There is apparently no sweet spot that immunizes any pregnant woman from this scrutiny, even when you are a health-conscious supermodel-type person who likely won’t gain much weight in the first place. It’s nearly impossible that she would not know exactly what is “good” and “bad” for the baby (as much as anyone can), given she has extraordinary access to resources that will ensure a perfect specimen to carry on the legacy of her extremely symmetrical genes.

Moore goes on to discuss uncertainties about fetal health, her own pregnancy story, and generally concludes

there was and always will be a complex negotiation going on between mother and child during gestation for resources, nutrition, and literal space in the body.

She suggests trust (that women are doing the best they can) and compassion for their struggle. Compassion is good and trust is valuable, but neither of them apply here. Teigen’s baby is not public property, and neither is her body. Whether or not she is doing her best, whether or not she knows what’s good, whether or not she even cares is her business. It’s arguably the baby’s father’s business (if there’s an involved father), and possibly the grandparents. You can make a case for it being the obstetrician’s business. You can stretch it to her close friends and family having an interest. But you and I, strangers on the Internet, journalists at Jezebel, bloggers at Body Impolitic, we don’t get to say one damned thing to Teigen about her choices, even if she posts them on the Internet. We get to back off and let her live her life, experience her pregnancy, have her baby, and eat whatever she wants to eat (and show us photographs of it if she feels like it). And we get to appreciate LifeWrap, and better options for women in labor.