Last month, I gave birth to my first child. While abortion was the last thing on my mind as I was trying to conceive, I thought more and more about it throughout my pregnancy because of what my experience taught me: our society does not care about pregnant people and values our fetuses above our own lives. Before I knew I was pregnant, I was scheduled for an exercise stress test to check on a potential heart issue. By the time the appointment came around, I was seven weeks pregnant. Although exercise is safe during pregnancy, and I had cleared this test with my primary doctor and notified the lab of my pregnancy, I showed up to my appointment to find that it had been canceled by the cardiologist without my knowledge. The manager of the lab explained that because I was pregnant, they were “not comfortable” putting me on a treadmill. Asked what was going to be done about my potential heart problem, the cardiologist told me I could “make an appointment if I have any further issues.” I, an adult human being, was denied care on the basis that someone felt, despite any evidence, that running on a treadmill might be harmful to my seven-week embryo.
Most people are familiar with the dietary and lifestyle restrictions recommended during pregnancy: don’t drink coffee or alcohol, don’t eat deli meat, don’t take x, y, or z medication, and on and on. I was very cautious during my pregnancy and attempted to do and consume only things that were safe for the development of my future baby until I realized that there was very little information beyond the standard “don’ts” (I first encountered this trying to determine which herbal teas were safe to drink). What’s more surprising, there is little evidence backing up even the basic prohibitions on alcohol and caffeine.
This is largely because research studies on the efficacy and safety of substances and procedures during pregnancy are severely lacking compared to studies on non-pregnant people. Researchers and drug manufacturers often give the justification that because pregnant people and fetuses are uniquely vulnerable, it is more dangerous to perform studies on them. However, as a doctor with the UCSF ASPIRE study explained in a recent webinar, the lack of data resulting from this patronizing exclusion of pregnant people is much more harmful than the safety data we would have if the research had been done. It means that pregnant people are left to make health decisions without sufficient evidence, and are often advised to abstain from interventions that could improve their own health because there is no data proving that it is safe for the fetus. In reality, the hesitancy to perform research studies on pregnant people has less to do with concern for their vulnerability and more to do with resources: including pregnant people in trials requires extra precautions and monitoring, and researchers must follow the pregnancy to its end as well as any children born for potential long-term effects. It means more work and more expenses, and the medical establishment would rather cheaply and quickly deliver new products and protocols than invest in equitable health outcomes for pregnant people.
An example with which anyone who has been pregnant in the past year is painfully familiar was the exclusion of pregnant people from COVID-19 vaccine trials. All three major vaccine manufacturers in the U.S. refused to enroll pregnant people, and people who became pregnant after signing up were kicked out of the studies. So, when the results came out promising that the vaccines were safe and effective for the general public, pregnant people—who are at higher risk for contracting COVID-19 and for severe illness and death from the disease—had no data to tell them if the vaccine was safe for them or their fetuses. Although the practice was overturned after a major outcry, many pregnant frontline healthcare workers were initially denied the vaccine. Guided by medical experts’ predictions and by the certain danger of COVID-19 infection, I and many other pregnant people chose to get the vaccine anyway. However, many other pregnant people chose not to be vaccinated out of concern for their or their fetus’s health, and there is currently a crisis of maternal death and stillbirth for the unvaccinated. The deaths of these pregnant people, which continue to happen, can be directly attributed to vaccine manufacturers’ disregard for their lives.
To employers and the ruling class, pregnancy is a question of producing more workers to be exploited, and working class women have historically been treated simply as their incubators.
The way abortion is debated in this country—as a compromise between two entities with a right to life—gives pregnant people less bodily autonomy than corpses. Even when an organ transplant from a recently deceased person would save someone else’s life, that corpse must consent (by registering as an organ donor before death or the family consenting on the deceased’s behalf) to its body being used to sustain the life of another. It is a matter of biology that fetuses, whether they have “rights” or not, rely on their parent’s body in order to survive. This does not oblige the parent to continue a pregnancy, just as someone with a rare blood type cannot be mandated to donate blood to someone who needs a transfusion.
This disproportionate regard for fetuses over the humans carrying them is not just a matter of cultural belief, but a symptom of our sexist political and economic system. To employers and the ruling class, pregnancy is a question of producing more workers to be exploited, and working class women have historically been treated simply as their incubators. As Jenny Brown explains in her impeccably researched book Birth Strike, laws restricting contraception and abortion globally have always been tied to the ruling class’s desire for a higher birth rate. This is rarely understood or discussed even among militant pro-abortion sections of our movement, as the opposition in the U.S. appears to be a religious right-wing that simply wants to “control women”. But while pearl-clutching evangelicals and Catholics are convenient foot soldiers for carrying out the public anti-abortion battle, politicians and corporations are the real beneficiaries when working class people are forced to give birth and to raise more children than they want. The ruling class gets a larger pool of workers, driving down wages for everyone, while parents are pushed to perform more unpaid labor at home and to settle for lower wages and worse working conditions in order to provide for their children.
This is a critical argument that we as socialists must make in the movement because a narrow, ideological focus on fighting the religious right allows our real class enemies to avoid confrontation and continue legislating against reproductive freedom (in the form of abortion, contraception, and lack of sufficient healthcare for pregnancy and birth). The liberal understanding of the abortion issue as simply one of sexist ideology prevents people from drawing the right conclusions about who benefits, as evidenced by Texas Democratic state representative Donna Howard’s confusion over why corporations are not speaking out against SB8 to “keep employees in the state.”
The ruling class’s interest in keeping working-class people pregnant is even clearer when we recognize that gestation is labor and high-value essential labor at that. As Sophie Lewis details in her book Full Surrogacy Now: Feminism Against Family, the formal practice of surrogacy simply lays bare the labor relations that are inherent in every pregnancy. While surrogates perform this labor for the families who will receive their babies, all gestational labor benefits society as a whole: children go on to become workers, producing the things and performing the services that people need and from which capitalists extract a profit. As more gestational labor is done by fewer people in less time (that is, as the birth rate rises), the same thing happens as when a factory speeds up production: the employer class can squeeze more surplus labor value out of workers, who are left overworked and underpaid. Since gestation is labor, abortion is the refusal to perform labor, and when abortions are denied, the resulting forced pregnancies and births are quite literally forced, unpaid labor performed on behalf of the ruling class.