In 1986 Margaret Atwood published The Handmaid’s Tale. The novel portrays a dystopian vision of the U.S. in the “near future”, a country transformed by religious extremists into a totalitarian theocracy, renamed the Republic of Gilead. It’s organizing principle – One Nation, Under One God. The new regime moves quickly to consolidate its power and reorganize society along a hierarchical, exclusively Christian regime of Old Testament-inspired social and religious conservatism.
In a world where environmental pollution has rendered a substantial portion of the population sterile, fertility is a treasured commodity. The small minority of women who are fertile are forced to become de-eroticized baby-making machines, empty childbearing vessels. Their bodies are hidden and their brains are denied. Handmaids are women who have committed gender crimes or otherwise broken social rules and conventions. Because they are fertile they aren’t punished with banishment, instead they are ‘re-educated’ to accept their new role as Handmaids. In Gilead, women are not allowed to use their minds – they’re forbidden from reading, working outside the home, or even spending money.
The book was published during the height of the Reagan era, its condemnation of the political goals of religious conservatives was criticized at the time as unfair and overly paranoid, however events over the past few years now make the novel seem eerily prescient. In a recent interview the author describes the themes she was exploring in the novel:
If you wanted to seize power in the US, abolish liberal democracy and set up a dictatorship, how would you go about it? What would be your cover story? It would not resemble any form of communism or socialism: those would be too unpopular. It might use the name of democracy as an excuse for abolishing liberal democracy: that’s not out of the question, though I didn’t consider it possible in 1985.
Nations never build apparently radical forms of government on foundations that aren’t there already. … The deep foundation of the US – so went my thinking – was not the comparatively recent 18th-century Enlightenment structures of the republic, with their talk of equality and their separation of church and state, but the heavy-handed theocracy of 17th-century Puritan New England, with its marked bias against women, which would need only the opportunity of a period of social chaos to reassert itself.
Like any theocracy, this one would select a few passages from the Bible to justify its actions, and it would lean heavily towards the Old Testament, not towards the New. Since ruling classes always make sure they get the best and rarest of desirable goods and services, and as it is one of the axioms of the novel that fertility in the industrialised west has come under threat, the rare and desirable would include fertile women – always on the human wish list, one way or another – and reproductive control. Who shall have babies, who shall claim and raise those babies, who shall be blamed if anything goes wrong with those babies? These are questions with which human beings have busied themselves for a long time.
These questions are definitely ones legislators and judges are busying themselves with today, especially in the southern region, and while we have not officially experienced a Christian-inspired coup to suspend the constitution and take away women’s rights as described in the novel, many states are well on the way to creating Gilead-like conditions, at least with respect to women’s reproductive rights. Over the past three years states have passed severe new restrictions on abortion. In 2011–2013, legislatures in 30 states enacted 205 abortion restrictions—more than the total number enacted in the entire previous decade. The political debate over the Affordable Care Act has enabled anti-choice activists to renew their assault on insurance coverage for certain forms of contraception considered by them to be abortifacients. Though science has refuted these claims, such evidence is apparently irrelevant since the U.S. Supreme Court affirmed the right of corporations and certain nonprofits to raise religious freedom objections to their legal obligation to provide such coverage.
In addition to restricting access to abortion and certain form of contraception, states have begun holding women accountable for the outcome of their pregnancies. One woman in Indiana was charged with attempted murder when she survived a suicide attempt while pregnant; another women in Mississippi was indicted for “depraved heart murder” after traces of a cocaine byproduct were found in her stillborn baby’s blood. National Advocates for Pregnant Women has documented hundreds of cases around the country in which women have been detained, arrested and sometimes convicted — on charges as serious as murder — for doing things while pregnant that authorities viewed as dangerous or harmful to their unborn child.
The justification for such actions is almost always cast as concern for the child but behind it is the strong need to control women. The need to control women is framed as adherence to ‘traditional Christian values’ and consequently not an appropriate area for state intervention. This biblical view was expressed most clearly by the Supreme Court of Alabama in a recent decision upholding the conviction of a woman charged with child endangerment for using drugs while pregnant. In ruling that the use of the word ‘child’ in the Alabama statute was meant to apply to an unborn child or fetus, Chief Justice Moore wrote a concurrence to his own majority opinion in order to advance the following argument:
As the gift of God, this right to life is not subject to violation by another’s unilateral choice: “This natural life being, as was before observed, the immediate donation of the great creator, cannot legally be disposed of or destroyed by any individual, neither by the person himself nor by any other of his fellow creatures, merely upon their own authority.” Even the United States Supreme Court has recognized that “‘[t]he right to life and to personal security is not only sacred in the estimation of the common law, but it is inalienable.’”
Under the Equal Protection Clause of the Fourteenth Amendment, states have an obligation to provide to unborn children at any stage of their development the same legal protection from injury and death they provide to persons already born. Because a human life with a full genetic endowment comes into existence at the moment of conception, the self-evident truth that “all men are created equal and are endowed by their Creator with certain unalienable rights” encompasses the moment of conception. Legal recognition of the unborn as members of the human family derives ultimately from the laws of nature and of nature’s God, Who created human life in His image and protected it with the commandment: “Thou shalt not kill.” Therefore, the interpretation of the word “child” in Alabama’s chemical-endangerment statute, § 26-15- 3.2, Ala. Code 1975, to include all human beings from the moment of conception is fully consistent with these first principles regarding life and law.
In the theocratic male-dominant world of Gilead only women were tested for fertility. If a wife or Handmaid failed to conceive, it was deemed the woman’s fault. In a society where women’s value derived from their ability to bear and raise children, failing to reproduce made one a social pariah. In the novel, suspecting her husband was the source of their fertility problem, the wife conspired with the Handmaid to assist her to become pregnant by another man. In a society where a woman could be hanged for fornication or adultery, better to risk the life of your Handmaid with illicit sex than your own.
Infant mortality is affected by the health and well-being of women before and during pregnancy, the quality of prenatal and delivery care, and the health and care of babies from birth. The infant mortality rate is considered a general measure or indicator of the overall health and well-being of a population, because risk factors such as poverty and access to health care also directly affect the health of infants. Reducing infant deaths requires addressing these multiple factors. Higher rates of these risk factors, contribute to Mississippi having the highest rate of infant deaths in the United States. Alabama is on its heels with the second highest infant mortality rate in the nation. Not surprisingly these statistics don’t reflect racial disparities within states – in Alabama the infant mortality rate for black babies is more than twice the rate for white babies. Tennessee, no slacker in denying access to health care, has the fourth highest rate of infant mortality in the United States. And yet each of these states along with the entire southern region (except Arkansas) has refused to accept federal funds for Medicaid expansion, effectively denying access to health care to millions of its poorest and vulnerable residents. In today’s theocratic south, women are held responsible for their birth outcomes, not society or any of the myriad factors commonly understood as social determinants of health.
Tennessee’s new law allowing women to be criminally charged if they use illicit drugs while pregnant went into effect on July 1st. When Tennessee Gov. Haslam signed the lawhe claimed, “The intent of this bill is to give law enforcement and district attorneys a tool to address illicit drug use among pregnant women through treatment programs.” It’s clear law enforcement intends to use their new tool, but not necessarily to get women into drug treatment. On July 8, Mallory Loyola was the first woman to be arrested and charged with assault when her newborn daughter tested positive for methamphetamine. Mallory was arrested while in the hospital a mere two days after giving birth, too soon for a medical diagnosis the newborn was suffering from any drug-related harm.
Some will say the arrest was necessary to get an addicted mother in treatment for her own good as well as her baby but experts say differently. According to the American College of Obstetrics and Gynecology:
Although legal action against women who abuse drugs prenatally is taken with the intent to produce healthy birth outcomes, negative results are frequently cited. Incarceration and the threat of incarceration have proved to be ineffective in reducing the incidence of alcohol or drug abuse. Legally mandated testing and reporting puts the therapeutic relationship between the obstetrician–gynecologist and the patient at risk, potentially placing the physician in an adversarial relationship with the patient
Pregnant women who do not receive treatment for drug dependence cannot be assumed to have rejected treatment. The few drug treatment facilities in the United States accepting pregnant women often do not provide child care, account for the woman’s family responsibilities, or provide treatment that is affordable. As of 2010, only 19 states have drug treatment programs for pregnant women, and only nine give priority access to pregnant women.
The use of the legal system to address perinatal alcohol and substance abuse is inappropriate. Obstetrician–gynecologists should be aware of the reporting requirements related to alcohol and drug abuse within their states. In states that mandate reporting, policy makers, legislators, and physicians should work together to retract punitive legislation and identify and implement evidence-based strategies outside the legal system to address the needs of women with addictions. These approaches should include the development of safe, affordable, available, efficacious, and comprehensive alcohol and drug treatment services for all women, especially pregnant women, and their families.
Criminalizing pregnant women does nothing to empower children but is an effective tool to disempower women and the people, who love, support and depend on them. Given these facts one wonders what interests are served by advancing such regressive and harmful criminal justice policies? As discussed in the following exchange between MSNBC’s Chris Hayes and Professor Dorothy Roberts, such practices serve the interests of those who seek to divert attention from the real conditions that pose substantial risks to the health and well-being of millions of children in the United States: parental poverty; inadequate housing; under-resourced schools; food insecurity; no access to health care; family and community violence; environmental hazards; employment insecurity; lack of economic mobility – just to name a few.
Most of these conditions are the result of structural and institutional forces indifferent to individual choices and behaviors. The ugly truth of contemporary life in the United States is significant numbers of people are living at, or near the poverty level and are at risk of falling further down the economic ladder regardless of their personal decisions.
In the Republic of Gilead, there is no need for amniocentesis, ultrasound, or other modern prenatal health detection techniques, since abortion is not a legal option and medical doctors who perform them face capital punishment. In Tennessee, Alabama and Mississippi state officials don’t feel the need to address the myriad factors that contribute to infant mortality and unhealthy babies, they can just blame it on their handmaid mothers.