When mainstream feminists don’t talk about the infrastructure that contributes to people aborting fetuses with disabilities, it leaves a ready-made space for those who would infringe on the right to choose. Like other people who have abortions, those who choose to abort fetuses with congenital abnormalities most likely do so because they already have children they’re providing for, they live in poverty, and/or they experience other structural oppression that prevents them from being able to commit to caring for a child with a disability. It is important for reproductive rights and reproductive justice frameworks to recognize that the choice to carry to term or to abort is heavily influenced by class, race, and other obstacles created by marginalization. Parents with disabilities are stigmatized as being unable to appropriately care for their children no matter how many successfully raise families. Some people with disabilities are at risk of being sterilized as a result of that stigma. Others were sterilized without consent based on the idea that they would have children with disabilities and thus create an intergenerational cycle of dependency on the minimal resources available.
In general, having children is expensive, and the lack of substantial social safety in the United States makes it even more difficult for low-income parents already struggling to afford the basics of housing, childcare, and medical care. Children with disabilities may require expensive specialized health care, educational support, a specialized diet, and therapy, and reproductive justice has to address what happens after a child is born. By and large, parents can’t afford to not work outside the home, which means that they must pay for childcare or attempt to cobble together some form of at-home care with opposite work schedules. There is a devastating choice on the table: a lack of family time and caregiver support or a substantial loss of income. Because institutions are not designed to help parents raise high-needs children, it becomes much easier to argue that children with disabilities are a burden to be avoided instead of addressing the paucity of resources.
Sympathy also bleeds away for parents of children with disabilities and parents with disabilities, particularly when those parents are of color, are LGBTQIA, or are anything outside the expected “traditional” middle-class, able-bodied, cis, white family dynamic. Their disability, race, immigration status, gender identity, sexual orientation, or income level becomes the center of a debate over their right to have a family instead of plans to support those families. Because like race, disability has long been an excuse for the medical establishment to forcibly sterilize people, and any concept of reproductive justice must include an understanding of that history.
And a true reproductive justice framework has to challenge the rights of guardians of people with disabilities to request, without their consent, sterilization of those who depend on them. As Human Rights Watch notes, people with disabilities who are sterilized and are unable to comprehend or consent to the procedure are particularly vulnerable to abuse.
We must be careful to avoid contributing to a damaging narrative about people with disabilities. Feminism can’t parrot the idea that people with disabilities are a drain on resources and thus their lives are worth less. Instead of bolstering the eugenicist myth that people with disabilities are a burden on the community and undeserving of public funding, we must address the fact that it is so expensive for families to raise children with disabilities in a society that doesn’t provide for anyone’s needs adequately. We must push back against the idea that disability status is a predictor of fitness to exist, to be heard, to have a choice. Eugenics makes the argument that members of many communities are not worthy or capable of making their own reproductive choices, and thus are not fit to be parents. That rhetoric is carried from pop culture all the way through to medical science.
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THOUGH THE PRIMARY FOCUS of maternal mortality research has been on Black mothers in the United States because the rates of maternal mortality are highest for us (Black women are 243 percent more likely to die from pregnancy-related causes), the same factors rear their heads in many communities. The outcomes in those communities, however, are slightly better, because there’s less of a stake in the idea that they don’t deserve respect or care. For Black communities in the United States, even when factors such as physical health, access to prenatal care, income level, education, and socioeconomic status are controlled for, Black women are still far more likely to experience maternal mortality at rates that hark back to the days when Black motherhood was seen as a problem to be solved with sterilization.
Social and environmental risk factors that influence poor maternal health outcomes disproportionately impact marginalized communities. Poverty-based risk factors, from housing instability to increased exposure to toxins because of subpar housing to increased exposure to violence, contribute to higher stress levels and lower access to quality health care, including comprehensive mental health services. Additional factors like workplace barriers and food insecurity can easily trap someone in a toxic environment and pregnancy in the United States.
In that same vein, we must be willing to confront the -isms that let people think maternity is only something to celebrate when the mother is white. If you read comments on articles about Black moms like Serena Williams, Beyoncé, or Meghan Markle, you notice a theme in the racism. A Black mom is somehow gross for cradling her pregnant belly, but the same posters find it adorable when white women do it. It’s a passive form of racism, rarely examined, much less discussed. And yeah, comments are a cesspool, but medical staff make comments on forums too. So when you see people on Twitter, Instagram, or Facebook claim the babies of Black moms are meal tickets or monkeys, or when they make hate into a hobby so thoroughly that they are profiled for it in the press, you have to ask yourself if they’re the kind of medical professional who treats babies like puppets and calls them Satan for Snapchat points.
When someone like Serena Williams or Beyoncé Knowles-Carter shares her stories of pregnancy complications and concerns, it briefly pushes the problem of the maternal deaths of Black women front and center in mainstream feminist media. But it shouldn’t take an impassioned story from one of the most famous Black women in the world to get it into everyone’s head that America can no longer ignore the health of Black mothers. Fully addressing the issue requires interrogation of not only the obvious flaws within the medical system but also all the other institutions that can affect various aspects of health-care access and quality for marginalized people. For too long, the same systems and institutions that oversaw slavery, Indian boarding schools, and eugenics programs have been allowed to operate without dealing with the biases rooted in their formation. Fully addressing maternal mortality calls for an acknowledgment that unexamined biases within the medical system and outside have been a key factor in the paucity of care for those communities where motherhood is perceived as a sin instead of a sacrament.
Imagery of white motherhood is standard in media, complete with the seemingly de rigueur write-ups from white feminists about the ways becoming a mother has changed their lives. Often hidden in those pieces is something casual about the caregivers they hire to help out. If you look closely, you can see the telltale marks of people who need to rely on communities of color for labor but who don’t really engage with what that means in any meaningful way. In a way, that reaction is bolstered by the world around us: we see white moms on TV, on billboards, on posters, and more. No matter if the story is sextuplets or a family of nineteen, TV channels are happy to take us inside the lives of those families. To humanize and validate and valorize their choices. Yet despite a history of Black, Asian, Indigenous, and Latinx caregivers for the white children of those families, popular media would have you believe that every other group is unqualified to care for or raise their own children.