One of the ways to identify whether a people group is oppressed is to note how seamlessly a rhetoric has been swallowed and then regurgitated. The global pregnant population has thoughtlessly vomited phrases like, “he wouldn’t let me,” and “I wasn’t allowed,” in relation to decisions about their bodies for so long that when we hear about intrusive things like mandatory drug screening done without knowledge or consent, we begin to qualify it as “necessary” or make feeble attempts to separate ourselves from the ones it directly affects.
Drug screening sometimes happens at prenatal visits and sometimes happens during routine blood draws following the birth. Most often, low-income patients and those on state funded assistance are targeted. Sometimes patients are informed about the testing; most often they are not.
“I was surprised after the birth of my daughter when the nurse came in with an adhesive bag to place over her vaginal area in order to collect urine for a drug test. I had never heard about this test, and asked if it was common practice. She replied that my midwife had specifically ordered the test for me. I tried to refuse and the nurse and a hospital social worker came in to inform me that if I refused, social services would be contacted and my daughter would not be released with me from the hospital. I relented, they collected the sample, performed the test, and of course, it was negative. I’m a birth doula now, and have been for over a decade. I often think on this experience, and wonder why exactly my midwife had done that to me. I think it was likely prejudice- I was a young, single, tattooed and pierced mother who was receiving DSHS (medicaid). Her assumption was that I was a drug addict because of my appearance, relationship, and socio-economic status. Im still mad about it.” – M., USA
“I was drug screened at my hospital birth, and wasn’t informed until it came back with a false positive. I was lucky that a nurse on staff new that a medicine I was prescribed for acute heartburn caused false positives for methamphetamine. The doctor who prescribed it nor the pharmacist who filled it nor the leaflet that came with it warned it would have that effect on a drug test. I was mortified. They made my husband leave me while in the early stages of labor to assess that I wasn’t on drugs or suffering abuse…It was scary and traumatic.” – C., USA
“The hospital where I birthed did a drug screen without my knowledge or consent. After coming back positive for THC, my baby was withheld from me in the hospitals nursery until someone from DCFS was able to asses me as fit to care fore my child. This took 2 whole days! It ruined my chances of breast feeding since I could only see my baby girl with hospital supervision and cast a horrible shadow on my entire birthing experience.” – D., USA
Drug screening in pregnancy is one example of the way in which pregnant people are teated as mere baby pumping, product-dispensers under a system of quality control. A patient’s agency in this process is deemed irrelevant, as their individuality, and their authority over their body are held in contempt of their baby. The supposition is that babies must be protected from their mothers and in doing so we have reduced half of humanity to being premeditative criminals who would, if given the chance, ignorantly or intentionally harm the fetus growing under their own hearts.
How We Justify
The rationale for justification I’ve heard usually goes something like this:
“It’s sad that it’s come to this, but, you know, some women just don’t even care about their babies. So, it’s up to us to protect them. I don’t like the idea of being tested, but I don’t really care, I’ve got nothing to hide.”
And then to that, I’ve heard the response about how we all “should” care because what if her test came back with a “false positive” – like in the story, above? It’s a legitimate concern, but it certainly doesn’t capture the enormity of the situation. And in fact, I think that reasoning represents a much more sinister problem.
This isn’t about protecting only the “good” portion of the population. This isn’t about “us” vs. “them” in some kind of perverted extension of the War on Drugs. This about all patients and the way that pregnant people are deemed to owe their bodies and their very lives to society as a whole. Where women are people, but the lowest forms of people; where a pre-formed human contained within her fleshy walls, under her pumping heart, fed by her own blood, may be deemed in competition with and superior to the one holding its very potential.
These “for the good of the baby” assertions reveal an age-old social construct that places women under the squeaky white shoe of her superiors.
These philosophical positions that suggest we protect unborn babies from their mothers also reveals an even broader and pervasive perversion that is as old as civilization, itself – the division of humans by class; the “us” vs. “them” mentality that we cling to for survival. The one that holds one person as better, more valuable, more intelligent; and the other as bad, ignorant and discardable. The one that offers us a sense of protection; that if we can just establish enough difference, enough separation, that we will be free of the potential oppression.
“Well, I don’t care, I don’t take drugs, so go ahead and test me,” misses the point, entirely, because it is singularly, narrow-mindedly, selfishly focused. It presumes that all other women who drug test positive are “bad;” that they are deserving of the repercussions. It makes a broad sweep to brush all women into one of two corners:
“Good Women Who Don’t Do Drugs”
“Bad Women Who Do Drugs and Hate Their Babies”
To hold this position we must really wrestle with the idea that there is actually a significant portion in any given population that truly don’t care about the outcomes of their pregnancies or their developing fetuses. It assumes the formula:
X Behavior + Pregnancy = Criminal
It is a reality that drug dependent babies are born to people every day. It is a sad reality that should not nor need not be dismissed as we discuss this issue. But holding that reality as justification for an end result of healthier outcomes is illogical.
Blanket policing of pregnant people and enforcing punitive measures does not improve health outcomes for patients or their babies. In fact, the fear of criminalization and of losing one’s child actually results in fewer people seeking prenatal care and often needless separation of babies and parents.
In order to throw all positive drug-tested women and babies into two corners, we need to acknowledge that one will be heaped with:
The occasional pot smoker
The woman with a legal THC prescription
The woman with prescribed pain medication from her doctor
The woman with an Oxycotin addiction, making painful attempts to abstain
The heroin addict, too deep into addiction to think straight
The woman who ate or ingested something that resulted in a false-positive result
Aside from the reality that the piles are not one-dimensional, is the realization that nearly all of the above folks give a lot more than two shits about their kiddos. It’s a lot easier for our brains to make neat piles of “those who care” and “those who don’t” – to fold them by color and size like stacks of t-shirts at the Gap. It makes things easier to understand; it keeps our belief systems – about ourselves, and humanity and right and wrong – orderly and easy.
But like most issues, it’s way more complex than that. Because rather than there being two even stacks of “the ones who care” and “the ones who don’t,” is a huge heap of unfolded shirts in various sizes, colors and levels of distress. But they all sit on the same table. And are you ready for this?
They all care.
The one that’s pressed and neat and folded perfectly at the seams doesn’t care more than the one with wrinkles and stains and holes in the sleeves. She just has more support; she has access to resources. The spills, the wear and tear, the wrinkles do not necessarily denote self-loathing or malicious intent. What it does reveal is struggle, lack of access to certain forms of support, probably inadequate income, and potentially illness and addiction.
Sometimes it can be easier to identify ourselves by what we are not, rather than what we are. This lack of depth, this unwillingness to share the struggle, this denial of oppressive realities; the way we turn our backs on others and mutter to ourselves about their stupidity; the way we motivate ourselves to survive through division, through elevation and superiority are visceral reminders of our own attempts to survive.
It matters that people are being jailed for poor pregnancy outcomes.
It matters that people are having tests performed in secret in order to incriminate them.
It matters that babies are being pried from their parent’s arms as another deems their worthiness to parent.
It matters not just to those specifically affected; it matters to us all. It matters because it represents a foundational choke-hold on pregnant people.
It’s time to stop caring selectively about pregnancy and birth-related issues. The protection of homebirth or a woman’s desire to use her vagina to birth is no more sacred than another’s right to privacy or informed consent or right to refuse within the containment walls of the labor room. These issues all matter, not just because of their interconnectedness or ability to bleed into one another, but because they all affect pregnant people.
Let’s stop caring about the issues we face, as individuals, and start caring about the issues that WE face, collectively.