January 3rd, 2012–5 years

Eleven years ago right now I was living in Israel on a kibbutz. I met a marvelous woman, who I’ll call Rose, who had been one of the founding members. She was well educated, an artist who had spent most of her life as a teacher in the extraordinary kibbutz education system she had also helped to found. Even as the kibbutz system was collapsing, she and her equally amazing husband remained committed socialists, and were heartbroken over the privatization of their home. I spent a lot of time with them listening to their stories about the founding (which was before the birth of the state), about the early years of Israeli statehood, and about how they had forged relationships and friendships with Israeli Arabs, Muslims, and Christians in the area.

 Rose told me one story that I appreciated, but didn’t ask much about, because it didn’t really touch me then. I wish now that I had asked more. She had been active in the Israeli feminist movement. She had formed a coalition with a number of Orthodox women to get rid of advertising posters plastered on the bus stops and kiosks around Israel which they considered pornographic and dehumanizing. She, as a woman and an artist, was disgusted by images of scantily clad or unclad women’s body parts being used to sell beverages, cigarettes, and other random products in the 1970s and 80s. The coalition was (temporarily) successful in setting public standards and rules for advertising. She was a leftist, Atheist, independent and outspoken woman. I thought of her as uncompromising, and yet she managed to work with and form a successful coalition with women who were very much her opposite.

I am thinking about Rose right now in part because today marks 5 years since Natan’s death. I’ve never really known what to do with the day (I don’t like to read/hear “birthday” greetings, and I’ve never wanted to make a cake). Every year since then, we were somehow bogged down with a major work/school event: the annual job-search conference or the start of a semester. Soon we’ll be on the road, driving back from seeing family. I’d pretty much like for the day to just fly by without notice. 

But since I don’t pretend it didn’t happen, since our lives are more settled and I’m thinking more and more about how January 3, 2007 changed me, I decided to expend some lines thinking more about what I wish I could do with the experience. I wish I could figure out how to bridge the divides between people over women’s health and reproduction. I wish I could talk to Rose about ideas on how to do that with the talents that I do have.

On my last post, a few friends chimed in with their thoughts about why friends and neighbors of the couple I described might have felt justified verbally attacking them. Angela and Rachel pointed to the tactics of anti-abortion groups, and questions of selective or insufficient understandings of the science of reproduction and the real options women have when they face complications in pregnancy. Courtney described misogyny, and the many ways a woman, in the eyes of others, loses primacy of self and bodily integrity when she becomes or decides to try to become pregnant. I certainly think the points have large grains of truth in them. But I don’t think they show us a way out. It’s also important to me that the pro-choice movement isn’t exactly golden, either. (I can say more about that later; it would take a lot of space.)

Those of us who lost babies to prematurity get wrapped up in this discussion for so many reasons. Ironically, the very advances in the treatment of preterm birth and preterm labor that I celebrate create some of the problems for those of us whose children didn’t survive. From the cutsie Cabbage Patch “preemie” dolls of the 1980s to the twenty-plus weekers featured in People Magazine to the birth of Josie Duggar, to the multitude of stories of women being told they’re in PTL or their cervixes have shortened and yet they make it term anyway, popular culture promotes the happy endings and the other ones vanish from polite conversation.

Certainly the news stories mention statistics. Yet somehow unless you’re listening to a doctor quote them about your own child’s chances, it’s not easy to comprehend fully what it means that a baby born between 20 and 22 weeks has at best a 10% chance of survival. From there the numbers don’t reach 50% until 25 weeks, and 90% at 28 weeks. That means someone has to be on the wrong side of all those statistics. Someone has to be in the 90%, the 50%, and the 10%, not to mention the multitude of health problems and disabilities that plague most survivors before 32 weeks.

The people who end up unlucky can’t always be easily distinguished from the lucky ones in terms of their behavior before the birth, although they may very well differ from one another in terms of where they live and what they can afford, and thus they might have very different levels of access to healthcare and medical expertise. It is inevitable that many pregnancies will end without a living child.

Yet I would like to think that we could at least try to do everything humanly possible to improve those statistics, that we could find a better way to take care of pregnant women and children no matter who they are, where they live, and what conditions they’re living in. I’d like to think the better way wouldn’t demonize women and might also involve useful conversations about sex in culture. I’d especially like to think we could take a broader view of women’s reproductive health that wouldn’t be so easily polarized around the issue of elective abortion. I’d like to think we could see our current fights over abortion as the symptom of a few problems—first, that women and children (really, people in general) are not valued highly by American culture and society; and second, that we are too quick to look for ways to blame people for their own suffering. Feel free to add others.

I’d like to think that those of us who feel passionately about women’s reproductive health and children should all share, I think we could all share, a few common goals: making sure that many many more children born in this country are wanted, that many many more children born in this country survive and are cared for, and that many many more mothers survive and thrive after their pregnancies. I think our current abortion debate and our debates over the economy (part of the so-called culture wars) only succeed in making it impossible for us to move forward as much as really ought to be possible given our scientific and medical knowledge. We’re not doing a good enough job at giving girls, women, and children sufficiently fair access to high quality obstetric and gynelogical care no matter who they are and where they live in this country. Why wouldn’t we want to do that? I’m not saying give them all cars and mansions—just access to knowledge about their bodies, and to skilled doctors and nurses and well equipped hospitals. I want to imagine a coalition of women from multiple faiths, backgrounds and political leanings, talking about pregnancy and women’s healthcare without falling into the trenches of the abortion debates, or culture wars.  When it comes to the real options we have for saving women and children, those of us who really care really ought to be on the same side. 

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7 responses to “January 3rd, 2012–5 years

  1. Thinking of you and Natan today. And your post is exactly correct….i don’t know why we can’t work together to accomplish those things.

  2. I have lots to say about this, but fear taking up too much space. I agree with all you’ve shared here. So much so that I sometimes dream of chucking what I’m doing and going on to an MPH or finish up and work toward advocacy for women’s health — women’s rights. I struggled a lot and continue to. I wonder, sometimes if this may help me continue that journey. Love to you and Josh, today and always.

  3. Rachel @ Eggs In A Row

    Thinking of you and Natan…

  4. I share your belief that everyone should be able to support children who are wanted and cared for, no matter where they stand politically, on reproductive rights or otherwise. But I want to push — as gently as possible — on the issue of survival and what it means.

    As I watch more and more of my friends in the throes of fertility challenges, and watch the laser-eyed focus on having their own children, I worry about what it means to put all the emphasis on biological reproduction to the exclusion of other forms of family. I’m trying to tread carefully here, as I know what I think and will write is contentious and hard for some to hear. But a childhood friend and her husband tried for 8 years to get pregnant, refusing all suggestions that adoption or other means might be the way to go. She finally became pregnant and had her child last spring. Although genetic testing suggested all was fine, all was not fine. Their child has a very rare genetic disorder with an unknown prognosis, but already has seizures, needs all sorts of therapies, and the like. It’s been a tremendous struggle for them to reconcile themselves to this, and, to be frank, I think the focus on needing to have their own biological children and focusing so much on the survival of that fetus has made it all the more difficult for them to handle the reality they now face. It’s not that this child shouldn’t exist and it’s not that she shouldn’t have the maximum care possible, but I’m not sure that the result of 8 years of trying to reproduce was worth it for them or for society.

    In this sense, children who are wanted and children who can survive and thrive are sometimes at odds with one another, and perhaps we need to think about that tension seriously, and think about which should be privileged. This gets very close to issues in debates over abortion, but I think that a holistic approach to women’s healthcare would also acknowledge that there are times when fetuses aren’t viable or that they are only partially viable and that quality of life really does matter — or should. Ultimately I firmly believe it’s the parents’ right to make the best decisions for them and their children, whatever those decisions are. At the same time, I’m not sure the medical advances of neonatal survival are always in the best interest of the child, the parents, and society. These are difficult discussions to have, but I think they are necessary.

    • Jordan, I’m wondering who you’re wanting to push? I don’t say that at all combatively, I’m just confused about whether you’re questioning something I said, or trying to open one of the many possible streams of conversation. Certainly your questions are ones I’ve heard even neonatologists ask, as well as parents. I admit myself that even as I wished 5 years ago more than anything that Natan would have survived, I was also scared out of my mind in my pregnancy with Samuel that he would be born very early, and with the warning we now have, would be more likely to survive. What would that have meant for his life? But that didn’t happen.

      Research happens slowly, and my goal, and those of the doctors I know, would be for survival to be paired with improved prognoses–and that has been true with preterm birth. A 32-week baby had a much much poorer prognosis 20 years ago. Of course, that can’t necessarily help with a genetic disorder. There I will always defer to families who experience it. But I where I differ from you, I think, is that I wouldn’t blame medical advances for suffering, but rather the field of expectations culture has produced out of them and possibly a problem that medical advances have outpaced social development and conversations about the ethics and morality of reproduction.

      In comparison with the wider world, my path to being the mother of living child with Samuel was tough. But in the world I now see most clearly, that of grieving parents, it was fairly smooth. I have no idea what I would have done had he died as well. And if I’d struggled to conceive, I don’t know. I think people who’ve gone through fertility treatments and either come out on the other side with living children or not would be far better suited than me to push that conversation.

  5. I just read my comment and realized it doesn’t make any sense. Just know that Cliff and I are sending our love today, sending it to you and to Josh and to Samuel.

  6. I just wanted to take a moment after reading and catching up to wish you a wonderful 2012 and I look very forward to seeing your thoughts here regarding the issues for women in our society.

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