Pregnancy Complications… How Ableism Affects Chronically Ill People in Pregnancy.
We often minimize the medical event of pregnancy. While it is true that humans have been giving birth for all of history, childbirth has long been a deadly and dangerous event. While we are lucky that pregnancy is made much safer in places with good access to modern medicine, it is still a medically massive undertaking even for a healthy body, and especially for those with chronic illness.
Complications in pregnancy often face the same stigma and prejudice as general chronic illness and disability including victim blaming, minimization and psycholigization.
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Pregnancy is a disability & medical condition
This seems like it should be a simple statement. Pregnant people are given seats on buses, take time off work, need medical accommodations and may become bedbound during their pregnancy.
Yes because of the stigma against disability, we often try to frame pregnancy differently. We call it a "magical gift" and a "blessing." Yet this sole focus on the beautiful outcome of pregnancy ignores the very real medical challenges of pregnancy.
This medical view of pregnancy is especially important to chronically ill people. Many may be physically unable to get pregnant. Those who can often face much greater risk. They may know from the onset they will require months of bedrest, C-sections, and complex medication management.
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Chronically ill people deserve the choice of pregnancy
Others will then argue that anyone with complex conditions affecting pregnancy just shouldn't get pregnant. This also comes along with the ableist lie that lives made more difficult by chronic illness and disability are not worth living.
Having a child is a huge undertaking and often the center of someone's life. To ask them to sacrifice such an important choice is discrimination. The choice to be pregnant is a matter of bodily autonomy and the medical care that chronically ill people need in pregnancy is a basic part of the medical care they deserve simply for being human.
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Pregnancy complications are not a choice
Victim blaming is a common form of ableism that pregnancy is not spared from. Our health is often individualized, fed by the myth that being healthy is solely a choice of eating right and exercising. In reality just as genetics, circumstance, and luck shape our overall health so too do they shape pregnancy.
Nobody would choose to have a complex pregnancy. Just as nobody chooses to have a disability. Chronically ill people might have a higher risk, but they do not go into pregnancy wanting complications. Blaming people for their misfortune does nothing but minimize and harm the people we should be helping to access care for these important medical issues.
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Natural birth is not a mindset
Similarly, you will often see the psycholigization of pregnancy. That if you have faith, trust your body, or are not afraid of pregnancy you will succeed in a "natural" birth away from medical interference.
It is true that some people enjoy their pregnancy and have no complications. But in refusing to acknowledge experience outside of the "natural miracle" of a perfectly smooth pregnancy and childbirth, we ignore the miracles that are successful complex pregnancies. Natural birth is not just a mindset.
Before modern medicine what happened to those with "complex" births was often death of mother and/or child. It is not a personal failing to need medical intervention during birth, it is a modern miracle that allows for babies and parents to survive.
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C Sections Are Not The "Easy" Way
It is true that there are some births that prior to C-section would have been deadly for parent and baby. Yet this often feeds the misconception that women who choose or are forced into a C-section have taken the easy path.
In reality, people who undergo a C-section have longer recovery times and are more prone to postpartum depression. The long recovery from surgery can prevent them from being able to be as present in the first year of their child's life. C-sections are not less painful or easier than natural birth and we should recognize the process of cesarian birth the same way we do natural birth. As a massive sacrifice and labor by a parent to bring their child into the world.
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Women's pain matters
There is no way around the fact that bringing a child into the world is painful. For people with arthritis, connective tissue disease, back pain, and other chronic pain pregnancy can exacerbate their pain. Many chronically ill people are also unable to relieve their pain in pregnancy as many modern painkillers are not safe to use in pregnancy. Similarly, morning sickness in the first trimester is often dismissed and untreated.
Pain during pregnancy is extremely normalized. We see it as "natural" and therefore not worth investing in. This is similar to how many chronic pain conditions affecting primarily women are seen. Unless a complication dangers the fetus, it is often dismissed, completely ignoring the health and suffering of the pregnant person.
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Pregnancy is valuable work
It is also important to acknowledge just how incredible the labor done in all pregnancies is. Without it, the human race would cease to exist. It is quite literally the most important work in the world. It is only by understanding and appreciating this importance that we can fully acknowledge that pregnancy is painful, disabling, and dangerous yet a rational choice for many.
It is also by understanding this that we can see pregnancy as the noble act that it is. Like organ or blood donation, pregnant people risk their bodies for the sake of someone else. They make huge sacrifice. This is even more true in the case of disabled and chronically ill pregnant people. The least we can do is support them.
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Summary
All pregnancy is dangerous and disabling. Minimizing the medical impact of pregnancy harms everyone but especially chronically ill people who take even greater risk by becoming pregnant.
Victim-blaming pregnant people for complications is a toxic form of ableism that harms people we should be supporting.
Natural birth is not a mindset it is a lucky circumstance and it is a miracle of modern medicine that we can now allow people with complex pregnancies a relatively safe birth.
Pregnancy is not a simple miracle. It is an incredible act that is difficult and requires great sacrifice by one person to create the life of another.
More information
The Hormone Diaries
Mama Doctor Jones
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Pregnancy can be beautiful but that doesn't stop it from being a medical condition. Which means chronically ill people have more considerations, risks, and need for medical care when dealing with this comorbidity
There are plenty of great posts about why abortion is a disability rights issue. However, often times these discussions focus on the difficulties faced by those who do not want to get pregnant. But the issue of high-risk pregnancy is perhaps most important to those with chronic illnesses who want to get pregnant. Like my amazing assistant @kamilljoana22 whose insights into her current experience with complex pregnancy inspired me to make this post.
Disabled and chronically ill people can be amazing parents. @jessicaoutofthecloset recently put out an amazing video explaining how being disabled makes her a better parent because being a baby is in essence a disability.
Being pro-choice does not just extend to disabled people's right to abort pregnancies, but also the right to additional medical accommodation and support in order to choose to become a parent. No one chooses pregnancy complications just as no one chooses to be disabled.
Discrimination against pregnant people in workplaces and society is ableism and this is compounded for those with complex pregnancies this ableism is especially pronounced. As a disability activist, I believe that aknowledging pregnancy as a disability and medical condition can help shed light on the way that sexism and medical gaslighting around pregnancy is an extension of the way we more generally devalue chronic pain and similar medical conditions that disproportionately affect women.
Finally to all those who struggle with high-risk pregnancies, wanted or unwanted, I applaud your strength and courage. Pregnancy is so much more than "the gift of life" it is a complicated medical condition necessary for humans to survive and the people who participate in this labor in any way deserve respect and accommodation.
Personal note: I don't want kids and having them would be dangerous for me. But wanted pregnancies can be the most important part of a person's life. I consider myself very lucky that I didn't want kids in the first place because I know firsthand how painful it is to have your life goals and plans ripped away from you.
Many people find their kids to be the most important part of their life and I have seen posted in support groups by mothers with MECFS that seeing their children grow up is their primary motivation for surviving this awful condition.
No one should get to decide for someone else that they shouldn't have that experience because they are too medically complicated and my heart goes out to those who struggle with miscarriage and infertility.
PS: any longtime followers of this account know I am very much prochoice with the rationality that no one has a right to use another person's body without their consent. But I did avoid making a strong pro-choice stance in these slides because whether you are pro-choice or pro-life you should still acknowledge that pregnancy is a disability and serious medical condition.
