The right to life is the right on which all other rights depend. It imposes on the State an obligation not only to refrain from threatening or killing people, but also to promote the conditions necessary for survival.
“Women are not dying of diseases we can’t treat. … They are dying because societies have yet to make the decision that their lives are worth saving.” – Mahmoud Fathallah, past-president of the International Federation of Obstetricians and Gynecologists
99% of maternal deaths happen in developing countries, where poverty and lack of infrastructure can threaten survival. In many of the places where women and their babies die around childbirth, women’s health and life is considered to be literally worth less than men’s, with deadly consequences for females. The promotion of women’s right to life in the context of maternity care requires consideration of the full range of women’s social, economic, and political circumstances.
African-American women are 3-4 times more likely to die in childbirth in the USA than the general population. What does this statistic indicate about Black women’s right to be alive in the USA? To be supported around reproduction? How is this statistic a legacy of the atrocities of childbirth in slavery, when African-American women were openly denied the right to life? What are the avenues through which African-American women’s right to life continues to be denied around childbirth today? HRiC supports the network of people working at both grass roots and policy levels to answer those questions and find solutions.
Who is looking out for the baby?
Objections to women’s efforts to exercise the right to informed consent and refusal in childbirth are usually couched in an assertion of the unborn’s right to life. When providers or lawmakers attempt to restrict women’s healthcare choices around childbirth—like the choice to refuse cesarean section, or the choice to give birth at home with a midwife—they often argue that birthing women don’t have the right to make choices that “put their baby at risk.”
From a legal perspective, these assertions are problematic. Every person has the right to refuse medical procedures, even if they the procedure (for example, an organ donation) might save the life of another person. It is a violation of the birthing woman’s bodily integrity to force her to submit to unwanted medical treatment, even if doing so would save the baby’s life.
More important, the reality of decision-making in childbirth is rarely, if ever, so clear. Every decision involves complicated short and long term risks and benefits. Nobody can guarantee a “good outcome” from a given decision, and stillbirth happens sometimes, no matter who is in control. Someone must weigh the unique risks and benefits of the decisions in a given birth, and have the final say in those decisions. That person must be the mother. An unborn baby is represented by the person who is most invested in its health and well-being. Nobody is more invested in the health and well-being of a being-born baby than the person who grew it under her heart, from her blood. The maternal-fetal dyad is best protected when the birthing mother is respected as a competent decision-maker for herself and her child.
Laws that restrict women’s reproductive options don’t change their choices, but they do increase their risk of dying from those choices. Some women will choose to give birth at home, whether or not their healthcare system supports that choice as legitimate. When that choice is marginalized or driven underground, continuity of care is undermined, with predictably deadly results for women and babies. Reproductive healthcare maximizes safety and survival when it serves to support women, instead of control them.