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"Depraved Indifference"
Caesareans, Patriarchy, and Women's Health
by Mickey Z.
www.dissidentvoice.org
March 15, 2004

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Melissa Ann Rowland, 28, of Salt Lake City was pregnant with twins. Her doctors claim they warned her about complications requiring a Caesarean section. Without the procedure, they believed the unborn twins might not survive. According to a nurse, Rowland refused the C-section because she didn't want scars.

Rowland's attorney, Michael Sikora, says his client has a long history of mental illness. He called a C-section major surgery and explained, "It would come as no surprise that a woman with major mental illness would fear it."

Only one of the twins survived childbirth.

Rowland was arrested and charged with one first-degree felony count of criminal homicide: "depraved indifference to human life." If convicted, she faces between five years and life in prison.

As of this writing, many things are unclear, i.e. whether Rowland was warned, how she was warned, if and why she ignored the warning, along with any useful details about her mental state. The media has dutifully run photos of Rowland in an pinkish prison jumpsuit; hair splayed out in all directions...fulfilling any spectator's notion of what a mother with "depraved indifference to human life" might look like. One source is now reporting she was convicted of child endangerment in Pittsburgh nearly four years ago.

Unexamined in the press reports is the efficacy of the C-section and the state of women's health care in America. We'll get to those in a moment. One tangential issue raised in an Associated Press article involved "the prosecution of mothers who smoke or don't follow their obstetrician's diet."

"It's very troubling to have somebody come in and say we're going to charge this mother for murder because we don't like the choices she made," said Marguerite Driessen, a law professor at Brigham Young University.

I'm no fan of taxpayer subsidized lung cancer, but we're talking about arresting women for smoking...not because they might hurt themselves but all in the name of protecting the unborn (sound familiar?). If you really wanna go the police state route, what about potential fathers who knowingly engage in unhealthy habits? It takes two...as they say. As for the obstetrician's dietary suggestions, well, I've written plenty about that topic so I'll remind readers that the typical American doctor sits through only two to four classroom hours of nutrition during medical school ...and leave it at that.

Ruth Hubbard is professor emerita of biology at Harvard and the first woman to be given a tenured biology professorship there. "The so-called war on drugs has produced a situation in which a single blood test on a pregnant woman or a newborn is sufficient to label that woman a drug abuser and call in the state," she says. "I suppose most people would agree that it is not a good thing for pregnant women to drink excessive amounts of alcohol or to smoke or use drugs. But if the state wants to protect a fetus, the way to do that is make it possible for pregnant women-and women in general-to have access to proper housing, food, jobs, a decent living environment, and good prenatal care."

What qualifies as good prenatal care, however, is not so easily defined...which brings us back to the C-section procedure.

"Our birth practices are crazy," says author and health advocate, John Robbins. "We have a Caesarean rate of 23 percent, which means that nearly a quarter of our newcomers is surgically extracted from their mothers' wombs." This is not so shocking when one takes a look at the male- and profit-driven world of Western medicine. "Natural birth can take place anytime, day or night," says Robbins. "There's no telling how long the labor will last, and there's no predicting when the baby will emerge. Caesareans, on the other hand, can be arranged to take place at the convenience of the hospital and the obstetrician."

Since the advent of direct tests of fetal health in the 1960s, the process of birthing has become progressively more medicalized and the role of the obstetrician (typically male) has dramatically increased. The man in the white coat has been transformed into an expert needed by women who are made to feel incapable. If that omnipotent obstetrician attended medical school in the 1970s, he may have used the textbook, "Obstetrics and Gynecology," which includes this appraisal of the women they will be treating: "The traits that compose the core of the female personality are feminine narcissism, masochism, and passivity." If he got his degree anytime from the

80s on, his text could have been "Medical, Surgical, and Gynecological Complications of Pregnancy," which warns future doctors how "dangerous" those patients "who consider themselves 'socially aware'" are. That type of woman is "not necessarily more mature but are trying, by their active interest in everything 'avant garde,' socially as well as medically, to persuade themselves and other that they are...This is the patient who is interested in such methods as 'natural childbirth,' hypnosis, of using childbirth as an 'experience'."

Recalling the example of Melissa Ann Rowland, the text concludes that such a woman "requires close and constant psychiatric support."

In his book, "Reclaiming Our Health," John Robbins points out a delicious judgment of the standard obstetrical text, "Williams Obstetrics": "The 15th edition is 923 pages long. In the index there appears an entry that was apparently slipped in unnoticed by some brave soul who, faced with the tedious task of preparing the index, wanted to voice his or her opinion about the book. The line reads: 'Chauvinism, male, pages 1-923'."

There's more than chauvinism at work in the C-section issue when obstetricians and hospitals are more highly reimbursed for surgical births than for vaginal births. "In the state of Washington," Robbins explains, "the Caesarean rate in nonprofit hospitals is 20%, while the rate in for-profit hospitals is 36%. A few years ago a Kansas health maintenance organization (HMO) changed its policies and began to reimburse doctors equally for Caesarean and normal deliveries, so there was no longer a financial incentive to do Caesareans. The Caesarean rate dropped from 28.7% to 13.5% in one year."

Upon closer examination, one will find that the entire system of medical research is tainted by patriarchy and profit. "Biologists and physicians have traditionally been men and have thought of males as the norm," says Ruth Hubbard. "And they have taught us to think of the ways in which women's bodies are different from men's as deviations from this norm."

Conditions that affect men and women equally-heart disease, certain cancers, etc.-are heavily researched, for sure. But they are studied "almost exclusively in men," says Hubbard. "Little research has been done on lupus, rheumatoid arthritis, scleroderma, and other conditions that affect primarily women. No one even understands why their incidence is skewed."

Melissa Ann Rowland, 28, of Salt Lake City may or may not have received sound medical advice and she may or may not have ignored it and this may or may not have contributed to the death of her child. We can only hope the truth is found amidst the scapegoating and hysteria. However, what we can focus on now is how demonizing Rowland and criminalizing her choices is yet another episode in a long, sad history of male- and profit-dominated medicine.

"To be both useful and benign," concludes Hubbard, "science needs to draw on the experience of people who are usually disqualified from making science, like women." In his book, Robbins offers examples of many women who are "beginning to stand up to this exploitation...They are saying no to unnecessary drugs and surgery, and using safe and natural methods...Their lives are messages to us all, male and female, of hope and inspiration."

Our job is to make sure that hope and inspiration is transformed into widespread awareness and tangible action.

Suggested reading:

Profitable Promises: Essays on Women, Science, and Health, by Ruth Hubbard (Common Courage Press)

Reclaiming Our Health: Exploding the Medical Myth and Embracing the Source of True Healing, by John Robbins (HJ Kramer)

Mickey Z. is the author of two upcoming books: A Gigantic Mistake: Articles and Essays for Your Intellectual Self-Defense (Prime Books) and Seven Deadly Spins: Exposing the Lies Behind War Propaganda (Common Courage Press). His most recent book is The Murdering of My Years: Artists and Activists Making Ends Meet. He has been a vegan for nearly nine years and can be reached at mzx2@earthlink.net.

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