Due Protections: The Pregnancy Discrimination Act at 40

Ruth Bader Ginsburg in 1977. Photo: Lynn Gilbert

Today, Susan Struck’s political positions are nothing that would stick out in a red state like Arizona. A few years ago, she joined the chorus of support for the once-threatened A-10 fighter jet program at Tucson’s Davis-Monthan Air Force Base. In a 2010 article on immigration, a writer noted her concerns about automatic citizenship for U.S.-born children.

Despite the rightward tilt that would be assigned to her views today, Struck was once at the center of a fight for reproductive justice, a cause taken up by a young Ruth Bader Ginsburg, back when “The Notorious RBG” was still a lawyer for the ACLU. It was that fight that led to Ginsburg’s involvement in the writing of the Pregnancy Discrimination Act of 1978, a landmark piece of legislation that turns 40 this month.


Despite 40 years of protections, pregnancy discrimination hasn’t gone away.


Now retired in an Arizona ranch community, Struck first arrived in the Copper State at the end of the 1960s, when she enlisted in the U.S. Air Force and was stationed at Davis-Monthan. She told Elle in a 2014 interview that she reveled in her newfound independence from the family and church she left in Kentucky. “She went on the Pill and stopped attending confession,” the article recounts, and she spent her free time enjoying her sexual freedom and the chance to experience Tucson’s foothills in a newly acquired Camaro.

Still, Struck wanted more excitement, so she asked to be sent to Vietnam. She was assigned to Phù Cát Air Force Base, where she quickly hit it off with an F-4 pilot — and ended up pregnant. Struck understood that the Air Force gave officers in her situation two choices: get an abortion or be honorably discharged. It was 1970 then, still a few years before Roe v. Wade, but the armed forces had made abortion legal ahead of civilian society. Continue reading

Sons Speak About Mom’s Abortion

“Mom, did you ever have an abortion?” It’s a simple question. Karen Thurston’s sons, Kevin and Stephen, never asked. Why would they? What would possibly make them even think to ask?

Thurston Family

Karen Thurston and her sons Kevin (left) and Stephen. Photo taken the day Karen told them about her 1973 abortion, courtesy of Karen Thurston.

On the flip side, why did Karen never speak to her sons about her teenage experiences with abortion care? Because, for decades, Karen heeded the advice of her father, who had arranged for her 1973 procedure when she was just 13: “You must never, ever, as long as you live, tell anyone you had an abortion, not even your husband when you are grown.”

In 2013, though, she did tell her sons, and now tells her story forcefully, publicly, and with great compassion to chip away at the stigma associated with abortion care.

Consider now Kevin’s and Stephen’s reactions:

Kevin: I first learned of my mom’s abortion story when I was 23 years old. My mom asked me if it would be possible for the two of us to fly to Pittsburgh and meet my older brother there for dinner. My brother and I could both tell that this wasn’t just a whimsical get-together; there was something she wanted to talk about. That’s when she shared her story. We could tell it really pained her. Not only was the story difficult to tell on its own, but she was clearly afraid of our reaction. Even after raising us our whole lives, after being closer to us than anyone we’d ever known, she didn’t know if she could trust us to understand, and I think that speaks to how cruel stigmatization is. It is so isolating for women who’ve made that choice that they do not even see allies in their families or the children they do go on to raise. Continue reading

Maternal Mortality: A National Embarrassment

Americans spend more money on childbirth than any other country, but we’re not getting a good return on our investment.

Less than a century ago, approximately one mother died for every 100 live births — an occurrence so common that nearly everyone belonged to a family, or knew of one, that was devastated by such a loss. Fortunately, in most nations, those tragedies have declined over the years. In fact, in the decade between 2003 and 2013, only eight countries saw their maternal mortality rates rise.

Unfortunately, the United States was one of those eight countries, joining a club that also includes Afghanistan and South Sudan. Within the 31 industrialized countries of the Organization for Economic Cooperation and Development, an American woman is more likely to die as a result of pregnancy than a citizen of any other country besides Mexico. Among developed countries, the United States has one of the highest maternal mortality rates — and those rates are only getting worse.

Graph: CDC

U.S. maternal mortality has attracted the attention of organizations whose oversight you wouldn’t expect. Amnesty International, which most Americans associate with the fight against human rights abuses in far-flung authoritarian regimes, considers our high maternal mortality rates to be a violation of human rights. Additionally — and pathetically — one of the biggest sources of funding for maternal health in the United States comes not from taxpayers but from the pharmaceutical company Merck. The Economist quoted a Merck spokesperson as saying, “We expected to be doing all our work in developing countries.” Continue reading

The Clash of Population and Prejudice in Madrigal v. Quilligan

Mural (detail) in Boyle Heights, East L.A. Photo: Mictlan Murals

In August 1973, Guadalupe Acosta was admitted to the county hospital in East Los Angeles. She had been suffering from labor pain for hours, but she would soon endure even more misery in the delivery room. She recounted later how the attending physician worked aggressively to induce labor, pushing down forcefully on her abdomen — even hitting her stomach when he was caught in the swing of her flailing arms. In the end, all the torment she endured culminated in the death of her baby in birth.

Acosta later said she was “very inattentive” in the aftermath of the experience. “People sometimes have to tell me things twice. It’s not that I don’t understand them, it’s that I’m not there.” For Acosta, it was not just the loss of her baby that devastated her but also the loss of her ability to have children in the future. She found out, months later, that the hospital physician had decided to sterilize her. At the time, she had been too traumatized to understand what was happening.


Just as the right to access birth control and abortion should be defended, so should the right to have children.


The University of Southern California – Los Angeles County Medical Center (USC-LAC Medical Center), as it was officially called in the 1970s, was a hospital that many in East L.A. tried to avoid. It was a place they would only visit out of necessity if other hospitals weren’t affordable. For Dr. Bernard Rosenfeld, who worked there as a resident in obstetrics and gynecology, it was not hard to see how his own department reinforced that reputation.

Acosta’s traumatic experience was similar to other cases Rosenfeld witnessed — cases that showed a disturbing pattern of subjecting women, especially Spanish-speaking women, to sterilization without their informed consent. According to Rosenfeld, insistent medical staff would push sterilization on patients “before they go home” — often while they were still in pain or exhausted — so that they wouldn’t “change their mind by the time they come back to clinic.” Patients who had limited understanding of English were often uncertain of what was happening. Shocked by the unethical practices, Rosenfeld secretly copied hundreds of medical records to document what was happening at USC-LAC Medical Center. Continue reading

Learning About Alcohol and Drug-Related Birth Defects

The week of May 14 is Alcohol and Drug-Related Birth Defects Awareness Week. According to the National Council on Alcoholism and Drug Dependence:

About 20% of pregnant women smoke cigarettes, 12% drink alcohol and 6% use an illicit drug at least once during pregnancy. These numbers are very alarming. If only people knew the dangers of their decisions, perhaps we would be looking at something more acceptable in those numbers.

So what are some of the dangers posed by these substances to a developing fetus?

Effects of Tobacco Use

According to the Centers for Disease Control and Prevention, the fetus gets less oxygen when the mother smokes. Smoking during pregnancy is a risk factor for low birth weight, preterm birth, placenta problems, miscarriage, and sudden infant death syndrome (SIDS).

Effects of Alcohol Use

I have written about the effects of alcohol use during pregnancy before — in fact, it was the subject for the first article I wrote for this blog.

Alcohol easily passes through the placenta, so when a pregnant woman drinks, so does her fetus. Continue reading

Bearing the Burden of Injustice: Black Maternal Mortality

Mother and babyWhen it comes to maternal mortality, American women don’t all live in the same country. While white women live in Qatar, black women live in Mongolia.

Maternal mortality is death related to complications from pregnancy or childbirth. Most of us don’t come from a time or place where the prospect of dying in childbirth is a tangible possibility — in the past century, as medicine has advanced, maternal mortality rates have plummeted.


To raise healthy families, we need access to general and reproductive health care, including preventive care, prenatal care, and maternity care.


The United States, though, hasn’t come as far as would be expected. Although its wealth should have put it on par with other developed nations like Canada, the United Kingdom, Australia, Japan, and those in Scandinavia, women in these countries fare far better than those in the United States. So do women in Libya, Bosnia and Herzogovina, Bulgaria, and Kazakhstan, indicating that national priorities — and not necessarily national wealth — are key to ensuring maternal health.

The United States’ high maternal mortality rate is heartbreaking no matter how you look at it, but is even worse for women of color. African-American women are 3.5 times more likely to die as a result of pregnancy or childbirth than white women. Between 2011 and 2013, the maternal mortality rate for white women was 12.7 deaths per 100,000 live births. Comparing that to 2015 data from the World Health Organization (WHO), that rate puts white women’s maternal mortality on par with mothers in Qatar and Bahrain, two wealthy Persian Gulf nations. African-American women, however, suffered 43.5 deaths per 100,000 live births, putting their maternal mortality on par with those of Turkmenistan, Brazil, and Mongolia. Continue reading

A Gun in the Oven

Last month, during an Arizona House debate on whether to ban bump stocks, which make semiautomatic rifles fire almost as fast as machine guns, Rep. Kelly Townsend (R-Mesa) blamed abortions for the epidemic of school shootings: “We are in a culture of death where it’s OK if you have an unwanted pregnancy to just go ahead and kill that child.”

This is not the first time a link between abortion access and school shootings has been suggested. In his commencement speech at the University of Maryland in 2013, U.S. Rep. Kevin Cramer (R-ND) proclaimed, “Forty years ago, the United States Supreme Court sanctioned abortion on demand. And we wonder why our culture sees school shootings so often.”

All morning, I’ve been trying to get inside the heads of these two legislators and follow the twisted reasoning behind their statements. Perhaps a Vulcan mind meld might work, though I suspect my brain could be permanently damaged. But, in the spirit of inquiry, I’ll take that risk.

OK, now that our minds are melded, I think I see a grand vision unfolding. Continue reading