The dehumanizing mistreatment of poor women in America

It is a business, complete with an address and posted hours of operation like any other. It even has reviews ("They do not answer phone calls for emergencies. Family member in there and we haven't heard from her, the money we placed in her account has not reached her") on Google Maps, averaging around two stars. But it does not sell products or offer services to customers; it locks them up.

I wish I could say that I was even remotely surprised by reports that emerged on Monday of horrifying abuses at a privately run Immigration and Customs Enforcement "detention center" in Georgia. According to whistleblowers, women at the facility are being given hysterectomies at astonishing rates. One person who has come forward compared the facility to an "experimental concentration camp." There are dark reports of a gynecologist who seems to be performing these procedures for no reason — or rather for some unspeakably twisted and private purpose of his own: "We've questioned among ourselves like goodness he's taking everybody's stuff out... That's his specialty, he's the uterus collector. I know that's ugly... is he collecting these things or something... Everybody he sees, he's taking all their uteruses out or he's taken their tubes out. What in the world." These surgeries are alleged to have taken place largely without the consent of the women upon whom they were performed, many of whom cannot speak English and say that they were not told why the procedures were being done. Monolingual nurses at the facility allegedly relied upon Google Translate in some cases.

There are many reasons why these reports, which ICE has dismissed as "anonymous, unproven allegations, made without any fact-checkable specifics," are worth taking seriously. The first is simply that they will not be shocking to anyone who has experienced the reality of how poor women — perhaps especially those who cannot speak English — are treated by the medical establishment in this country. Just before Labor Day my wife, a certified birth assistant, spoke to the sister of a young Hispanic woman who was giving birth for the first time at a hospital in Indiana. Due to absurd COVID-19 restrictions, the woman, who had reached the end of a routine healthy pregnancy, was prevented from bringing her sister or a third party to advocate on her behalf. For no discernible medical reason her water was forcibly broken and she was told that she would have to undergo an "emergency" caesarean section. After she refused the latter, she was given a heavy dose of pitocin. The cycle of unnecessary but (for the hospital anyway) convenient and lucrative interventions ended with a unilateral oophorectomy.

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Situations like the one I have just described are distressingly common, if unfortunately underreported, in this country. They are the result of two factors: the treatment of pregnancy and delivery as some kind of assembly line process in American hospitals, and the unworkable public-private hybrid that is our health-care system. Even women with ostensibly decent private insurance routinely find themselves misled into accepting scheduled inductions, epidurals, and C-sections that are wholly unnecessary and would be unthinkable in most European countries, where midwifery is the norm for healthy pregnancies. These interventions make complications in future pregnancies vastly more likely.

I do not think it is an accident that women like those alleged to have had their uteruses removed in Georgia are treated this way. Undergirding the assembly-line attitude toward pregnancy is the widely held but rarely articulated view that poor women, especially those who are racial minorities, are subhuman, that this country and the world do not need more of their children, that their pregnancies are the unfortunate and wholly unnecessary result of the failure of their mothers to render themselves infertile, which is now apparently the default condition of the female sex.

When I say "rarely articulated" I do not mean never. This vision was laid out with horrifying clarity some years ago in a report by the Congressional Budget Office on the consequences of eliminating federal funding for Planned Parenthood. Forgive the bureaucratese:

This is what they call saying the quiet part out loud. Here the very possibility that poor women might become pregnant becomes a danger that they or others working on their behalf must "avert"; their children are inhumanly dismissed as "additional births," as if they were tumors or bulbs, and damnably expensive too. In case the fundamentally anti-human logic were not obvious enough from the report itself, a write-up in the Washington Post provided a helpful gloss on the hideous consequences of defunding Planned Parenthood under the headline "Defunding Planned Parenthood would lead to thousands more births, CBO says": "Anti-abortion advocates zeroed in on the expectation that more babies would be born, which struck them as reason to celebrate."

How should it strike us, the arrival of new human lives? We know what the answer seems to have been at Irwin County Detention Center in Georgia.