Book Review - Dangerous Pregnancies: Mothers, Disabilities, and Abortion in Modern America

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Publication Date: 
Wed, 2013-02-06

Reading even recent histories about women's health issues is fascinating for how much it reveals about what has, and more often, what hasn't really changed over time. Thus, another insight from this book is how, early on, vaccination campaigns focused on the desires of women to protect their health and that of their babies only later to be transformed, "ahistorically" Reagan suggests, into efforts to make women responsible for harms to their children: their poor behaviors were to be viewed as threats to children's health and well-being instead of the true risks created by  the external conditions of their lives—with this culminating in attempts (in Canada as in the United States) to criminalize pregnant women who do not behave "properly."

According to Reagan, rubella "marked bodies and then marked society." This is a broad claim and although she offers much evidence to support it, her insistence on it is not always convincing. Perhaps the many threads she is trying to connect directly just don't blend sufficiently so that some of this seems forced. Thus, despite her vast knowledge of the social history of the times she writes about (mainly the 1960s), too often Reagan inserts this material casually when her focus is elsewhere and this can disrupt her own story line. For example, in the middle of a discussion of blood tests for rubella, with its biomedical context only coming about two paragraphs later, she refers to events in Berkeley (California) and Selma (Alabama) that may be interesting but aren't really needed here. 

Similarly, the archival/historical research in Chapter 4 ("law making and law breaking in an epidemic") may also be overwhelming for the general reader, the importance of the points about how the political debates about abortion were fueled by the rubella epidemic notwithstanding.

Rubella is no longer the scourge it was in North America, and this is likely due to the efforts of women over the years first to clarify its nature as a distinct disease (mainly by comparing their experiences that led to recognition that a generally mild infection of a pregnant adult could lead to serious problems in children born subsequently) and then to make abortion "respectable" insofar as having rubella during pregnancy became an accepted indication for what was then called a "legal" (or "therapeutic") abortion. Unfortunately, by framing children with congenital rubella syndrome as unwanted or undesirable—rather than in need of social and medical services to which they were entitled— this framing likely paved the way for what was to become generally uncontested offers of and requests for abortion  when women began routinely to undergo routine prenatal tests for such conditions as Down syndrome: the normalization of abortions for "fetal abnormalities" detected in utero was underway. As was the view of children with disabilities as objects of pity or worse.

Despite all that has changed since the 1960s to make pregnancy less dangerous for many women and children, the benefits are not equitably distributed today. Choices to become or to avoid pregnancy, to control the number of children one has, to be able to raise the children one wants in conditions of safety and security all remain elusive for too many. So even if the dangers of rubella need not be the biggest concerns of women in Canada (and the United States), we still have far to go to achieve reproductive justice and to proclaim reproduction and motherhood as safe for all.


Abby Lippman is a longtime feminist activist with special interests in women's health and women's health policies. Also an academic based at McGill University and passionate about writing, Abby is past president of the CWHN, and is now on the board of the FQPN where she works closely with them in building an inclusive reproductive justice movement in Québec.