The Growing Perils of Pregnancy in America (with Irin Carmon)

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Introduction – 0:00

 

BLAIR HODGES: Welcome back to Relationscapes. It’s the podcast where we explore human identity and human connection in order to make the world a little better for everybody. I’m journalist Blair Hodges in Salt Lake City, and our guide in this episode is journalist Irin Carmon.

IRIN CARMON: (Clip) Each one of these women’s stories told a different piece of the American story of pregnancy, infertility, miscarriage, criminalization, birth, racial inequality, the history of medicine, with the through line being that America has made choices that make pregnancy more unbearable for more of us, and that none of this is inevitable, but that so much of this is a choice.

BLAIR HODGES: Irin Carmon was eight months pregnant when the Supreme Court recently gave states the right to outlaw abortion again, overturning decades of established law. Even though she was excited to welcome her baby, Irin knew the ruling posed a direct threat to her and to anybody who was pregnant or could become pregnant, whether they wanted to have a baby or not.

Because long before Roe v. Wade fell, the American health care system was already making pregnancy more dangerous, more unequal, and more unbearable in blue states and red states alike. Irin Carmon explains it all in her new book. It’s called Unbearable: Five Women and the Perils of Pregnancy in America, and she joins us to talk about it and how we can fight back right now.

 

How Dobbs Endangers Everyone – 02:01

 

BLAIR HODGES: Irin Carmon, welcome to Relationscapes.

IRIN CARMON: Thank you so much for having me.

BLAIR HODGES: I want to start with the overturning of Roe v. Wade. This just happened a few years ago. Here you were, eight months pregnant when that happened, and this overturning allowed states to outlaw abortion. And this was your second pregnancy, and you’d been reporting on legal and medical and personal struggles with reproduction.

What was it like reporting this out as you yourself were experiencing your own second pregnancy?

IRIN CARMON: Thank you so much for asking, because it was really the genesis of the book Unbearable. I had, by that point, spent about 12 years reporting on reproductive rights, the battle over abortion during COVID. I was also reporting on what was happening inside hospitals. That was during my first pregnancy.

But what I realized, both through my first pregnancy and my second pregnancy, was how deeply interconnected these different reproductive experiences were. So I was not seeking to end my pregnancy. I was excited to be pregnant. But the medical and personal experiences of pregnancy, they are in some ways shared and universal, even though there are so many other things in the law and in politics that set them apart.

And so when that decision came down, something that I had been preparing for for so much of my career, the fact that somebody else could be forced into the experience that I was going through at that very point really hit me in my bones. It was very visceral.

And as I was reading Samuel Alito’s opinion, first when it was leaked and then when it became final, I was so struck by how it erased the physical, emotional, economic, logistical, religious, medical experience of pregnancy. It was all about fetal development. There was no recognition of what people would now be forced to undergo or the impact it would have on their lives or their dignity to have that decision taken away.

And so that was the starting point where I thought, I feel like I’m in the same shoes, even though my circumstances are different. How do I take that feeling or that recognition of our shared humanity and tell a story, and understand how it is that these experiences, which are so deeply linked, have been separated out in our politics and our law?

BLAIR HODGES: And you weren’t alone in all of those feelings you were having. When you would talk to people about what your upcoming book was about, you kind of had this one-liner: it’s about how you get treated when you’re pregnant. And women would give you really strong, immediate responses to that.

IRIN CARMON: Yeah. You know, I write in the book about how I accidentally came across one of the five characters that I write about by being at a preschool picnic, and somebody asking me, and me saying—you know, not wanting to kind of reveal too much, and it was still kind of early. And you’re in this casual setting with people you don’t know or don’t know that well.

And when I said it’s about how you’re treated when you’re pregnant, somebody said, “like a child.” And then somebody else said, “like an animal.” And someone else said, “like a child animal.” And that woman was one of the five women I ended up writing about, Maggie Boyd.

And I was so struck by this because people are used to hearing about difficult pregnancy stories in places like Alabama, the other place that I write about. But it was important to me to write about New York City. And it was important for me to recognize that even though so much can vary in your experience of pregnancy depending on where you live and who you are, there is an opportunity, again, to build these kinds of bridges between people who are differently situated or make different decisions.

Because they’ve had that experience of being treated like less than a person or like public property the moment that they become pregnant, even if it’s something that they undertook enthusiastically.

BLAIR HODGES: And with that Supreme Court ruling, the Dobbs decision, there were two huge consequences you point out in the book.

The first is that it stops people, when states want to stop people who want to terminate their pregnancies, from doing that. And the second one—and that’s important—but the second one, which I think is more overlooked, is it also harms women who don’t want to terminate their pregnancies, and it puts them in grave harm’s way.

IRIN CARMON: So I think abortion care was quietly load-bearing in a lot of reproductive health care in ways that people are only realizing now in the aftermath of Dobbs. And so when you hear these heartbreaking stories of people being denied miscarriage or ectopic pregnancy care, or being denied life-saving abortion care, all of those show how, even though we were told that other kinds of pregnancy care would not be affected by these abortion bans, it’s not so easy to draw these bright lines in practice.

There’s a chilling effect where doctors fear giving their patients this kind of care because they don’t want to be prosecuted or lose their licenses. But also, you know, these definitions are invented. Saying what is life-threatening, what is an emergency—waiting until somebody bleeds out in a parking lot—is something that has now become part of our daily experience.

And as I show in the book, this also comes from an explicit guideline from anti-abortion obstetricians and gynecologists who explicitly say that the pregnant person’s medical needs and desires are less important. So it doesn’t matter whether they want to be pregnant or not in their eyes, because it’s better to, for example, perform a risky C-section, they say, early in pregnancy, when there’s no chance of a live birth of a baby, if someone’s gone into premature labor, than it is to do anything that would remotely look like an abortion.

So I think that one of the women I write about, Allison, is an example of this. She’s somebody who is undergoing fertility treatments. She and her wife are desperately trying to get pregnant in Alabama, and she has recurrent miscarriages. And what ends up happening to her is that she has to drive for hours to a former abortion clinic just to get a checkup to find out if her miscarriage has completed or not.

And that’s because the culture of fear imposed by abortion bans means that even a situation where there’s no fetal heartbeat and where somebody wants to be pregnant becomes freighted with this kind of, “Well, we can’t provide that kind of care for you,” this kind of fear. And it’s another way in which pregnancy has become more dangerous for everyone.

BLAIR HODGES: We’ll return to Allison soon. But before we get there, your introduction says that what’s wrong with pregnancy in America today isn’t simply a matter of right versus left. That’s what you say. And it’s not simply a matter of male control of female bodies. And it’s not enough to simply say what women need is a choice.

Let’s unpack that framing. I think that’s a really important way to frame it. It’s not just right versus left. It’s not just about men controlling women, nor is it just about, hey, women should have a choice.

IRIN CARMON: So I wanted to talk in the book about what was happening in my home city, New York, a place where, you know, we have, at least on paper, a lot of progressive policies around, for example, access to abortion. But it is also a place where the gap in maternal mortality on the basis of race is significantly worse than the country at large.

So, for example, roughly every year, a Black woman is three times likelier nationwide to die for a pregnancy-related reason than a white woman, which is inexcusable. In New York, during the time that I wrote about—of course these numbers can vary year by year with the statistics—a Black woman was eight to twelve times likelier than a white woman to die for a pregnancy-related reason.

And the reasons for that are complex, but they don’t come down to the Christian right. Right? They come down to economic inequality, health inequality, systemic racism. That is not just a Republican saying something bad. It’s a fundamental disinvestment in communities, and especially community hospitals, as well as, as I write about in my book, examples of interpersonal racism that happen in blue states.

You know, I tell this story in my book of going to get an ultrasound myself when Roe v. Wade was overturned and having an ultrasound tech talk over me to my fetus and say, “You were a person from day one.”

BLAIR HODGES: Yeah, because you had said, like, “Oh, it’s looking a little bit more like a person.” And the tech talked to the fetus instead of you: “You were a person from day one.”

IRIN CARMON: Yeah, she was contradicting me. I mean, I even was kind of saying that tongue in cheek. But I was having a private moment with my husband. And it was just another moment in which you realize that, in many cases, it doesn’t matter where you are. You could still be treated as secondary to the story of your pregnancy and denied the right to define your pregnancy for yourself.

So it was important for me, for those of us who live in blue states, to not be complacent—that this is something that’s a problem that happens somewhere else. I also think, in terms of men versus women, it is a deeply gendered situation in which health care that women primarily receive is devalued or is controlled.

And certainly the history of the medical takeover of pregnancy is a deeply gendered one. But the vast majority of OB-GYNs in this country are female. And I’m often asked, “Well, doesn’t that mean that everything is better?” It’s so much bigger than who is the individual making the decision. It’s so much more systemic.

And I think that there are also the dimensions of race and class that make this much more complicated than just men controlling women’s health care, although that does happen far too often.

 

Five Women in Two States – 11:56

 

BLAIR HODGES: And we’ll talk more about “pro-choice” as a framing of reproductive health and its shortcomings. We’ll talk about that a little bit later on. But now we come to the book itself, Unbearable: Five Women and the Perils of Pregnancy in America, and this book covers five women’s stories.

And you tell their stories from the time that they discover they’re pregnant, through the pregnancy, to labor and delivery, and then in the aftermath of labor and delivery. And we get to meet these women as their stories progress. It’s a complicated narrative where you’ve woven them all together. I thought it was skillfully done.

IRIN CARMON: Thank you.

BLAIR HODGES: Did that choice come early on, how to tell their stories that way?

IRIN CARMON: No, it was very late, and it involved a lot of Post-it notes. [laughter]

I mean, I knew that there were people I wanted to talk to. I knew that there were places I wanted to go. I knew that there were histories and ideas that I wanted to explore, but I did not know how it was all going to come together narratively.

And, you know, I guess early on I thought maybe I was going to track the book by weeks of pregnancy in the same way that Samuel Alito, in the Dobbs decision, tracks fetal development. But it wasn’t so easy, because at first I worried that because the pregnancies didn’t occur at the same time, it would be confusing, or that there would be too many people to keep track of.

And the other issue that I was contending with was that one of the women that I write about, Dr. Yashica Robinson—although she did experience a couple of pregnancies during the majority of the book’s action—you mostly experience her as someone who is fighting to make the pregnancy care system better, both as an abortion provider and as an OB-GYN delivering babies.

And I just thought, well, isn’t that confusing, because I can’t track her according to pregnancy?

BLAIR HODGES: Yeah, she’s not pregnant.

IRIN CARMON: Right. But I realized, you know, the book Evicted was a big inspiration for me in terms of its structure. And when I went back to read it for, like, the third or fourth time, I realized that one of the characters that is followed is not a tenant, even though most of them are tenants. It’s a landlord.

And through the landlord, we understand the broader system. And so I knew from the beginning that Dr. Yashica Robinson was really important to the book, because she was already, in her work, exemplifying this kind of understanding that I wanted to portray in the book of how deeply interconnected these different experiences of reproduction were.

And also to show somebody who is actually an OB-GYN who’s trying to make the system better, using all of her authority to even give some of it up, to work collaboratively with midwives.

And so, in the end, the three-part structure of the book came together toward the end, realizing that each one of these women’s stories told a different piece of the American story of pregnancy: infertility, miscarriage, criminalization, birth, racial inequality, the history of medicine.

But if I thought more expansively, it would be first who they were at the beginning of the story. That was the crux of the book. They’re navigating the health care system, including trying to make it better, but also in their pregnancy. And then everything that happened afterwards, after the sort of climactic events of the book.

And at that point it felt like, okay, now this all came together. And hopefully, when you finish reading it, you’ve seen this mosaic and you can step back and see the big picture of a very complicated story, with the through line being that America has made choices that make pregnancy more unbearable for more of us, and that none of this is inevitable.

That there’s inherent biological unpredictability of pregnancy and birth, but that so much of this is a choice. And that choice means that we don’t take the lives and the concerns and the dignity of pregnant people seriously.

BLAIR HODGES: I think this is the real power of this book, is that it shows how Dobbs, although it’s a catastrophe, is part of a bigger systemic set of issues that came before Dobbs, that came before Roe, you know, up to the present—that there are these systemic issues.

And you selected, as you mentioned, New York and Alabama. So we bounce back and forth between those states, more of a stereotypically liberal area and Alabama in the conservative South. So you’re jumping back and forth to show, hey, just because Dobbs went away doesn’t mean you’ve got these blue safe havens and these red areas of danger. There’s danger all around, and the whole system needs some help.

 

When "Life at Conception" Was Conceived – 16:12

 

BLAIR HODGES: Let’s go now to your chapter on life at conception. You already mentioned that ultrasound tech in New York who said, you know, who said, “Oh, you’ve been a little person from day one.” How did we get there?

You tell the history of how that idea even came to be, because that’s new. It wasn’t the case that everyone thought life began at what we say is conception.

IRIN CARMON: You know, there was no way to detect an early pregnancy for almost all of humanity. I mean, that is something that took place in the middle of the 20th century. And the at-home pregnancy test is something that only one or two generations have had access to.

So the way that people understood that they were pregnant was through knowledge of their own body. And throughout most of human history, our own bodies were messy, sick, unpredictable, didn’t have access to medical care, you know, could not have a period for lots of reasons, could have a late period that could be a miscarriage and you’re not really sure.

And so, in most cases, the definition of when a pregnancy began to be recognized was quickening, and that was fetal movement. So it could be halfway through a pregnancy.

BLAIR HODGES: And the woman, the pregnant person, was the expert on it.

IRIN CARMON: They were the ones who said, yes. And it was the kind of thing that, until you started showing to the outside world or reporting it to the outside world, it was your private experience.

And so the fact that you were—life at conception—there was no understanding of that. There was no way to even know when that happened. Even now, there’s no way to know when it happened. Because pregnancy is also—I mean, even unless you’re literally doing it in a petri dish—there’s a broad window of time and a broad range of possibilities about why each step can happen, whether that’s conception or a pregnancy loss. Much of this is still very mysterious.

But I think that this notion of control really comes into play around the 19th century, when the traditional experience of pregnancy—which was, again, self-reported by the pregnant woman, as it was understood at the time, and centered on being surrounded by women, including lay midwives, you know, who were trained through apprenticeship in the community and through practice—this exclusively female, local experience became superseded in the United States and in Europe by the rise of the medical field.

White men who were interested in taking over pregnancy and birth as part of a broader establishment of the medical trade. And one of the ways that they sought to gain respectability and market share for themselves was to take over birth. And the other way was to defame abortion.

And so, I mean, it’s so striking, the parallels with the current day, when you hear the fact that the anti-abortion movement was born from physicians who were capitalizing on fears that so-called aliens would overtake, quote unquote, our women in their birth rate.

BLAIR HODGES: In other words, not white people.

IRIN CARMON: Right. Not white people, or people that they didn’t consider white. Some of them would be considered white today—right? Immigrants, Jewish people, Slavic people, Italian people.

And so I think that there’s a lot of parallels to our present day. But it was really striking to me how, actually, in the 19th century, this conversation about what was abortion, what was non-abortion pregnancy care—they were all wrapped up. Because the doctor reserved the right to control how a pregnancy would go, who would attend you.

And one of the ways that they gained that control was by arguing that an embryo or a fetus was a person and that abortion should be illegal. And so abortion was not legal at the founding of the United States. All of these 19th-century abortion bans that Roe v. Wade struck down came out of this medical movement.

BLAIR HODGES: Yeah. Just to clarify, it sounded like you said it was illegal at the founding. Abortion was legal at the founding, then later on they—

IRIN CARMON: I mean, the law was silent. The law was silent. It wasn’t like you can have an abortion; it just wasn’t illegal.

But the 19th-century abortion bans were championed by doctors who were pointing out that women were choosing to have fewer pregnancies and that they should crack down on midwives and unlicensed doctors who were helping women space their pregnancies by preventing them, and by whatever methods they had for abortion at the time and that they had access to.

And so there was a eugenic and nationalist and racist agenda behind both the takeover of birth and the banning of abortion and the eradication of midwifery care, which, you know, they did the best with the tools that they had. There are lots of tools that we have now in the medical field—like antibiotics, like handwashing, like, you know, surgery—all of this that hadn’t been developed at the time.

And so the argument was, trust us. And many of these discoveries, you know, as I write about in the book—one of the powerful elements of setting the story in Alabama was that Alabama is also the birthplace of the bloody history of obstetrics and gynecology.

And one of the first presidents of the American Medical Association, and the so-called father of gynecology, whose statue still sits in front of the Alabama State Capitol, was J. Marion Sims, who invented the speculum and who experimented upon enslaved women who could not consent, had no choice in the matter, without anesthesia, without any kind of pain relief, for years.

And so the very foundation of mainstream obstetrics and gynecology was built on their bodies without their consent. And when we think about how we got the system that we have now, we do need to understand where it came from.

 

Chemical Endangerment Laws – 22:00

 

BLAIR HODGES: Another problem that you mentioned in the book is that it’s hard to pinpoint why a pregnancy terminates, right? So there are estimates like one or two out of ten pregnancies miscarry, maybe even up to a third.

So it also gets into this area of: if someone’s known to be pregnant and they miscarry, what do we do then? Did they do it? Are they supposed—was this on purpose?

And so these questions start to get asked too, the blaming women. It’s referred to by some people as the zero-trimester stuff—the things that they do before their pregnancy and early on in their pregnancy that could harm or terminate a pregnancy.

And this is where Alabama’s chemical endangerment charge comes into the story. Tell us a little bit about that and how it impacts women.

IRIN CARMON: Well, the sociologist Miranda Waggoner coined this term, “the zero trimester" for this idea in public health—a contemporary idea that you are supposed to be completely blameless and follow whatever rules, even though these rules can often shift, not just during a pregnancy, but even before.

And that if there is that kind of loss that you alluded to, that that would automatically raise questions about whether it was your fault and whether it was your conduct.

And this sounds innocent, but as I write in the book, it’s also the same rationale—again, a punitive rationale—as opposed to giving people good information about how to make the best choices that they can. And if they need help, offering them support. That would be one way to do it.

But since this is America, the mechanism by which this is enforced more often than not is punitively, either through family courts or, in the case of Alabama, criminal courts.

And so even before Dobbs—as you say, this is a long story that Dobbs did not create—even before Roe v. Wade was overturned, Alabama started prosecuting women under a chemical endangerment law that, when it was passed, was supposed to crack down on people who were supposedly taking their young children to meth labs.

Immediately, prosecutors started bringing cases against pregnant women who were accused of using drugs during their pregnancies—whether they were addicted, whether they used drugs before they knew they were pregnant.

Whether there was—in one case—a woman was arrested for this who was not even pregnant, and she was in jail for 24 hours before they bothered to check.

So again, opening everyone’s bodies and conduct up to scrutiny. And the Alabama State Supreme Court said that interpreting this child abuse law as applying to embryos and fetuses was lawful because of the unborn child, quote unquote, being equivalent to a child walking around in the world.

And they pointed out at the time that if it was up to them, this would also apply in the abortion context. At the time, we still had the guardrails of Roe v. Wade, but it did not stop women from being arrested.

Now hundreds of women have been arrested under these chemical endangerment laws, including the woman that I write about, Haley Burns, who was arrested in her son’s hospital room six days postpartum and spent months sleeping on a concrete floor.

Postpartum—she’s still bleeding from birth—and experienced a horrific punishment, really. Even though her son was doing fine. Even though what she needed was medical treatment and addiction support, not the cold floor of a jail cell.

 

What Comes First, The Fetus or the Woman? – 25:17

 

BLAIR HODGES: Right. This is one of the biggest problems that arises when life is thought to begin at conception. People begin to place the value of a fetus over the life or the reproductive health of the pregnant person, even when the fetus isn’t viable.

And this is one of—I think—one of the most shocking things, where they start to prioritize, like, okay, this pregnancy is not viable. This pregnancy will terminate. But we’re still going to treat that fetus as a more important living entity than the actual person who’s pregnant.

IRIN CARMON: Right. And I think that there are people who—that is how they conceive of their own pregnancies and their own experiences. But for the state or the doctor to impose their own definitions and meaning, and to use it to punish somebody who’s pregnant by denying them medical care or by cracking down on them legally, by tossing them into jail—it’s a kind of thinking that we are seeing now just how far it extends.

And so people who might have thought, well, this is not going to apply to me because I would never do that. I would never be addicted to opioids. I wouldn’t even—as if it’s a choice to have an addiction.

Or I would never, you know, make a decision that would endanger my pregnancy.

Well, what if somebody then comes to you and says, you shouldn’t have ridden on that roller coaster. You shouldn’t have had that glass of wine. You shouldn’t have taken—you should have taken the prenatal vitamins six months before you got pregnant. You should have known you were pregnant even though you have irregular periods.

Where does it end? Where does it end?

And then also, you know, you mentioned the emergency care. I think I talked about how AAPLOG—the American Association of Pro-Life Obstetricians and Gynecologists, a small but very powerful legal and legislative group—they explicitly say that both the doctor’s morality and the potential life of a future baby, even if it cannot be born, that any kind of complication or harm is preferable if it keeps your hands clean as a doctor from doing anything that could even look like an abortion.

And it just becomes a question of who makes that decision. If you’re given all of your informed choices and instead of the decision being made based on your own values and your own preferences and how you read the evidence, it is simply going to be: we choose the embryo or the fetus.

BLAIR HODGES: That’s Irin Carmon. We’re talking about the book Unbearable: Five Women and the Perils of Pregnancy in America. Irin is currently on staff at New York Magazine, and you might have seen her work in places like CNN, The Washington Post, MSNBC, NBC News, Salon, and Jezebel. And she’s also co-author of the New York Times best-selling book Notorious RBG.

All right, Irin, you’ve given us a preview of the next part of the book, which talks about "Taking Care." So this is more about what's happening during the pregnancy. You provide a little bit of the history of obstetrics and its racist origins, the really troubling ways this medical field arose.

These male doctors are the ones who were initially trying to ban abortion. But also abortion started making a comeback because doctors were increasingly dealing with women who had incomplete abortions, for example, or they were dealing with instances where pregnancies were terminating—a miscarriage.

And this is why abortion starts to make a comeback, because the doctors who were originally trying to squeeze it out were like, oh, it actually is more complicated.

IRIN CARMON: Right. Well, they were dealing with people who had gone to unsafe providers or who had tried to take matters into their own hands. And this is especially happening during the 1950s and ’60s. It was a leading cause of maternal mortality in cities.

There were wards that were just full of women with sepsis from complications from unsafe abortion.

And so when the Supreme Court decided Roe v. Wade, it was very much—it was a decision that was not based on the liberation of women or any ideas of equality or feminism. It was about how doctors were being prevented from providing the medical care that they saw fit.

So in that sense, it was kind of an incomplete story. But it actually shows that over the generations, medical opinion shifted because of the consequences of these abortion bans.

So maybe it’ll happen again. I don’t know. But I think that, you know, we have different technology now for abortion outside of the law. We have safer ways to do it through medication abortion.

BLAIR HODGES: Well, they’re trying to go after those too, though. So they are totally trying.

IRIN CARMON: To go after those. That’s—I’m working on reporting about that right now.

 

Yashica Robinson's Fight to Fix the Alabama System – 30:00

 

BLAIR HODGES: This is the part of the book where you introduce us to Yashica Robinson. Say a little bit more about her experiences. She’s an interesting woman—a single mom of two, I think, in Huntsville. This is an Alabama story.

IRIN CARMON: Yes. She’s not currently a single mom, but she became a mother twice before she graduated high school and still managed to graduate at the top of her class. Managed to put herself through college and medical school afterwards.

She wanted to specialize in obstetrics and gynecology, actually, because the care that she received while pregnant as a teenager was so respectful.

And so there are examples in the book of people getting care that is really respectful and great. And it made her want to do the same to girls like her and to offer that same kind of experience. And especially as a Black woman, to offer it to other young Black women, or people throughout their life cycle.

So she, from the beginning, sees abortion as just part of obstetrics, which it is, but which is just not so easy to put into practice in the political environment, even before Dobbs.

And so she ends up kind of having to fight against the tide. Providing abortions in Alabama is hard enough. The law is throwing all kinds of barriers at the clinics that have nothing to do with medicine.

You know, all these different restrictions—admitting privileges, building requirements. They’re constantly in court fighting those.

BLAIR HODGES: Just as a footnote to that, what you’re saying is when you say abortion is part of reproductive health, this is where places like Alabama have divided it away from other kinds of care and tried to make it its own thing. So it’s not happening at hospitals. They make all these special rules, like how it has to happen in this separate place with all these different requirements—there are all these hoops people have to jump through.

They basically make it virtually impossible to let it happen and cordon it off from larger reproductive health care. And this is what Yashica is saying—What the heck? Like, this doesn’t work. Why are we making it like this? Tear down that wall!

IRIN CARMON: She would like to tear down that wall, but they make it almost impossible. In parallel, she’s also learning that even attending births in the hospital and providing care to her OB-GYN patients, she comes across the same kinds of paternalistic attitudes among her colleagues, not just among lawmakers.

Where they are kind of bulldozing their patients—where her patients are crying to her about interventions that they didn’t consent to, were feeling fear, or felt like they’d been bullied by their doctors.

And she’s trying to provide an alternative. And that ends up leading her to learn more about midwifery and different models of care that are more patient-centered.

And so she realizes that with the shortages in providers, with the ways she’s seeing people getting treated in hospitals, that instead of seeing herself in opposition to midwives, as doctors historically did, she wants to work in partnership with them—where they can take care of the patients who are looking for that model and who are relatively low-risk.

And then if they need a more advanced model of care, she can step in.

But that becomes really difficult too, because when she wants to open up a freestanding birth center for patients who, again, are interested in low-intervention birth and midwifery care—and who always have the option to transfer to the hospital—she finds that the law is not interested in that either.

Because doctors see it—other doctors see it—as too much competition. And the state board of health is controlled by these doctors.

BLAIR HODGES: And there’s already anti-abortion sentiment too. So it’s like, oh, this is actually just an abortion place.

IRIN CARMON: She’s been penalized already. She’s been ostracized for being an abortion provider. But there are also other OB-GYNs and midwives in Alabama who are not abortion providers who are also not being allowed to provide this.

But it’s really driven home the parallels between the supposedly pro-life state, which won’t provide another option for pregnancy care, even though research shows that it leads to really excellent outcomes for both parents and for babies.

And that’s really driven home when they issue building regulations shortly after—coincidentally—the Dobbs decision. The building regulations for birth centers sound a lot like the ones that were imposed on abortion clinics.

So this same method of control is now being used to prevent access to safe and respectful birth care, not just abortion.

You really start to wonder, well, what is this about? Is this about being pro-life? If so, why are you not providing more options for people who do want to be pregnant that are safe and that are evidence-based?

And so she winds up having to go to court to fight that system.

And what she realizes also is that the easiest way for her to comply in the meantime—to be able to have this service as soon as possible—is to open up the birth center in the closed-down abortion clinic.

And so it ends up having this new life, where she is trying to continue to be there for her patients. It would be so much easier to practice somewhere else, and she keeps showing up for them.

BLAIR HODGES: She stays in Alabama?

IRIN CARMON: She stays in Alabama. And by opening up a birth center in the abortion clinic. And so in the book, you kind of—you see her battle. You’re sitting in the room for the trial. And by the end of the book, spoiler alert, they prevail.

 

Kirsten Clark: The Doula Who Changed – 35:16

 

BLAIR HODGES: You know what else I loved about that story was Kirsten Clark? So Kirsten Clark, if I remember correctly, was working as a doula. She was a natural birth advocate—someone who really wants low intervention and that kind of stuff, which can get associated with, like, that can go to an extreme.

Right? Like, she’s not that. She just wants women to know more about their bodies and be able to feel more in control during the process of labor and delivery.

And she is an unlikely ally to Yashica because she’s anti-abortion, right? She is not really on board with that. But she needs a doctor to help her attend to someone—I think it was during COVID.

So she’s looking for someone who’s going to be interested in this. It’s Yashica. And she would be inclined to see Yashica as like, oh, that’s kind of an abortion person. I don’t know about that.

But they get to know each other, and they both kind of change each other’s perspectives about each of their roles. This was a really beautiful story.

IRIN CARMON: I love this story because I think there’s so few—you so rarely learn about people changing their minds.

And you know, I personally don’t love the phrase “natural birth” because I think, you know, all births are natural. What is natural? But at the same time, I also think that less-medicalized birth gets a bad name by the so-called free birthers who don’t want any kind of medical care at all.

BLAIR HODGES: And they’ll even say if your baby dies, they die and just, like, release it to the universe.

IRIN CARMON: Yeah. This kind of nihilistic—it’s almost kind of, I don’t know. That is not what I’m talking about, and that is not what Dr. Robinson is talking about.

The model that they are talking about is actually much more like what happens in many parts of the world, including Western Europe, where the midwife is your threshold of care and then collaborates with the doctor.

BLAIR HODGES: Right.

IRIN CARMON: It happens to be one that leads to better outcomes, that leads to more patient satisfaction. Statistics are better. And also it is cheaper for the system, and it leads to people feeling like they’ve been heard.

BLAIR HODGES: Well, that’s what Kirsten realized, right? Was that, oh my gosh, Yashica was willing to do abortion and help with that because she listens to patients, because she knows more about reproductive health—not because she’s some sort of baby murderer. Right? That’s where Kirsten’s change happened.

IRIN CARMON: Right. Yeah. Kirsten Clark grew up going to Christian rock concerts, tabling against abortion and midwifery.

You know, it’s complicated politically because it is kind of a horseshoe, where you have home-birth midwifery on the right, in really Christian circles, as well as Orthodox Jewish circles. And then you also have a kind of lefty white version of it. You have a lefty reproductive justice version of it.

People come to it from all different kinds of backgrounds. In Alabama, the majority of the midwives are white and Christian and anti-abortion.

And so I think Kirsten Clark first came to Dr. Robinson’s work when there were people who were looking for vaginal birth after cesarean—doctors who would be willing to try labor.

And the context—all you need to know about this—is that the American C-section rate is far higher than the World Health Organization recommends. And the ability to try, if you qualify, to have a vaginal birth after cesarean could be much less risky for the patient, depending on their individual profile.

But also it’s just more complicated and requires more skill and more patience on behalf of the provider.

And so Dr. Robinson was basically the only provider in that part of Alabama who was willing to offer VBAC for patients. And so word got around in the self-described natural birth communities.

And they would say things like, well, you could get a VBAC with her, but know she’s killing babies across town. Right?

And it was when working as a doula that Kirsten saw how Dr. Robinson actually worked, how much she actually did listen to her patients. While the anti-abortion doctors—who were, you know, the medical director of the crisis pregnancy center, the activist against abortion—they were bulldozing their patients.

There was a doctor who refused to do a tubal ligation upon patient request, and later on that patient ended up needing to get an abortion. So that was beginning to change her mind—change Kirsten’s mind—about this whole thing. And she kind of went on a journey, a learning journey.

This is before Dobbs, and she realized over time that she herself was interested in not just being a doula to birthing patients, but also in attending abortions.

And they worked out a model where a local nonprofit funding structure could be set up to keep the doulas independent. And they had a rotation of people who would just automatically be assigned to be a patient advocate and support—again, not a medical provider, but just somebody to be your eyes and ears and to hold your hand if you need your hand held.

And so Kirsten went from being an anti-abortion activist to witnessing hundreds of abortions and supporting patients through it because of her encounter with Dr. Robinson.

And Dr. Robinson, having had a very conventional medical training, through working with doulas like Kirsten, saw the benefits of, when appropriate medically, lower-intervention birth, and also giving patients more time, making them feel more listened to.

BLAIR HODGES: Right.

IRIN CARMON: And that was actually how the idea of opening up the birth center came about—to create a place where you weren’t always kind of fighting with the bureaucracy of the hospital, but where you also had the expertise of an OB-GYN when you needed it.

That you could kind of have the best of both worlds. And that really—both of them kind of came to that through their relationship with each other.

 

Maggie Boyd and Christine Fields: Life and Death at Woodhull – 41:04

 

BLAIR HODGES: It’s such a good story. And we have to say there are also really difficult and tragic stories in the book.

I’m thinking of Maggie Boyd and Christine Fields. These are two women whose stories intersect. They both delivered at the same hospital, they both had extreme complications after their delivery, and they both had very different outcomes.

Give us a brief glimpse at those two stories.

IRIN CARMON: So I met Maggie through the conversation that I described. She was the one who uttered the words “child animal” to me. And when I heard her story, I found out that she had given birth at a hospital that I was already really interested in reporting on for my book. And that was a public hospital in my community known as Woodhull, which had a mixed reputation—both as being kind of a tough, under-resourced place to go to.

And I learned during my reporting in COVID that it was also a place where people went because they did want midwifery care in a hospital. And it was really hard to get, for all these historic reasons that I lay out.

Maggie had ended up at Woodhull because she transferred from the one and only birth center here in New York City. Even in a blue state, it can be really, really hard to keep these places open—or even open them in the first place.

And her problem ended up not being the midwifery care that she got, but the complications and the negligence and harm that she experienced from a botched C-section.

And she explained to me that when her husband called for help, it was the only thing that saved her life. He was in an extended back-and-forth with the doctor, who insisted that everything was fine.

BLAIR HODGES: And he could tell she was dying. Like, she did not look good.

IRIN CARMON: In reality, she was hemorrhaging, and she needed a full-body blood transfusion. The only thing that saved her life was that when he screamed, he was listened to.

And I was horrified by the story. But I also really wasn’t sure how to fit it into the broader matrix of this experience. Like, it’s so awful what happened to her—what does it mean?

And two months after we had that conversation—like, what does it tell us about the hospital? What does it tell us?

And I was also really interested in Maggie’s story because she came from Canada and she moved here for love. And she was completely flummoxed by the American system of health care and insurance.

BLAIR HODGES: And I don’t blame her, because we’re all flummoxed too.

IRIN CARMON: Yeah. And to have actually lived the alternative—you know, she came from a country that was single-payer, where midwifery is not so hard to find, where there’s not a huge inequality in going to one hospital versus another.

So she very much wanted to go to a hospital or caregiver in her community and only switched to the birth center because somebody told her, “You’re not going to find what you’re looking for here.” It was too callous. It was too impersonal.

She ends up kind of being bounced around from provider to provider. And she survives to tell the tale, but has lifelong hormonal damage and repercussions—complications in subsequent pregnancies.

And two months after we had that conversation, Christine Fields, a healthy 30-year-old Black woman who had just put herself through college by working two jobs, who had overcome a lot of challenges in her childhood, who had fallen in love with a wonderful man named Jose Perez and was excited to be pregnant with their second child together, went to Woodhull to give birth. Had, I discovered, the same doctor and the same botched closing up of the incision.

BLAIR HODGES: Yeah. He closed them up while they were bleeding internally. 

IRIN CARMON: He did not properly close the suture so they bleed internally. He does not report his mistake, which he tries to correct. So he clearly knew there was a mistake. And while Jose is in the NICU with their baby, Christine is abandoned.

And throughout the process of the day—in which, you know, an emergency C-section is called and she’s resisting it and she doesn’t feel safe and she doesn’t feel trust in the situation—this is the hospital where she was born.

Every time Jose tried to advocate for her, they call security on him. They restrain him. They don’t allow him in the room for the C-section.

All of these ways in which, from the beginning, there was disparate treatment of the two of them—a Latino man and a Black woman—compared to Maggie and Matt, who experienced something horrible, but again were listened to when they asked for help.

And so when Jose comes to Christine after being with the baby and going to get some snacks, something to drink—because it’s been like a two-day ordeal—he comes back and Christine has been completely abandoned by the nurses.

She’s not being checked up on, as the standard of care. Her lips are gray, and they have not noticed that, in her disorientation because she was hemorrhaging, she has ripped out the IV cords from her arm and she’s completely dehydrated. And subsequently, Christine is pronounced dead after some interventions that they try to save her.

And they try to drag Jose away. You know, they try to just—and they won’t let him take home his baby. And he comes home, and they lock him out of his apartment because Christine was on the lease. They locked the children out of the apartment.

And so every step of the way is compounded by a toxic cocktail of racism and classism, on top of the horrific treatment that Christine received as a pregnant Black woman.

And so this statistic that we hear about Black women being likelier to die than white women, I discovered, was just kind of laid bare by the two of them.

Both of them just seeking to bring a child joyfully into the world, and instead experiencing this grievous harm—but not in the same way.

 

The Reproductive Justice Movement – 46:35

 

BLAIR HODGES: And this is a big crux of the book, where you recognize how racism fits into this as you trace the history.

The first abortion bans in the 19th century were fueled by alarm that white women were being "outbred" by "lesser beings," as they thought. Which, you know, it was racism.

And then a century later, anti-abortion rhetoric again pitted innocent babies against self-centered, evil white women—like, oh, they just want to party and be sexually active and then abort their babies. So that was kind of the rhetoric then.

But in between those two poles, you talk about how the demonization of Black pregnant women in particular created legal ways, and how medical providers got involved and how prosecutors got involved, to control women’s bodies.

So now it’s coming full circle. And now white women as well are really getting the brunt of what was put into place by anti-Black systems. Right?

IRIN CARMON: Yeah. I think this really comes into play with the prosecutions of pregnant women and the arrests, like Haley’s story, because the seeds of that were planted with the crack epidemic and the demonization of so-called crack babies and their selfish mothers.

Haley, who I write about, is white, and the majority of the arrests in Alabama are of white women. But reproductive justice scholars like Dorothy Roberts warned that Black women were the canary in the coal mine when it came to reproductive control.

And what was being tested out on Black women would eventually expand further.

When it comes to Christine and Maggie, I think the canary in the coal mine is a profound disinvestment in our public health system—in public hospitals.

You know, here in New York, we have some of the most celebrated and wealthy hospitals in the world, but we don’t talk about what happens in the hospitals that the majority of people of color go to in the outer boroughs, which suffer from a pattern of disinvestment.

The doctor that operated on Christine—by that point, he was 72 years old. He had asked not to work night shifts. They put him on night shifts anyway.

BLAIR HODGES: Wasn’t he recovering from COVID or something too?

IRIN CARMON: Yes. He had been hospitalized for COVID. So there was a deep element of interpersonal racism in a lot of the treatment that they had from the beginning until the very end.

But then it was also operating in a context where the hospital had experienced an exodus of staff, where bad doctors were tolerated because they were worried that they couldn’t get any doctors.

The doctors who worked there were paid less. There aren’t a lot of places in New York where midwives can work in hospitals and really feel like they can call the shots, relatively speaking.

And a lot of the midwives who work at Woodhull—the reason it had the reputation that it did—are really mission-driven. They really wanted to provide better care to communities that needed it and didn’t get it a lot.

But the doctors—at least some of them, according to my reporting—many of them were just there because they couldn’t get a better job.

And I would just say that this is systemic racism. You know, this has been tolerated.

During the time that I write about, I write about the deaths of three different Black women at Woodhull in a very short period of time, between 2020 and 2023.

There is research that shows that part of the racial gap in maternal mortality can be attributed to the hospitals that Black women go to, and that if you go to a hospital that predominantly serves other Black women, you are likelier to have a bad outcome.

That doesn’t mean that if you go to a predominantly white hospital you’re not going to also have challenges like interpersonal racism, but that the resources, if you have an emergency—or the way you’re treated from the beginning, the level of care that you receive—is so racialized, again, because of structural racism.

BLAIR HODGES: And let’s take one more second to expand on the difference between the reproductive justice movement compared to, let’s call it, pro-choice feminism. Right? Just unpack that a little bit more.

IRIN CARMON: So about 30 years ago, Black women created the phrase "reproductive justice" to describe a broader, more holistic, more intersectional vision of reproductive freedom and access.

It was not merely focused on a narrow idea of "choice"—it included abortion rights, but wasn’t solely focused on it. It included the right to prevent a pregnancy, but also to be pregnant, and to stay pregnant, and to raise your children in a safe environment.

I think Dr. Robinson’s work is both deeply informed by and a really on-the-ground example of reproductive justice in action.

Jose, Christine’s surviving partner, has also become involved in reproductive justice work since Christine’s death. Some of it happened after the book was published.

So to provide an update on that: He not only has served as a kind of informal community advocate—I write in the book about how he ends up blowing the whistle and reporting on another Black woman who dies at Woodhull one year after Christine.

He’s actually the one who ends up tipping off The New York Times. He helps organize a press conference. He supports the family. He’s mentoring other bereaved fathers who have lost their partners to medical racism and maternal mortality.

And since I finished writing the book, Jose has actually become a doula. He’s trained through a program that is specifically aimed at helping support dads as they support their partners through hospitals.

He’s speaking to medical students. He’s helping train them on racism and on reproductive justice.

And so it’s incredible, because he’s also been navigating all of these hostile systems. He was not in the advocacy world before, but he’s really kind of found his voice.

And he is doing incredible work while also raising his children, two of whom are five and under. Christine’s son, who she was giving birth to when she was killed, is now two years old.

BLAIR HODGES: Well, I love the coverage that you gave to reproductive justice.

One of my favorite things about doing this podcast has been—I would even call it a conversion—from pro-choice feminism, which has its benefits, to a broader reproductive justice feminism.

And I hope to cover this more in future episodes. But this book is an important one for people to read so that they can learn more about reproductive justice and the women of color who have pioneered that perspective.

It includes abortion access and things like that, but it’s broader than that and really encompasses things that will help anyone who becomes pregnant. So thank you for covering that in this book. I thought you did a great job.

IRIN CARMON: Thank you.

BLAIR HODGES: That’s Irin Carmon. We’re talking about Unbearable: Five Women and the Perils of Pregnancy in America. Irin is an award-winning senior correspondent at New York Magazine, writing about gender, law, and politics.

 

Grappling with the Work Ahead – 53:33

 

BLAIR HODGES: I’ve seen criticism of your work, of your reporting and of this book, as fear-mongering—as exaggerating worst-case scenarios, as being part of this leftist movement to discourage people from having kids and scare people. What do you say to those kinds of critiques?

IRIN CARMON: I don’t think we should infantilize people who can become pregnant by withholding information that is factual. The CDC says 80% of maternal mortality is preventable. And that doesn’t even count maternal morbidity, which is serious complications from pregnancy.

I think without recognizing the reality of all of the different ways in which pregnancy has become more dangerous, more restricted as a result of abortion bans—but also as a result of the way the medical system is constructed—people are not going to feel safe making this decision.

I mean, there is research showing that, unrelated to any reporting that I did or book that I wrote, Dobbs made people less likely to want to have children because of stories of real people in the world—stories that some would rather pretend are not happening—experiencing harm, even in ways that were not technically related to abortion.

So I guess I just feel like people know when you’re trying to infantilize them or trick them, and they’re not buying it. We need more reporting. We need more honesty. We don’t need people just being told, “Oh, just have a baby and smile.” We know that doesn’t work.

BLAIR HODGES: It’s so silly to be like, oh, you’re just highlighting the few really terrible things that definitely can happen. Yeah, like, that’s not a good argument.

Like, hey, you’re just scaring people with actual stories of real people who die and stuff like that. So, yeah, it’s bad faith. I see it as just sort of pundit deflection, and it doesn’t grapple with the arguments that you make in the book.

And that’s what we need people to do.

IRIN CARMON: Yeah.

BLAIR HODGES: So, Irin, I feel like the setbacks that we’re facing today—like the rolling back of Roe v. Wade—my fear is that we’re just going to claw and fight to get back to that already problematic status quo.

Like, now we’re set back even further. So is there a reason to see it differently? Is there a reason for hope? What are we fighting for at this moment?

Is it just to get something like Dobbs overturned? Like, what are you seeing for our future?

IRIN CARMON: I do think that when so much is lost, it’s important to listen to people who are working in the states where so much was already lost.

And so I’m thinking about when I mentioned Dr. Robinson and the work that she’s doing. She’s now partnering with the Yellowhammer Fund, which is an abortion fund, to help support the training of more midwives and more reproductive justice work in Alabama.

It’s like, what does it mean to keep showing up even though your lawmakers don’t represent you? They are actively fighting against your values. They’re actively harming people who you are trying to help.

And I think the answer right now is that kind of on-the-ground, grassroots work—drawing attention to it, supporting it, understanding that it’s going to be a very long strategic game.

Even the goal of overturning Dobbs, with the current composition of the Supreme Court, is a very long-term project.

BLAIR HODGES: Or you expand the court, but who knows if—

IRIN CARMON: Yeah. Well, all of that is not happening tomorrow. But what is happening tomorrow is that people are getting pregnant, and they need help.

And so I think in the short term, what I’m hoping people take away from the book is that there are people already putting these ideas into action.

Abortion rights are not in a vacuum. Birth justice is not in a vacuum. Infertility, loss, criminalization—these are all interconnected. They’re about the dignity and the safety of pregnant people and people who can become pregnant.

So I think really supporting that on-the-ground work—again, really lifting up folks like Jose and Dr. Robinson—in the short term.

And then also, as I mentioned, thinking about, okay, if this model that we have is getting basically dismantled, what would be a better model? What would it look like?

BLAIR HODGES: Right.

IRIN CARMON: Can it at least—in places where people do have access to resources—can we imagine more models like what Dr. Robinson would do in an ideal world?

Which is midwives and doctors working together, abortion provision not being cordoned off from everything else.

BLAIR HODGES: More providers, as well

IRIN CARMON: More providers. Well, more providers also would mean that doctors wouldn’t be fighting midwives from even having any kind of market share, even as maternity wards are closing all over the country.

BLAIR HODGES: Yeah. So they’re fighting for market share, but then they’re also trying to crank deliveries out—rushing C-sections and stuff.

IRIN CARMON: Yes, yes, absolutely.

And I think—and also, you know—what we’re actually seeing is people are choosing to become pregnant or stay pregnant a lot less.

They’re voting with their feet, and they’re citing the fears that they have about the post-Dobbs medical environment.

We also have OB-GYNs who don’t want to work in or match into red states because they don’t want to have these kinds of horrific medical experiences. And I don’t blame them.

But it exacerbates this patchwork of care.

BLAIR HODGES: Idaho has had a huge exodus of providers, for example.

IRIN CARMON: Yep. And they went all the way to the Supreme Court for the right to deny emergency care.

BLAIR HODGES: Unreal.

IRIN CARMON: So I think seeing these kinds of interconnections, having these conversations with people where, actually, you scratch the surface—just like me at that preschool picnic—you find out that more people than you realize have experiences that put them in the shoes of feeling like they were treated like less than a person when they became pregnant. Even if they were excited about it.

And then supporting this kind of grassroots work I think is really, really important.

BLAIR HODGES: Okay, correct me if I’m wrong, but you don’t particularly sound hopeful. You sound determined. Is that a fair distinction?

IRIN CARMON: Yes. I’m very tentatively hopeful. At the moment that you and I are speaking right now, I think people on the national level see what is going on, and they’re not happy with it. You know, people are pushing back at the kidnapping and the jailing of our neighbors—our immigrant neighbors. There are people pushing back against that. There are people who are unhappy with the status quo.

And, you know, I don’t even know what to say about the fact that this so-called pro-life administration is actively harming babies by its anti-vax guidelines and messaging. But I don’t think that the American public likes it. And I don’t think that they like abortion bans. And so I think I’m optimistic that people are seeing this for what it is.

There was this moment at the beginning of 2025—I mean, it’s crazy what a year 2025 has been—where the so-called vibe shift was like, the resistance is dead. There’s no more resistance. As though Democrats and progressives pushed too far on abortion and trans issues and immigration and crime.

But I think the right showing its true face on this is so deeply distasteful to the vast majority of people. Most people are not trolls on X.

BLAIR HODGES: Right.

IRIN CARMON: Most people don’t want to see women bleed out.

And so I think if we can keep at least a semblance of a democracy, people are pushing back at this. They don’t want to see it. And that’s one of the reasons why they’re being so chaotic and roughshod—because they don’t want people to see it for what it is.

I’m actually optimistic, in a broad sense outside of the reproductive justice space, that people are starting to recognize this for what it is and use their voices to say that they don’t like this.

BLAIR HODGES: That’s Irin Carmon. We’re talking about Unbearable: Five Women and the Perils of Pregnancy in America. And we’ll be right back with regrets, challenges, and surprises after this.

 

Promo Break – 01:01:16

 

BLAIR HODGES: Hey, everybody. I wanted to take a quick second to say that if you’re enjoying this show, I have another podcast to recommend that I think you might enjoy. It’s called What Your Therapist Thinks.

This is a mental health show where actual licensed therapists come on and open up about what they’re really going through, what they’re thinking about as you’re sitting across from them.

And if you haven’t been in therapy or you haven’t been in a while, I think the show will give you a really nice inside look at what to expect and the kind of insights that you can get from therapy on things like performance anxiety and why people cheat, what people-pleasing really looks like and how to deal with it, what’s up with ketamine therapy, and a lot more topics besides.

So two things kind of make this a standout show for me. The first is that co-host Felicia Keller Boyle is a licensed therapist. So I like having somebody who’s trained and has professional obligations on board to speak to the best thinking in the field and kind of, you know, do best-practices-type stuff. And I put a lot of stock in people who have that kind of training and background.

And also her co-host, Christy Plantinga, is sort of a stand-in for people like me. I’m not a therapist, I’m not trained, but I’m interested in mental health. That’s kind of what Christy does for the show.

They’re a dynamic duo, and I really love the conversations that they have with other licensed mental health professionals that they bring on in each episode.

So if that sounds like something you’d be interested in, again, I recommend you check it out wherever you get your podcasts. It’s called What Your Therapist Thinks.

Now let’s get back to our interview with Irin Carmon, talking about the book Unbearable: Five Women and the Perils of Pregnancy in America.

 

Regrets, Challenges, & Surprises – 01:02:38

 

BLAIR HODGES: Irin, I always like to close interviews talking with the author about the process of writing their book. So the book’s out in the world now. I wonder if there’s anything you would change about it.

And, you know, once it goes to press—it’s been a while since you put your work down, right? Is there anything that came up where you were like, I wish I did this differently?

Or what was the hardest part about writing it? Or was there anything surprising that you learned while doing this project that changed your mind about anything?

You can pick any of those—kind of wherever the best story is.

IRIN CARMON: Basically, a challenge that comes with writing a book like this is that it is hard to see the reality of pregnancy in America for what it is, because it is a difficult story.

And I think it is a challenge to balance the fact that pregnancy can often involve joy and happiness, as it did for me for both my pregnancies, while also not insulting people’s intelligence and saying, you know, here are all the ways in which America makes it more difficult than it needs to be.

The challenge is people being like, that sounds important, but really hard. I don’t think I want to read a book that’s really hard.

But I do really feel like until we recognize this for what it is, we can’t make it better. And it could be so much better.

And I do think that we can be optimistic—not necessarily about, like, a politician or even a policy, even though there are amazing, great ideas about it—but we have to be optimistic about people being better than this and not wanting this to be the reality.

That once people understand the realities of how America treats you when you’re pregnant—whether you want to have an abortion, whether you want to give birth, whether you’re trying to get fertility treatment or miscarriage care or you need addiction care—that these are all choices that have nothing to do with the biological unpredictability of pregnancy.

So it is challenging, I think, to tell a nuanced story about that—one that takes into account what’s difficult, but also is hopeful in the sense that, you know, people helping each other makes me hopeful. People supporting each other and having empathy for each other makes me hopeful.

So I talk about the people in my book that I’m really hopeful about. I learned from a lot of thinkers, and that makes me hopeful.

But I also understand that we live in a really depressing time, and people are like, oh God, I know that’s hard. But I promise it’s worth it, because if we don’t recognize the problem, we can’t make it better.

BLAIR HODGES: Well, the book is hard-hitting. Like, there are difficult things in this book, but we also do need to reckon with the tough stuff.

I think you did a great job in the book carrying the heavy stuff lightly—bringing it to us in a way that’s like, we’ve got to learn from this stuff. We have to face it, but we also can’t let it defeat us and make us give up, basically.

So that’s how I felt reading this book.

IRIN CARMON: I appreciate that. I like how you said that.

BLAIR HODGES: All right, well, Irin, thanks for joining us on Relationscapes. I highly recommend the book.

IRIN CARMON: Thank you so much. I really appreciated our conversation.

 

Outro – 01:05:31

 

BLAIR HODGES: Thanks for listening to another episode of Relationscapes. I was wondering if you’d do me a favor and take a second to rate and review Relationscapes in Apple Podcasts. I ask this in every episode, and occasionally some of you go do it, which is awesome. I love reading these reviews as they’re coming in.

Let’s take a look at one that we got recently here. I didn’t pick one out—let’s just pick a random one: jared_in_TX. All right. What does jared_in_TX say?

“One of my favorite things about Relationscapes is all the different people I get to 'meet' while listening. So many different stories and perspectives, and I enjoy Blair’s preparation to be able to provoke thoughtful discussions.”

All right. Hey, jared_in_TX, thank you so much. Thanks for leaving that review from the Lone Star State.

And if you’re in the Lone Star State, like Jared, leave a review and tell me what you think of the show. And if you’re not in the Lone Star State, leave me a review as well.

You can also rate the show in Spotify, by the way. It’s a little bit easier to do that. But it all matters. I love you wherever you’re listening from, so stick around or check out past episodes.

Mates of State provides our theme song. I’m journalist Blair Hodges in Salt Lake City, and I’ll see you on another episode of Relationscapes soon.

 

Note: Transcripts are lightly edited for readability. Check the transcript against the audio for accuracy.