Interview with Jennifer Block, Author of “Pushed”

Amie Newman

Amie Newman interviews Jennifer Block about her new book "Pushed: the Painful Truth About Childbirth and Modern Maternity Care," taking us on a sincere truth-seeking expedition to discover why childbirth has become "medicalized" around the United States.

Jennifer Block, a former editor at Ms. Magazine as well as an editor of the revised Our Bodies, Ourselves, has clearly devoted herself to uncovering the obstacles to ensuring women's health and health care access in this country. Block's first book, "Pushed: The Painful Truth About Childbirth and Modern Maternity Care," takes you on a sincere truth-seeking expedition to discover why childbirth has become "medicalized" around the United States. As you wind your way through hospital halls and birth centers, listening in on interviews with midwives, OB/GYNs and childbirth advocates, Block uses meticulous research to paint a picture of a world where women are encouraged to disconnect themselves from their own bodies, rely on "modern" medical intervention for labor and delivery, and where hospital personnel are pushed to advocate for speed and profit over maternal and baby health.

AN: Why did you write this book?

JB: I get that question a lot—you've never given birth, why a book about childbirth? I've always been interested in women's health, in how we experience our bodies, the healthcare system, and in how politics so often affects our health and our healthcare. Childbirth never struck me as a political issue, but it turns out that it very much is. And I think it's important to know just how it affects the kind of care women receive, and what birth options they have or don't have. So I wrote the book to shed light on the reality of the U.S. maternity care system, which is not serving women and babies as best it could.

AN: What do you see are some of the root causes for, according to you, "overusing medical technology at the expense of maternal and infant health"? Have we (women) become less comfortable with and confident about our own bodies and our ability to birth naturally?

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JB: I would agree that there has been a collective loss of confidence in the female body's ability to give birth, and a quiet acceptance of surgical birth as the solution. Having said that, however, I think we still have to ask how much of this system women are choosing, and how much is beyond their control. The women I've talked to overwhelmingly just want what's best for themselves and their babies.

When women agree to, say, induce labor because they're "overdue," or to schedule a cesarean because they're told the baby has grown too big (both are common reasons) those might be considered "patient choice" procedures, but we need to ask what kind of information they were given about the risks and benefits. The fear of a lawsuit and the financial pressures exerted by malpractice premiums drive physicians to intervene more. Many doctors told me that they are moving to cesareans more quickly because "you don't get sued for doing a cesarean."

At the same time, women are just bombarded by messages that our bodies don't work, that physiological childbirth isn't important. And the cesarean trend feeds this doubt, because women begin to think that if one-third of their sisters can't do it, then maybe they can't either. The fact is, we know from studies of healthy women who labor and give birth in supportive environments, with care providers who are trained to support the physiological process, 95% can birth vaginally. And that's optimal, for both mother and baby. The cesarean trend does not represent necessary cesareans.

AN: You address the issue of women seeking a vaginal birth after a cesarean (VBAC) in your book. Can you tell us a little bit about why VBACs are controversial? And why you believe this to be a reproductive "choice" issue?

JB: VBACs are controversial because they put doctors at risk of a lawsuit they can't defend, and because the American College of Obstetricians and Gynecologists has set a standard of care that is nearly impossible for physicians to meet. I explain more in the book, but the result has been that hundreds of hospitals have banned VBACs, and many doctors are refusing to attend them altogether.

The best data we have say that 1 in 2000 VBACs will result in the death or severe brain damage of the baby. That's an outcome that nobody wants, of course. But the reality is that the chance of a baby not making it through a first-time vaginal birth is about the same. One prominent OB/ethicist calls the VBAC hype a "distortion of risk."

So the decision of whether to plan a vaginal birth or a repeat cesarean is one that women need to make with full, unbiased information. But for many women, there is no choice. A recent survey found that more than half of women seeking a VBAC were denied it by their provider or hospital. Many, many women are being told they must have surgery – a clear violation of their constitutional rights.

AN: You tell the story of a man in Seattle who handcuffed himself to his wife's maternity bed so that he could be with her during the birth of their child. Washington State has been on the forefront of licensed midwifery. However, in Seattle, where I live, our second longest-running independent midwifery practice is only seven years old. Many have been forced to close—or have chosen to close—because of rising malpractice rates or are being "pushed" out by the mainstream medical movement. Can you elaborate on the "midwifery strain" and the discrepancy you uncovered in the ways in which midwifery is treated in this country from state to state?

JB: Midwives are a vital part of maternity care around the world. The World Health Organization has called them the most appropriate care providers for women experiencing normal pregnancies and births. They provide the bulk of care throughout Europe, and yet here in the U.S., Certified Nurse-Midwives are constantly fighting for coverage from Medicaid and private insurance while battling sky-high malpractice rates. At the same time, Certified Professional Midwives, who attend births out of the hospital—in birthing centers or in women's homes—find that in about ten states their job is illegal. For consumers it is a terribly confusing system. In New Mexico, for instance, you can choose a home birth with a midwife and Medicaid will cover it; in Illinois, you have to go "underground" and find an illegal provider. Midwifery care both in and out of hospital has been studied extensively and shown not only to be safe, but more likely to result in a healthy, vaginal birth. And yet in the U.S., we are driving midwives out of practice and underground.

AN: Did you research or uncover distinctions between upper-and middle-class women and their childbirth experiences and lower-income women's childbirth choices and experiences?

JB: The media often present obstetric trends as consumer trends, but the research (not mine, but large studies by CDC epidemiologists and public health researchers) actually shows that the rising cesarean and induction rates have little to do with women's bodies or choices, and more to do with changes in the way OBs practice. For a while there was a perception that high cesarean rates were specific to a white/wealthy demographic (one theory was that women with private insurance were more likely to be sectioned) but this isn't true today. Black women are generally more likely to give birth via cesarean. A recent survey actually found that almost half of first-time black mothers had given birth surgically.

One major difference between low-income women and high-income women, however, is that low-income women generally have fewer options to raise their standard of care. Doulas, who provide birth support and patient advocacy, cost between $500 and $2000 out of pocket. A home birth with a certified midwife can be anywhere from $1500 to $5000 [Editor's Note: in some states, as referenced above, midwifery care is covered by Medicaid for those who qualify]. So women who would otherwise choose a midwife often go with the care covered by their insurance because they can't afford otherwise.

AN: I know you spent a lot of time doing field research, watched many babies being born, and spent time with many laboring mothers. Was there one story or situation that particularly moved you?

JB: I did see a number of births, and I found them all moving in various ways. I like to tell the story of the very first birth I saw, because it was such a surprise. I was expecting to see what most of us think of as "normal" birth—woman lying flat on her back, people yelling "Push!", woman screaming, then baby screaming. I got quite a re-education. First of all, the woman gave birth standing up—I barely saw the baby coming out! The whole event was so much more peaceful than I'd imagined. The baby hardly cried, the mother was certainly experiencing pain, but the contractions looked more like hard work than anything else. There was hardly any medical intervention. Afterward, her family brought in a roast chicken and they had a party. Six hours later she went home. This is about as optimal as it gets, but this was in an independent birth center run by certified professional midwives. It's unfortunately not the norm.

AN: You say that this issue needs to be addressed as a significant women's rights issue. How can the women's movement/feminism address this issue more thoroughly? What do we need to do?

JB: Childbirth was an issue that feminists took up in the 70s and 80s, and some change happened. Even in the mid 1990s, a coalition of groups published a position paper calling for an overhaul of the maternity care system. But the issue has largely been dropped, and the focus is on preserving a woman's right to prevent pregnancy or terminate pregnancy, rather than on what happens when women choose to carry a pregnancy to term. In January, the National Advocates for Pregnant Women held a tremendous conference and challenged the pro-choice movement to advocate for pregnant women's rights, not just abortion rights. I strongly agree. I think the VBAC ban is the most salient issue, and women's health groups need to stand up and hold physicians, insurers, and hospitals accountable for effectively forcing women into unwanted surgery. But there's a much larger issue of women's access to optimal maternity care that feminists need to address. Some women are going to great lengths to access support for physiological birth, meanwhile most women are getting care that is not evidence-based and more likely to cause themselves or their babies harm. This should be of major concern to feminists. Women deserve better.

Commentary Violence

This is Not The Story I Wanted—But It’s My Story of Rape

Dani Kelley

Writer Dani Kelley thought she had shed the patriarchal and self-denying lessons of her conservative religious childhood. But those teachings blocked her from initially admitting that an encounter with a man she met online was not a "date" that proved her sexual liberation, but an extended sexual assault.

Content note: This article contains graphic descriptions of sexual violence.

The night I first truly realized something was wrong was supposed to be a good night.

A visiting friend and I were in pajamas, eating breakfast food at 10 p.m., wrapped in blankets while swapping stories of recent struggles and laughs.

There I was, animatedly telling her about my recently acquired (and discarded) “fuck buddy,” when suddenly the story caught in my throat.

When I finally managed to choke out the words, they weren’t what I expected to say. “He—he held me down—until, until I couldn’t—breathe.”

Hearing myself say it out loud was a gut-punch. I was sobbing, gasping for breath, arms wrapped as if to hold myself together, spiraling into a terrifying realization.

This isn’t the story I wanted.

Unlearning My Training

I grew up in the Plymouth Brethren movement, a small fundamentalist Christian denomination that justifies strict gender roles through a literal approach to the Bible. So, according to 1 Corinthians 11:7, men are considered “the image and glory of God,” while women are merely “the glory of man.” As a result, women are expected to wear head coverings during any church service, among other restrictions that can be best summed up by the apostle Paul in 1 Timothy 2:11-12: Women are never allowed to have authority over men.

If you’ve spent any number of years in conservative Christianity like I did, you’re likely familiar with the fundamentalist tendency to demonize that which is morally neutral or positive (like premarital sex or civil rights) while sugar-coating negative experiences. The sugar-coating can be twofold: Biblical principles are often used to shame or gaslight abuse victims (like those being shunned or controlled or beaten by their husbands) while platitudes are often employed to help members cope with “the sufferings of this present time,” assuring them that these tragedies are “not worthy to be compared with the glory that is to be revealed to us.”

In many ways, it’s easy to unlearn the demonization of humanity as you gain actual real-world experience refuting such flimsy claims. But the shame? That can be more difficult to shake.

The heart of those teachings isn’t only present in this admittedly small sect of Christianity. Rather, right-wing Western Christianity as a whole has a consent problem. It explicitly teaches its adherents they don’t belong to themselves at all. They belong to God (and if they’re not men, they belong to their fathers or husbands as well). This instilled lack of agency effectively erases bodily autonomy while preventing the development of healthy emotional and physical boundaries.

On top of that, the biblical literalism frequently required by conservative Christianity in the United States promotes a terrifying interpretation of Scripture, such as Jeremiah 17:9. The King James Version gives the verse a stern voice, telling us that “the heart is deceitful above all things and desperately wicked.” If we believe this, we must accept that we’re untrustworthy witnesses to our own lives. Yet somehow, we’re expected to rely on the authority of those the Bible deems worthy. People like all Christians, older people, and men.

Though I’ve abandoned Christianity and embraced feminist secular humanism, the culture in which I grew up and my short time at conservative Bob Jones University still affect how I view myself and act in social situations. The lessons of my formative years created a perfect storm of terrible indoctrination: gender roles that promoted repressed individuality for women while encouraging toxic masculinity, explicit teaching that led to constant second-guessing my ability to accurately understand my own life, and a biblical impetus to “rejoice in my suffering.”

Decades of training taught me I’m not allowed to set boundaries.

But Some Habits Die Hard

Here’s the thing. At almost 30, I’d never dated anyone other than my ex-husband. So I thought it was about time to change that.

When I found this man’s online profile, I was pleasantly surprised. It was full of the kind of geekery I’m into, even down to the specific affinity for eclectic music. I wrote to him, making sure my message and tone were casual. He responded instantly, full of charisma and charm. Within hours, we’d made plans to meet.

He was just as friendly and attentive in person. After wandering around town, window-shopping, and getting to know one another, he suggested we go to his favorite bar. As he drank (while I sipped water), he kept paying me compliments, slowly breaking the touch barrier. And honestly, I was enthralled—no one had paid attention to me like this in years.

When he suggested moving out to the car where we could be a little more intimate, I agreed. The rush of feeling desired was intoxicating. He seemed so focused on consent—asking permission before doing anything. Plus, he was quite straightforward about what he wanted, which I found exciting.

So…I brought him home.

This new and exciting “arrangement” lasted one week, during which we had very satisfying, attachment-free sex several times and after which we parted ways as friends.

That’s the story I told people. That’s the story I thought I believed. I’d been freed from the rigid expectations and restraints of my youth’s purity culture.

Now. You’re about to hear me say many things I know to be wrong. Many feminists or victim advocates almost certainly know the rationalizations and reactions I’m about to describe are both normal responses to abuse and a result of ingrained lies about sex in our culture. Not to mention evidence of the influence that right-wing conservatism can have on shaping self-actualization.

As I was telling people the story above, I left out important details. Were my omissions deliberate? An instinctive self-preservation mechanism? A carryover from draconian ideals about promiscuity?

When I broke down crying with my friend, I finally realized I’d kept quiet because I couldn’t bear to hear myself say what happened.

I’m a feminist, damn it. I left all the puritanical understandings of gender roles behind when I exited Christianity! I even write about social justice and victim advocacy. I ought to recognize rape culture!

Right?

If only being a socially aware feminist was enough to erase decades of socialization as a woman within rape culture—or provide inoculation against sexual violence.

That first night, once we got to my car, he stopped checking in with me. I dismissed the red flag as soon as I noticed it, telling myself he’d stop if I showed discomfort. Then he smacked my ass—hard. I pulled away, staring at him in shocked revulsion. “Sorry,” he replied, smirking.

He suggested that we go back to my house, saying we’d have more privacy than at his place. I was uneasy, unconvinced. But he began passionately kissing, groping, petting, and pleading. Against my better judgment, I relented.

Yet, in the seclusion of my home, there was no more asking. There was only telling.

Before I knew it, I’d been thrown on my back as he pulled off my clothes. I froze. The only coherent thought I could manage was a weak stammer, asking if he had a condom. He seemed agitated. “Are you on birth control?” That’s not the point! I thought, mechanically answering “yes.”

With a triumphant grin and no further discussion, he forced himself into me. Pleasure fought with growing panic as something within me screamed for things to slow down, to just stop. The sensation was familiar: identical to how I felt when raped as a child.

I frantically pushed him off and rolled away, hyperventilating. I muttered repeatedly, “I need a minute. Just give me a minute. I need a minute.”

“We’re not finished yet!” he snapped angrily. As he reached for me again, I screeched hysterically, “I’M NOT OK! I NEED A MINUTE!”

Suddenly, he was kind and caring. Instead of being alarmed, I was strangely grateful. So once I calmed down, I fucked him. More than once.

It was—I told myself—consensual. After all, he comforted me during a flashback. Didn’t I owe him that much?

Yet, if I didn’t do what he wanted, he’d forcefully smack my ass. If I didn’t seem happy enough, he’d insistently tell me to smile as he hit me again, harder. He seemed to relish the strained smile I would force on command.

I kept telling myself I was okay. Happy, even. Look at how liberated I was!

All week, I was either at his beck and call or fighting suicidal urges. Never having liked alcohol before, I started drinking heavily. I did all I could to minimize or ignore the abuse. Even with his last visit—as I fought to breathe while he forcefully held my head down during oral sex, effectively choking me—I initially told myself desperately that surely he wouldn’t do any of this on purpose.

The Stories We Tell and The Stories That Just Are

Reflecting on that week, I’m engulfed in shame. I’m a proud feminist. I know what coercion looks like. I know what rape looks like. I know it’s rarely a scary man wearing a ski mask in a back alley. I’ve heard all the victim-blaming rape apologia you have: that women make up rape when they regret consenting to sex, or going on a date means sex is in the cards, or bringing someone home means you’re game for anything.

Reality is, all of us have been socialized within a patriarchal system that clouds our experiences and ability to classify them. We’re told to tend and befriend the men who threaten us. De-escalation at any cost is the go-to response of almost any woman I’ve ever talked to about unwanted male attention. Whatever will satiate the beast and keep us safe.

On top of that, my conservative background whispered accusations of being a Jezebel, failing to safeguard my purity, and getting exactly what I deserve for forsaking the faith.

It’s all lies, of course. Our culture lies when it says that there are blurred lines when it comes to consent. It violates our personhood when it requires us to change the narrative of the violence enacted against us for their own comfort. Right-wing Christianity lies when it says we don’t belong to ourselves and must submit to the authority of a religion or a gender.

Nobody’s assaulted because they weren’t nice enough or because they “failed” to de-escalate. There’s nothing we can do to provoke such violence. Rape is never deserved. The responsibility for sexual assault lies entirely with those who attack us.

So why was the story I told during and after that ordeal so radically and fundamentally different from what actually happened? And why the hell did I think any of what happened was OK?

Rape myths are so ingrained in our cultural understanding of relationships that it was easier for me to believe nothing bad had happened than to accept the truth. I thought if I could only tell the story I wanted it to be, then maybe that’s what really happened. I thought if I was willing—if I kept having him over, if I did what he ordered, if I told my friends how wonderful it was—it would mean everything was fine. It would mean I wasn’t suffering from post-traumatic stress or anxiety about defying the conservative tenets of my former political and religious system.

Sometimes, we tell ourselves the stories we want to hear until we’re able to bear the stories of what actually happened.

We all have a right to say who has what kind of access to our bodies. A man’s masculinity gives him no authority over anyone’s sexual agency. A lack of a “no” doesn’t mean a “yes.” Coercion isn’t consent. Sexual acts performed without consent are assault. We have a right to tell our stories—our real stories.

So, while this isn’t the story I wanted, it’s the story that is.

I was raped.

Analysis Law and Policy

Justice Kennedy’s Silence Speaks Volumes About His Apparent Feelings on Women’s Autonomy

Imani Gandy

Justice Anthony Kennedy’s obsession with human dignity has become a hallmark of his jurisprudence—except where reproductive rights are concerned.

Last week’s decision in Whole Woman’s Health v. Hellerstedt was remarkable not just for what it did say—that two provisions in Texas’s omnibus anti-abortion law were unconstitutional—but for what it didn’t say, and who didn’t say it.

In the lead-up to the decision, many court watchers were deeply concerned that Justice Anthony Kennedy would side with the conservative wing of the court, and that his word about targeted restrictions of abortion providers would signal the death knell of reproductive rights. Although Kennedy came down on the winning side, his notable silence on the “dignity” of those affected by the law still speaks volumes about his apparent feelings on women’s autonomy. That’s because Kennedy’s obsession with human dignity, and where along the fault line of that human dignity various rights fall, has become a hallmark of his jurisprudence—except where reproductive rights are concerned.

His opinion on marriage equality in Obergefell v. Hodges, along with his prior opinions striking down sodomy laws in Lawrence v. Texas and the Defense of Marriage Act in United States v. Windsor, assured us that he recognizes the fundamental human rights and dignity of LGBTQ persons.

On the other hand, as my colleague Jessica Mason Pieklo noted, his concern in Schuette v. Coalition to Defend Affirmative Action about the dignity of the state, specifically the ballot initiative process, assured us that he is willing to sweep aside the dignity of those affected by Michigan’s affirmative action ban in favor of the “‘dignity’ of a ballot process steeped in racism.”

Meanwhile, in his majority opinion in June’s Fisher v. University of Texas, Kennedy upheld the constitutionality of the University of Texas’ affirmative action program, noting that it remained a challenge to this country’s education system “to reconcile the pursuit of diversity with the constitutional promise of equal treatment and dignity.”

It is apparent that where Kennedy is concerned, dignity is the alpha and the omega. But when it came to one of the most important reproductive rights cases in decades, he was silent.

This is not entirely surprising: For Kennedy, the dignity granted to pregnant women, as evidenced by his opinions in Planned Parenthood v. Casey and Gonzales v. Carhart, has been steeped in gender-normative claptrap about abortion being a unique choice that has grave consequences for women, abortion providers’ souls, and the dignity of the fetus. And in Whole Woman’s Health, when Kennedy was given another chance to demonstrate to us that he does recognize the dignity of women as women, he froze.

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He didn’t write the majority opinion. He didn’t write a concurring opinion. He permitted Justice Stephen Breyer to base the most important articulation of abortion rights in decades on data. There was not so much as a callback to Kennedy’s flowery articulation of dignity in Casey, where he wrote that “personal decisions relating to marriage, procreation, contraception, family relationships, child rearing, and education” are matters “involving the most intimate and personal choices a person may make in a lifetime, choices central to personal dignity and autonomy.” (While Casey was a plurality opinion, various Court historians have pointed out that Kennedy himself wrote the above-quoted language.)

Of course, that dignity outlined in Casey is grounded in gender paternalism: Abortion, Kennedy continued, “is an act fraught with consequences for others: for the woman who must live with the implications of her decision; for the persons who perform and assist in the procedures for the spouse, family, and society which must confront the knowledge that these procedures exist, procedures some deem nothing short of an act of violence against innocent human life; and, depending on one’s beliefs, for the life or potential life that is aborted.” Later, in Gonzales, Kennedy said that the Partial-Birth Abortion Ban “expresses respect for the dignity of human life,” with nothing about the dignity of the women affected by the ban.

And this time around, Kennedy’s silence in Whole Woman’s Health may have had to do with the facts of the case: Texas claimed that the provisions advanced public health and safety, and Whole Woman’s Health’s attorneys set about proving that claim to be false. Whole Woman’s Health was the sort of data-driven decision that did not strictly need excessive language about personal dignity and autonomy. As Breyer wrote, it was a simple matter of Texas advancing a reason for passing the restrictions without offering any proof: “We have found nothing in Texas’ record evidence that shows that, compared to prior law, the new law advanced Texas’ legitimate interest in protecting women’s health.”

In Justice Ruth Bader Ginsburg’s two-page concurrence, she succinctly put it, “Many medical procedures, including childbirth, are far more dangerous to patients, yet are not subject to ambulatory-surgical-center or hospital admitting-privileges requirements.”

“Targeted Regulation of Abortion Providers laws like H.B. 2 that ‘do little or nothing for health, but rather strew impediments to abortion,’ cannot survive judicial inspection,” she continued, hammering the point home.

So by silently signing on to the majority opinion, Kennedy may simply have been expressing that he wasn’t going to fall for the State of Texas’ efforts to undermine Casey’s undue burden standard through a mixture of half-truths about advancing public health and weak evidence supporting that claim.

Still, Kennedy had a perfect opportunity to complete the circle on his dignity jurisprudence and take it to its logical conclusion: that women, like everyone else, are individuals worthy of their own autonomy and rights. But he didn’t—whether due to his Catholic faith, a deep aversion to abortion in general, or because, as David S. Cohen aptly put it, “[i]n Justice Kennedy’s gendered world, a woman needs … state protection because a true mother—an ideal mother—would not kill her child.”

As I wrote last year in the wake of Kennedy’s majority opinion in Obergefell, “according to [Kennedy’s] perverse simulacrum of dignity, abortion rights usurp the dignity of motherhood (which is the only dignity that matters when it comes to women) insofar as it prevents women from fulfilling their rightful roles as mothers and caregivers. Women have an innate need to nurture, so the argument goes, and abortion undermines that right.”

This version of dignity fits neatly into Kennedy’s “gendered world.” But falls short when compared to jurists internationally,  who have pointed out that dignity plays a central role in reproductive rights jurisprudence.

In Casey itself, for example, retired Justice John Paul Stevens—who, perhaps not coincidentally, attended the announcement of the Whole Woman’s Health decision at the Supreme Court—wrote that whether or not to terminate a pregnancy is a “matter of conscience,” and that “[t]he authority to make such traumatic and yet empowering decisions is an element of basic human dignity.”

And in a 1988 landmark decision from the Supreme Court of Canada, Justice Bertha Wilson indicated in her concurring opinion that “respect for human dignity” was key to the discussion of access to abortion because “the right to make fundamental personal decision without interference from the state” was central to human dignity and any reading of the Canadian Charter of Rights and Freedoms 1982, which is essentially Canada’s Bill of Rights.

The case was R. v. Morgentaler, in which the Supreme Court of Canada found that a provision in the criminal code that required abortions to be performed only at an accredited hospital with the proper certification of approval from the hospital’s therapeutic abortion committee violated the Canadian Constitution. (Therapeutic abortion committees were almost always comprised of men who would decide whether an abortion fit within the exception to the criminal offense of performing an abortion.)

In other countries, too, “human dignity” has been a key component in discussion about abortion rights. The German Federal Constitutional Court explicitly recognized that access to abortion was required by “the human dignity of the pregnant woman, her… right to life and physical integrity, and her right of personality.” The Supreme Court of Brazil relied on the notion of human dignity to explain that requiring a person to carry an anencephalic fetus to term caused “violence to human dignity.” The Colombian Constitutional Court relied upon concerns about human dignity to strike down abortion prohibition in instances where the pregnancy is the result of rape, involves a nonviable fetus, or a threat to the woman’s life or health.

Certainly, abortion rights are still severely restricted in some of the above-mentioned countries, and elsewhere throughout the world. Nevertheless, there is strong national and international precedent for locating abortion rights in the square of human dignity.

And where else would they be located? If dignity is all about permitting people to make decisions of fundamental personal importance, and it turns out, as it did with Texas, that politicians have thrown “women’s health and safety” smoke pellets to obscure the true purpose of laws like HB 2—to ban abortion entirely—where’s the dignity in that?

Perhaps I’m being too grumpy. Perhaps I should just take the win—and it is an important win that will shape abortion rights for a generation—and shut my trap. But I want more from Kennedy. I want him to demonstrate that he’s not a hopelessly patriarchal figure who has icky feelings when it comes to abortion. I want him to recognize that some women have abortions and it’s not the worst decision they’ve ever made or the worst thing that ever happened to him. I want him to recognize that women are people who deserve dignity irrespective of their choices regarding whether and when to become a mother. And, ultimately, I want him to write about a woman’s right to choose using the same flowery language that he uses to discuss LGBTQ rights and the dignity of LGBTQ people.  He could have done so here.

Forcing the closure of clinics based on empty promises of advancing public health is an affront to the basic dignity of women. Not only do such lies—and they are lies, as evidenced by the myriad anti-choice Texan politicians who have come right out and said that passing HB 2 was about closing clinics and making abortion inaccessible—operate to deprive women of the dignity to choose whether to carry a pregnancy to term, they also presume that the American public is too stupid to truly grasp what’s going on.

And that is quintessentially undignified.