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When Roe v. Wade was decided in 1973, feminists regarded it as a total victory: having unlimited access to legal abortion across the United States would, they assumed, finally give American women the reproductive choice they had been seeking. Sara Matthiesen begs to differ, contending that access to abortion alone does not give women full autonomy; they must also have the resources to make families, if that is their wish—resources that many, especially poor women, women of color, single mothers, and members of sexual minorities, may lack. Family making, according to Matthiesen, takes labor—not just the labor of childbirth but also the work entailed in providing care and financial security, and in all these areas, millions of American women are left more or less on their own, with little social or cultural, much less state, support and high barriers to reaching what might be available.Surveying the period between 1973 and the early 2000s, Matthiesen identifies five major types of challenges to women's family making: legal biases against lesbians as parents; a penal system that prevented incarcerated women from mothering; health care inequalities that compromised the well-being, if not the survival, of both pregnant women and infants; the invisibility of women's particular risks in the treatment of HIV/AIDS; and the lack of state supports such as paid parental leave, family allowances, and childcare.While paying lip service to the division of labor between male breadwinners and female homemakers/mothers, the book shows, American policymakers' parallel insistence on individual responsibility blocked development of the state supports needed to maintain it, with particular harm to lesbians and single mothers. Moreover, when such harm was pointed out, the evidence could be turned against the populations affected. For example, some policymakers used disproportionately high rates of infant mortality among urban African Americans to berate the mothers for their own culture and associating them with practices such as drug abuse, instead of advocating for increased public funding for programs such as Medicaid.Moving beyond conventional research in government documents, Matthiesen turns to more obscure publications, records, and traces of local and marginal groups that not only protested perceived injustices but also devised ingenious ways of resisting them. Pursuing a lead in the Seattle Gay News, for example, she discovered that members of one gay men's commune staged an orgy that ended with them pooling their sperm and donating it anonymously to lesbians seeking to conceive but unwilling to identify the fathers of their children, which might oblige them to grant paternity rights. (This also allowed the men to avoid assuming the responsibilities that came with those rights.)The chapter I found most interesting was about the "lifelines of last resort" provided by the Emergency Pregnancy Services and Crisis Pregnancy Centers set up by anti-abortion organizations, starting in 1971—even before Roe v. Wade—and offering access to needed supplies and assistance, both pre- and postnatal: maternity dresses and baby clothing and equipment, food, referrals to obstetricians and pediatricians, help obtaining affordable housing, and even rent subsidies and cash. Though inconsistent over time and place due to uneven funding and organizational priorities, such provisions met crucial needs in the absence of adequate state support. The paradox, of course, is that they came with strings attached—applicants had to run the gauntlet of anti-abortion rhetoric. As a result, many abortion supporters denounced the programs as a form of deceit and delusion for pregnant women who, once lured in by the promise of assistance, were offered only one alternative: carrying their babies to term.Matthiesen is to be commended for taking a closer look at these providers and acknowledging that, despite their rhetoric, their work met a real need (though of course public support with no strings would be the ideal). She notes that it was the women in the anti-abortion movement who recognized this need in the first place and sought to address it, challenging the more confrontational approach of leading male abortion opponents. The conflict over strategy continued when poor women who had no intention of terminating pregnancies or were already mothers realized that these providers could be a resource for them and began applying for help in great numbers. When it appeared that they might crowd out the pregnant women the organizations were supposed to be diverting from abortion (their "best clients"), sympathetic providers were compelled to turn away women who needed assistance to carry pregnancies to term or support the children they already had (162, 183).While acknowledging the financial barriers to family making, Matthiesen tends to be dismissive of women seeking to combine motherhood with work; indeed, she characterizes the idea of work-life balance as a "euphemism" (16). A propos, she might have devoted more attention to the dearth and poor quality of childcare in the United States, largely due to the scarcity of public funding, and to the debate over parental leave. In general, while frequently denouncing what she calls "state neglect," she might have engaged more deeply with the historiography of the American welfare state (14–15, 56, 63, 89, 130, 159, 169). But does she really think that the ideal way for women to spend their adulthoods is as caretakers, albeit with public support? Do they not have the right to pursue occupational advancement, even professions? Full choice should include the option of eschewing motherhood altogether.This, admittedly, is a theoretical concern. Meanwhile, as Matthiesen notes in her epilogue and as current media confirms, high barriers to family making continue. One is clearly the Dobbs decision, which jeopardizes access to legal abortion at the state level. Another is ongoing inequalities in healthcare outcomes, which result from restricted access to healthcare for poor and minority women and children as well as malpractice due to medical professionals' obliviousness to the complaints of Black women. There has been less public attention to the constraints of mothering in prison, but professional journals have recently published findings that echo precisely the carceral conditions in earlier decades that Matthiesen describes. And then there are anti-abortion counselors who also oppose single parenthood and urge single pregnant women to instead consider either marriage or giving up their babies for adoption. They receive support from scholars like economist Melissa Kearney, whose new book, The Two-Parent Privilege, suggests that no matter how much public support for families is improved, children in single-parent families will continue to suffer. As long as such barriers persist, the idea of choice in family making will remain elusive.
Sonya Michel (Wed,) studied this question.