I’m pretty terrible at being pregnant. I start barfing about ten seconds after sperm meets egg, and I had to be hospitalized twice during my pregnancy with my son (not quite so bad with my daughter, but I still had to be medicated the entire time). But for all the issues I had with both of my pregnancies, the babies were never in danger and I’m truly grateful for that. But those pregnancies left me with both a fascination for all that can go wrong for both parties during a pregnancy and the unnecessarily complexities and sometimes deadly consequences the American healthcare system likes to heap upon pregnant people (would you like to hear how my insurance company wouldn’t pay for medication to keep me out of the hospital, but it would pay for hospitalization? And how during my second pregnancy, it wouldn’t pay for medication at all? I’m still incredibly angry about all of this.) This is why Challenging Pregnancy: A Journey through the Politics and Science of Healthcare in America by Genevieve Grabman (University of Iowa Press, 2022) caught my eye on NetGalley. A quick tap of the request button and it was added to my kindle in just a few days. Much thanks to NetGalley, University of Iowa Press, and Genevieve Grabman for the opportunity to read this thoroughly engaging account of the author’s medically complex pregnancy and the system that stood in the way of solutions every step of the way.
What doctors first suspected to be a blighted ovum turned out to be a set of twins, shocking Genevieve Grabman. And things would only grow more complicated. The twins were soon diagnosed with a complicated condition known as twin-to-twin transfusion syndrome (TTTS), for which the outcomes for both babies and mother are often not good (death for all three is a distinct possibility, along with lifelong neurological problems for the babies). Alongside of this, the smaller twin was suffering from sIUGR, or selective intrauterine growth restriction and a dangerous two-vessel umbilical cord (which was only tenuously attached to the placenta), both boys had heart defects- basically, a lot of what could go wrong did.
Ms. Grabman’s degree in public health and her experience as a lawyer helped her navigate the often difficult-to-understand research articles about the serious medical conditions she and the twins were experiencing, giving her a massive advantage over most other people dealing with similar problems, but even with these advantages, she ran up against the wall of politics. Anti-abortion legislation heavily limits what treatments are available to pregnant women in the US, and time and time again, Ms. Grabman found that what she wanted for her pregnancy and what was considered best practice and safest in a medical sense wasn’t allowed, in favor of more dangerous procedures with worse outcomes, thanks to anti-choice politicians.
Woven throughout Ms. Grabman’s tense and frustrating narrative are facts and statistics about the dire landscape that is American maternal healthcare. For every 100,000 live births in the US, 17.4 mothers die, a statistic that is the highest out of the fourteen most-developed countries. Women’s lives are sacrificed on the altar of politics, and outcomes are decried in favor of placating the religious right. Twin-to-twin transfusion system statistically has a particularly poor outcome (along with suffering from a dearth of good research), and readers will come away from this book with a fresh sense of horror for not only the dangers of such a complex medical condition, but also for the ease of which politicians are willing to disregard medical necessity (for children and mothers they have no stake in caring for) for ideals.
This is a moving, intense narrative. I appreciated Ms. Grabman’s attention to detail in terms of the research available, and her acknowledgement that if she found accessing proper medical care difficult, with her degrees and knowledge of reproductive law, how much more difficult and stressful is it to navigate the medical system for women with potentially deadly conditions who have less education, less ability to read the scientific studies, and fewer qualifications that mark them as someone to take seriously for the researchers and doctors she contacted?
Challenging Pregnancy will have readers questioning everything they thought they knew about the American healthcare system, abortion politics, and what the true consequences are for voting for candidates who call themselves pro-life.
Challenging Pregnancy: A Journey through the Politics and Science of Healthcare in America by Genevieve Grabman is available on March 1, 2022.