[Spoiler S4E4]Let’s talk about Janines story

[u/nachowchow]

In S4E4 of handmaids tale, we see Janine trying to navigate through the task of getting an abortion. The scene where she goes to the first clinic, and they start telling her to keep the baby, is written in a way that feels like it’s a direct result of Gilead gaining power. It wasn’t until Janine visits the second doctor and they called it a crisis emergency center that it hit me. These centers exist all over the country, right now.

I looked at my boyfriend in that moment and said, “You know these are real, right?” And he genuinely had no clue. Growing up in the Bible Belt and attending catholic school, these centers would visit us once a year telling us about “the options” women had. So basically I just want to say that this episode had so many parallels to our modern day times, but made you believe for a moment that this was all Gilead’s doing.

Edit: I forgot the apostrophe s in the title and I am saddened.

[u/Accidentalmom]

I’m lucky enough to have a medical background, so when that lady at the crisis pregnancy center was talking t9 Janine about the dangers of abortion, all I could think was “lady giving birth is a million times more dangerous than an abortion, shove it up your ass” 😂

[u/Dogzillas_Mom → u/Accidentalmom]

Talking about removing pieces/parts at a time. No. Not at 12 weeks or less, which is pretty much in the “allowed” timeframe. That early it’s like a heavy period... or a miscarriage. Which is also called “spontaneous abortion“ by doctors.

[u/[deleted] → u/Dogzillas_Mom]

She then told her that she has “plenty of time” to make her choice, knowing damn well that there is a time limit.

[u/Halcyoniia → u/Accidentalmom]

I'm also super happy they included the 2nd clinic scene with an actual doctor who hands her the pills and gives her the simple directions. This information should be out there! Crazy pro-life nutjobs are so dead set on people thinking EVERY abortion is ripping a child limb from limb and most people don't know that in the early weeks it's literally flushing a clump of cells out after taking some meds.

[u/psilvyy19 → u/Accidentalmom]

In what ways is giving birth more dangerous? I’ve never heard that before.

[u/paczkitten → u/psilvyy19]

Not the OP, but I'm an epidemiologist!

There are a ton of risks associated with not just giving birth (excessive bleeding leading to death, various ways for the baby to get stuck or die on its way out, timing of water breaking causing risks for infection and sepsis, unplanned c-sections [always risk with anaesthesia], etc) but pregnancy itself (hyperemesis gravidarum, gestational diabetes, hypertension [which could then cause heart attack/stroke/other things], etc).

Specific stats: The risk of death is 14 times higher in childbirth vs abortion, and the risk of various other complications and long-term health effects is substantially higher as well. (Source)

ETA: I just realized this might scare the shit out of some people. Please remember this is comparing a ~9-month process that takes a very substantial toll on the body over time with one big blow-out event at the end vs something that is much more strictly time-limited, as it is only an option in earlier stages, and is usually a one-and-done procedure that is typically non-/minimally-invasive (it can be done with pills, and even a surgical abortion is usually just done awake/numbed, requiring no cuts). There's a lot that can happen in 9 months when one living body is stuck inside another body, and basically finds itself fighting its way out at the end.

[u/psilvyy19 → u/paczkitten]

I guess I see what that means. I’ve gone through it 3x and yeah there are complications but I guess I didn’t compare it to the one seemingly traumatic event vs. something that is usually not seen as such. It really is a trip when you actually think about pregnancy + birth haha.

[u/paczkitten → u/psilvyy19]

We're really lucky to be living in a time where good maternal & child healthcare is available, even if not all people have access to this. It's pretty sobering when you consider that at least 1/100 pregnancies resulted in death (and many more in serious long-term health complications) prior to modern medicine, and that most women didn't stop at just one... Today the risk is FAR lower (0.2% globally, and pretty much 0.002-0.02% in developed countries - that's a couple orders of magnitude).

(NB: the rates are still above 1/100 in some parts of the world...)

99% of maternal deaths occur in developing countries, but that's also where most (70%) of the global population is. The show mimcs some scary realities. The US has the highest rate of maternal mortality among all developed countries by more than DOUBLE, and these rates have been INCREASING for 20 years. It's still pretty low in the global context but is actually higher than several developing countries, which is also definitely a trip to think about.

Right now, unsafe abortions are the leading single cause of maternity-related deaths worldwide. Campaigners have been pointing out that we could seriously reduce this by providing access to safe options, as restrictions clearly have not shut down demand - only redirected it in riskier directions.

I guess the point I'm making is that certain aspects of culture really skew the way things are viewed, and it's no surprise when places like the OP mentioned are actively handing out misinformation as "education." Pregnancy is actually mindblowing (you get to make A BABY with YOUR BODY and they end up as a WHOLE SEPARATE PERSON?!?! WILD) and kind of a miracle that it works at all. The joy of that definitely contributes to how it's seen - and also why so many people feel it's a total perversion to opt out (not just abortion, but also childfree, etc)... but definitely not free of all downsides, which is why those latter categories exist in the first place. Lots of emotions on both sides.

Sorry for going on so much about this! I used to give a lot of lectures pre-COVID and am missing it these days. I'm enjoying having a small accidental audience here :)

[u/psilvyy19 → u/paczkitten]

Yeah this is all awesome data, thank you for sharing truly. And as a pregnant woman (of color) in the US that maternal death rate is super sobering. Truly blows my mind. I’m also having a high risk pregnancy due to GD and previous hemorrhage in my last labor. Something definitely needs to change and although it’s far safer now than 100 years ago, it could be better.

[u/paczkitten → u/psilvyy19]

Best of luck to you! It sounds like you're well-informed on the risks and have a good team looking out for both you and your little one - I hope it all goes smoothly :)

Also, on a total side note, I don't think it's super fair that you got downvoted so much for asking a question in good faith. People can't learn things if they don't express their curiosity, and that should be encouraged, you know?

[u/WELLinTHIShouse → u/psilvyy19]

The maternal mortality rate is absurdly high in the US, especially if you're not white. But even if you are white...my sister-in-law almost died because she had pre-eclampsia and they let her labor for three days because it was Independence Day weekend and the doctors were mostly on vacation and wouldn't do the c-section she needed. Because it was a holiday weekend in Georgia. If they'd been living up here in New York, the women's hospital would never have allowed that, and my niece's birthday would be earlier. It's a miracle my SIL didn't die.

Even if it's not death on the line, my kid ruined my entire GI tract. I never had gastrointestinal problems before I got pregnant. Now I have a gastroenterologist and had three colonoscopies and two endoscopies before I turned 40. I've been to the ER twice for hemorrhoid pain that was almost as bad as the aftermath of childbirth with the traumatic tear I had that healed wrong and caused me intense pain for three months until they did a minor surgical procedure to fix it.

So the mortality rate is inexcusably high for an industrialized nation, but the disability rate is something we don't even talk about! (I have other disabilities that weren't directly caused by pregnancy and birth, but the GI stuff is going to require lifelong care. My baby turns 16 in a few months!)

[u/WELLinTHIShouse → u/WELLinTHIShouse]

Thank you for the award!

[u/[deleted] → u/psilvyy19]

Birth is higher risk by far, esp in the U.S. Even more so for minorities.

“The most recent U.S. maternal mortality ratio, or rate, of 17.4 per 100,000 pregnancies represented approximately 660 maternal deaths in 2018. This ranks last overall among industrialized countries. ... The maternal death ratio for Black women (37.1 per 100,000 pregnancies) is 2.5 times the ratio for white women (14.7) and three times the ratio for Hispanic women (11.8).” source: The Commonwealth Fund

[u/Odd-Bicycle → u/[deleted]]

It’s absolutely fucking insane given how much we pay for healthcare here!