The Criminalization Of Miscarriage Makes Me Fear My Eating Disorder

By Meghan Racklin

By the time I was nine and she was 41, my mother had had three children and 11 miscarriages. I was about eight when she was pregnant with twins, and far enough along to tell me. We started planning for two new babies. Then, we were sitting in the car when she told me that something had changed — she would only be having one baby. We tried to adjust our expectations and our planning. On the day she lost the second twin, my parents dropped me and my younger sister off at school and drove to the hospital; they were admonished by the doctor for not having called an ambulance.

Before I learned how someone could get pregnant, I learned that a pregnancy could be lost. I quickly understood pregnancy to be an uncertain, dangerous thing. The capacity to have a pregnancy also means the capacity to lose one. Experience has taught me to view my own reproductive ability with suspicion — this is something I can fail at. This is something that could hurt me.

Just how much it could hurt me has shifted along with the political landscape. I watched in horror as Indiana woman Purvi Patel was sentenced to 20 years in prison for feticide and neglect of a dependent after she said she suffered a miscarriage and left the fetal remains in a dumpster. She was arrested when she sought emergency medical treatment for heavy bleeding after this. Prosecutors accused Patel of taking abortion-inducing drugs, though none were found in her system. This accusation, however, formed the basis for the feticide charge against Patel, even though Indiana’s feticide statute was intended to punish those who knowingly harm pregnant women and their fetuses — not to punish pregnant women themselves.

Her case is one of a growing number in which pregnant people are prosecuted for their actions during pregnancy, including a woman in Mississippi who was charged with murder after a stillbirth, an Indiana woman charged with murder after attempting suicide while pregnant, among many others. Lynn Paltrow, executive director of National Advocates for Pregnant Women, told The New York Times: “This case shows how easy it is to sweep up women who’ve had miscarriages and stillbirths into a criminal justice framework.”

It’s made me realize that my mother could have been swept up into that framework. I could be, too.

Eating Disorders and the Miscarriage Risk

Miscarriage is far more common than most people realize, occurring in approximately 15–20 out of 100 pregnancies. Women with restrictive eating disorders — women like me — are two to three times more likely to miscarry.

I have been in recovery from my eating disorder for almost three years. My disorder emerged when I was 16, and at 18, I missed six consecutive periods. A person in recovery is not the same as a person who was never sick. At least twice in the last six months, my partner has suggested we go out to dinner, and I immediately erupted into tears. But I am so much better than I was before.

There is a theory of restrictive eating disorders that views them as an attempt at reversing or halting the passage of time — or, more specifically, sexual and reproductive development.

Restrictive eating disorders and their consequences — including amenorrhea, an abnormal absence of menstruation — can be viewed as a rejection of reproductive capacity. It’s too simplistic to say that this alone explains my eating disorder, and it can be dicey to construct one’s own psychology.

But I have always known that reproduction was a test that was easy to fail, and I’ve never wanted to fail. Eating disorders are also, of course, commonly associated with perfectionism and a deep discomfort with one’s own body. In a society that demonizes fat people, perfectionism can take the form of intense fear of gaining weight. Weight gain is viewed as being undisciplined, as a collapse of self-control, and restrictive eating disorders offer a fantasy of self-discipline, perfection, accomplishment — of ultimate control. These factors help to explain why eating disorders so commonly emerge around puberty, a time at which the body grows and changes, without any way to intervene. Coincidentally, this is also the time when the body can biologically begin to bear children.

Recovery requires overcoming the maturation fears that often accompany eating disorders, and becoming more comfortable in one’s body generally. This is a long and difficult process. Eating disorders are in many ways similar to chemical addiction — and, as they say, “once an addict, always an addict.” Many believe that there is no such thing as being recovered from an eating disorder, but rather, one enters a constant process of recovery. Three years on from full-blown eating disorder behavior, it’s hard to say if that is true for me, but it is certainly true up to this point. I am mostly better. I haven’t gone more than a day without food in years, and I haven’t purged in at least a year. But it is always work.

It was hard to reach a healthy weight, and to learn how to live in that new body. It is still hard not to fall back into old patterns, and to remind myself to be kind and gentle to my body. For the most part, I have built a fragile peace with my body, and with food.

I am trying. I will always be trying.

The Fear of Relapses

Approximately one-third of women with a history of anorexia nervosa or bulimia nervosa relapse after recovery. This possibility can be heightened by circumstance — stress, life changes, comments from family and friends.

Pregnancy — another point in life where the body changes uncontrollably — can trigger a relapse in many people with a history of eating disorders because changes in body shape can increase anxiety about weight gain. One study suggests that 22% of pregnant women in eating disorder recovery may relapse. That relapse increases the likelihood of adverse pregnancy outcomes, including miscarriage. In a country where miscarriage is increasingly viewed as suspect, this is dangerous. In a country where miscarriage is criminalized, a relapse during pregnancy could not only damage my mental health and the health of my fetus — it could land me in jail.

This is particularly true because of the ways that laws criminalizing adverse pregnancy outcomes target women who are stereotyped as bad mothers. Miriam Yeung, executive director of the National Asian American Pacific Women’s Forum, notes that Purvi Patel’s race is not incidental to her prosecution: “Asian women have been singled out when it comes to criminalized reproduction because of ugly stereotypes that claim we have a disregard for life.” In a study of 413 arrests and forced interventions on pregnant women in the United States, 71% were poor and 59% were women of color. The women whose reproduction is criminalized are the women who do not fit the stereotypical idea of what a “good pregnancy” looks like.

Mentally ill women who suffer from restrictive eating disorders during pregnancy certainly fail to meet expectations of good pregnancy and motherhood. Katherine Jack, an attorney who defended a woman charged with homicide after losing a pregnancy, told the Guardian that the Patel case could set a precedent “that anything a pregnant woman does that could be interpreted as an attempt to terminate her pregnancy could result in criminal liability.” I can’t help but think that starving oneself could fall under that scope.

I do not plan to get pregnant anytime soon, and I am lucky to have consistent access to birth control and, were my birth control to fail, abortion care. I wish I could put the criminalization of miscarriage out of my mind. It would be easier to not worry until I have to. But this makes my everyday life in recovery harder. When I was actively eating disordered, I felt like my body couldn’t be trusted. I felt the need to be so, so careful, lest everything spin out of my control. My body was the enemy. My body could turn on me.

Recovery is a painful process of unlearning, and the criminalization of miscarriage is destroying the tenuous peace I have made with my body. Not only could my body turn on me, it could turn me into an unwitting criminal.

This is the cost of the anti-choice campaign to control reproduction, and to criminalize what they cannot control. It marginalizes the people who are more at risk of miscarriage, and discourages us from conceiving wanted children, because attempting to do so could put us at risk — even more so for the many women of color with eating disorders. These efforts put people in prison, and force people to live in bodies that don’t feel safe.

I have spent years trying to make a home out of my body, trying to learn to care for it, to feel safe within it, to trust it. The criminalization of miscarriage is making that impossible.

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Lead image: Pixabay

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