Fetal Positions

Americans living in the mid-nineteenth century knew almost nothing about the human fetus, at least in a biological sense. Prior to a mother’s perception of fetal movement, which occurs in the fourth or fifth month of gestation, the very existence of a pregnancy could not be definitively established. Despite the discovery of the mammalian egg in 1827 and the development of cell theory in the 1830s, many ordinary Americans continued to regard the fetus prior to “quickening” as inert matter and evinced remarkably tolerant attitudes toward first-trimester abortion. As early as the 1840s, however, activist physicians were pressuring the various state legislatures to criminalize abortion. By the 1880s, the decade that saw the first significant breakthrough in American embryology, abortion had been made a felony in nearly every U.S. jurisdiction. Why were popularly elected legislators willing to protect an entity that many of their constituents could not yet visualize? Sara Dubow, the author of Ourselves Unborn, explains it by invoking period anxieties about changing gender roles and a rapidly industrializing society, anxieties that many in the overwhelmingly male electorate can be presumed to have shared. The status of the fetus, she argues, has “more to do with social values and political circumstances than with biology or theology.”

Whatever one thinks of this argument, Americans in subsequent decades did learn more about fetal biology, as Dubow explains in her splendidly informative early chapters. Wax models of fetal development were displayed at the 1893 World’s Columbian Exposition in Chicago; actual human fetuses featured in two different exhibits—one of them curated by the Loyola University Medical School—at the Chicago World’s Fair in 1933. By 1938, endocrinologists had developed a test that could establish the presence of fetal life during the first month of gestation; by the 1950s a similar test provided the pregnant woman with results in a matter of hours. Dr. John Rock announced the in vitro fertilization of a human egg in 1944 to wide publicity; the first successful pregnancies were achieved by means of artificial insemination in the early 1950s. In 1950 Life magazine published a series of photographs tracing the first thirteen weeks of fetal development “from a single cell to a fully formed baby” and the photograph of an early-stage fetus’s face in 1953. The 1950s also produced new information on threats posed to the fetus by diseases such as rubella and syphilis, as well as the flowering of prenatal psychology. “The possibility of prenatal consciousness and unconsciousness intrigued psychologists working in the emerging field.” And 1953 brought the astonishing news of the decoding of DNA.

The 1940s and ’50s mark the high point of what might be called a “profetus” consensus in the United States, where strict abortion laws still prevailed. (Legal abortions, surprisingly numerous in the early decades of the twentieth century, were far less common by the 1940s, thanks to improvements in obstetrical science.) The fetus was increasingly regarded by Americans of all backgrounds as deserving of care and protection—indeed, as possessing what we would call rights. In 1946, for the first time in American history, a court recognized the humanity of the fetus from the moment of conception, a judgment that was validated in subsequent cases, most of them involving suits over prenatal injury. “The legal profession was largely supportive of the spate of legal decisions ascribing individuality to the fetus, and few legal scholars suggested any downside to this trend.” Dubow attributes these developments less to the fetus’s new visibility than to anxieties generated by the Second World War and subsequent tensions with the Soviets. “The fetus became a symbol in the struggle to define and defend individuality,” she writes. If the argument seems a stretch at this juncture, the author soon serves up evidence that significantly strengthens her case.

By the late 1950s, despite the fetus’s new visibility, concern was beginning to surface about the nation’s strict abortion laws. Significant numbers of American physicians had come to favor their liberalization, primarily by expanding the “therapeutic exceptions” that nearly all such laws permitted. (One widely advocated amendment would permit an abortion if a panel of doctors agreed that continuing a pregnancy might be seriously detrimental to a woman’s mental health.) Given the state of fetal discourse in the 1950s, reform-minded physicians kept a low profile and claimed no legislative triumphs. But by the mid-1960s, a rapidly growing movement for abortion-law reform was beginning to generate change. By 1971, fully one-third of the states had liberalized their abortion laws, albeit mostly in modest fashion. Under Governor Ronald Reagan, California effectively legalized abortion in the first trimester of pregnancy in 1967, while New York followed suit in 1970. What explains the shift in public opinion that would seem to provide good evidence for Dubow’s assertion that assumptions about fetal life have less to do with biological knowledge than politics and culture? (Information about fetal development continued to proliferate in the popular media in the 1960s.) Dubow has little to say on the subject, beyond brief references to the thalidomide crisis and a rubella epidemic in the early years of the decade. Perhaps she regards the proreform cause as so eminently sensible that its triumph requires no real explication.

The second half of Dubow’s book deals with the years since Roe v. Wade, with chapters devoted to controversies over late-term abortion, various efforts—legal and otherwise—to regulate the conduct of pregnant women, and debates over whether fetuses experience pain. Here, I fear, we learn more about the author’s politics than about those of the nation. Invested in the notion of a polarized public, she says nothing about the deep ambivalence most Americans express with regard to abortion in public-opinion polls. Nor will she concede any moral integrity to those who oppose abortion, in part because her argument assumes that talk about the fetus is nearly always about something else. “The debate about abortion is less about the life and rights of the fetus than it is about women’s role in society,” she argues. But even conceding her point—one can hardly talk about abortion or fetal claims to protection without saying something about women’s roles—her assessments in these pages are wildly one-sided. Anyone who endorses the rights of even late-term fetuses becomes an apologist not just for women’s oppression but the most savage aspects of unregulated capitalism. “Fetal rights,” she writes, “are paid for in the erosion of privacy, medical research, environmental protection, industrial safety, public health, and racial and economic justice.” I could understand such rhetoric, I suppose, if she were focused solely on politicians who cynically exploit abortion in pursuit of a right-wing agenda. But she makes no such distinctions. Given the logic of this dispiriting narrative, the best one could say about someone like the late Cardinal Joseph Bernardin, whose advocacy of a “seamless garment” approach to politics gave as much priority to fetal rights as it did to conventionally liberal causes, is that he was seriously deluded.