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Reproducing inequality and identity: An intersectional analysis of maternal health preferences

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Pregnant workers and workers who are new mothers are, fundamentally, workers. They should not be relegated to second class citizenship in employee rights or benefits. The Pregnancy Discrimination Act does not…require employers to offer maternity leave or take other steps to make it easier for pregnant women to work. Introduction Can pregnant working women capture the benefits of equal citizenship? Or do the physical effects of pregnancy, combined with the law's general failure to insist that they be accommodated, make that an elusive goal?This chapter takes up those questions by reconsidering pregnancy discrimination law through the lens of social citizenship. Despite vital legislative and judicial victories that together had established a broad-based federal right of sex equality by the early 1970s, pregnant women continued to face myriad forms of discrimination in the workplace. During the campaign for and debate over the Pregnancy Discrimination Act (PDA) of 1978, advocates and legislators bandied about the familiar fear of second-class citizenship to argue for greater protection for pregnant women in the workplace. Like other important legislative enactments and of the same era, the central goal of the PDA was to promote women's equality by breaking down formal barriers to participation. At its core, this movement was a quest for equal social citizenship – access to paid work and economic security – for women. © Cambridge University Press 2009 and Cambridge University Press, 2010
Book
The aim of this book is to offer a comprehensive approach to understanding social injustice and its impact on public health. Part I explores the nature of social injustice and its adverse effects on public health. Part II describes in detail how the health of ten specific population groups is affected by social injustice. Part III explores how social injustice adversely affects health in ten different areas, ranging from infectious diseases to mental health, from prevention of assaultive violence and war, to occupational health and safety. Part IV provides an action agenda for what needs to be done to prevent social injustice and to minimize its impact on health. In sum, the book examines social injustice as a principal causative factor and as a consequence of many public health problems.
Book
While extensive research has demonstrated that social determinants make a substantial difference to the health of adults and children alike, it can be difficult to understand how social conditions actually affect biology. Healthier Societies: From Analysis to Action addresses the fundamental questions that need to be answered in this regard before countries will invest seriously in addressing social conditions as a way of improving the health of the entire population. Part I of this book addresses the extent to which health is determined by biological factors or by social factors, and, more fundamentally, how the biological and social factors interact. Part II examines four case studies that demonstrate the ways in which social change can dramatically affect the health of adults, as well as launch children's lives onto healthy trajectories; this section analyzes nutrition, working conditions, social inequalities, and geographic disparities. Part III outlines the challenge of translating the research described in the first two sections into action. Even when people are convinced that social factors are as important as biological ones in determining health, and even when they believe that the impact is enormous in both adulthood and childhood, the challenge of changing and developing public policies and programs still remains. This last section takes a serious look at what would be involved in meeting this challenge.
Article
In the 1980s, Margaret Atwood, Gena Corea, and other feminists envisioned dystopias in which wealthy white women’s reproduction was valued and privileged and women of color’s reproduction was devalued and exploited. In subsequent decades, feminist scholars continued to criticize the stratification of reproduction by contrasting policies that penalize poor nonwhite women’s childbearing, on the one hand, with the high‐tech fertility industry that promotes childbearing by more affluent white women, on the other. In recent years, however, companies that market race‐based biotechnologies have promised to extend the benefits of genetic research to people of color, and media promoting genetic technologies have prominently featured their images. At the same time, the important role of genetic screening that makes individual citizens responsible for ensuring good health by reducing genetic risk may support the wider incorporation of genetic technologies into the neoliberal health care system. I argue, therefore, that we need a new reproductive dystopia that accounts for the changing political context of reproduction. This article critically explores the role of race and racism in the emergence of reproductive technologies that incorporate advances in genetic science and considers the implications of including women of color in the market for reprogenetic technologies, particularly when this is done with the expectation that women will use these technologies to manage genetic risk. In investigating these issues, I hope to shed light on the critical relationship between racism, neoliberalism, and reproduction.
Article
The post-civil rights era has left an important dilemma in U.S. politics. Despite the fact that the United States has become more integrated across racial and gendered lines since the 1960s, inequality, particularly economic inequality, has grown. Although much of that inequality continues to fall along racial, gender, and class lines, the opportunities afforded by the “rights revolution” have also created an important heterogeneity of privilege within marginal groups. As social scientists, how best can we identify the sources and results of this inequality? More specifically, how can we better understand the crosscutting political effects of both marginalization and privilege within and among groups in U.S. society? I contend that intersections theory may be a useful place to begin, and that the idea of intersectionality could provide a fruitful framework with which to understand issues of inequality in the post-civil rights era. Such a framework would help address some of the theoretical problems that sometimes arise within empirical work on marginal groups in political science and, ideally, allow scholars to understand better how experiences of marginalization and privilege affect the shape and character of American political life.
Article
In response to the direct and indirect consequences of removing birthing practices from communities, Canada is exploring new initiatives to return childbirth to Aboriginal communities. Lessons learned and insights into this major problem can be used internationally to plan efforts to reduce maternal mortality in low-resource countries around the world.
Article
The 1998 public awareness campaign on Safe Motherhood called attention to the issue of maternal mortality worldwide. This paper focuses upon maternal mortality trends in the United States and Canada, and examines differentials in maternal mortality in the United States by maternal characteristics. Data from the vital statistics systems of the United States and Canada were used in the analysis. Both systems identify maternal deaths using the definition of the World Health Organization's International Classification of Diseases. Numbers of deaths, maternal mortality rates, and confidence intervals for the rates are shown in the paper. Maternal mortality declined for much of the century in both countries, but the rates have not changed substantially between 1982 and 1997. In this period the maternal mortality levels were lower in Canada than in the United States. Maternal mortality rates vary by maternal characteristics, especially maternal age and race. Maternal mortality continues to be an issue in developed countries, such as the United States and Canada. Maternal mortality rates have been stable recently, despite evidence that many maternal deaths continue to be preventable. Additional investment is needed to realize further improvements in maternal mortality.
Article
This report presents data on U.S. deaths to pregnant or recently pregnant women, summarizes long-term processing issues, and examines recent changes affecting the data and the impact of the changes on the statistics for these women. This report presents descriptive tabulations of information reported on death certificates that are completed by funeral directors, attending physicians, medical examiners, and coroners. The original records are filed in the state registration offices. Statistical information is compiled into a national database through the Vital Statistics Cooperative Program of the Centers for Disease Control and Prevention's (CDC) National Center for Health Statistics (NCHS). Causes of death are processed in accordance with the International Classification of Diseases (ICD). Maternal mortality fluctuates from year to year but was 12.1 deaths per 100,000 live births in 2003. The implementation of the International Classification of Diseases, Tenth Revision (ICD-10) in 1999 resulted in about a 13 percent increase in the number of deaths identified as maternal deaths between 1998 and 1999. The rate increased again between 2002 and 2003 after a separate pregnancy question became a standard item on the U.S. Standard Certificate of Death. The adoption of a standard separate question on pregnancy facilitates the identification of late maternal deaths. Maternal deaths increased with the introduction of the ICD-10 and with changes associated with the addition of a separate pregnancy status question on the U.S. Standard Certificate of Death. These changes may result in better identification of maternal deaths.