In a work documenting a series of moments in the modern American history of the fetus, historian Sara Dubow skillfully weaves together shifts in medicine, politics, religion, and society to demonstrate how the way in which we understand the human fetus often has much to tell us about how we understand ourselves. Ourselves Unborn: A History of the Fetus in Modern America (Oxford University Press, 2010) begins in the Progressive Era and across a series of five chapters considers how “fetal discourses” were constructed and deployed within a series legal and socio-political contexts. Dubow considers the “discovery” of fetal life (1870s-1920s), the interpretation of fetal bodies (1930s-1970s), the definition of fetal personhood (1973-1976), and the defense of fetal rights (1970s-1990s) as distinct from the personhood and rights of pregnant people. The book closes with a brief examination of the discourse of fetal pain (1984-2007) which brings the study up to the near-present in reproductive politics.
While not an exhaustive study, Ourselves Unborn nevertheless achieves its goal of documenting how “legal, political, religious, anthropological, sociological, [and] cultural” narratives work together to construct an increasingly individuated fetal citizen over the course of the long twentieth century. The subject of scientific study and moral concern, the fetal subject is troublingly divorced from the bodies and lives of the predominantly-female persons, or patients, who sustain fetal life within. This historical trajectory will be familiar to any scholar who has had reason to study the abortion case law and legislation, as well as a penumbra of other legal-political contexts in which a pregnant person’s autonomy and health come into seeming conflict with the emerging legal protections for the fetus. As Dubow writes:
Beginning in the 1970s, Americans were increasingly confronted by the possibility that the postwar economic expansion that had once seemed unbounded was approaching its limits. [In the face of this,] rights were no longer conceptualized as an infinitely available resource to be discovered, but as a fixed commodity to be distributed. The fetus, whose body could be protected only by invading the impregnable fortress of pregnant women’s bodies, and whose rights could be recognized only by taking them from women, became a symbol encoding these anxieties (113).
At the beginning of the twentieth century, prenatal medicine meant addressing the pregnant individual’s bodily needs and regulating their behavior. Restrictive labor laws, for example, or programs designed to provide women better access to healthcare while pregnant, concerned the pregnant individual not the fetus itself. By the turn of the twenty-first century, the fetus was seen as needing protection from the pregnant person themselves, whose decision-making capacity and bodily autonomy was understood both socially and legally as having been diminished by the fact of gestation.
While the story Dubow tells may be a familiar one to specialist scholars, the specific stories she tells to bring these narrative shifts into focus may be less familiar. Chapter 1, for example, opens with the story of Armenouhie Tashjian Lamson, for example, the director of a prenatal clinic in Seattle who in 1916 published “a chronicle of her unborn baby’s nine-month struggle to develop from an egg to a zygote to an embryo to a fetus to a baby” (10). The second half of chapter three explores the dramatic trial of Dr. Kenneth Edelin, an African-American physician who worked at Boston City Hospital and was convicted in 1973 for causing the death of a fetus in the course of providing a legal abortion (80-111). Whether discussing eugenicists arguments in favor of white women’s “reproductive obligations to the nation’s manifest destiny” (21), Edelin’s trial, or the disproportional imprisonment of pregnant women of color for drug addiction (147), Dubow is mindful throughout of the way racial as well as gender politics inform our collective constitution of fetal identity.
Dubow’s study is by no means comprehensive, nor is it meant to be. Its brevity, instead, offers readers an opportunity to consider the ways in which the fetus has been constituted in American culture, the dense historical contexts that have informed that constitution, and provides a useful framework for further analysis. At a time of resurgent anti-abortion politics, Ourselves Unborn offers a clarifying perspective on the path that brought us here.