At Women's Expense: State Power and the Politics of Fetal Rights (review)

At Women's Expense: State Power and the Politics of Fetal Rights was originally published in 1993, with the first paperback edition appearing in 1996. Given that the book is close to a decade old, I wondered, as a reviewer, whether it still had something to offer. The answer is decidedly, yes. In particular, the book offers a valuable conceptual framework, historical background, and political context for interpreting policies intended to regulate pregnancy for the purpose of fetal protection.

The politics of fetal protection, says Daniels, an associate professor of political science at Rutgers, is a new phenomenon and one that adds a new aspect to the politics of reproduction. Whereas American reproductive politics has historically focused either on reproductive choice (the beginning of pregnancy) or the politics of motherhood (the aftermath of pregnancy), the politicization of fetal rights has shifted the focus to pregnancy itself--in particular, to the mediation and regulation of the relationship between the pregnant woman and the fetus (p. 2).

For those who have been following the recent embryonic stem cell debates in the United States, this characterization of the relationship between fetal rights and pregnancy may seem parochial. After all, in the stem cell debate, the embryos in question have developed independent of a woman's body, through in vitro fertilization (IVF) or cloning techniques, and concerns about their moral and legal status have nothing to do with pregnancy. But, it is precisely this point and technologies such as IVF and fetal ultrasound, Daniels argues, that have given rise to the perception that the fetus is an independent entity autonomous from a woman's body (ch. 1). The fact that embryos are able to be created in vitro and fetuses are able to be visualized and surgically repaired in utero, has created the impression that fetuses are separable from gestation, and that women are "third parties"--literally, parties incidental to fetal development.

The upshot of this impression is the language of fetal rights that has been used not only to bolster the antiabortion movement, but also to justify forced medical treatment of pregnant women, restrictions on women's employment, and legal sanctions against drug dependent pregnant women.

Daniels structures her book around three important contemporary legal cases in these areas. Chapter 2 is devoted to the case of Angela Carder (In re A. C.). In this case, a hospital sought and a court ordered a cesarean section be performed on a woman 25 weeks pregnant and in the end stages of cancer. Chapter 3 examines United Auto Workers v. Johnson Controls in which the union contested a company policy of excluding all fertile women from the manufacture of automobile batteries on the basis of potential lead hazard to "an unborn child." Chapter 4 analyzes the case of Jennifer Johnson (Johnson v. State of Florida), who was the first woman in the United States to be convicted of delivering drugs to a minor by "delivering" cocaine through the umbilical cord to two infants after they had been born but before the cord had been cut.

The framework that Daniels offers for interpreting theses cases is not the narrowly conceived framework of "maternal-fetal conflict" but rather the relationship of gender and state power. In each of these cases, Daniels argues, we are confronted with "fundamental questions about the difference between men's and women's relationship to citizenship and state power" (p. 5). Is pregnancy a condition that legitimately limits the established right to bodily integrity? How can public structures of work and politics be responsive to gender differences without reinforcing traditional gender stereotypes? How can the state use its expressive function--its inevitable creation of moral narratives--in ways that do not reinforce stereotypes of race, class, and good mothering?

In setting the stage for discussion of these contemporary cases, Daniels...