Care That Respects Patients: Dr. Robinson's Example

Back in 2021, Margaret Atwood came on the show to give her dark take on the American future. Four years later, Atwood’s prescience, particularly in her 1985 classic The Handmaid’s Tale, is increasingly self-evident. As the journalist Irin Carmon notes, MAGA America has become an Atwoodian dystopia of trad wives and state fecundity. But it is also, Carmon warns in her new book Unbearable, a place that actively discriminates against pregnant women, especially those of color. American women are dying in childbirth at three times the rate of their peers in other wealthy nations. Even in liberal New York City, Black women are nine to twelve times likelier to die than white women. So MAGA America is simultaneously fetishizing and punishing fecundity—celebrating “Trump babies” while jailing pregnant women who test positive for drugs. Forget the trad wives. The problem lies with the trad men making pregnancy so unbearable in America today.

1. America’s Maternal Mortality Crisis Is a National Disgrace American women die in childbirth at three times the rate of their peers in other wealthy nations. In New York City—one of the world’s wealthiest cities—Black women are nine to twelve times likelier to die from pregnancy-related causes than white women. For every death, there are 60-70 cases of severe maternal morbidity, including hemorrhage, sepsis, and hysterectomy.

2. MAGA’s Pronatalism Is Rooted in White Supremacy The natalist ideology espoused by RFK Jr., JD Vance, Elon Musk, and Trump himself is explicitly linked to eugenics and deportation. As Carmon notes, “We want our people to have babies” is something you hear openly from MAGA leaders. They celebrate “Trump babies” while considering children born to immigrants as not truly American—making fertility central to their white supremacist project.

3. Pregnancy Has Been Criminalized in America Since Dobbs, there have been 412 pregnancy-related arrests in the United States, about half of them in Alabama alone. Women are being jailed for testing positive for drugs while pregnant—not offered addiction treatment, but arrested and held on impossible $10,000 cash bail. Some women don’t even know they’re pregnant until they’re tested upon admission to jail. Their pregnancies become evidence against them.

4. The Handmaid’s Tale Was Always About American Slavery As Carmon points out, the dystopia Atwood portrayed was already the reality for enslaved Black women in America. The “father of obstetrics and gynecology,” J. Marion Sims, experimented on enslaved women—Anarcha, Betsy, and Lucy—for years without anesthesia or consent. American pregnancy care was founded on the torture of Black women’s bodies, and that legacy continues today.

5. The Trump Administration Is Erasing the Evidence Trump has effectively canceled PRMS (the pregnancy research monitoring service) that tracks maternal morbidity and mortality nationally. Research grants studying how to improve maternal health are being cut as “DEI violations.” CDC pregnancy data is being deleted from websites. As Carmon warns: you can’t solve a problem you’re not allowed to document or even count.

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