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23 January 2018

Giving birth to a daughter in Trump’s America has shattered my belief in social progress

My daughter was one of four million babies born last year in the US, the most dangerous country in the developed world to give birth.

By Sophie McBain

It fills me with bitter sadness that my daughter, my first child, was born under a president who is an open misogynist, who brags about sexual assault, who responds to criticism with sexist slurs and whose policies will harm large numbers of women. I had not believed that Donald Trump could be elected, in part because I had long harboured an optimism that with each new generation the world was becoming a more progressive and tolerant place. How naive and complacent I was.

My daughter was born last March and I marvelled at the determination with which she rooted for milk and gripped my finger, and then learned to hold her head up, to propel herself forward, to stand tall. And I found myself worrying: when would someone first make her feel smaller because she is a girl? When will someone first make her feel vulnerable, first make her scared? How can I prepare her for the demeaning remarks and furtive gropes that women have learned to laugh off and shake off, and the incidents we just can’t? How can I teach her when to be fearless, and when to trust her fear?

My daughter was one of four million babies born last year in Trump’s America, the most dangerous country in the developed world to give birth. The US maternal mortality rate is the highest in the OECD – and rising. Childbirth kills between 700 and 800 women a year here. The US spends more on healthcare per capita than any other country, but funds are unevenly distributed. In a medical system that regularly overlooks maternal health, women of all classes and ethnic backgrounds die from preventable complications, but the inequalities are stark: black mothers are three times more likely to die in childbirth than white mothers.

Almost half of births in the US are paid for by Medicaid, the state-funded healthcare system for people with low incomes and no private health insurance. During Trump’s first year in office the Republicans have fought unsuccessfully to shrink Medicaid and roll back Obama-era reforms that protect women and newborns, such as regulation to stop insurers refusing to cover pregnant women, or selling healthcare plans that do not cover prenatal care and childbirth. Without health insurance, mothers can expect medical bills of $30,000 to $50,000 to have a baby.

Just under half of pregnancies in the US are “unintended”: where the woman became pregnant earlier than planned or had not wanted to have a child. The Trump administration has launched multiple attacks on women’s reproductive choices. Only swift legal challenges from the American Civil Liberties Union thwarted attempts by officials to block four teenagers in immigration detention from obtaining abortions. One of them had been raped. And last year, Republicans threatened to cut federal funding to Planned Parenthood, an organisation that provides millions of women with access to contraception, cancer screening, STI tests and abortions. This is more than an assault on individual freedom. When women have children before they are ready, they are more likely to suffer from medical problems. Their babies are more likely to be born underweight and less likely to receive adequate prenatal care. Unintended pregnancies can be deadly.

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Tens of thousands of babies were born suffering from opioid withdrawal this past year, because of their mothers’ addictions to prescription painkillers, heroin or fentanyl. Thanks to the opioid epidemic, life expectancy in the US has fallen for two consecutive years. It is America’s greatest public health crisis in decades and one that disproportionately affects Trump’s white working-class base – and yet the president has not allocated any new funds to the issue. He has failed to deliver on his promised “really tough, really big, really great” drugs awareness campaign and major public health posts remain unfilled. According to the most recent government figures, which are six years old and probably too low, one baby is born suffering opioid withdrawal every 25 minutes in the US. They are delivered in agonising pain, their bodies stiff and feverish, their cries unnaturally high-pitched. 

What future is there for the children whose parents do not fit into Trump’s vision for a restored America? Those whose parents are undocumented, and who now face a heightened risk of deportation? Those born to Salvadorans, Haitians and Nicaraguans who have been stripped of their protected status and may now be sent home? Or for Americans born to those known as Dreamers, who were brought to the US illegally as children but who may soon lose their work rights and protection from deportation.

There were also other babies born this past year who deserve America’s protection but have not received it. A few weeks ago, I got in touch with a Yazidi man with whom I had worked in Iraq. His older brothers had resettled in America under a visa programme for Iraqis who worked as translators for the US military. My friend could have applied under the same scheme, but he wasn’t sure he wanted to leave his homeland. Then, in 2014, Islamic State rampaged through his village, killing hundreds of men and enslaving thousands of women and girls. When we met in 2016, he was living near a refugee camp and waiting for his visa to be processed.

 We had lost contact for many months, and I wanted to know if he had managed to make it to the US before Trump came to power, with his travel bans and slashing of refugee resettlement quotas. He hadn’t. He emailed me photographs of his first child, a daughter the same age as mine. I think of them often, the sad, kind family whose lives are in limbo, and the girl born into a community almost destroyed by murderous religious zealots, and I can’t believe I was stupid and lazy enough to believe in the steady march of social progress. 

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This article appears in the 17 Jan 2018 issue of the New Statesman, Churchill and the hinge of history