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Op-ed

Are we back to the days of Jane Austen, when maternal death was a regular risk? | GUEST COMMENTARY

Recently my daughter, Lisa, called from Texas where she moved last year when she got married. She and her new husband are hoping to start a family when she finishes grad school. “Mom, I’m worried about what’s happening in Texas. What if something goes wrong when I’m pregnant?” Lisa said. “I won’t be able to get help.”

“Just come back to Pennsylvania,” I said. When problems crop up, moms double down, right?

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“But, Mom, what if I can’t get there on time?”

The anxiety in Lisa’s voice hit home — especially as I considered it in the context of the federal abortion ban bill that South Carolina Sen. Lindsey Graham introduced Tuesday. While it would allow for exceptions to save the life of the mother in its current form, I couldn’t help but wonder if that, too, will one day be stripped as an option.

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If something were to go wrong with my daughter’s eventual pregnancy or birth, would she be able to implement Plan B? (Not Plan B, the emergency contraceptive, though that also may be in jeopardy from overreaching lawmakers). To make matters worse, some doctors and medical students are reluctant to practice and study medicine in states like Texas with expansive anti-abortion legislation.

The new dark reality of maternal danger and death brought to mind my favorite author, Jane Austen.

Nowadays we associate Austen with lavish movie adaptations replete with gauzy Regency gowns and sumptuous balls leading to a blissful union between the principals. (Lisa was raised on the 1995 BBC “Pride and Prejudice,” a gift of six guilt-free TV hours for me when Lisa was home sick.) But beneath the opulent films and dazzling brilliance of Austen’s prose lurks a darker reality: what followed after marriage in the early 19th century. In Jane Austen’s day, there was no option for childbirth gone awry. Of her five married brothers, three lost a wife to childbirth.

In other words, Plan B was death.

Jane had the romance and the Regency frocks, but we have modern medicine, right?

Apparently not so much in the post-Dobbs ruling world where state legislatures, especially in the South, seem to be trying to outdo one another in strict anti-abortion laws and harsh penalties. In short, we are in serious danger of returning to Jane Austen’s world, where pregnancy was a matter of serious concern.

If you were a healthy young woman in the early 19th century, your chance of dying in childbirth of a bacterial infection, hemorrhage or preeclampsia (high blood pressure) was one in five. Serial pregnancy in Austen’s day was a reality of married life — and a game of Russian roulette. The risk of death increased with each pregnancy. Austen herself appears to have had a phobia of childbirth, and never had any, which is hardly surprising given the number of women she knew who died in childbirth.

Death during or following childbirth was so common in the early 19th century that Austen’s letters to her sister often sandwiched the news casually in between other family or domestic matters: “I believe I never told you that Mrs. Coulthard and Anne, late of Manydown, are both dead, and both died in childbirth. We have not regaled Mary with this news,” she wrote on Nov. 17, 1798. (Mary, the wife of one of Jane’s brothers, was expecting at the time.)

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In her fiction, Austen refers to anxiety about death in childbirth only obliquely. In “Emma,” for example, Emma Woodhouse decides to delay telling her father about her engagement to Mr. Knightley: “She had resolved to defer the disclosure till Mrs. Weston [Emma’s friend and former governess] were safe and well.” Emma is referring to Mrs. Weston’s first pregnancy in her mid-30s. Her friends are apprehensive about the coming birth, and indeed, Austen writes: “Mrs. Weston’s friends were all made happy by her safety.”

Fortunately for the hundreds of millions, past and present, who treasure Jane Austen’s work in all its incarnations, Austen’s mother survived the birth of the six children who preceded Jane, as well as a final son afterward.

Though times have changed in many ways since then, new laws are again making pregnancy frightening. My daughter and the daughters of future generations shouldn’t have to wonder whether they will be as fortunate as Jane Austen’s mother.

Pamela Jane (pamelajane@pamelajane.com) has written over 30 children’s books. Her essays have appeared in the New York Times, the Wall Street Journal and the New York Daily News.


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