Reproductive Regimes

This chapter argues that defensive medicine is not a significant problem in American obstetrics, despite strong myths about it. Maternity care providers intervene into labor and birth more than is optimal for maternal and infant health, but they do not do so primarily for legal reasons. An analysis of weekend births reveals that births are less likely to occur on the weekend in tort reform states. This suggests the opposite of defensive medicine: providers intervene more in the timing of births when they face less liability risk. Weekend births are also less likely in states with fetus-centered laws, so providers intervene more when women have fewer choices during pregnancy. This chapter then explores two cases as examples of a woman-centered and a fetus-centered regime: Oregon and Mississippi. From a policy perspective, laws that support women’s ability to make decisions for themselves and their fetuses encourage more evidence-based maternity care practices. Reproductive justice would also benefit from universal healthcare that covers all aspects of reproductive health.