When I heard that an Indian-American woman named Purvi Patel had been sentenced to 20 years in prison for the contradictory charges of feticide and neglect of a child — for allegedly killing an unborn baby and allowing a live one to die — I immediately felt connected to her. I felt connected both as an Asian-American woman and one who had faced her own miscarriages — all three of them. If I had lived in Indiana, or one of the other 37 U.S. states with fetal homicide laws like the ones used against Patel, instead of in Vancouver, Canada, could I have been sentenced to 60 years in jail?
A miscarriage, after all, is what Patel said happened to her in July 2013: a painful stillbirth in the bathroom of her parents’ house, where she lived, along with her 90-year-old grandparents. Bleeding heavily and disoriented, Patel went to a hospital alone, where she eventually admitted to doctors she had a miscarriage. Asked about the fetal remains, she said the baby was stillborn and that she had tried unsuccessfully to resuscitate it. Because she was in shock, she said, she didn’t call 911, and, before going to the ER at a friend’s urging, she placed the remains in a bag in a dumpster. “I assumed because the baby was dead there was nothing to do,” Patel later told police. “I’ve never been in this situation. I’ve never been pregnant before.” Later, police were able to recover the body, as well as text messages and internet searches about abortion pills, though no traces of the drugs were found in Patel or the fetus.
At the same time as abortion rights are disappearing across the U.S., so, paradoxically, are the rights of pregnant women. There have been 413 documented cases of arrest and forced intervention on pregnant women in the U.S. since 1975, according to a 2013 study published in the Journal of Health Politics, Policy and Law. Feticide laws passed to prosecute illegal abortion providers and abusive partners are increasingly used against pregnant woman, often for using illegal drugs and, now, having a miscarriage. The laws are disproportionately applied against low-income women and women of color (in the study, 59% of those detained were nonwhite) and heedless of the heartrending complications that can accompany many pregnancies, even those under routine perinatal health care. I should know.
I had my three miscarriages in a row years ago. My husband and I were newlyweds. Each left me devastated. My first loss caught me completely off guard, even though I knew miscarriage was common. (About 15 to 20% of known pregnancies end in miscarriage. One in 160 pregnancies ends in stillbirth.) I had known I was pregnant for a month when I started spotting around eight weeks, and, even though my midwife said it was probably nothing, the next day I miscarried — large, dark red blood clots — in a friend’s bathroom. I looked away and flushed.
The second one was at nine weeks. I knew what was happening as soon as I started bleeding. But because we had made it one week further, and I had just seen the fetus — and its beating heart — during an ultrasound, we were hopeful. The midwife sent me to the hospital, where a clinician confirmed I was miscarrying and asked me to collect “the conception material” for genetic testing. That night, while sitting with my husband in a theater (I decided going out was better than waiting at home for it to happen), a surge of warmth filled my pants. I went to the bathroom and felt something fall out. I stuck my hand in the toilet bowl and scooped up “my baby”: a clear, gumball-sized amniotic sac with something inside that resembled a head and eyes. Attached was a liver-colored placenta the size of a small apple. I opened the sanitary napkin disposal container in my stall, took out the bag, and dropped it all in.
If it had been up to me I would’ve looked away and flushed, just like I did the first time — keeping myself numb, distancing myself from what was happening. I wasn’t a cold-hearted, callous bad mom, the kind the state of Indiana made Patel out to be. In fact, I wasn’t a mom at all. I was a woman trying to cope.
Although we conceived and lost pregnancies under different circumstances, Patel and I have many things in common. Like Patel, I was raised in an Asian immigrant household, by a traditional — though in my case Chinese — family. Sex before marriage was considered immoral, and talks about sex and sexuality were virtually nonexistent. I lived under constant pressure to “save face,” preserve honor, respect my parents above all else — pressures that make women like me and Patel keep a lot of secrets to ourselves. If I were, like Patel, single, 33, and having an unplanned pregnancy with a married man with whom I worked in the family restaurant, I probably also would have kept silent, afraid of being shamed and blamed. I would have felt trapped and depressed, avoiding a doctor out of fear that my parents would find out.
I also feel connected to another Asian-American woman in Indiana: Bei Bei Shuai. Shuai, a Chinese immigrant, was eight months pregnant when her then-boyfriend told her he had no interest in marrying her, and would return to his wife and children. (She didn’t know he was married.) Distraught, Shuai, then 34, attempted to kill herself by eating rat poison. She survived, but her daughter, delivered by emergency C-section, died. After a month in a psychiatric unit, Shuai was charged with murder and attempted feticide. After 435 days in jail, she pleaded guilty to criminal recklessness and was sentenced to time served. “I feel like myself a failure. I failed my parents, failed my best friend, they are the only ones who loved me,” Shuai said in an interview after she was released from jail in 2012.
Another topic almost as taboo as sex and reproductive health among many Asians is mental illness, even though it is very common in our communities. Suicide is the eighth leading cause of death for Asian-Americans, (compared to 11th for the national population), and according to studies, Asian-Americans are significantly less likely than Caucasians to mention their mental health concerns to a friend or relative. The same studies show that for nearly half of Asian-Americans, access to mental health care is limited due to lack of English proficiency and shortage of therapists and other providers with the necessary language skills.
Four years ago, my husband and I left Canada and moved back to the San Francisco Bay Area. I got pregnant again and gave birth to a healthy girl. We were elated. But a month later, I began experiencing extreme anxiety, nonstop panic attacks, and insomnia. I had thoughts of killing myself, and my child. Three months later I was diagnosed with severe postpartum depression (PPD) and anxiety and nearly hospitalized. With medication and therapy I was treated and recovered within a year. Nobody had told me that depression affects up to 1 in 5 pregnant women (and suicidal thoughts are experienced by 30% of those women) and that PPD is experienced by 1 in 7 women — or that multiple miscarriages is one of the leading risk factors for PPD.
What Shuai, Patel, myself, and many other Asian-American women need is culturally competent reproductive and mental health care without the shame and stigma that places many women in physically and mentally complicated pregnancies, often in isolation. What we don’t need are laws that criminalize our predicament.
In places like Indiana, we may be especially targeted. “It’s scary for all women, but especially for Asian-American women in Indiana right now,” said Shivana Jorawar, reproductive justice program director of National Asian Pacific American Women's Forum. And it’s getting worse. Since 2009, eight states have enacted laws prohibiting sex-selective abortion — in part due to the misconception that Asian-Americans — and specifically those of Chinese and Indian descent — prefer male babies and practice sex selection abortions. (On the contrary, reports indicate Asian-Americans are having more girls than other Americans.)
Jorawar believes it’s no coincidence that the only two charges of feticide in Indiana — a state where only 2% of the population is Asian — were against Asian-American women. “There is a connection between the stereotypes that are being told about Asians and what is going on in Indiana and what happened to Purvi and Bei Bei,” she said. “That Asians have some kind of criminal disposition when it comes to pregnancy and reproduction… it’s an idea among anti-abortion activists that we cannot be trusted.” Jorawar is concerned that these stereotypes will result in Asian women being treated with more suspicion — or even turned away — when seeking abortions, out of fear that they are aborting on the basis of sex, which could mean prison time for doctors.
My third miscarriage — at 12 weeks — was my most painful, physically and emotionally, but also, in many ways, my most humane. At a routine ultrasound, the technician stared at the screen, pressed her lips, and said, “I’m sorry.” As I tried to process that I had lost yet another pregnancy, I listened to her explain that this time my body was unlikely to pass the fetus quickly, especially if I didn’t take medication to move things along. I could either wait for it to happen naturally, which could take weeks, risking painful cramping, or go to the hospital’s abortion ward to have the contents of my uterus removed. I chose the latter.
I was lucky, and so were the other women there. We were in Canada, where abortion is legal and free. Afterward, the hospital offered me a free session with a therapist, who helped me talk through my grief, anger, and self-blame. It was the kind of caring and compassionate perinatal health care that Patel and Shuai deserved. I went home rested and healed. But I also could have chosen to miscarry at home. I could have discarded the fetus myself before going to the hospital for follow-up care. The last thing I would’ve suspected or needed was for my doctor, along with police, lawyers, judges, and politicians, to treat me like a “baby killer,” accuse me of aborting my own child without sufficient evidence, and then throw me in jail.
What concerns me about Patel and Shuai’s cases now is that what happened to them could happen to my daughter someday. I want to raise her knowing that if she ever becomes pregnant — and even if it ends in miscarriage, stillbirth, or abortion — she won’t be imprisoned for seeking medical care. I also really wish our country would begin paying more attention to perinatal mental health — providing culturally competent screening, treatment, and overall support for depression and anxiety for all women during and after pregnancy. Most of all, for my daughter and her generation, I hope we can become a society that values the lives of women as much as we seem to value those of unborn babies.