Feminism and Womens Control Over Their Bodies in A Neoliberl Context - Cristina Alcalde - Feminist Formations

Feminism and Women’s Control over Their Bodies in a
Neoliberal Context: A Closer Look at Pregnant Women on Bed

Rest
M. Cristina Alcalde
Feminist Formations, Volume 25, Issue 3, Winter 2013, pp. 33-56 (Article)
Published by Johns Hopkins University Press

DOI: https://doi.org/10.1353/ff.2013.0045
For additional information about this article

https://muse.jhu.edu/article/530780
[132.248.9.8] Project MUSE (2024-05-03 20:28 GMT) Universidad Nacional Autonoma de Mexico
Feminism and Women’s Control over
Their Bodies in a Neoliberal Context:
A Closer Look at Pregnant Women on
Bed Rest
M. Cristina Alcalde
Feminist self-identification influences women’s voting practices, perceptions of gender

discrimination, and views about their bodies. However, there is little information
on how feminist self-identification influences women’s experiences of high-risk preg-
nancy, if at all. The article focuses on women’s identification with feminism within
a neoliberal US context to examine how women make sense of and experience the
medical prescription of pregnancy bed rest. Each year, medical professionals prescribe
pregnancy bed rest for 700,000 to 1 million women in the United States. On the one
hand, women’s overwhelming expectation of control over their bodies and reproduc-
tion suggests that they cannot easily be divided into feminist and nonfeminist camps;
on the other, preliminary findings from a small-scale qualitative study suggest ways
in which feminist identification may affect women’s experiences of pregnancy bed
rest. Feminists were more likely to be in an egalitarian relationship that facilitated
the redistribution of household chores during bed rest.
Keywords: bed rest / bodily control / individualism / medicalization /

neoliberalism / pregnancy / US feminism
A high-risk pregnancy that includes weeks or months on bed rest is not the
sort of pregnancy experience women tend to imagine, yet it is far from rare.
In the United States, medical professionals prescribe pregnancy bed rest for
700,000 to 1 million women each year (Maloni 2010, 115, 106). How women
experience this loss of control over their pregnancy and make sense of bed rest
©2013 Feminist Formations, Vol. 25 No. 3 (Winter) pp. 33–56

34 · Feminist Formations 25.3
can be better understood by examining the sociocultural context in which

these experiences take place—in particular, by examining the implications of
dominant ideologies on women’s bed-rest experiences. Research on reproduction
and pregnancy suggests that pregnancy commonly “raises questions for a woman
about her sense of identity and embodiment” (Schmied and Lupton 2001, 32).
Some studies suggest that feminist self-identification influences women’s specific
voting practices (Cook 1993), perceptions of gender discrimination (Fischer
and Good 1994), views about their bodies (Ojerholm and Rothblum 1999),
and adherence to sexual double standards (Bay-Cheng and Zucker 2007). As
Sylvia Walby (2011) reminds us, however, feminist self-identification is only one
of several possible way of recognizing feminism in day-to-day interactions and
academic studies. We can understand women who reject the feminist label but
who seek to reduce gender inequality as also practicing feminism because they
advance feminist goals (3–4).1 Bed rest and feminism are rarely, if ever, discussed
in relation to each other.
This article foregrounds pregnancy bed rest as a site for examining the
intersection of neoliberalism and feminism in the lives of women in the con-
temporary United States. The intersection of feminism, with its emphasis on
control over one’s body and gender equality, and neoliberalism, with its empha-
sis on individualism, choice, and control, results in the distortion of feminist
trajectories and an emphasis on individual accountability and blame in cases
of pregnancy bed rest. In the US neoliberal context, where demonization of
feminism in the news and other media is common (Beck 1998; Lind and Salo
2002; McRobbie 2009; Walby 2011), feminist values of control over one’s body
and gender equality become increasingly viewed as common-sense expectations
that are devoid of feminist trajectories and goals. Women blame pregnancy
complications and unequal gender relations on their individual choices. Femi-
nist attention to the need for broader transformation of societal structures to
ensure both control over one’s body and gender equality is absent from women’s
discussions of bed rest and feminism. Women stay clear of questioning the
broader, often patriarchal cultural and medical structures that present bed rest
as the only or best solution, and that undergird the unequal gender relations
informing women’s daily experiences of bed rest in their homes.
I am not alone in suggesting that neoliberalization distorts feminist trajecto-
ries and values. Focusing on India, Shubhra Sharma (2011) finds that neoliberal
ideals of control, choice, individualism, and governance quickly displaced the
feminist agenda touted by a state-run women’s education program. The neo-
liberal focus on individualism and individual choice is particularly visible in
the growth of therapy and self-help groups and literature in the United States.
While therapeutic practice and self-help books draw their methods and goals
from feminism, the subjects of transformation are individual women, rather than
the system that constrains and devalues women; a feminist critique would also
include a systemic approach (Kelly, Burton, and Regan 1996).
M. Cristina Alcalde · 35
The first part of the article introduces the central role of neoliberal eco-
nomic and cultural ideologies in the United States, which I connect to the
medicalization of women’s bodies and the commodification of childbirth and
maternity. The article then shifts focus to the relationship between feminist
goals during the second wave and the undermining and even co-opting of
feminist goals within popular culture and state institutions in the contemporary
United States. I do so to introduce the experience of bed rest as a site for the
examination of the intersection of feminist goals and neoliberal values. I exam-
ine ways in which feminist and neoliberal goals influence both self-identified
feminist and nonfeminist women’s experiences of bed rest. I pay special attention
to women’s ideas about feminism and control over their bodies and reproduction,
as well as to the distribution of household chores as a measure of gender equal-
ity. Throughout the article I propose that today, women’s experiences of bed
rest are better understood when we also consider the influence of neoliberalism
in the contemporary United States. The findings presented here contribute to
feminist literature on women’s relationship to their bodies and the experience
of pregnancy, particularly in a neoliberal context.
Methodology
Data for this study came from twenty-five online surveys and ten face-to-face
interviews. I conducted surveys in 2009 that included questions about employ-
ment, family and relationships, support networks, coping strategies, feminism,
and the impact of bed rest on views about the body. I also conducted individual
interviews, after concluding the survey portion of the study. Interviews with
women who had not completed the survey provided a more in-depth examina-
tion, through lengthier and more detailed discussions, of the issues covered in
the survey. Interviews were digitally recorded and transcribed verbatim by the
researcher. Close readings of the transcripts allowed me to identify recurring
themes. In addition to interview transcripts and surveys, I draw on literature
about US feminism, bed rest, and neoliberalism—three bodies of literature that
are rarely discussed in relation to one another.
Three survey and interview questions focused specifically on feminism.
These questions asked women if they self-identified as feminist, what their
definitions of feminism are, and if and how their definition or views of feminism
changed as a result of bed rest. The women were also asked to discuss their
employment status, division of household chores, and reactions when their
doctor prescribed bed rest. An additional area consisted of questions about
women’s general rapport with their doctors and nurses.
I recruited survey participants by invitation from online pregnancy and par-
enting forums,2 having received permissions from the site manager and listserv
owner to post an invitation to the study.3 I identified myself as a researcher and
professor in gender and women’s studies and as someone who had personally
experienced pregnancy bed rest. I also used the snowball technique within
my social networks; I asked friends and acquaintances who had recently given
birth if they knew anyone who had been on bed rest, and later interviewees
referred me to additional participants. The interviews typically took place in
participants’ homes or at cafes.
Survey participants came from various states, although the majority of
interview participants lived in Kentucky. I conducted two interviews over the
telephone because the participants lived outside of the state. I provided partici-
pants with a link to the survey, and they could complete the survey either in
parts or all at once. The participants were not compensated. Survey completion
was estimated to take between ten and thirty minutes. I asked interview par-
ticipants to set aside one hour to meet with me and gave them a $15 retail-store
gift card at the beginning of the interview.
Participants had experienced pregnancy bed rest for at least one week at
home or in the hospital starting as early as the nineteenth week of pregnancy
during the past five years. Women may be prescribed total or partial bed rest
for varying amounts of time and at any point during the pregnancy: in total
bed rest, women spend all day in bed “lying down or sitting up slightly” and
may or may not have bathroom privileges; in partial bed rest, women may rest
in bed for several hours each day and stand for only a few minutes at a time
(Adler and Zarchin 2002, 420). Medication and frequent medical monitoring
are common during bed rest. The women in this study had been on bed rest
from one to twenty weeks.
There was some variation in terms of race, religious background, age,
number of children, household income, employment status, and the prescription
of hospital or home bed rest. Among survey participants, 75 percent identified
as white, 13 percent as Latina, 3 percent as African American, 3 percent as
Asian, and 6 percent as multiracial. Among interviewees, 90 percent identified
as white and 10 percent as Latina. Religious preference included a range of self-
identifications: Catholic, Protestant, Seventh-Day Adventist, Christian, Jewish,
Mormon, Buddhist, Wiccan, atheist, and nonreligious. The two largest groups
among survey participants were Catholic and nonreligious (both 23 percent).
Among interviewees, most women identified as Christian (80 percent).
All but two women identified as heterosexual and were married, although
single women and those living with a partner also participated.4 Women
between the ages of 21 and 41 participated; the average age was 31 for the survey
and 37 for the interview. Women with children at the time of their bed-rest
experience had between one and five children; twelve did not have any living
children at the time of their bed resting. Annual household incomes also varied:
among survey participants, 10 percent of women reported less than $20,000, 13
percent reported between $41,000 and $50,000, and almost 20 percent reported
over $100,000; among interviewees, the average household income was $80,000,
which reflected the predominantly middle-class background of interviewees.
Of the thirty-five participants, ten identified as feminist, and seventeen

rejected the feminist label. The remaining eight stated that they were not sure
whether they would identify as feminist. Women who identified as feminist
came from diverse racial and religious backgrounds, as did women who rejected
the feminist label. Similarly, both self-identified feminists and nonfeminists
exhibited diverse educational backgrounds and levels of income. While 89
percent of the women were prescribed to take their bed rest at home, 43 percent
were prescribed to take it in the hospital; as suggested by these percentages,
several women experienced bed rest both at home and in the hospital. Among
survey participants, most women (68 percent) worked outside the home before
beginning bed rest; similarly, the majority of interviewees (90 percent) worked
outside the home.
The Context: Neoliberalism and the Medical Prescription of Bed Rest
Neoliberal Influences
The economic dimensions of neoliberalism—namely, privatization, market lib-
eralization, and fiscal austerity—and their impact on public policy are popularly
recognized, yet the cultural politics of neoliberalism is rarely examined (Duggan
2003, 11). However, it may be equally important to examine neoliberal cultural
politics if we are to understand women’s experiences of the medical prescription
of bed rest, how women relate to feminist identities, and the development of
ideas about feminism in the contemporary United States, where neoliberalism
has been the dominant paradigm since at least the early 1980s.
According to Kristin Bumiller (2008, 13), for example, the implementation
of neoliberal agendas, characterized by an emphasis on choice, consumerism,
and personal responsibility, as well as indifference to structural inequalities,
significantly contributed to the derailing of a more progressive feminist agenda
within the anti-violence (against women) movement. Rather than addressing
“women’s systematic oppression,” the co-optation of the movement included
a focus on crime control, including dual-arrest policies that further victimize
women, the increasing bureaucratization of rape-crisis intervention, and the
individualization of the problem of sexual violence. Although these interven-
tions were developed in the name of feminist goals, the practical result was the
prioritization of crisis containment and maintenance of social control, security,
and order. These results were incompatible with reducing systemic oppression.
The neoliberal economic and cultural focus on governmentality, consumer-
ism, individual choice, and responsibility is also apparent in the marketization
of health care and the commodification of childbirth and maternity. Even as
women’s bodies are increasingly controlled and governed through higher rates
of induction, ultrasounds, and fetal monitoring, women are touted as consum-
ers with infinite choices available to them. In some cases, targeting women as
consumers means that hospitals produce and increasingly rely upon homelike
birthing rooms to attract women. This idealization of the home space as desir-
able, however, is problematic, not least because of the real threat of the lack of
autonomy and intimate partner violence that many women face precisely in
the home (Fanin 2003). Motherhood presents even more possibilities to target
women as consumers, since women feel pressure to embrace consumerism and
choose appropriate child-friendly goods and services to become and be publicly
recognized as “good” mothers (Taylor, Layne, and Wozniak 2004).
Pregnancy Bed Rest

Mainstream neoliberal cultural expectations of choice and self-control are
more restricted by gender, health, and ability than may at first appear; pregnant
women, the ill, and the disabled may experience and be expected to give up
control in ways that others are not. The feelings of guilt and self-blame that
women with pregnancy complications commonly experience can thus be better
understood within the context of the cultural expectations that the mainte-
nance of a healthy body is an individual responsibility (Becker 1997; Kukla
2005), that the body becomes the emblem of the self (Greil 2002, 105–6), and
that failure is a reflection of bad choices.
The medical knowledge that leads to the prescription of bed rest is far from
certain. On the one hand, bed rest is among the most common prescriptions to
treat a range of pregnancy complications in high-risk pregnancies. Among the
women who participated in this study, the diagnoses that led to prescriptions
of bed rest included preeclampsia, irritable uterus, vaginal bleeding, cervical
effacement, placenta previa, hypertension, placental abruption, and preterm
labor. The most common diagnoses were preterm labor (PTL) and cervical
effacement. In most cases, women were unaware that there was something
wrong with their pregnancy until a doctor informed them and prescribed bed
rest. On the other hand, there is little evidence of the causes of preterm labor
and that bed rest is effective in preventing it (Adler and Zarchin 2002; Aleman
et al. 2005; Maloni 2010; Maloni and Kasper 1991; Schroeder 1998). There have
been calls within the medical profession to reevaluate the effectiveness of bed
rest (Allen, Glasziou, and Del Mar 1999). Existing studies point to “either no
effects or negative effects of bed rest on fetal outcomes” (Schroeder 1998, 47).
In one study of 326 women with high-risk pregnancies, pregnancy outcomes
proved similar for women who followed the prescription of bed rest and for
women who did not (Josten et al. 1995).
While it may be true for some women that “if a baby is a priceless benefit, then
almost any risk is worth taking” (Becker 2000, 97), it is also the case that women
do not always know about all the risks connected to bed rest. PTL is a common
reason for the prescription of bed rest; on its own, however, bed rest may not stop
PTL, and doctors may prescribe anti-contraction drugs to help prevent PTL while
women are on bed rest. One of the drugs commonly prescribed is terbutaline,
which “relaxes smooth uterine muscle but stimulates the body to be active in other
ways” (Williams and Mackey 1999, 37), making it especially challenging for women
to remain still and in bed. Women commonly accept anti-contraction medication
in the hopes of having a healthy baby at the end of the pregnancy. However, in
their study on PTL, Susan Williams and Marlene Mackey found that among the
women who participated in the study, “none said they were advised of the risks
and benefits of treatment” (ibid.). Perhaps more disturbing is that the Food and
Drug Administration (FDA) has not approved terbutaline to treat PTL; in fact,
in February 2011, it issued a warning against using the drug to treat PTL, linking
it with maternal heart problems and death (FDA 2011).
Incomplete medical knowledge, however well-intentioned, is rarely ques-
tioned in a context in which it is upheld as purely objective and in which
medical institutions become spaces of control over women’s reproductive experi-
ences. Women’s bodies are continuously medicalized and controlled to ensure
that women make “responsible” choices about their bodies and health in their
path to motherhood, and this medicalization of pregnancy dates back to the
mid-1950s (Oakley 1984). By the 1960s and ’70s, women had organized against
the medicalization of their bodies, and the US women’s health movement ques-
tioned the authority of medical professionals and the patriarchal practices of
the medical world at the same time that it advocated for more self-help (Reed
and Saukko 2010, 86). However, forty years later, it is still commonly the case
that “medical knowledge, as a scientific product, is assumed to represent ‘uni-
versal truth,’ arrived at through the application of objective, detached reason”
(Williams and Mackey 1999, 31).
Doctors’ good intentions, coupled with incomplete medical knowledge, may
not be the only reason that bed rest persists. According to Carole A. Schroeder
(1998), the prescription of it continues for several reasons, including the fear of
malpractice lawsuits and, significantly, because of idealized and outdated views
of women. The belief that women remain at home while the husband works full-
time may inform some medical professionals’ decision to prescribe bed rest; they
assume that there will be no or very little economic harm done to the family
if women are forced to quit their jobs in order to stay in. As Schroeder points
out, only a small minority conforms to this idealized version of the family (47).
The persistence of bed rest as a common prescription, in spite of a lack
of evidence to support its effectiveness, leaves women with few alternatives.5
Because PTL continues to be a significant maternal/child health issue in the
United States, the threat of it encourages women to accept bed rest as neces-
sary. In 2005 in the United States, preterm infants made up 68.6 percent of all
deaths of infants under age 1 (Maloni 2010, 106). Within this cultural context
of medical control over women’s reproductive experiences, incomplete medical
knowledge, and serious risks to preterm infants, women have few options but
to follow the prescription of bed rest.
Although women are initially surprised about the prescription of bed rest
because they are not given—and, indeed, there may not be—other viable
treatment options, they accept the prescription of bed rest to manage and con-
tain the crisis they face in their pregnancy, often at high personal and family
costs. Among women who give birth at twenty or more weeks of pregnancy in
the United States, almost one-fifth are prescribed bed rest for at least a week
during their pregnancy (Adler and Zarchin 2002, 419). Another study finds
that “more than 90% of obstetricians recommend bed rest to avoid miscarriage,
preterm labor, and other pregnancy complications” (Maloni, Cohen, and Cane
1998, qtd. in Sprague 2004, 545).
Side effects associated with bed rest include sleep disturbances, headaches,
thromboembolic disease, atrophied muscles, backaches, bone demineralization,
indigestion, fatigue, anxiety, depression, inability to work, and loss of wages
(Allen, Glasziou, and Del Mar 1999; Heaman and Gupton 1998; Maloni and
Kasper 1991; Maloni and Park 2005; Richter, Parkes, and Chaw-Kant 2007).
Women on bed rest also experience increased fatigue and muscle weakness
and an overall longer recovery time during the postpartum period than women
who are not prescribed bed rest (Maloni et al. 1993; Maloni and Park 2005;
Schroeder 1998). Because bed rest forces women to stop working, it is likely to
significantly impact family income and women’s careers; it also necessitates the
redistribution of household chores and child care.
As the medicalization of women’s bodies—in particular, pregnancy and
childbirth—has intensified over the last five decades, women have faced sig-
nificant challenges maintaining control over their bodies, and feminist schol-
ars have become increasingly interested in women’s embodied experiences of
pregnancy, pregnancy loss, and new reproductive technologies (Becker 1997;
Bridges 2011; Kahn 2000; Kukla 2005; Layne 2003; Lundquist 2008). Pregnancy
bed rest has received scholarly attention from health professionals (see, for
example, Adler and Zarchin 2002; Aleman et al. 2005; Allen, Glasziou, and
Del Mar 1999; Heaman and Gupton 1998; Josten et al. 1995; Maloni 2010;
Maloni, Brezinski-Tomasi, and Johnson 2001; Maloni and Kasper 1991; Maloni
and Park 2005; Richter, Parkes, and Chaw-Kant 2007; Schroeder 1998), but
the subject is largely absent from feminist social science scholarship. Bed rest
appears to be primarily discussed in connection to new reproductive technolo-
gies, particularly in vitro fertilization (IVF), and is mentioned in passing as part
of the long path from infertility to fertility (Becker 2000). Although blogs and
websites dedicated to pregnancy complications, including bed rest, are becom-
ing increasingly common, women who expect uncomplicated pregnancies have
little reason to become familiar with these; thus women have little idea that bed
rest is a treatment possibility. The reaction of Callie, one of the participants in
this study, was fairly typical among the women who participated: “[the book]
What to Expect When You’re Expecting and doctors, they never tell you about
this possibility, and then it happens and you’re blindsided.”6
Women who do not follow the medical prescription of bed rest may face
the disapproval of their doctor, as well as state intervention. In 2009, Samantha
Burton, a mother of two toddlers who worked full-time, asked to receive a second
opinion when her doctor prescribed bed rest at twenty-five weeks of pregnancy.
Her doctor was granted a court order to force Burton to undergo bed rest and
any other medical treatments that her doctor deemed necessary—against Bur-
ton’s will and without a second opinion—in order to save the fetus. Three days
into her forced hospitalization and bed rest, she was court ordered to undergo
a cesarean section; the fetus was found dead. Burton’s doctor, backed by the
Circuit Court of Leon County, Florida, denied her control over her own body
as a pregnant woman, in addition to denying her the right to make her own
informed medical decisions. The American Civil Liberties Union (ACLU) and
the ACLU of Florida filed a friend-of-the-court brief on behalf of themselves and
the American Women’s Medical Association (AMWA) to support Burton. The
case, Samantha Burton v. State of Florida, ended in 2010, the court ruling that
Burton’s rights were violated by the state of Florida and her doctor when she was
forced to remain hospitalized and on bed rest against her will. While the court
decision makes clear that pregnant women have the right to maintain control
over their bodies—an issue that the women’s movement fought for during the
1960s and ’70s—and to refuse medical treatments, this case also exemplifies
the cultural acceptance of medical control over women’s bodies and the lack
of choice women confront in cases of prescribed bed rest.
Feminism and Feminist Identification
Feminist Histories
Women’s control over their bodies and reproduction, as sources of power as well
as of vulnerability, has historically been a central concern for feminists. These
discussions have taken many forms: the relationship between the body and the
self (Beauvoir 1957); examinations of female embodiment during pregnancy
and through motherhood (Rich 1986; Young 1984); theorizations of the lived
body (Grosz 1995); embodied gender performance (Butler 1990); condemnations
of state and institutional regulation of women’s bodies; and calls for greater
reproductive freedom in communities of color (Nelson 2003; Roberts 1998;
Silliman et al. 2004). More broadly, as suggested by Walby (2011), an emphasis
on reducing gender inequality has also been reflective of feminism.
The second-wave feminist movement in the United States challenged dual-
isms that devalued women’s roles vis-à-vis men and was particularly concerned
with women’s reproductive rights (Budgeon 2011). Following on the heels of
victories for reproductive self-determination like Roe v. Wade (1973), the widely
known and cited feminist text Our Bodies, Ourselves (1976) supported women’s
efforts to increase their knowledge about and control over their bodies and
health. The book challenged biomedical institutions’ control over and objec-
tification of women’s bodies by demystifying medical information about them.
The feminist movement of the 1970s also brought attention to other issues that
profoundly affected women’s lives, including pornography, intimate-partner

violence, child care, and paid employment (Eisenstein 2005).
Considering the achievements in the area of women’s entry into the work-
force and professionalization, and examining the statements of women on bed
rest about their participation in the workforce, is one way to briefly examine
how feminist movements have influenced society and the experiences of women
on bed rest. The 1970s women’s movement transformed popular attitudes in
the United States about the role of women in society; middle-class women were
no longer expected to limit themselves to being housewives and mothers but
became an important and accepted part of the modern professional workforce
(ibid.). Women’s, especially white middle-class women’s, entry into the work-
force was facilitated through the collective efforts of women who advocated
for their rights and autonomy. These efforts made possible the passage of the
Equal Pay Act of 1963, which mandated equal wages for men and women doing
equal work, and the Civil Rights Act of 1964, which prohibited discrimination
against women by companies with twenty-five or more employees. In 1967, a
presidential executive order prohibited discrimination against women in the
hiring practices of federal government contractors. In 1978, Congress passed
the Pregnancy Discrimination Act, mandating compensation for women denied
employment opportunities because of pregnancy.
In spite of these improvements, working mothers continue to face obstacles
in balancing responsibilities at home with work outside the home, and to earn-
ing enough to support their families. In particular, the lack of company- and
government-subsidized child care disadvantages working mothers. In 1993,
women won a major battle with the passage of the Family and Medical Leave
Act (FMLA), which provides parents with up to twelve weeks of unpaid,
job-protected leave per year to care for a newborn or adopted child. The act
represents the first time that women’s need for maternity leave was recognized
by federal policy, although it did not specifically protect mothers because of its
gender-neutral tone; in fact, working mothers may be at a particular disadvan-
tage for using FMLA. Women are overrepresented in part-time jobs, but to be
eligible for FMLA an employee must have worked 1,250 hours in a year. Because
women are more likely to be employed in businesses with fewer than fifty
employees, which are not eligible for FMLA, many women who could benefit
from the act are unable to use it (Prohaska and Zipp 2011). Additionally, many
women are not able to support their family without an income.
Women’s advocacy for greater rights and autonomy, as well as equal pay,
have made possible significant gains in rights and protections in terms of entry
into the workforce; however, there is still much to be done. The majority of the
women in this study worked outside the home before bed rest (68 percent of
survey participants, and 90 percent of interviewees). For many women, careers
outside the home are an important source of identity, besides also being nec-
essary for their family’s economic sustenance. As one self-identified feminist
stated when her doctor prescribed bed rest, she felt that “things were ending.
Like I had no identity if I can’t work, do things I do every day.”7 In her initial
shock, she asked her doctor if she could at least finish the workweek. Another
self-identified feminist explained that one of the most challenging aspects of
bed rest was that, because she really enjoyed her job, she could not go to work.
Both feminist- and nonfeminist-identified women expressed concerns that bed
rest would negatively impact their family’s economic situation.
Feminist Identification
Women in the contemporary United States have benefited from, and been
influenced by, the struggles and accomplishments of second-wave feminism, yet
feminism has been largely cast out of political culture as being something of
the past that is now unnecessary. Few women openly self-identify as feminists
(McRobbie 2009, 2010). Although it is common for women to espouse broad
feminist ideals, in the contemporary neoliberal context, the feminist values of
empowerment, autonomy, and choice are celebrated primarily in connection
to neoliberal ideologies that promote individualism and self-invention through
consumerism (2009).
Among women on bed rest who participated in this study, ten identified as
feminist and seventeen rejected the feminist label. Overall, women who iden-
tified as nonfeminist provided short and more general definitions of feminism
than women who identified as feminist. Typical definitions of feminism among
nonfeminist women included “being pro-women,” “a little beyond equality
between men and women,” and “standing up for women’s rights.”8 For feminists,
definitions included the following:
Feminism is really a sociopolitical term, which does not have too much
application in 2009 as part of the national lexicon. . . . I have always been
considered to be a very strong and powerful woman.
Feminism means the right and ability for a woman to take care of herself
financially, emotionally, and being able to take care of herself in the everyday
things without the expectation that she has to rely on anyone else.9
The limited details and generalizations that dominated the responses of women
who rejected the feminist label suggest that such rejection may have more to do
with lack of knowledge and misinformation than with the informed rejection
of any specific aspect of feminism as a lived multidimensional practice.
Eight women stated they were “not sure” if they identified as feminist. In this
group, which made up 22.8 percent of all participants, discomfort and negative
connotations associated with the term were clear. One woman explained that
although she believed feminism was “a fight for the equal rights and treatment
of women both in society in general and in the workplace,” she was hesitant to
identify as feminist because she did not “subscribe to the militant connotation
that the term ‘feminist’ now has.” Another woman stated that she “would have
been [a feminist] at a certain point in history, but I don’t agree with the feminist
movement today”—also hinting at though not providing any details about the
negative aspects with which she did not wish to be associated. A third woman
reported that she believed “in equality between men and women, but I don’t
associate this with being a feminist.” Similarly, a fourth woman said that “I
believe in women’s rights, and agree/sympathize with a lot of feminist’s ideals,
but do not consider myself a feminist.”10
Women’s alienation from feminist self-identifications can be partly explained
through the backlash against feminism and the stereotypes now commonly asso-
ciated with it. Largely orchestrated by increasingly powerful right-wing evangeli-
cal groups, this backlash resulted in the stigmatization of feminists as separatists,
extremists, and men-hating lesbians (Eisenstein 2005; Faludi 1991; Ramsey et al.
2007; Walby 2011). The stereotype of the man-hating feminist is perpetuated by
the media and encourages women to disassociate themselves from the feminist
label (Beck 1998; Lind and Salo 2002); it also helps to explain the hesitance of
almost a quarter of the participants to identify as feminist in spite of agreeing
with the struggle for women’s equal rights and equal treatment.
Similarly, in a recent national poll, a majority of women held positive
views about the women’s movement and believed that it benefited their lives
and opportunities. At the same time, less than a quarter of the women who
were polled identified as feminist, and almost one-fifth of them considered the
term to be an insult (CBS News 2009). Laura Ramsey and colleagues’ (2007,
611) finding that “all women [in the sample], regardless of feminist identifica-
tion, believed that others view feminists negatively and as more likely to be
homosexual than heterosexual” also helps to explain the hesitance of women
on bed rest to identify as feminist.
As Hester Eisenstein (2005, 509) suggests, however, the selective touting
of feminism by the state within the neoliberal context has been useful to the
United States’s neoliberal agenda in the international arena because “the suc-
cess of the U.S. women’s rights movement has become central in the selling
of capitalism to the third world.” As the US government pushes for women’s
liberation elsewhere, it ensures corporate profit through the feminization of
the workforce in export-processing zones under the guise of women’s autonomy
and economic independence (Eisenstein 2010). In the United States, the
undermining of feminist goals within neoliberal agendas has contributed to
the privileging of choice and individualism over collective struggles against
systems of power and oppression (Grewal 2005; Hooton 2005; Liss and Erchull
2010; Skeggs 1995; Welsh and Halcli 2003). As neoliberalism and feminism
converge, then, individualist choice and consumerism become a way to express
(feminist) agency (Grewal 2005, 28). Additionally, although women of color
have criticized mainstream, white feminism for focusing only, or at least mainly,
on gender instead of upholding a more intersectional approach that also takes
into account the effects of racial, class, and sexual identities (Cho, Crenshaw,
and McCall 2013; Crenshaw 1991; MacKinnon 2013), gender continues to be
the main variable that is popularly linked to feminism.
Control
Pregnancy and motherhood constitute key areas in which women’s knowledge of

and control over their bodies in both the private and public spheres have faced
challenges. According to Tamsin Wilton (1995, 182), it is “precisely because of
their ability to mother that women’s bodies (and their political and social selves)
have been so rigidly controlled within all patriarchal political systems.” Yet, even
as women’s bodies and reproduction are subjected to more medical and political
control, the neoliberal milieu celebrates autonomy, choice, and control. Within
this context, “neoliberal ideologies of choice and self-determination seemingly
mirror and endorse many feminist ideals such as self-determination and self-
sufficiency” (Budgeon 2011, 65). Women discuss control over their bodies and
reproductive rights as a commonsensical expectation, not as a feminist value.
Control over their pregnant body is further associated with making “good”
choices about proper diet and exercise (Dworkin and Wachs 2004). In an envi-
ronment in which good individual choices should lead to positive outcomes,
women are surprised by being prescribed bed rest because it signals bodily failure
in spite of good choices.
Among feminist-identified women, there was a clear expectation of control
over their bodies. Significantly, this control was not directly linked to feminist
values, but instead to diet and exercise. The following are common answers to
my question about how much control feminist-identified women felt they had
over their bodies before bed rest:
• “I had control over my body to the extent that I stayed healthy by eating
properly, etc. I could move to exercise.”11
• “I felt like I had total control over my body, or I at least took care of my
body, and knew that if I exercised and ate certain foods things would be
okay.”12
• “I felt I had a lot of control. You know, I ate healthy, was swimming,
walking.”13
Having taken care of their bodies by carefully controlling their food intake and
exercise regimes, women without previous pregnancy complications may be
initially shocked to learn they do not have the control they believed they had
over their bodies. For example, one woman explained that she was surprised by
the bed-rest prescription because she had “always been in strong health. I just
never considered the possibility.”14
Of all the women surveyed and interviewed, only one explicitly connected
feminism to control over her body and reproduction. When I asked her if she
identified as feminist, she responded: “I would consider myself liberal feminist.

I believe women should have charge of their own bodies.”15 This woman’s state-
ment is significant precisely because the connection between feminism and
control over women’s bodies is glaringly absent from other women’s responses,
as well as from their reactions to doctors’ prescriptions of bed rest.
Among women who rejected the feminist label, a typical answer to my
question about how much control they felt they had over their bodies before bed
rest was: “I thought I was able to take care of myself and be in control of what
happened to me and now I realize that I can’t control everything.”16 Nonfeminist
women did not directly refer to exercise and food intake as a way to control
their bodies, yet, they too hinted that their behavior—for example, neglecting
exercise or eating unhealthy food—was directly connected to control over their
bodies. For instance, they made statements like “I need to get healthier, I feel
guilty, I often wonder that this is my fault” and “I feel like I have done something
wrong, or like somehow it’s my fault.”17 As a result of bed rest, women felt that
they had, as one put it, “lost all control.”18
There was no apparent difference in how women who identified as femi-
nist and others who did not described their expectations of control over their
bodies and pregnancies. For both feminist- and nonfeminist-identified women,
the body appears as limiting and inhibiting; it is both the site of control before
pregnancy complications and of loss of control during such complications.
Responses from both groups of women underscore that both feminist and
nonfeminist women alike understood their bodies to be under their control.
As many women emphasized, this control was made possible largely through
individual behaviors and choices, such as eating healthily and exercising, and
not through feminist values. For both groups, individual lifestyle choices were
assumed to be effective ways in disciplining the body to ensure that it does
not become unhealthy. Because of this expectation of control, both feminists
and nonfeminists felt an almost complete loss of control over their bodies and
lives when they were prescribed bed rest, and yet, they did not question the
prescription.19 Women critically self-examined and blamed their individual
lifestyle choices for the onset of pregnancy complications; they steered clear of
examining or questioning the cultural and medical structures that present bed
rest as the only or best solution.
Feminism, Egalitarianism, and Household Chores
Young women typically expect gender equality in their lives, yet they resist
the feminist label (Rich 2005). Gender equality is assumed to be a given and,
therefore, openly pushing for and using the language of gender equity is viewed
as unnecessary (Stevenson, Everingham, and Robinson 2011). In this environ-
ment, both social inequality and people’s successes and failures are popularly
explained away by referring to good and bad personal choices (Budgeon 2011,
93). When the commonsensical expectation of gender equity falls through,

however, women may blame themselves by viewing their personal choices as
contributing to unequal gender relationships in their intimate relationships.
Cohabitating couples tend to share chores more equitably today than just
fifty years ago, but even in cases in which women have full-time jobs outside
the home, they take on a disproportionate share of household chores and child
care (Askari et al. 2010). In fact, young women today anticipate that they will
do more household chores than their partner, in spite of the egalitarian ideals
of both partners (ibid.). While ideals of control similarly influence self-identified
feminist and nonfeminist women’s views about control over their bodies, as indi-
cated in the previous sections, in the area of egalitarianism and the distribution
of domestic chores, there was a marked difference in the day-to-day practices
between these two groups.
Egalitarian relationships are particularly difficult to define. While the exact
ratio of men’s to women’s household chores may vary in specific egalitarian rela-
tionships, overall, researchers define egalitarian relationships as ones in which
“neither partner is doing more than 60% nor less than 40% of the labor” (243).
As Andrea Doucet (2006) suggests in her study of men’s involvement in child
care, even in egalitarian relationships in which men perform several household
chores and child care, women continue to multitask and be responsible for a
disproportionate amount of household work.
Among women on bed rest, self-identified feminists were more likely than
nonfeminists to share household chores equally with their partners, and this
had significant implications for women’s bed-rest experience. Among feminists,
eight women (80 percent) stated that they shared chores equally with their
partner before bed rest, while among nonfeminists, eleven (35 percent) said the
same. During bed rest, however, 80 percent of both self-identified feminists’ and
nonfeminists’ male partners performed more than half of the household chores.
Although there was no difference in the percentage of partners performing
more than half of the household chores during bed rest among self-identified
feminist and nonfeminist women, women’s discussions of bed rest and their
male partners’ behaviors and attitudes provide additional insight into women’s
connection to the feminist goal of reducing gender inequality during bed rest.
Among self-identified feminist women, one stated that she and her husband
shared household chores equally before bed rest; after her bed rest began, however,
she was no longer able to perform even the most basic of tasks, such as preparing
her own meals. In this case, the woman said that during her bed rest, her “hus-
band did all the housework, laundry, cooking, and cleaning without a complaint
and would not let me do anything.”20 He also borrowed a wheelchair so that she
could get some fresh air on weekends. Another woman who also identified as
feminist and equally shared household chores before bed rest said that “I watched
my husband doing chores around the house and helping me out and I adored
him for it.” She then added: “I would have given anything to do them myself.”21
In these two cases, the women’s loss of control over their daily routines during
bed rest was allayed, at least partially, by their partners’ efforts in assuming the
household chores. These women’s cases, however, were not the norm.
One nonfeminist-identified woman discussed how the unequal distribution
of household chores before bed rest affected her. She had performed more than
half the chores before bed rest. Her bed rest experience was heavily informed by
what she described as her disappointment “in my husband and his lack of caring,
understanding, and compassion for me in this situation. I expected him to step
up and take on more responsibility around the house and help out more with
our daughter. He does this . . . but with much complaining, whining, guilt-trips,
and selfish rampages. I am filled with resentment, which is something I have
never felt toward my husband.” As a result of her husband’s failure to take on
more household chores without making her feel bad, coupled with her lack of
control over the situation, she felt that “my marriage is not nearly as strong as
previously [I] believed [it] to be.”22 This woman’s comments indicate her wanting
to reduce the existing gender inequality in the distribution of household chores,
at least during her period of bed rest; a more equal distribution of chores would
have, in her view, proven that her marriage was as strong as previously believed.
Another woman who identified as nonfeminist and who performed more
than half of all household chores before bed rest explained that, although the
doctor had told her she should not do such chores, her husband continued to
expect her to cook for him and their children. This woman received the most
support from her mother, in whose house the woman and her young children
stayed during the day while her husband was working. There, her mother cared
for her children and prepared meals and would not allow her to rise from her
bed. Invoking egalitarian ideals were particularly difficult for these two women,
whose experiences suggest that concerning the unequal distribution of house-
hold chores, pre-pregnancy bed rest may lead to more difficulties in couples’
negotiation of the redistribution of such chores, which may also foster additional
stresses on intimate relationships.
Preliminary findings suggest that self-identified feminist women are more
likely to have supportive male partners or husbands who agree with their views
on gender equality and are willing to take on a disproportionate amount of
household tasks and child care while women are on bed rest. All of the women
who identified as feminist listed their partners or husbands as part of their sup-
port systems. However, three woman (17 percent) who rejected the feminist
label and lived with a husband or male partner did not cite them as part of
their support network. These women indicated that their partners performed
less than half of the household chores before bed rest. Women who did not
cite their husbands or male partners did, however, mention their mothers or
mothers-in-law as part of their support systems. In these women’s experiences,
this gendered division of labor resulted in less support during bed rest from their
partners in performing household chores.
Conclusions
While, as one woman put it, “I am not any less of a feminist lying down versus
standing up,” previous studies have not examined bed rest and feminism in
relation to each other. Feminist literature has focused on pregnancy, birth,
and infertility, but prescribed bed rest—a common treatment for pregnancy
complications—has not received attention as an issue worthy of scholarly
examination. This article focuses on the intersection of bed rest, feminism, and
neoliberalism to better understand feminist identification and neoliberal influ-
ences in the United States, and to contribute to feminist literature on women’s
experiences of pregnancy.
Feminism is popularly viewed as irrelevant to women’s lives in the United
States, but it has had, and continues to have, significant influence on society.
Signs of the influence and development of feminism are all around us. For exam-
ple, in the international realm, feminism is evident through the mainstream-
ing of feminist projects by state institutions, the creation and maintenance of
ministries for women and women’s issues, and the inclusion of gender equity in
national foreign-policy projects around the globe (Hawkesworth 2004). In the

United States, feminist activism has led to greater reproductive rights, family
leave, and labor rights, among many other accomplishments. As this article
suggests, feminism and feminist influence are also evident in women’s agree-
ment with and expectation of gender equity and control over their bodies and
reproduction both before and as they confront the reality of prescribed bed rest.
As one feminist identified woman stated: “You have to be mentally strong to
lie down all day and limit your movement, especially while in physical pain. You
have to be ‘hard core’ and have a mission.”23 The “mission” of making it through
the pregnancy was similar for all women on bed rest. Their strong expectation
of control over their bodies and reproduction before bed rest suggests that
women cannot easily be divided into feminist and nonfeminist camps. Signifi-
cantly, the connection these women made between control over their bodies
and good choices—for example, of diet and exercise—also reflects the ways in
which neoliberal values have blurred feminist goals, even as the expectation of
control underscores the influence of feminist struggles on women’s expectations.
Gender equality is also a feminist goal, and it too has popularly been
assumed to be a given in the current US neoliberal milieu, yet the blurring
of feminism and neoliberalism has not resulted in similar practices regarding
gender equity among self-identified feminists and nonfeminists. Women who
identified as the former were less likely to experience difficulties due to the
necessary redistribution of household chores while on bed rest; for the latter, it
was less common to be in a relationship in which male partners were already
doing at least half the household chores before the prescription of pregnancy
bed rest. This suggests that, at least among the group of women in this study,
although the expectation of control was similar among women who identified
as feminist and those who did not, the everyday practice of egalitarianism in an
intimate relationship is more common among women who identify as feminist.
In providing a feminist perspective on women’s experiences of bed rest in
the United States, this article engages with the socioeconomic and cultural
context to underscore that women’s expectations of control over their reproduc-
tion and bodies, as well as the distribution of household chores, are informed by
both feminist and neoliberal values. Carefully examining women’s relationship
to feminist ideals in a neoliberal context suggests that we are best equipped
to approach and understand the complexities of women’s experiences of the
common medical prescription of pregnancy bed rest. In a context in which
autonomy and choice are celebrated, the medicalization of women’s bodies and
commodification of maternity have, in practice, resulted in fewer choices for
women.
Bed rest is often presented to women as a medical mandate, not a choice.
Women undergo bed rest in spite of a lack of evidence of its effectiveness, its
potentially harmful consequences on their family’s economic well-being, and
its negative consequences on their careers, since women must stop working
to stay in bed. To make sense of their mandatory bed rest, women commonly
search for “bad” choices they may have made and that contributed to pregnancy
complications. Their discussions of bed rest fall short of critiquing the cultural
and medical system that imposes limited and sometimes dangerous options on
women. Women’s experiences of bed rest demand that scholars and medical
professionals work together to better understand the impact of bed rest on
women; to find ways to address women’s autonomy, choices, and control; and to
draw on rich feminist histories, precisely when bed rest is regarded as the only
good “choice” a woman can make in the current US milieu.
M. Cristina Alcalde is an associate professor of gender and women’s studies at

the University of Kentucky. Her research and teaching focus on gender, violence,
migration, masculinities, and motherhood in the United States and Latin America.
Her work has appeared in Meridians, Journal of Latin American and Caribbean
Anthropology, Men and Masculinities, Sex Education, Journal of Immigrant
and Minority Health, Journal of Education, Journal of Gender Studies, Inter-
national Perspectives in Psychology, Latin American Perspectives, Journal of
the Association for Research on Mothering, and Latino Studies. Her first book,
The Woman in the Violence: Gender, Poverty, and Resistance in Peru, was
published in 2010. She can be reached at cristina.alcalde@uky.edu.
Notes
1. Sylvia Walby (2011, 4) also offers a third possible definition of feminism as

including people and institutions “advancing the interests of women.” She notes that
this definition of feminism is more applicable to the global South than the global North,
where my interviews took place.
2. Online discussion groups with discussion threads or sections on bed rest
include: pregnancy.com; ehealthforum.com; Fertile Thoughts; mothering.com; and
PregnancyWeekly.
3. Blogs and websites specifically about bed-rest experiences or with sections
on pregnancy bed rest include: http://www.mamasonbedrest.com/blog/; http://www
.americanpregnancy.org/pregnancycomplications/bedrest.html; and http://www.whatto
expect.com/pregnancy/pregnancy-health/bed-rest/types-of-bed-rest.aspx.
4. One survey participant and one interview participant self-identified as bisexual.
5. Because women are not provided with alternatives following the prescription
of bed rest, the only alternatives they have if they cannot or do not want to follow the
prescription is to deviate somewhat from it (for example, to leave their beds more or do
more household tasks than instructed) or else to not follow it at all.
6. Interview with Callie, Lexington, Kentucky, October 8, 2009.
7. Interview with Alissa, Lexington, Kentucky, October 20, 2009.
8. These excerpts come from individual surveys conducted in March 2009.
9. These excerpts come from individual surveys conducted in March and April
2009.
10. These statements come from individual surveys conducted in March and April
2009.
11. Interview with Jennifer, Lexington, Kentucky, November 3, 2009.
12. Interview with Callie.
13. Interview with Alissa.
14. This statement comes from an individual survey conducted in April 2009.
16. Interview with Cynthia, Lexington, Kentucky, November 10, 2009.
17. These statements come from individual surveys conducted in March and April
2009.
18. Interview with Joanna, Lexington, Kentucky, October 27, 2009.
19. Women’s statements regarding whether their pregnancy was planned or
unplanned also provide insight into the issues of their feelings of control over their
bodies and reproduction. In the United States, unplanned pregnancies are common,
with nearly half of all pregnancies in 2001 described as unintended (Foster et al. 2008,
352). While these pregnancies may be unplanned, they are not necessarily unwanted,
as women who did not plan to become pregnant may desire to continue the pregnancy
and look forward to having the child. Life circumstances, such as economic stability
and the status of their relationship, may influence women’s views of pregnancy being
wanted or unwanted, regardless of whether or not it was planned (ibid.). A planned
pregnancy commonly signals the exercise of control over one’s body and reproduction
through access to family planning. Women may refer to their pregnancies as planned if
the decision to become pregnant results from informed discussions with a partner, and
if there is “a conscious decision to become pregnant and/or it was a pregnancy where
a longer term view had been taken about how the baby would fit into the woman’s/
couple’s life” (Barret and Wellings 2002, 548). In planning a pregnancy, women described
making decisions that were fully under their control and that included willingly stopping
contraception (ibid.).
Among women on bed rest, the majority (twenty-five women) said that their
pregnancies were planned. Significantly, the percentage of women who viewed their
pregnancies as such was higher among feminist-identified women than among nonfemi-
nists: among the former, eight of ten women (80 percent) stated that their pregnancies
were planned, while among the latter, ten of seventeen (59 percent) said the same.
These findings suggest that women who self-identify as feminist may be more likely to
take steps to control their reproduction. The findings also suggest that more research
is needed on whether, in the United States, feminist-identified women seek to control
their reproduction and bodies through family planning more than women who do not
identify as such.
20. This statement comes from an individual survey conducted in April 2009.
21. Ibid.
22. Ibid.
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Feminism and Womens Control Over Their Bodies in A Neoliberl Context - Cristina Alcalde - Feminist Formations

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Feminism and Women’s Control over Their Bodies in a

Neoliberal Context: A Closer Look at Pregnant Women on Bed

Published by Johns Hopkins University Press

For additional information about this article

Feminist self-identification influences women’s voting practices, perceptions of gender

Keywords: bed rest / bodily control / individualism / medicalization /

©2013 Feminist Formations, Vol. 25 No. 3 (Winter) pp. 33–56

can be better understood by examining the sociocultural context in which

Of the thirty-five participants, ten identified as feminist, and seventeen

The Context: Neoliberalism and the Medical Prescription of Bed Rest

Pregnancy Bed Rest

Feminism and Feminist Identification

profoundly affected women’s lives, including pornography, intimate-partner

Pregnancy and motherhood constitute key areas in which women’s knowledge of

identified as feminist, she responded: “I would consider myself liberal feminist.

Feminism, Egalitarianism, and Household Chores

93). When the commonsensical expectation of gender equity falls through,

national foreign-policy projects around the globe (Hawkesworth 2004). In the

M. Cristina Alcalde is an associate professor of gender and women’s studies at

1. Sylvia Walby (2011, 4) also offers a third possible definition of feminism as

Hawkesworth, Mary. 2004. “The Semiotics of Premature Burial: Feminism in a Post-

———. 2010. “Reflections on Feminism, Immaterial Labour and the Post-Fordist

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