So I was dealing with a bout of insomnia tonight and while I was sitting in front of my computer (which I know does not help), I came across a Huffington Post piece on The Pregnant Workers Fairness Act (PWFA), which has just been introduced in the Senate. The bill, which mirrors one introduced to the House in the spring, would require that employers make workplace accommodations for pregnant workers. You know, like giving a pregnant worker regular bathroom breaks. But, not surprisingly, it faces opposition by, that’s right, Republicans. Republicans see things a little differently. See, to them, that baby bump and its need for “accommodations” will kill profits. Don’t you know that requiring an employer to allow a pregnant woman to carry a water bottle during work or making them give her routine bathroom or rest breaks will cause an economic burden? The GOP, made up of primarily desperate white men clinging to their hegemony, are not surprisingly holding steadfast to their antiquated notions of pregnant women (and women in general). With many big businesses funding (and running) the GOP, the party of “pro-life” reveals its true colors yet again by stipulating that an individual’s well-being should not get in the way of profits. At the same time though, most Americans do not recognize a pregnant woman as an employee. Although there are 77 million women in the workforce, many of whom are working in low-wage jobs, a pregnant worker is not the norm. A pregnant woman is not a worker.

I have written a couple of times on Nursing Clio about particular expectations of pregnant women throughout history, but what I never really stressed is that the pregnancy we recognize in many pregnancy magazines and advice manuals is a twentieth-century invention, what I call the modern pregnancy. It was only in the late nineteenth century that obstetricians began to take a serious interest in the health of women during pregnancy, arguing that a direct correlation between prenatal health and infant mortality existed. The medicalization of pregnancy turned pregnant women into pregnant patients, and prenatal care expanded slowly throughout the first half of the twentieth century. At the same time, retailers caught wind of the new medical information, and in the 1910s began to market new items and services to pregnant women. (Lane Bryant was the first maternity wear designer and retailer). The influence of retailers commericalized pregnancy and transformed pregnant patients into pregnant consumers.

As pregnant women became both patients and consumers, specific norms developed that shaped perceptions of pregnancy. At the core of these two new identities, were white, middle-class assumptions about womanhood, motherhood, and family. Working was not considered. Now was this the reality? Absolutely not. Women had always worked during their pregnancies, whether it was outside or inside the home. However, the baby bump took on a greater significance during the early twentieth century. Maternalists sought to reduce the abysmal infant and maternal mortality rates and advocated both the medical and consumer ideal of pregnancy as a way to fight the rising statistics. A healthy pregnancy reduced complications and improved the likelihood that a mother and her newborn would make it through labor and delivery alive. A healthy pregnancy included a good diet, long walks, light housework, regular visits to the obstetrician, shopping, attractive clothing, and a sunny disposition.

A healthy pregnancy did not include employment outside the home. A healthy pregnant woman was not a pregnant worker.

There were a multitude of maternity advice manuals written during the twentieth century and for the most part, if pregnant workers were mentioned, it was usually in passing, stating that they must get as much rest as possible during the day and not sit for long periods of time. Although many government agencies, starting with the Children’s Bureau, worked tirelessly for pregnant women, many of their goals were tinged with the norms that had become so attached to the modern pregnancy. It was assumed that a pregnant worker could not meet the medical and consumer expectations fully and therefore she was putting her baby at risk.

The reality of course was very different. Pregnant workers were visible on factory floors, offices, restaurants, and so on. Many of them worried about losing their jobs throughout their pregnancies and worked until the very last moment, hoping to save enough to cover unpaid maternity leave. With second wave feminism and the increase of white, middle-class women in the workplace, which suddenly seemed to make pregnant workers visible, challenges to discrimination emerged and eventually lead to the passage of the 1978 Pregnancy Discriminatory Act (PDA). The PDA banned employers with more than 15 employees from firing pregnant workers and to treat their maternity leave as disability leave. It was a huge step, but it has not stopped employers from firing women once they announce their pregnancies. In April, the Washington Post reported that there had been 5,797 pregnancy discrimination complaints, a 23 percent increase since 2005. In explaining the increase and why pregnancy discrimination still exists, EEOC general counsel David Lopez stated at a hearing that “At the core, all of these cases involve employers who held stereotypical assumptions about pregnant women.” Another legal expert, Sharon Terman, claimed that it also had to do with “employers’ ‘unfounded assumption about the woman’s capacity to do her job.”’

Both Lopez and Terman are right, and it is the assumption that pregnancy does not belong in the workplace that has allowed the discrimination of pregnant workers to continue. Whether it is the outright firing or fighting against any type of accommodation, what is influencing any discrimination against pregnant workers are the expectations, norms, or assumptions (whatever you want to call them) created early in the twentieth century. These assumptions still dictate the perceptions of a pregnant woman. A pregnant woman is only a patient, who dutifully sees her obstetrician regularly and takes care of herself.

A pregnant woman is only a consumer, who carefully picks out personal and baby items.

It is those assumptions that lead to discrimination, the GOP’s false assertions that pregnant workers’ “accommodations” cost employers money, and the belief that a pregnant woman is not a worker who would need to carry a water bottle, need help lifting an item, and need another pee break.