Reading Midge:
Assumptions and Racial Bias in Pregnancy Literature

June 4, 2018

[Author’s retrospective note: This was my first Bachelors’ Thesis, written in 2006 for my BS in Women’s Studies at Portland State University. The research itself is of course dated, but my arguments are still valid. In the past 12 years, I hope that the state of pregnancy literature has improved, but were I to re-research the topic, I expect I would be disappointed and angry again. In addition, my own words are also dated, and though I’ve updated links and made a few edits, the text is largely original. I acknowledge the cisnormativity of this piece, and though that stems from the cisnormativity and trans-erasure of the source material, which stood out to me as problematic at the time, I should have explicitly named it as such in my first writing. I’m planning to update this aspect soon.]

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Barbie’s married adult friend, Midge, is having a baby. She’s part of a very happy family with her husband, Alan and their first child, Ryan… If your Midge doll’s baby has a pink diaper, it’s a girl! If the baby comes with a blue diaper, it’s a boy! Midge doll comes with everything girls need to play out the birth and care of a new baby… Lots of other accessories that every new mom needs are included. Midge measures approximately 11.5 inches tall. Alan and Ryan figures sold separately.¹

Several years ago, Mattel introduced Happy Family Midge, a pregnant doll with white, freckled skin and strawberry‑blonde hair that reaches to her waist. Midge has the figure with which we are all familiar, from her over-sized breasts (actually, potentially more realistic on a pregnant person) to her non-swollen, permanently-heeled feet. The only deviation from the standard, Barbie-shaped mold is Midge’s cute, removable magnetic belly (which just screams for an analysis on planned Cesareans). Midge is specifically a “married adult,” although, unlike her best friend Barbie, she has no noticeable career. We can assume that Alan’s job pays well, so he can buy Midge “lots of…accessories,” and that she is covered by his health insurance plan. Midge is “very happy” to be pregnant, and both she and baby are in perfect health, because they had Obstetrician Barbie for the delivery. She is pop culture’s perfect pregnant person.

Examining pregnancy statistics², one sees that 13.4% of pregnant parents are uninsured (Thorpe 7), 33.5% are “unmarried” (“Table 1-20”), of which an unknown number are LGBTQ, 49% of pregnancies are unintended (Finer, “Disparities” 92) and 5% of babies born have a genetic disorder (Nelkin, referenced in Dean³). The pregnant person represented by these demographics is not the same person represented in pregnancy manuals. Texts paint a picture of happy, glowing, white, middle‑class, insured, heterosexually married, cisgender women in their mid-to-late twenties who plan their pregnancies. In addition, both mother and baby are conveniently free of any condition less innocuous than morning sickness or colic. This ubiquitous unmarked person looks nothing like the statistic demographic of pregnancy—but is the spitting image of Midge.

According to the National Center for Health Statistics (US Department for Health and Human Services), only 35.9% of births are to married white women.⁴ When one takes into account those people who are uninsured, living with HIV, and whose pregnancies will not result in a live birth, Midge actually represents less than one‑fifth of the population of pregnant people. So why are all the pregnancy books written for her? Building off the many works discussing Barbie as model for the unattainable “right” female form, I would like to suggest that Midge acts as model for the unattainable “right” pregnancy.

In most pregnancy books, the assumptions begin on page one. “Congratulations! We’re thrilled that you’re thrilled to be pregnant!” You’ve seen the ads for home pregnancy tests, right? Every pregnancy is a planned pregnancy, and all parents are happy when they find out. This assumption is laced with moral judgments, and Midge is here to uphold the model of propriety: she doesn’t accidentally get knocked up, and neither should you. The majority of pregnancy books view pregnancy through a rose-colored lens, glossing over a pregnant person’s potential feelings of grief, fear or desire to terminate the pregnancy. When nearly half of all pregnancies were unintended, and one in five end in abortion (Finer, “Disparities” 93), continued use of this perspective requires an author to be ignoring the facts.

Assumptions like this one have long irked me when reading pregnancy manuals. However, I had never really examined the matter until I came across The Mocha Manual to a Fabulous Pregnancy (Seals-Allers). Written for a black audience, this book changed my outlook on pregnancy literature. Seals-Allers does acknowledge unplanned pregnancies. What’s more, she discusses feelings other than ecstasy that may follow the pee test. To be one of the few writing about this topic, Seals-Allers had to know something that other authors didn’t. Was she simply more aware of issues that should be present in all pregnancy books? No: she knew that other pregnancy books were written specifically to white folks. Statistics show that unintended pregnancies are also unevenly distributed among people of color: 40% of pregnancies to white parents were unintended at time of conception, compared with 54% for Latino/as and 69% for blacks (Finer, “Disparities” 93).

This brings me to a related topic that also gets very little discussion—dealing with the death of a baby, either by miscarriage or abortion. Some books are better than others, and slightly more than half discuss becoming pregnant again following a miscarriage. More authors talk about grieving over a past miscarriage than a past abortion, although the actual percentage of pregnancies ending in abortion is higher than that ending in miscarriage: 20% vs 17% (Finer, “Disparities” 92).

Who is having abortions? The issue is complicated, and varies by income, education, age, marital status and race (Finer, “Disparities” 93). Though it is out of the scope of this paper to discuss the interactions between these forces, one must keep them in mind. Race seems to be the most important factor, however, with 40% of black pregnancies ending in abortion: more than twice the rate of white pregnancies (Finer, “Disparities” 93). Not surprisingly, rates of maternal and neonatal deaths are also higher among people of color and undocumented people. Everyone ought to be comforted when losing a baby, regardless of whether they made the choice, but when less than half of all black pregnancies end in a live birth and no one mentions it, something is obviously wrong.

I did a brief investigation, looking at discussion of HIV in various pregnancy manuals, which showed an assumption of HIV negativity and correlated lack of useful information regarding interactions between pregnancy and HIV/AIDS. The specific results were most disturbing: of the seventeen books I reviewed, thirteen are what I will call “wholly insufficient” in speaking to readers living with HIV. Three contain no reference to HIV or AIDS at all; eight others only mention HIV very briefly, usually in the context of common tests. Two (interestingly, the two books written for lesbian readers) include some combination of what HIV is, facts and myths of transmission, and rudimentary safer sex info—basic sex ed information, which could be very useful for educating readers who are HIV‑negative and had previously been relatively uniformed about the subject. However, these books fail to offer any useful information to those readers who are pregnant and living with HIV.

Three of the seventeen books seem to be written as though the authors made an effort to speak to the issue of HIV/AIDS. I will call these texts “incompletely sufficient.” The authors of these books do mention how HIV/AIDS and pregnancy interact with one another, some including how someone might reduce risk of parent-infant transmission. The amount of space devoted to HIV/AIDS ranges from one paragraph to a page and a half. However, these books share the fact that over half of this is “HIV 101” information, such as who is at risk, how the virus can be transmitted and testing.

It is important to note that in all of the above books, the section on HIV is written primarily in the third‑person, although the rest of the book talks about “you.” Using a theoretical “she” creates a distance from the virus that allows the author to maintain the illusion that none of the readers are living with HIV.

Only one book covers HIV and pregnancy in a manner I would deem “appropriately sufficient.”⁵ I was troubled but unsurprised that this book is The Mocha Manual to a Fabulous Pregnancy. Seals-Allers devotes over two full pages to the virus, almost all of which is directly applicable to pregnant people living with HIV. Most importantly, Seals‑Allers is the only author who speaks directly to the HIV‑positive reader, as opposed to turning HIV into something that happens to “some people.” Seals‑Allers also discusses the racialization of HIV, stating, “sixty‑two percent of all children born to HIV/AIDS‑infected mothers were African American” (156), although black babies represent only 15% of total births. The only other book to mention that HIV disproportionately affects people of color, Waiting For Bebé (Alcañiz), is written to a Latina audience.

This is quite worrisome—what does it mean when only the books to pregnant persons of color discuss the disproportionate numbers of people of color among those living with HIV? What does it mean that of seventeen pregnancy books, only the one written to black readers discusses HIV in a realistic manner, or that twelve of fourteen books written for a “non‑race‑specific” audience were wholly insufficient?

7000 babies are born to “women with HIV” each year, 80.7% of whom are people of color (HIV/AIDS Surveillance Report, 2004).⁶ Considering that HIV disproportionately affects people of color, when “non‑race-specific” books do not cover the issue sufficiently, speaking from a position of assumed negative status, one can infer that this omission is racialized and racist as well. The problem is not that Seals‑Allers, writing to pregnant black people, discusses HIV. The problem is that other authors do not, while presenting their books to a “general” pregnancy audience: “non-race-specific” books are specifically NOT written to people of color. There is, in fact, an assumed whiteness.

It could be argued that such information falls out of the scope of pregnancy texts; that a pregnant person’s prenatal care provider will handle everything beyond the test. I understand that one book cannot cover every aspect of every complication, and certainly advocate for readers to be under the care of a professional. However, not all pregnant people have access to health care, or have restricted quality of health care, due to lack of insurance.

In 1999, pregnant people without health insurance represented 13.4% of the US population (Thorpe 7), but were disproportionately people of color: 9% of whites, 16% of blacks and 30% of Latino/as (Thorpe 13). Undocumented pregnant people were uninsured at rates more than four times those of US‑born citizens (Thorpe 15). The numbers of pregnant people who rely on Medicare as their only source of health insurance are similarly skewed: Latino/as are more than twice as likely as whites to be on Medicare, and blacks more than three times as likely (Thorpe 13).

Of the seventeen books I examined, only one discusses being pregnant without health insurance: the book written for a Latina audience. It is obvious that insurance is a racialized issue as well; lack of discussion around this issue furthers my theory that current pregnancy books are written with an unmarked white person in mind.

When creating Happy Family Midge, Mattel went out of their way to provide her with a (non‑removable) wedding ring, which serves to as evidence for the legitimacy of her unborn child. Despite this evidence, however, the public was outraged, and Wal-Mart pulled Midge from their shelves. The primary complaint against Midge? In part because her husband and 3‑year‑old son are sold separately, but also just introducing childbirth as a play topic, parents felt she promotes and glamorized unwed teenage pregnancy for young girls.⁷ Mattel discontinued Happy Family Midge; today, one can buy her on eBay.

Based on the fiasco with Midge, we can be certain that Barbie will never have a friend who is actually a single parent. Like Mattel, pregnancy books tend to create a world in which all parents are heterosexual, married parents. Although the percentage of pregnant persons who are in heterosexual marriages is declining, writers of pregnancy literature feel compelled to uphold the Midge model. A sickening number of texts talk about “your husband,” though some recognize that many unmarried couples have stable relationships and children, and use the more-inclusive term “partner.” However, these texts still assume there is a partner, and that the reader and partner are in a heterosexual relationship: they refer to this person shamelessly and exclusively as “he” and include sections written for “dads.” Most books include a paragraph or sidebar on parenting alone, but this seems a token gesture when the main texts still insist that there is a partner involved. These half‑hearted attempts at inclusion serve to alienate readers who do not fit the assumptions.

The rates of births to “unmarried women” are almost twice as high for Latinas as for white women, and more than three times as high for black women, which indicates that marital status at birth is also a racialized issue. Interestingly, however, both Alcañiz and Sears-Allers make the same assumptions as books written for “everywoman.” In addition to being a racialized issue, assumptions of marital status contain a built-in heteronormativity, as evidenced by the fact that the only books that do not assume a male partner are the two books written for lesbians. Although non-heterosexuality in itself is not a racial issue, it is important to note the intersections of assumptions and oppressions present.

I am aware that there are other issues and populations that are not addressed in present pregnancy literature. Several topics are certainly built on assumptions, but I have not had the time to find out whether the assumptions are racialized. These topics include assumptions of health, assumptions of age, and assumptions that parents will choose not to abort a fetus with a genetic disorder. Other issues I am aware of, but have not researched yet at all, and do not know which (if any) books approach the subjects appropriately, such as addiction, homelessness, abuse, prostitution and imprisonment.

It has long been apparent that the Barbie line represents only a marginal number of people. Several writers, including S. J. Gilman and S. Strohmeyer have recognized this void, providing a thorough analysis of what Barbie represents in our culture and the impact she has had on developing psyches. As part of these works, the authors each describe several fantasy Barbies, like “Hot Flash Barbie” (Strohmeyer), “Birkenstock Barbie,” and my personal favorite, “Our Barbies, Ourselves” (Gilman 20).

Other artists have gone even further, by physically creating “Anti-Barbies” that represent a broader range of diversity. S. Pim had an exhibit in San Francisco International Airport with such pieces as “Hooker Barbie,” and “Drag Ken” (Esteves). Based on the same idea, B. Tull has a shop, also in San Francisco, that sells “Carrie Barbie” and “Big Dyke Barbie”; S. Wandell invented “Voodoo Barbie” (Haddock). Mattel does not approve, sometimes even starting law suits over the matter, but customers love these dolls, in part because they are subversive, but also because they can locate themselves in the characters.

I would like to do the same for Midge and the pregnancy books that represent her. It is obvious to me the need for readers to see themselves in a text; I am writing a pregnancy text that addresses omissions made in current manuals written for pregnant people. The focus of this research was initially to speak to those who do fit the assumption of gender identity, but it is apparent to me that I need to alleviate the additional shortcomings of the current pregnancy literature by addressing all assumptions.

I am at once encouraged and disappointed by pregnancy texts designed to alleviate assumptions. For example, The Ultimate Guide to Pregnancy for Lesbians (Pepper) challenges heteronormativity and assumptions of relationship status, but fails to notice issues of insurance or HIV status, falling into the same assumptions that other books do. Similarly, Alcañiz speaks to underrepresented Latina women, addressing issues of race, class and language, but assumes all her readers to be heterosexual and married. Even Seals-Allers assumes her readers have health insurance. The shortcomings of these books are more frustrating than those of books written for “everywoman,” because the authors are aware of systems of oppression. These authors are working to challenge certain assumptions and invisibilities, but somehow fail to see others.

Adopting this approach, though it may not seem to change much, is fairly radical. I am writing my book from a position as inclusive as possible, attempting to make no assumptions about my reader, other than pregnancy or an interest in pregnancy. I hope that with awareness and thorough editing by individuals active in combating these systems of oppression, I can create a book that does not make my readers feel othered. I am not proposing to write a book specifically for people of color, but a book that can be used by anyone.

Most present pregnancy manuals claim to be written for all pregnant people, whether this claim be stated or implied. However, the amount and quality of information that applies to a given reader depends on one’s social location. I say that this is inequitable and offensive to all readers. I say authors making claims of universal applicability ought to deliver. The racial assumptions outlined here are unacceptable, and need to be addressed, so everyone can have access to quality information about their pregnancies.

 

Works Cited

Alcañiz, L. Waiting for Bebé: A Pregnancy Guide for Latinas. NY: Ballantine, 2003.

Broder, M. S. The Panic-Free Pregnancy. NY: Perigee, 2004.

Brott, A., and J. Ash. The Expectant Father: Facts, Tips, and Advice for Dads-to-Be. Second edition.  NY: Abbeville, 2001.

Closing the Health Gap. “HIV/AIDS, 2005.” Updated Dec 2005. Accessed June 2006 at <http://www.healthgap.omhrc.gov/hiv_aids.htm>. [2018: No longer able to locate this piece. The current website for the Office of Minority Health is <https://www.minorityhealth.hhs.gov/>.]

Curtis, G. and J. Schuler. Your Pregnancy After 35. Revised Edition. Cambridge, MA: Perseus, 2001.

—. Your Pregnancy Week by Week. Fifth Edition. Cambridge, MA: Da Capo, 2004.

Dean, M. “Human Genetic Screening.” 1999. Accessed June 2018. <https://www.ndsu.edu/pubweb/~mcclean/plsc431/students99/dean.htm>.

Eisenberg, A. et al. What to Expect When You’re Expecting, Third Edition. NY: Workman, 2002.

Esteves, M. “Barbie goes butch.” Golden Gater. Feb 13, 1997. Accessed June 2006 at <http://www.journalism.sfsu.edu/www/pubs/gater/spring97/feb13/BARBIE.html>. [2018: No longer able to locate this piece.]

Falk, S. and D. Judson. The Jewish Pregnancy Book: A Resource for the Soul, Body & Mind during Pregnancy, Birth & the First Three Months. Woodstock, VT: Jewish Lights, 2004.

Finer, L. B. and S. K. Henshaw. “Disparities in Rates of Unintended Pregnancy In the United States, 1994 and 2001.” Guttmacher Institute. Perspectives on Sexual and Reproductive Health, 38.2 (2006): 90–96. Accessed June 2018. <http://www.guttmacher.org/pubs/journals/3809006.pdf>.

—. “Estimates of U.S. Abortion Incidence in 2001 and 2002.” The Alan Guttmacher Institute, May 2005. Accessed June 2018. <http://www.guttmacher.org/pubs/2005/05/18/ab_incidence.pdf>.

Ford-Martin, P. The Everything Pregnancy Book. Second edition. Avon, MA: Adams Media Corporation, 2003.

Gilman, S. J. “Klaus Barbie, and Other Dolls I’d Like to See.” Body Outlaws. Originally published as Adios, Barbie. Ed. O Edut. Emeryville, CA: Seal Press, 1998. 14-21.

Haddock, V. “Trailer Trash, Drag Queen Barbies thrill those who love to loathe her.” San Francisco Examiner. Dec 17, 1996. Accessed June 2018. <https://www.sfgate.com/news/article/Trailer-Trash-Drag-Queen-Barbies-thrill-those-3109064.php>.

Iovine, V. The Girlfriends’ Guide to Pregnancy: or Everything Your Doctor Won’t Tell You.  NY: Pocket, 1995.

Luke, B. and T. Eberlein. When You’re Expecting Twins, Triplets, or Quads: Proven Guidelines for a Healthy Multiple Pregnancy. Revised edition. Previously published as When You’re Expecting Twins, Triplets, or Quads: A Complete Resource. NY: HarperCollins, 2004.

Nelkin, D. “The Social Power of Genetic Information.” The Code of Codes: Scientific and Social Issues in the Human Genome Project. Ed. D J Kevles and L Hood. Cambridge: Harvard University Press, 1993. 177-190.

Pepper, R. The Ultimate Guide to Pregnancy for Lesbians: How to Stay Sane and Care for Yourself from Preconception Through Birth. Second edition. San Francisco: Cleis, 2005.

Rogers, J. The Disabled Woman’s Guide to Pregnancy and Birth. Previously published as Mother-To-Be: A Guide to Pregnancy and Birth for Women with Disabilities, with M. Matsumura. NY: Demos Medical, 2006.

Romm, A. J. The Natural Pregnancy Book: Herbs, Nutrition and Other Holistic Choices. Berkeley: Celestial Arts, 2003.

Seals-Allers, K.  The Mocha Manual to a Fabulous Pregnancy. NY: Amistad, 2006.

Sears, W., and M. Sears. The Pregnancy Book. Boston: Little, Brown & Company, 1997.

Simkin, P., et al. Pregnancy, Childbirth, and the Newborn: the Complete Guide. Minnetonka, MN: Meadowbrook, 1991.

Strohmeyer, S., and G. Hansen. Barbie Unbound: A Parody of the Barbie Obsession. Norwich, VT: New Victoria, 1997.

Thorpe, K. E., et al. “The Distribution of Health Insurance Coverage Among Pregnant Women, 1999.” March of Dimes, April 2001. Accessed June 2018. <http://208.74.202.51/chapterassets/files/2001FinalThorpeReport.pdf>.

Toevs, K. and S. Brill. The Essential Guide to Lesbian Conception, Pregnancy, and Birth. LA: Alyson Books, 2002.

U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. “Abortion Surveillance, US 2002.” Nov 2005. Accessed Dec 2018. <https://www.cdc.gov/mmwr/preview/mmwrhtml/ss5407a1.htm>.

—. “HIV/AIDS Surveillance Report, 2004.” Vol 16. Atlanta: US Department of Health and Human Services, Centers for Disease Control and Prevention; 2005. Also available at: Reviewed Feb 2006. Accessed June 2018. <https://www.cdc.gov/hiv/pdf/library/reports/surveillance/cdc-hiv-surveillance-report-2004-vol-16.pdf>.

U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics. “Fertility, Family Planning, and Reproductive Health of U.S. Women: Data From the 2002 National Survey of Family Growth.” Vital and Health Statistics, 23.25 (2005). Accessed June 2018. <http://www.cdc.gov/nchs/data/series/sr_23/sr23_025.pdf>.

—. “Table 1-20. Number and Percent of Births to Unmarried Women, by Race and Hispanic Origin: United States, 1940-2001.” Accessed June 2018. <http://www.cdc.gov/nchs/data/statab/natfinal2001.annvol1_17.pdf>.

1. Common advertising blurb about “Happy Family Midge and Baby Surprise”; found on the sites for multiple online stores, including <http://www.etoys.com/genProduct.html?PID=2651179&ctid=17> and <http://stores.tomshardware.com/search_getprod.php/masterid=2649052>. [2018 update: the above links no longer work and I could not find any of the original copy for Baby Surprise. There was also a non-surprise version of Midge with similar wording, minus the creepy color-gender-coding.]
   
2. It is important to note as a disclaimer that even with census information, one must look critically at the data, because assumptions and biases play a role in both the gathering and compiling of information.  Heterosexism and assumptions about partner status intertwine to misrepresent those individuals who are not legally married.  Births to women involved in long term, committed relationships are categorized under the general “unmarried women,” which in this case is code for “single mothers,” a group that those in power are highly concerned with monitoring.  On the compiling end, a good example is many charts provide information for “white,” “African American,” and “Hispanic” groups only.  This demonstrates an interest in keeping tabs on information pertaining to blacks and Latinos, commonly perceived to be “problem” populations; people of Asian descent, the “model minority,” and members of other assimilable, non‑threatening groups are not represented in as many of the charts.
3. I am aware that the age of the statistic is problematic; all other statistics I found were non-academic and listed no sources.
4. Total number of births to “white, non-Hispanic unmarried women” (879848) subtracted from total number of babies born to “white, non‑Hispanic women” (2326578), giving the assumed number of births to “white, non‑Hispanic married women” (1446730), divided by total number of births (4025933).
5. Jane Kennedy has written a book entitled HIV in Pregnancy and Childbirth.  Because it is written for midwives, I did not include it in my research, but it could serve as a valuable resource to those for whom it is applicable.
6. Women in general, not specifically pregnant women: of the 123405 women living with HIV/AIDS in 2004, only 23841 of them identified as white, non‑Hispanic.  This represents a mere 19.3% of all women living with HIV/AIDS in the US, a disproportionately low number.
7. It seems a bit ironic that the other big Barbie controversy entailed feminists’ outrage over a doll seeming to perpetuate a female stereotype of being bad at math, whereas this doll angered an entirely different group of people by appearing to deviate from the female stereotype.

Tags: Academics, Flashback

Author Bio: Jasper Moon, CPM LMT (they/ them)

Perinatal care specialist. Parent of two. Hosted three fetuses: my big kid, a surrogacy in the middle, and my little kid. Vegan; drinks a lot of tea. Board game (and general) geek. Goat hugger extraordinaire.

Read more about Jasper here.