Contributor: The ugly message behind Trump telling pregnant women to ‘toughen up’

The nineteenth-century “doctrine of maternal influence” held that a woman’s thoughts and experiences could physically affect her child. A person born with a strawberry-shaped birthmark must have a mother who loved strawberries at birth. The family of Joseph Merrick, known as the elephant man, publicly said his disability was caused by his pregnant mother’s terrifying encounter with an elephant.

This surname was promoted by today’s medical guidelines, according to to the cultural historian Karin Weingarten, and after the dismissal of their British colleagues by American doctors. An 1869 book, George H. Neffis’s “Physical Life of Woman,” warned that children would be born “stupid or deformed” from the effects of “some severe mental trauma received by the mother during pregnancy,” meaning she should avoid it. If a child deviates from the norm in any way, it must be the fault of the pregnant woman.

I thought about this myth recently when President Trump once again offered scientifically unproven medical advice to pregnant women, in the form of an all-caps. Post Oct 26 on Real Social, tell them not to take acetaminophen or they’ll give birth to autistic children. Trump’s own Food and Drug Administration and the American College of Obstetricians and Gynecologists found insufficient evidence for the link, but for Trump and his Health and Human Services Secretary, Robert F. Kennedy Jr., it’s an obsession.

Trump previously suggested that women who need pain relief during pregnancy should simply “Toughen it up.” And at a cabinet meeting in October, Trump nodded in approval when Kennedy came up with a video he said he saw of a woman “sewing Tylenol with her baby in her placenta “to insult the president. (The fetus grows in the womb, not the placenta). Trump’s opposition, Kennedy marveled, “could inspire millions of years of motherhood to put the baby at risk.” He added that “anyone who takes these things during pregnancy unless they have to is irresponsible.”

In their desire to stigmatize autism and autistic people, both men display an understanding of science and human anatomy that should have remained in the 19th century. They also expose the latest iteration of America’s centuries-long obsession with controlling pregnant bodies, one with devastating real-life effects. The idea that selfish pregnant people are a danger to their fetuses has been weaponized to prosecute them for addiction, for abortions, for stillbirths, even as the standard of pregnancy perfection is constantly changing.

In my new book, “Intolerable” I write about Haley Burns, an Alabama woman who was arrested in 2022 in her son’s hospital room just six days after giving birth and charged with chemical child endangerment. Burns had struggled with opioid addiction and took maintenance medication that at times could not be tolerated.

When she tested positive twice for drug use during her prenatal care, the response was not to offer her treatment, but to shut her down, even though her son was healthy. Burns spent months in jail, was denied sanitary supplies and adequate health care, and was told he could only post bail with $10,000 cash and an approved place for rehabilitation. The county jail was confined to several pregnant and postpartum women on similar charges, four of whom shared a cell known as the “Chemical Crew.”

Burns in Etowah County, Ala. had the misfortune of living in a rural northeastern province under “chemical hazard” laws originally designed to police child neglect by aggressively charging women. On the theory that embryos and fetuses are the same as unborn children, Alabama has long allowed pregnant people to be charged under the law. That being said, this is how the government has led the nation in criminalizing pregnant women Data by Pregnancy Justice, the legal advocacy group that helped represent Burns in court. Only between 2022 and 2024, the group find That Alabama brought charges against 192 people for their pregnancy-related behavior.

Ironically, for a state that touts itself as pro-life, if Burns had an abortion — which is still legal in Alabama — she may never have seen the inside of a cell. Instead, even though she was prepared to seek treatment for her addiction, she was punished by losing her freedom, her dignity, and custody of her two children, consequences that she still faces after years of prosperity. Burns’ story shows what happens when we treat pregnancy not as a human experience worth helping, but as a crime scene; When we see pregnant women not as people but as vessels to be watched, controlled and punished.

In a way, America has only updated the myth of maternal influence, never replaced it. In the 1980s, crack fears led to widespread criminalization of fetuses by mothers, mostly black women. Even evidence-based public health has moved to what sociologist Miranda Wagoner calls the “zero trimester,” which expects women to act as if they’re pregnant at all times, and to follow the health dictates of the moment even if they’re not.

The post-Dobbs era sent it into overdrive. As many as 412 cases of criminalization of pregnancy were documented nationwide by Pregnancy Justice in the two years when Dobbs was involved in drug use. However, in 29 of those cases, the charges against the women included failure to provide prenatal care. In a country that according to As of March, 35% of countries lack substantial access to prenatal care. The anti-abortion movement has often said that patients will not be criminally charged for abortions where they are now illegal, but police and prosecutors have other ideas. Nine of the cases involved allegations of obtaining, attempting or probing abortions against pregnant women.

While banning women only, both Trump and RFK urged women to have more children; RFK called the birth rate a “national emergency.” But who, given the choice—increasingly unpleasant—will rush to have more children when you’re treated as a vector of harm rather than a human being?

Erin Carmon is a senior reporter at New York magazine and the author of a new book “Intolerable: Five Women and the Dangers of Pregnancy.”