Why the 'Essential Labor' of raising kids is to lonely and expensive : Shots - Health News In her book, author Angela Garbes makes the case that the work of raising children has always been undervalued and undercompensated in the U.S. Then came the pandemic, and everything got harder.

Raising kids is 'Essential Labor.' It's also lonely, exhausting and expensive

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TERRY GROSS, HOST:

This is FRESH AIR. I'm Terry Gross. Like a lot of parents during the COVID lockdown, especially mothers, my guest, Angela Garbes, had to stop working and become a full-time parent because she no longer had daycare. Although she loves being a mother, during this period, she experienced a loss of identity and clinical depression. She abandoned the book she had been writing and instead wrote an article about what women lost during that period. The article was retweeted by Elizabeth Warren and went viral. That led to Garbes' new book, "Essential Labor: Mothering As Social Change." The book is about how the work of mothering in the U.S. has always been undervalued and under compensated.

By mothering, she means the work of raising children, and that includes all people who help raise children - mothers, fathers, extended family, nannies, daycare workers, preschool teachers, babysitters, domestic help and friends. She describes mothering as the invisible economic engine driving our culture. This is also an issue related to race and class, since the underpaid childcare professionals are often women of color. Garbes' parents emigrated from the Philippines after her mother became a registered nurse and her father a pathologist. In the book, she writes about how the Philippines became the care workers of the world. She says the Philippines is by far the leading supplier of nurses to America. Garbes' previous book, "Like A Mother," was about the science and culture of pregnancy.

Angela Garbes, welcome back to FRESH AIR. Tell us more about how it felt to not have day care and not be able to write because you were constantly involved with parenting. And even when your husband was officially on parenting duty, you were interrupted by your children a lot.

ANGELA GARBES: Yeah. It was complicated, I'll say. In many ways, I felt so sure. And if you go back, you know, to those early days of the pandemic, when we didn't know what was happening, we didn't understand this virus, I remember thinking we could all get COVID from our groceries, right?

GROSS: Oh, I remember.

GARBES: Yeah. You know, when we were disinfecting our mail and, you know, my hands were red and peeling from so much, as my daughter calls it, hanitizer (ph). It felt really clear to me that the most important thing I could be doing was not writing. It was not writing. It was not making a podcast. It was taking care of my family, taking care of my children and keeping them safe, and also taking care of my community. And that meant pulling away, you know, living in isolation.

And so I felt so strongly that's what I should be doing. It was the most important thing I could be doing day in and day out. But I also felt, you know, as you mentioned, I really - I like caregiving. I like cooking. I like taking care of people. I like cuddling. I like reading. But I really felt like I was watching the pleasure and the color drained from my life. So it felt very one-dimensional. And I felt like someone who was just a caregiver. And while I knew that that was valuable work, I had to confront that that wasn't enough for me. And so there was a time when I really just wished my desire to create would die.

And then I thought, you know, I could at least start over then, and then maybe I could be satisfied with the life that I had. Yeah. And as far as my husband working, we were, you know, he's the person that had a regular paycheck. As a writer, I have, you know, deadlines on the horizon. It's all very nebulous, you know, when my work is due. And, you know, there were no regular paychecks. There was no health insurance coming our way from my work, but we were getting those from him. So it was easy for me to say, let's prioritize your work. But he has always insisted - we have always - this is a part of our marriage where we say, you know, my work is not more important than your work. It's equal. But so he would say, take your time. Like, go write. Go lock yourself in the guestroom, put on the noise-canceling headphones and do what you can do.

And my children couldn't respect that boundary. There were basically no boundaries within our home. But also, I felt my ability to uphold those boundaries kind of slipping away. And my therapist said something that was very useful. She said, maybe you need to make a sign that says mama is working and you put it outside of the office, and I did that. And honestly, Terry, the sign was more for me. Like, it was me insisting on that - right? - because, I mean, also, only one of my children could read at that point.

GROSS: How old were they in 2020?

GARBES: They were 5 and 2. And now they are 7 and 4. And the 7-year-old is soon to be 8. And I guess the 4-year-old can't really read. She couldn't read a sentence. She's pretty good with stringing her letters together. But, yeah, it was - I needed to create that boundary.

GROSS: Did you feel guilty about not feeling fulfilled by full-time parenting?

GARBES: You know, I hate to admit it, but yes. In general, I reject guilt, and I reject the guilt that many mothers feel because I think that is - I'm not the problem. You know, individuals are not the problem. It's a system and the culture that we live in that doesn't value care work and that doesn't value mothers and that doesn't value women. And I know that, you know, rationally. But when you're just doing this day in and day out and there feels like no relief, I really struggled.

Yes, I felt guilty that I wanted more because I also believe that every parent is a working parent, whether they work outside of the home or not. And I know that there are people who can - who feel fulfilled by caregiving and by their duties as a parent or as a mother. And I support that. And I think everyone should be able to feel that way. But I had to confront that that wasn't enough for me.

GROSS: I'm sure you're still very cautious about COVID. Your youngest daughter, who is 4 now, is still just too young for a vaccine.

GARBES: Yeah.

GROSS: So I know you're being cautious, but what have you taken from the lockdown period and applied to the post-lockdown period? Do you feel like you came away from that period with any new insights about your life and you and your husband's approach to parenting, you know, insights that are helpful to you now?

GARBES: Yeah. I mean, in some ways, I wrote a book about it.

GROSS: Well, yes.

GARBES: Which is what we're here to talk about. But, I mean, I would say that there were several things. The No. 1 thing I would say is that, you know, we live in nuclear families in America. We live pretty siloed off from one another. It's a very, like, individualistic, like, we take care of ourselves first. And we also feel like it's my responsibility. My children are my responsibility. I have to figure this out. But, you know, in America, until your child is age 6, you're entirely on your own figuring out how to take care of them. We don't guarantee pre-K in any affordable way. We have privatized health care. So this is like these sort of patchwork solutions and individual solutions are - things that people have been living with.

And what I saw, and I think what a lot of people saw, what was made clear, one thing, is that we cannot do it alone. So the reason why I felt like I was drowning and losing myself during those first three or four months was because I was, right? We were not meant to raise children in isolation. They need other people. They need family. They need friends. They need, you know, adults who are not related to them, who have a certain patience and bring something different to their life. And it really, I guess what I'm saying here is that it's cemented for me that raising children is a social responsibility.

GROSS: You write about the rage of mothers and...

GARBES: Oh, yeah.

GROSS: ...You say you half-jokingly asked your husband if mothers could unionize. And he said to you, but who would you complain to?

GARBES: Right. Yeah.

GROSS: Who do you file a complaint with? And I think the answer was maybe the government.

GARBES: Yes. I mean, I certainly - we've seen some of that - right? - like this rage of mothers. You know, there have been organizations formed. There was - during the pandemic, there was something called the Marshall Plan for Moms - and the Marshall Plan referring to the plan that came out after World War II to help families, to guarantee some income and a standard of life in America. And then, we also saw something called the Chamber of Mothers forum, which was a lot more people who work in, like, you know, the corporate world - but saying, like, we need to acknowledge that, you know, America doesn't have a social safety net. America has mothers.

And, you know, there are 2 million less women in the professional workforce right now than there were at the start of the pandemic. And the statistic that always stays with me and - is, in September of 2020, 865,000 women left. I mean, I don't want to say left - were forced out of the workforce, really, in one month. And that was because schools remained closed. And that was, you know, people who were saying, essentially, like, I can't be a mother, be an online school proctor, and to be a professional worker at the same time. It's just too much.

And so I think, like, that anger, which, you know, like - as I mentioned, you know, this care crisis as we talk about it, it predates the pandemic. And a lot of us were more familiar, you know, with the financial hardship of having kids in daycare. So people have been making these decisions and logistical negotiations for years. But suddenly, it was a problem that affected everyone. And that's when we really saw a lot of that anger. And I felt like there was attention being paid. There were some articles, including mine, you know, that are basically, like, women are not OK. Mothers are not OK.

And then we saw things like the advance child tax credit, which was the government sort of acknowledging, yeah, this is hard work, having families and raising children, and so we're going to give you some money each month. And that funding for the CTC was allocated for a year. And in December, Congress let that lapse even though the funding had been set aside. It was - in trying to figure out Build Back Better. You know, I guess that was like collateral damage or just something that we were willing to let go of. And I feel a certain amount of anger at lawmakers and some anger at Democrats and at the administration that I voted in because that administration, you know, also bargained away paid leave, which was something that the Biden administration ran on. So, yeah, I feel like we are losing that momentum, and we're losing some of the energy behind that very righteous anger that so many women and parents felt.

GROSS: Well, let's take a short break here, and then, we'll talk some more. If you're just joining us, my guest is Angela Garbes, author of the new book "Essential Labor: Mothering As Social Change." We'll be right back after a break. This is FRESH AIR.

(SOUNDBITE OF RHYTHM FUTURE QUARTET'S "IBERIAN SUNRISE")

GROSS: This is FRESH AIR. Let's get back to my interview with Angela Garbes, author of the new book "Essential Labor: Mothering As Social Change."

You know, in talking about race and class and how that pertains to child care and how undervalued and underpaid it is, professional child care, it's interesting to talk about your experiences visiting the Philippines where your parents grew up. They immigrated to the U.S. when they were in their 20s.

GARBES: Yeah.

GROSS: And they grew up with domestic workers, with, you know, a maid, child care at home. And you visited the Philippines with them. You've been exposed to it. So I want to talk about that and what you learned about race and class and child care and domestic help, comparing the Philippines to the U.S. So I'm assuming - let's start with this. I'm assuming that in the Philippines, the people who were the domestic workers and child care workers at home were also from the Philippines.

GARBES: Yes. They are. And oftentimes, they come from the provinces, so - you know, more rural areas. And domestic work is an economic opportunity for them. So...

GROSS: So race and ethnicity are not an issue with that.

GARBES: I mean, I think it is. I mean, there's - within...

GROSS: Maybe ethnicities, yeah.

GARBES: ...The Philippines, there's certainly...

GROSS: Right.

GARBES: Yeah, there's so many different cultures. And, you know, because the Philippines was a Spanish colony for 400 years and a American colony for the first half of the 20th century, certainly, you know, most - I'm generalizing here, but most people who are upper class are light-skinned or maybe have some Spanish blood in them. So there is an element of race, but it's definitely - yeah - an issue of ethnicity. So it's all - you know, it's all there. But it's - but they're - you know, to use the blanket term, they're all Filipino. They're domestic workers who are literally domestic people - (laughter) right? - from within the country. And so, I mean, I saw that growing up.

And, you know, my - I was raised with, literally, my mother saying, clean your plate, wash dishes, you make your bed, you put away your clothes because I am not your maid. And when we went back to the Philippines, there's always a maid. And this was something that I really had to contend with. And, you know, you don't - in the Philippines, too, it's so normalized. You don't have to be filthy rich to have domestic help. Most families do. Because in a country that is still developing and that is economically disadvantaged, unfortunately, there's usually someone poorer than you.

So that was something that I just didn't understand, you know? And I felt uncomfortable by - with it at first because I didn't know how to treat them. I saw how valuable they were in the family from house to house. Sometimes, they were treated, like, very intimately, like familiars. There's one woman, Ate Celia, who I have known for pretty much my entire life, who has worked for my Tita Ginny's family for over 40 years, who is an integral member of the family. But there's obviously a power differential. And so I don't know exactly what I've learned. I'm sorting through it very actively. I'm definitely doing that in the book.

But one of the things that strikes me is that it does feel like a more honest way of living in the sense that there's a team of people to provide child care, to clean the house, and to cook three meals a day - the idea that that's too much for one or two people to do. And so that's why when I see in America us outsourcing that work, I think if you can afford that, I don't want to take that away from you. I want to figure out a way for those people to make a living wage. And I want to figure out a way for more people to be able to feel less burdened by our caregiving.

GROSS: What was it like watching your mother's behavior around the maid when you return to the Philippines to visit your grandparents? Because at home, your mother would tell you, I'm not your maid.

GARBES: Right.

GROSS: Pick up your dirty clothes. Wash the dishes.

GARBES: Yeah.

GROSS: But when you visited your grandparents, there was a maid. And your mother would often defer to them and tell you that you needed to let them wash the dishes.

GARBES: Yeah. You know, it wasn't always that way. I've actually watched - this has been interesting in my life, to watch her transition to that place because she would, at first, always get up. She would clear the table. She would do things. And she would be trying to help and trying to show that I don't think I'm better than you. That's how I interpreted it, right? And over time, she really started to respect their authority and see, like, there's a way a household runs. And she's actually an interloper here. She doesn't know. She actually slows up the system.

And so I've seen her really defer to their authority. And she even said to me once, like, who am I to say that I can do their job better than them? I can't. So she just kind of stays out of their way now. And I think her way of dealing with it, I've noticed, is that when she leaves, she slips them some cash. And she brings them gifts from America, like Victoria's Secret lotions and things like that.

GROSS: When your mother immigrated to the U.S. after becoming a nurse when she was in her 20s, her mother-in-law offered to send someone with her to help with housecleaning and, eventually, child care, assuming that she was going to have children, which she did. And your mother declined. How did she explain to you why she declined having somebody from the Philippines accompany her and your father to America to help them?

GARBES: Yeah, I thought it might be a tough decision for her. But she was very clear. She was actually raised by maids and nannies. They call them yayas in the Philippines. And I think that she missed - honestly, I think she missed that connection with her mother. And so I think there was a little bit of that. And she also said, you know, having maids means they hear everything you say, and so you have no privacy. So that was another factor for her.

And she said - and this is the thing that I've come to, upon reflection, see a lot more meaning in, is that she said, you know, I want to be responsible for what happens in my family. And I also don't want to be responsible for somebody else. I think she saw it as a duty, another caretaking duty, to have someone else there. And I think she also was aware, like, this concept of sending someone - you know, giving someone a person, it made her uncomfortable, the idea that someone would be part of her family who didn't have, necessarily, an active say or choice in that.

GROSS: How has your experience seeing the domestic workers at your grandparents' homes and watching your mother reject that kind of work in her own home, how has that affected your attitude about having a nanny or a babysitter or, you know, daycare? Daycare, you're sending your child outside. And so you don't have somebody in your home. You're not responsible for that person. You're not directly paying that person. So like, when you were trying to decide which approach you wanted to take...

GARBES: Yeah.

GROSS: ...Were you informed at all by your family's experiences with domestic help?

GARBES: Yes. Absolutely. I knew that I couldn't do it alone. My husband and I knew that. We were sort of - we were naive. I think we were actually pretty devastated to realize how expensive it was to figure out child care, you know? We had - you know, when my first daughter was born, we both had full-time jobs. And it was still - it was very hard to make ends meet. And so we relied on a mix of things. My mother helped us, and that was unpaid labor.

We did a nanny share with two other families who - we had very clear conversations. This woman was a woman from Mexico. And we wanted to make sure she - you know, she would take care of 2 to 3 babies at a time in these other two homes. And we made sure we had a meeting where we were paying her at least $15 an hour. And we gave her a month off every year. And she was welcome to bring her son, who was about 3, to the home where she was caring for the children.

So I make decisions where I feel like I am paying people as much as I can, as fairly as I can and that I am giving them time off. I treat it like a real labor negotiation. And I should say also that my husband is a union organizer. So these issues happen to be top of mind for us. And then when it was time to choose a daycare and a preschool, we made a decision to go with a school - it's essentially a private school. But it's a bilingual program where most of my daughters' authority figures for the first four years of their lives have been brown women who speak English as a second language.

And they also have a curriculum that's rooted in social justice and pride in culture. And every May, the theme of the month is Workers of the World. So I felt like we were giving them, you know, something more than - valuing these teachers for being more than just, you know, someone minding our children. We think of them as integral to the work of mothering. And we could not do this work without them.

GROSS: Well, let me reintroduce you here. If you're just joining us, my guest is Angela Garbes, author of the new book "Essential Labor: Mothering As Social Change." We'll be right back after a short break. I'm Terry Gross, and this is FRESH AIR.

(SOUNDBITE OF SUN RA'S "SUNRISE")

GROSS: This is FRESH AIR. I'm Terry Gross. Let's get back to my interview with Angela Garbes, author of the new book "Essential Labor: Mothering As Social Change." She wrote it after having to give up work during the COVID lockdown when she no longer had daycare. The book is about how mothering is the invisible economic engine driving our culture, but it's undervalued, and the professionals who take care of children are undervalued and usually underpaid. And those professionals are often women of color. Garbes' parents immigrated from the Philippines after her mother became a registered nurse and her father a pathologist. Her previous book, "Like A Mother," was about the culture and science of pregnancy.

Your mother, as we've mentioned, was a home hospice nurse, your father a pathologist. And they talked openly to you and your siblings about bodies in distress, ailments, diseases, recoveries, survival, death. I mean, these are the things they dealt with.

GARBES: Yeah. Oh, yeah.

GROSS: But what they didn't talk to you about was, like, your body (laughter).

GARBES: Right.

GROSS: And, yeah, I think you wish that they had talked to you more about your body and wish that that would have you more comfortable in your body. What do you...

GARBES: Yeah.

GROSS: ...Wish your parents had talked with you about that you think maybe the culture they're from prevented them from discussing with you?

GARBES: Yeah, I - many things. I mean, I'm so grateful to them, like, that - they talked very clinically about bodies. And so things like death and ailments were - again, as you said, like, I could come to them, like, whenever I'm sick, right? I could come to them and be like, I think my tonsil's swollen. Like, what's happening? But I couldn't come to them and say, I feel like I'm growing these breasts, and they hurt. And I'm confused, and I don't know what to do with that.

You know, I feel like I couldn't come to my mom. I mean, I did come to my mom and be like, I want to try these things called tampons, which I had read about in, like Seventeen magazine. And my mom was like, no, we don't use those. I just use pads. Like, I don't know about sticking something into your body. And it was kind of just, like, shut down. And, you know, I saw my mom really talk about how she thought her body was fat and flabby even though she's extremely petite and thin and is amazing-looking. And she also - I have a larger body than my mom's. I always have. So I felt really - I felt some shame around my body.

And she also chided me because I love to sit in the sun and I love to get tan. And she was always, like, in a hat and long-sleeve shirt gardening and, like, would always really sort of - to be telling me it was bad for me to be getting dark. And so I felt a lot of conflict around that. And the way I feel about it now is - I think I was angry for years with my parents or frustrated and feeling like they didn't give me what I needed and what I deserved. And as I've gotten older and especially since becoming a parent myself, I started to understand my parents were people. They're just human beings.

And they were really - you know, what they inherited was a culture of colonial - a colonial mindset, again, Spanish colonialism, American colonialism that told them that they needed to assimilate to be successful - right? - that they needed to adopt other cultures, that their - who they were as Filipinos was dirty and diseased and not as valuable. And so the way to be valuable was to be compliant, to be light-skinned, to work really hard and be productive. And so I see now that my parents couldn't give me things that I wanted because they didn't have those things for themselves.

And so I think a lot of what I'm trying to do is make sense of that and sort of - I mean, my mom doesn't need my forgiveness. But I think in my mind, I've kind of had to make peace - right? - with the flawed humans who raised me and realizing that I am a flawed human and I am a flawed human raising children. And I'm going to make mistakes, too. And I'm not going to give - I probably won't be able to give my daughters everything that I want, but I want us to be able to talk about those things. And I want to talk about these things with my parents because I feel like I'm just always trying to connect with them.

GROSS: How have you tried to talk to your daughters about body issues in a way that you think will be helpful? I think you've been going in the opposite direction of your mother when it comes to that.

GARBES: Yes (laughter). Yeah. I mean, I am - for better or worse, I talk about everything. And my husband teases me and says, you know, a child's attention span is not very long. And so I'll still be talking, and, you know, my - about the colonial mindset. And my children are, like, biting apple slices into the shape of a butt or a moon and showing it to me. And my husband will say, not every moment is teachable, right? But, like, I grew up with so much silence. And I think silence is the place where guilt and shame really flourish. And I just don't want to - I don't want that, right? So I'm out trying to, like, impart on them many things.

But, I mean, we talk about - you know, when I was growing up, like, I didn't know what my, like, vagina and vulva was. Like, we - my mom called it a peckadooty (ph), and I didn't know until I was, like, 14 what the parts of my body were called. And for - with my girls, we talk about vagina, vulva, clitoris because it's just like an arm or a chin or a finger. They're just parts of your body, right? There isn't - we're not adding a lot more to it than that. They're just parts of the body. So that's one thing that I do.

Another thing is I try to get them to see that their bodies are not just about aesthetics, right? That - I mean, little girls receive that message so early about being pretty and being beautiful. And, you know, sometimes the first thing we comment on with children is their appearance. And I try to emphasize for them that their bodies, like, do such a good job of keeping them alive, right? Their bodies are so useful, and they're strong, and they're flexible, and they're capable. And, you know, it's - there's a story that I share in the book that is - it's humbling. You know, like, I am not, like - I'm at a good place with my body, but it's - every day I have to do the work to tell myself, you know, that my body is good and my - every body is good.

And there was this time that I was showing them pictures of my husband and I on, like, our first vacation together. This was, like, 14 years ago. And I thought the photo was amazing because it's - we're on a beach in Mexico. It was taken by, like, a photographer who was wandering around, and it's, like, ludicrously overexposed. So my husband looks - he's a pale guy. He looks like a ghost. Like, it's his like, his - all of the features of his chest are washed out. And I thought we'd look at the photo and we would laugh at him. And instead, my daughters looked at the photo, and they said, hey; did you get fat?

GROSS: Oh.

GARBES: Yeah. And I was like, this is where the rubber meets the road. This is where what I'm trying to teach them, like - this is my chance. And I hope to God I can rise to the occasion. And I was humiliated, you know? And I just said, yeah, yeah, I got fat. You know, some bodies get bigger. Some bodies get smaller. My body is really good at keeping me alive. My body grew the two of you. And - yeah, and now it's a little bit fat. And I'm just, like, white-knuckling myself through this momentary - and then my daughter just - well, my younger daughter goes, yeah, you definitely got fat. And then my oldest daughter said - she goes, yeah, you got fat. But I like your squishy tummy because it's soft, and it's kind of like a pillow.

And then they're just like laying on me and really, like, forcing me to look at my body and, like, accept it and think, like - and I actually felt in that moment, like, I'm doing an OK job because to these children right now, in this moment, fat isn't bad. Fat is an adjective. Fat is just fat. And it's only me who's bringing all of this weight and tension to it. And they just, like, love my squishy fat body (laughter). And so I'm trying to get them to - and, you know, in this way I feel like they're teaching me and they're, like, leading the way on that - in that sense.

GROSS: Well, let me reintroduce you. If you're just joining us, my guest is Angela Garbes, author of the new book "Essential Labor: Mothering As Social Change." We'll be right back. This is FRESH AIR.

(SOUNDBITE OF JULIAN LAGE'S "IOWA TAKEN")

GROSS: This is FRESH AIR. Let's get back to my interview with Angela Garbes, author of the new book "Essential Labor: Mothering As Social Change."

Children have been exposed to so much death lately. If the TV is ever on, if it's ever tuned to the news, children are hearing about mass shootings, mass shootings in elementary schools. They're hearing about an incredible number of deaths from COVID. They're hearing about massive suffering and death in Ukraine. Your mother was a hospice nurse. She talked to you about death. She was surrounded by death. That was her job, helping people die in a peaceful way. How have you used your mother's experiences and your experiences being raised by her in helping guide you through this time when it's hard not to talk to your children about death? It's hard for them not to want to ask you about it.

GARBES: Yeah, I'll say, in all of those events and death and war and the thing in grief that you just listed, I am protecting my children in some ways through that. You know, we have talked about you - can we talk about things generally in an age-appropriate way? I have not been able to talk to my oldest about the specifics of children and teachers being murdered in Uvalde. Like, I know that that day will come, and I know that she knows what the drill is at her school and where she needs to go. And I wish - I tell her that I wish that I could keep her safe when she's at school, but I can't always. And I'm glad that her teachers are there to help do that.

So it's really hard. I don't know. I have no idea, like, exactly what the right time is to talk to people about that or how to do it. And I sympathize with so many parents who are navigating that. But as far as death goes, you know, I have always taught my children that it's just a natural part of life. That's what I inherited most from my mother. Like, death is going to come, and there should be dignity in death, and that taking care of people, like, end of life and honoring their life is very important work.

GROSS: Do they ask you questions about police shootings of Black men and women or about the elementary school, you know, mass shootings? How or where are they now of what's been going on with guns?

GARBES: Yeah. They're less aware of about mass shootings and guns. That is something that I frankly feel a little lost with at this moment. So I'm like talking to my friends about it.

GROSS: So they're not hearing about it from other children or in school.

GARBES: Not as far as I know. And I ask them. They were, like, in the summer of 2020, they had a lot of questions - and my older one especially - about police shootings. They understand that it's not fair, but it is true that in America, if you are brown or Black, there's just more chances that you'll die and more chances that you'll die early from, like, health outcomes. Like, that's COVID, right? You know, one of those things that I write about is - so much of why I brought in my Filipino family into this book is because there was a statistic that came out during COVID, which is that Filipinx nurses are 4% of the nursing workforce in America, but they're close to 34% of COVID-related nursing deaths. So, to me, that is, I had to talk, you know, I have to talk to my children about these things, about how institutional racism is like tied to shorter life outcomes for people because that could have been their grandmother.

And I don't know. I just feel like I do them a disservice to not include them in things. And I'm not trying to scare them. I'm trying to allow them to enter the world with a better consciousness and to be able to, like, think about other people. I also, you know, I encourage my husband to talk to them about whiteness. I talk to them about their Philippine identity all the time. But they are mixed-race kids, and they will have privileges that other kids who are Filipino, like, won't necessarily have. And so all of this is just - it's work that we're constantly doing. And I don't have definitive answers.

GROSS: We've talked about how your mother spent most of her career as a home hospice nurse. And she got her, you know, registered nursing certification in the Philippines, where she's from. And then as soon as she got that, she moved to America and became a nurse here. And a lot - like thousands and - tens of thousands of nurses from the Philippines over the years have come to the U.S. and become nurses here. What changed in the immigration laws that explains that?

GARBES: So my parents are health care workers because when the Philippines was an American colony, the American government set up education systems, public education systems where they learned English and then medical schools and nursing schools, which offered people economic opportunity. And that's what they told Filipinos. Internally, I should say, that they talked about needing to have medical schools and a health care workforce because they needed to sanitize a population that they felt was diseased and dirty.

So my parents were the beneficiaries of this system. And when they graduated, it was an interesting time. So post-World War II, there was a nursing shortage in America, and there was a health care worker shortage. And so the American government, which had previously limited the number of immigrants that could come from the Philippines, lifted quotas in 1965. And this was called the 1965 U.S. Immigration Act, also sometimes called Hart-Celler. And they raised it for highly skilled immigrants. So obviously, my parents, as new graduates of medical and nursing school, qualified, and that's why they were able to come over.

And so it was a moment of tremendous economic opportunity that, as we discussed, worked out for my parents. But it was also a decision that reflects the way that America approaches other countries. And to me, it's exploitative, and it's taking what you need from a population when you need it and shutting them out when you don't.

GROSS: Do you think your parents felt that way?

GARBES: No. And I've talked to them about it, and it's complicated, you know? I think we got to a place where my parents understand that the system is inherently exploitative. You know, both of my parents, they were fronted money for their airfare to move to the United States, and then that money was deducted from their first paychecks. So talking about that sort of helped them see, you know, this system is - was, you know, used to - was exploitive. And so...

GROSS: Well, you can say it was just like a loan but without interest.

GARBES: You could say that. Yeah.

GROSS: They were loaned money to come to the United States where they'd be making more money than they would have made in the Philippines, and they didn't have to pay it back with interest.

GARBES: Yes, you could say that, and that's what they say. And so I think that there's - you know, and I think that they have a - there's a more nuanced understanding. And I also know I'm, like, crashing the party by coming in and being like, but what about colonialism? But what about, you know, Hart-Celler? And I think for a lot of years, my parents were like, why do you want to ask all these questions? Like, why do you care? You have a nice life. Like, what's the point of all of this? And, you know, unfortunately for them, I just am the kind of person that cannot ask those questions. I don't think history exists in a vacuum. And I'm so grateful that my parents had the opportunities that they had. But they also could have had a different life and possibly a great life in the Philippines.

GROSS: Let me reintroduce you. If you're just joining us, my guest is Angela Garbes, author of the new book "Essential Labor: Mothering As Social Change." We'll be right back. This is FRESH AIR.

(SOUNDBITE OF BRIAN ENO AND JOHN CALE SONG, "SPINNING AWAY")

GROSS: This is FRESH AIR. Let's get back to my interview with Angela Garbes, author of the new book "Essential Labor: Mothering As Social Change."

I want to ask you about Roe v. Wade.

GARBES: Yeah.

GROSS: And I'll preface this by saying our previous interview, which we recorded in 2018, was about your book "Like A Mother," which is about the science and culture of pregnancy. Your second daughter had just been born. You were still breastfeeding. And your older daughter was - what? - 2 or 3, I think?

GARBES: Three, yeah.

GROSS: OK. And one of the things we talked about in that interview was how earlier in your relationship with the man who became your husband, you'd had an abortion. I don't think you were married yet. But I think you were...

GARBES: No, we weren't.

GROSS: Yeah. And you just felt like the time was wrong. I mean, you wanted to have children but not then. And then you had one or two miscarriages after that, and I asked you if you'd regretted having an abortion 'cause I think women are told that they will regret it if they later find that they can't have children or that they miscarry. And you said you still didn't regret it 'cause you think that it wouldn't...

GARBES: Yeah.

GROSS: The time was not right.

GARBES: Equivocal no. Don't regret it.

GROSS: Yeah. And you weren't even sure your relationship with your husband would have survived if you had children then 'cause you...

GARBES: Yeah, that's actually the first...

GROSS: ...Just weren't prepared.

GARBES: ...Thing I thought when you said that.

GROSS: Oh, OK. OK.

GARBES: Yeah.

GROSS: So I'd love to hear your thoughts now about the possibility of - the likelihood, I should say...

GARBES: Yeah.

GROSS: ...Of Roe v. Wade soon being overturned by the Supreme Court.

GARBES: Yeah. I think the reality is we've - that we were talking about this four years ago - right? - in a different context. But we've known this was coming. And really, for many women and - for many people in the United States, especially poor people of color in the South, abortion access is already extremely limited. And so, you know, I think that rich people will always be able to get abortions, and the people who will suffer the most are already the people who are suffering.

And I - my favorite abortion statistic is that 66% of people who have abortions are already parents. They're already mothers. And to me, that says so clearly - I mean, we know the cost of having children - financial, emotional, psychological, you know, but financial mostly. And I think when we condemn people, when we force people into motherhood, we are forcing them into poverty. And I think in that sense, what's happening right now is that our system is working exactly as it's designed - to keep people in power in power and to keep poor people and people of color and marginalized people in lives that are harder than they need to be.

GROSS: Opponents of abortion often talk about the health risks of abortion and how dangerous abortion can be. In your book about the science and culture of pregnancy, you wrote in part about the health hazards of pregnancy and childbirth. And, I mean, you're an example of what can go wrong. You had two caesareans, and one of them was because your baby was in your womb sideways, not breached, not head first, but sideways. And so, like, there was no way of the baby coming out unless there was a cesarean. You went to all kinds of people who promised that they could, like, turn the baby around in the womb. None of that worked.

GARBES: Actually, they did - the baby - the second baby did turn head down, but I still had to have a cesarean.

GROSS: OK. Yeah.

GARBES: Yeah. We - apparently, I have what some people call an incompetent cervix.

GROSS: So you could have - if it wasn't for, like, surgery, you could have died in childbirth.

GARBES: It's possible. Yeah. I mean, I think as you're asking me this question or just raising this issue, I feel like - I mean, I don't know who these - I'm not familiar with abortion opponents who are like it's really, really dangerous. I mean, it's actually a basic health care procedure. But I also think, you know, every - many things related to female reproductive health are dangerous because, also, we tend to prioritize a fetus over a human being who's, like, living independently in the world. So I think that actually all of the dangers that come with these things are because we devalue and do not listen to women and people with female reproductive parts.

GROSS: You had two caesareans, and you say it changed your body shape. But also, there's part of your abdomen that is still slightly numb.

GARBES: Yeah. It's, you know, you cut nerves, and sometimes damage is there, and sometimes it lasts forever. But it's also - I don't know. Like, I think back to that story that I told you about my daughters. Like, there are parts of me that are numb down there. And I think the way I deal with it, you know, emotionally and mentally is to be sort of numb to it, too.

And I just have this tremendous gratitude for my daughters because I feel like they force me to look at it, to look at my body and to not feel numb, and to feel what I feel about it, which is a mixture sometimes of disbelief and difficulty, but also gratitude - and sometimes, like, when I'm really in a good place, like, celebration. And yeah. I don't want to be numb. You know, I guess there's like some parts of me, you know, physically that will remain that way. But I don't need to be that way emotionally.

GROSS: You write pretty openly about body issues. I wonder what your parents' reaction is to that, because growing up in the Philippines, culturally, you don't talk about stuff like that.

GARBES: Yeah.

GROSS: At least that's how you describe it.

GARBES: Yeah, they are - I will say that they are tremendous and generous in their love and support of me and what they might feel personally. I know that, you know, my mother said to me the first time she read a copy of the book - I gave her an advanced copy. And she said, you say in the book - just what you said, Terry - you say in the book that we don't talk about things. But then you went and put all of our things in a book for everyone to read.

And I said, yes, I'm sorry. I'm a writer. And I'm a traitor. I'm sorry. But I think that there is - I think people can learn from this. And I think people - this will help people. And writing it, you know, helped me. And, you know, I love my parents so much. And, like, their love and support is the greatest gift of my life. And the way my mom ended that conversation is by saying, well, I don't really like it, but these are your stories, and they're your stories to tell.

GROSS: Angela Garbes, it's been such a pleasure to talk with you. Thank you so much. I hope you and your family stay well.

GARBES: Thank you, Terry.

GROSS: Angela Garbes is the author of the new book "Essential Labor: Mothering As Social Change." Tomorrow on FRESH AIR, we'll talk about the hidden world around us. The sights, smells, tastes, sounds, vibrations and magnetic fields that are imperceptible to humans but are perceived by various animals, birds, fish and insects. My guest will be science writer Ed Yong, author of the new book "An Immense World." We'll also talk about covering COVID for The Atlantic - oh, on monkeypox, too. I hope you'll join us.

(SOUNDBITE OF SUN RA SONG, "BEAUTIFUL LOVE")

GROSS: FRESH AIR's executive producer is Danny Miller. Our technical director and engineers is Audrey Bentham. Our interviews and reviews are produced and edited by Amy Salit, Phyllis Myers, Sam Briger, Lauren Krenzel, Heidi Saman, Ann Marie Baldonado, Thea Chaloner, Seth Kelley and Joe Wolfram. Our digital media producer is Molly Seavy-Nesper. Therese Madden directed today's show. I'm Terry Gross.

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