The male Dr said to the Martha Doctor 'we met in 2012 when you were speaking at.....', so if we are in 'current time' then Gilead can't be more than 6-8 years old, assuming the most draconian measures didn't come to pass until a takeover was complete and Gilead had existed for a period of time. This puts in more in perspective for me, I guess, and can explain why so many questions about 'how things work' seem to be unanswered. It's probably because the problem hasn't arisen yet.
I was so appalled at Fred 'chastising' Serena. It was so demeaning that it actually made me feel ill. And it made me wonder, too, given that Fred seemed decent and appeared supportive of Serena's writing and campaigning in the 'early days' of the 'revolution' (based on flashback scenes) just how many men in our lives, men that we think of as decent, would end up supporting a patriarchy once they realized that it gave them 'free rein' to do as they pleased without having to consult the women in their lives. But Fred had better be careful. Serena and June are in a good place to do him a great deal of harm if they ever decide to join forces.
As far as the episode before last and the 'orders', am I correct in understanding now that Serena Joy was actually acting on Fred's behalf, not writing orders behind his back?
Angela/Charlotte's 'mother' had made comments in the past that the baby was 'difficult' and that she hadn't really bonded with her, and childcare is so left to the wife that it's easy to believe that the baby was suffering from 'failure to thrive'.
I think Serena is a perfect example of that old saying "Be careful what you wish for, you just may get it". I think she was envisioning a world where women still had choices, even if she felt that housewifery and motherhood should be the primary choice. I don't think she envisioned a world in which she would be so powerless. And I think her powerlessness snuck up on her and she didn't really see it until now, when she's finally felt (literally) how under Fred's heel she really is. A velvet prison is still a prison.