I had many plans for this post. I was gonna write about Copenhagen 15. But weeks later I still feel so damn furious and depressed that I decided to ignore that. So I intended to featuring another blog, or writing about the recent incidents of whitewashing. But this morning I looked over at Alas a blog and found the two first posts. And I had missed the “Blog Prochoice Day” last week Friday. And so, it was decided.
Most people think of abortion as the be-all and end all of women’s reproductive health struggles. But it isn’t. Not by a long shot. Here are some links on the reproductive Justice Movement, a movement founded by people of color who rejected the abortion-only model of activism held by the mainstream feminism movement in favor of a holistic and inclusive movement to demand that women get and keep the rights over their own bodies.
Without ado therefore, lets begin.
Definition
What is reproductive justice? According to A New Vision for Reproductive Justice PDF by the Asian Communities for Reproductive Justice
We believe reproductive justice is the complete physical, mental, spiritual, political, economic, and social well-being of women and girls, and will be achieved when women and girls have the economic, social and political power and resources to make healthy decisions about our bodies, sexuality and reproduction for ourselves, our families and our communities in all areas of our lives.
The paper continues on to explain that:
The Reproductive Justice framework is rooted in the recognition of the histories of reproductive oppression and abuse in all communities, and in the case of ACRJ, in the histories of Asian communities and other communities of color. This framework uses a model grounded in organizing women and girls to change structural power inequalities. The central theme of the Reproductive Justice framework is a focus on the control and exploitation of women’s bodies, sexuality and reproduction as an effective strategy of controlling women and communities, particularly those of color. Controlling a woman’s body controls her life, her options and her potential. Historically and currently, a woman’s lack of power and self-determination is mediated through the multiple oppressions of race, class, gender, sexuality, ability, age and immigration status. Thus, controlling individual women becomes a strategic pathway to regulating entire communities. To realize a vision of the complete health and well being of all women and girls, a Reproductive Justice framework also engages with issues such as sex trafficking, youth empowerment, family unification, educational justice, unsafe working conditions, domestic violence, discrimination of queer and transgendered communities, immigrant rights, environmental justice, and globalization. Analysis of the Problem Women’s ability to exercise self-determination—including in their reproductive lives—is impacted by power inequities inherent in our society’s institutions, environment, economics, and culture. The analysis of the problems, strategies and
envisioned solutions must be comprehensive and focus on a host of interconnecting social justice and human rights issues that affect women’s bodies, sexuality, and reproduction.MORE
SisterSong, which seems to be the umbrella organization has this paper: Understanding Reproductive Justice PDF
One of the key problems addressed by Reproductive Justice is the isolation of abortion from other social justice issues that concern communities of color. Abortion isolated from other social justice/human rights issues neglects issues of economic justice, the environment, immigrants’ rights, disability rights, discrimination based on race and sexual orientation, and a host of other community-centered concerns directly affecting an individual woman’s decision making process. By shifting the definition of the problem to one of reproductive oppression (the control and exploitation of women, girls, and individuals through our bodies, sexuality, labor, and reproduction) rather than a narrow focus on protecting the legal right to abortion, we are developing a more inclusive vision of how to move forward in building a new movement.
Because reproductive oppression affects women’s lives in multiple ways, a multi-pronged approach is needed to fight this exploitation and advance the well-being of women and girls. There are three main frameworks for fighting reproductive oppression: 1) Reproductive Health which deals with service delivery, 2) Reproductive Rights which address the legal regime, and 3) Reproductive Justice which focuses on movement building. Although the frameworks are distinct in their approach, they work in tandem with each other to provide a complementary and comprehensive solution. Ultimately, as in any movement, all three components of service, advocacy and organizing are crucial to advancing the movement.MORE
Reproductive Justice and Women’s Rights
Reproductive Justice: Who is fit to have children? Controlling Poor Pregnant Mothers. (Race and Class Intersect big time here)
The New York Times writes a nice article on The Crack epidemic that wasn’t
When the use of crack cocaine became a nationwide epidemic in the 1980s and ’90s, there were widespread fears that prenatal exposure to the drug would produce a generation of severely damaged children. Newspapers carried headlines like “Cocaine: A Vicious Assault on a Child,” “Crack’s Toll Among Babies: A Joyless View” and “Studies: Future Bleak for Crack Babies.”
But now researchers are systematically following children who were exposed to cocaine before birth, and their findings suggest that the encouraging stories of Ms. H.’s daughters are anything but unusual. So far, these scientists say, the long-term effects of such exposure on children’s brain development and behavior appear relatively small.
“Are there differences? Yes,” said Barry M. Lester, a professor of psychiatry at Brown University who directs the Maternal Lifestyle Study, a large federally financed study of children exposed to cocaine in the womb. “Are they reliable and persistent? Yes. Are they big? No.”
Cocaine is undoubtedly bad for the fetus. But experts say its effects are less severe than those of alcohol and are comparable to those of tobacco — two legal substances that are used much more often by pregnant women, despite health warnings. MORE
Except, as Colombia Journalism Review points out, The New York Times carefully refrains from pointing out that they were among the “newspapers” that were running front page screaming headlines
Newspapers like… the Times, producer of the “Crack’s Toll Among Babies: A Joyless View” headline that today’s Times mentions but doesn’t cop to having authored. In this 1989 “Crack’s Toll” piece, a research psychologist is quoted saying that “prenatal exposure to illegal drugs, particularly powdered cocaine and its smokable derivative, crack, seems to be ‘interfering with the central core of what it is to be human.’” (Read: Epidemic!)
…
Back in 2004, Mariah Blake wrote for CJR about the “media myth” of the “crack baby” and detailed how the Times contributed to it over the years (even quoting from the “Crack’s Toll” article). Blake wrote about “a group of doctors and scientists …lobbying The Times to drop terms like ‘crack baby’ from its pages,” because, the group said, these terms are “stigmatizing” and “lack scientific validity.”
Reported Blake four years ago (emphasis mine):
While the [Times] hasn’t used “crack baby” in the last several months, it has referred to babies being “addicted” to crack, which, as the researchers told the editors, is scientifically inaccurate, since babies cannot be born addicted to cocaine.
Which leaves me wondering about the photo caption accompanying today’s (print) Times piece (emphasis mine): “In a 1988 photo, testing a baby born addicted to cocaine.”
That led to increased oppression of poor pregnant women, especially if they were of color
Earlier medical studies of women who used drugs while they were pregnant demonstrated the bias of the studies’ authors. While the authors were looking for the singular effect of cocaine on pregnancy, they often failed to notice that many of the women they studied were polydrug users, meaning they often used more than one drug, including tobacco and alcohol, during pregnancy.10 Additionally, the women studied had limited access to prenatal care or other health care services, they had co-occurring illnesses or diseases, they had suffered from some sort of sexual or psychological trauma, and they were frequently exposed to environmental contaminants. All of these factors have been shown to play a role in negative pregnancy outcomes. Additionally, it has recently been discovered that men can also affect pregnancy outcomes, depending on contaminants they might be exposed to or other physiological factors.
….
After the crack baby’s birth, pregnant and parenting women began to face the scorn of both the public and the police throughout the country. South Carolina began to arrest and prosecute women who used drugs while they were pregnant, and this trend was to be followed by states across the country. The leading teaching hospital in the state of South Carolina, the Medical University of South Carolina, instituted a policy of searching and arresting pregnant women on charges of child (fetal) abuse-but only if they had used cocaine. The policy-that resulted in some pregnant and newly delivered women being taken out of the hospital in chains and shackles-was applied only to those women who used cocaine and none of the scores of other legal and illegal substances that women used that caused potential damage to future children.
Children Requiring a Karing Community (C.R.A.C.K.), a program that offers $200 to women to be sterilized or undertake long-term birth control like Norplant or Depo-Provera if they use drugs, is another product of the crack baby scare. The program, created and spearheaded by a white, upper class woman, thrives on a rhetoric that speaks to the laziness and selfishness that has become the stereotype of the poor, black crack mother: C.R.A.C.K. literature reads “Don’t let a pregnancy get in the way of your habit.” These are just a few examples of the way that the representation of crack babies and their mothers trumped any medical or scientific truth-they were the truth in the war against poor women who use crack. MORE
While we are at though, it appears that Alcohol is not quite the villain that it has been portrayed by the sensationalistic mainstream media and pious interfering men-know-best politicians, doctors and otther groups. You see, what causes what is referred to as Fetal Alcoholic Syndrome may be more complicated than just alcohol itself…
Fetal Alcohol Syndrome and the Social Control of Mothers
It turns out that only about 5% of alcoholic women give birth to babies who are later diagnosed with FAS. This means that many mothers drink excessively, and many more drink somewhat (at least 16 percent of mothers drink during pregnancy), and yet many, many children born to these women show no diagnosable signs of FAS.
…So, drinking during pregnancy does not appear to be a sufficient cause of FAS, even if it is a necessary cause (by definition?). In her book, Conceiving Risk, Bearing Responsibility, Elizabeth Armstrong explains that FAS is not just related to alcohol intake, but is “highly correlated with smoking, poverty, malnutrition, high parity [i.e., having lots of children], and advanced maternal age” (p. 6). Further, there appears to be a genetic component. Some fetuses may be more vulnerable than others due to different ways that bodies breakdown ethanol, a characteristic that may be inherited. (This may also explain why one fraternal twin is affected, but not the other.)MORE
The Still Cruel Maternity Wards
In 1959, the Ladies’ Home Journal published an article called “Cruelty in the Maternity Wards,” in which women told stories of their inhumane treatment during childbirth. Despite the uproar it provoked, 50 years later, nothing substantial has changed. Really. Recently, a pregnant Florida woman was confined by the court to bedrest and ordered to submit to any treatment her doctor deemed necessary, including cesarean surgery. This is one of a string of similar stories appearing over the past months: A New Jersey woman with PTSD and depression in her past was deprived of custody of her child at birth because she refused to sign a blanket consent at hospital admission for cesarean surgery, an act cited as proof she was too mentally ill to be a fit mother. An Arizona woman with a prior cesarean was told if she showed up in labor and refused automatic surgery, the hospital would get a court order and perform it anyway. And an Illinois woman was literally tortured throughout labor by her doctor to punish her for not calling before coming to the hospital while medical staff stood by and did nothing
MORE
And then there is Reproductive Coercion Is Sexual Violence
Pregnancy Coercion, Intimate Partner Violence and Unintended Pregnancy is the first quantitative examination of the relationship between intimate partner violence, reproductive coercion and unintended pregnancy. It finds that young women and teenage girls often face efforts by male partners to sabotage their birth control or coerce or pressure them to become pregnant – including by damaging condoms and destroying contraceptives. These behaviors, defined as “reproductive coercion,” are often associated with physical or sexual violence. Conducted by researchers at the University of California Davis School of Medicine and the Harvard School of Pubic Health, the study also finds that among women who experienced both reproductive coercion and partner violence, the risk of unintended pregnancy doubled.
From August 2008 to March 2009, researchers worked at five reproductive health clinics in Northern California, querying some 1,300 English- and Spanish-speaking 16- to 29-year-old women who agreed to respond to a survey about their experiences. They were asked about birth-control sabotage, pregnancy coercion and intimate partner violence. Approximately one in five young women said they experienced pregnancy coercion and 15 percent said they experienced birth control sabotage. Fifty-three percent of respondents said they had experienced physical or sexual violence from an intimate partner. Thirty-five percent of the women who reported partner violence also reported either pregnancy coercion or birth control sabotage.MORE
Reproductive Justice: Disability
On Claiming My Movement: Disability and Reproductive Justice
Reproductive justice and disability are connected on a deeply fundamental level. Disabled people, issues, history, politics and analysis allow us to see parts of reproductive justice that we would otherwise never know. After all, how can you talk about bodies without talking about disability? How can you ignore the fact that disabled women are forcibly sterilized or given dangerous contraceptives to control their menstrual cycles for the convenience of their caretakers and institutions? How can we learn to fight for not only the right to receive care, but also the right to refuse it? How can we forget that female bodies were historically coded as “disabled” because they were “different” and had “different abilities” than male bodies? Or that ableism is so easily and successfully used as a mechanism of reproductive oppression?MORE
Disabled Women and Reproductive Justice
In the United States, a culture of ableism, which maintains that able-bodied people are superior and most valuable, prevails. In this culture, disability is feared, hated, and typically regarded as a condition that reduces the value of disabled people. The reproductive justice framework helps us understand how eugenic “science” is still a vibrant part of U.S. culture that interacts with and shapes the reproductive lives of disabled women in many ways.
Right to Parent
Women with disabilities (WWD) have a long history of forced sterilization, are often seen as “unfit” mothers and are discouraged from having children, or not allowed to adopt children. Authorities press disabled women to feel guilty for their decisions to be parents, pointing out that their decision will take a “toll” on their children, families, communities and on themselves.Sexuality
Society typically defines disabled women as asexual and as dependent on able-bodied people, undermining these women’s access to reproductive health. Disabled women and girls often do not receive sex and reproductive health educationMORE
Reproductive Justice: Transgender persons and their healthcare.
Trans Healthcare is a matter of life and death
Robert Eads was visiting friends in the late 1990s when he woke up in a pool of blood. His terrified hosts quickly began calling hospitals, clinics, and private physicians, explaining that Robert was a partially-transitioned female-to-male transsexual and demanding an immediate appointment.
The request was repeatedly rebuffed. By the time Eads found physicians willing to diagnose and treat him at an Augusta, Georgia teaching hospital — a three-hour drive from his home in rural Taccoa, Georgia — his ovarian cancer was so advanced that nothing could be done to save his life. He died in 1999, at age 53.
…
Indeed, members of the transmasculine community understand that the line separating them from Eads is frighteningly narrow. Most, like him, have undergone radical mastectomies to better present as male. Furthermore, like him, most have neither the money nor the inclination to have their female genitalia removed. This means that they need to see a physician for routine, annual Pap smears, STD testing and gynecological exams.MORE
And the shit comes from all sides, including the feminist movement as this recent clusterfuck shows:
I’ve been hearing about this from friends in Vancouver for a few weeks now, and it would seem according to a note posted to the Facebook group Lu’s Pharmacy Women-Born-Women-Only Policy is Discriminatory & Oppressive, Lu’s pharmacy in Vancouver, BC, has quietly ended their no trans woman policy:
I just wanted to share the good news. Lu’s has de facto removed their women-born women policy! This has been in effect for about two weeks…
Lu’s Pharmacy was opened last summer in Vancouver, BC, by the Vancouver Women’s Health Collective. From its opening the pharmacy had a woman-born-woman policy, which immediately brought negative response from trans and cis activists and agencies in Vancouver’s downtown east side.MORE
Reproductive Justice: Immigrants
Immigration and Reproductive Justice: The Basics PDF Just the Facts: Immigration and Reproductive Justice blogpost
>About 36 million foreign-born people live in the United States as of 2005–12 percent of the U.S. population. Over half of these immigrants are from Latin America, just under one-third are from Asia, 14 percent are from Europe, and the remaining 6 percent are from Africa, North America, and elsewhere. Slightly less than 50 percent of these 36 million immigrants are women, and 95 percent of these women are of childbearing age.
Female immigrants, both documented and undocumented, often work in industries that are low-wage and do not offer health insurance. They may not speak English and are likely to have reduced access to culturally and linguistically competent reproductive health information and services. As a result, access to affordable, quality reproductive health care is of significant concern to these women.
…
Reproductive justice involves more than the right to end a pregnancy. Safeguarding an individual’s right to determine her or his own reproductive future is an integral part of an overall agenda to promote social justice. That vision includes the ability of all people, whether American-born or immigrant, to:
- Become a parent and parent with dignity.
- Determine whether or when to have children.
- Have a healthy pregnancy.
- Have healthy and safe families and relationships.
Rejecting the efforts of comprehensive immigration reform opponents to control the reproductive decisions of immigrant women is an important component of ensuring continued reproductive freedom for all Americans and the humanity of all immigrantsMORE
Pregnant and Shackled: Hard Labor for Arizona’s Immigrants
PHOENIX, Ariz.– Miriam Mendiola-Martinez, an undocumented immigrant charged with using someone else’s identity to work, gave birth to a boy on Dec. 21 at Maricopa Medical Center. After her C-section, she was shackled for two days to her hospital bed. She was not allowed to nurse her baby. And when guards walked her out of the hospital in shackles, she had no idea what officials had done with her childMORE
2009 Article Cirila Baltazar Cruz and The Plight Of The Unworthy
Here’s what we have so far: Cirila Baltazar Cruz gave birth to a baby girl, Rubi Juana, on November 16, 2008, at the Singing River Hospital in Pascagoula, Mississippi. It is, as you might imagine, a predominantly white area. The hospital provided Cruz with a Spanish interpreter. However, Cruz doesn’t speak Spanish; she speaks Chatino, an indigenous language from the Oaxaca region of Mexico. Two days after the birth, the hospital reported the baby as a neglected child to the Department of Human Services, after which Rubi Juana Cruz was promptly taken from her mother and placed in the custody of an affluent couple in Ocean Springs.
According to court records obtained by The Mississippi Clarion-Ledger, the child was deemed neglected in part because Cruz “has failed to learn the English language” which “placed her unborn child in danger and will place the baby in danger in the future”. In addition, the hospital report noted that Cruz “was an illegal immigrant” who was “exchanging living arrangements for sex”.
Of course, it’s a bit of a mystery how they were able to establish these facts when there were apparently no Chatino-speakers on hand. More to the point: it’s irrelevant. I’m no legal expert, but in my understanding, immigration status, language skills, and highly-questionable allegations of sex work are not grounds for snatching a baby from her mother and initiating adoption proceedings. But that’s exactly what’s happening. The case is currently in the Jackson County Youth Court, where Cruz is being represented by the Southern Poverty Law Center. As mentioned, the case is under gag order so it’s been difficult to get updates on the situation and the fate of Rubi Juana remains unknown.
Unfortunately, the National Coalition for Child Protection Reform’s Child Welfare Blog notes:
The case is not unique. In 2005, the Lebanon (Tenn.) Democrat, revealed that, at least twice, a local judge ordered Mexican mothers to learn English — or lose their children forever. […] In one case the child still lived with the mother, in the other the child was in foster care. In both cases, the mothers spoke an indigenous language rather than Spanish.MORE
Immigrant Narratives: Your Mother or your child? and the site also links to an article that gives us good news, a couple of days ago Ms. Cruz got her child back Mexican immigrant gets baby back from state
JACKSON, Miss. (AP) – A Mexican immigrant walked out of the Gartin Justice Building on Friday holding the daughter who had been taken from her by state officials in 2008, when advocates say she was accused of being an unfit mother because she doesn’t speak English.
Cirila Balthazar Cruz and her 1-year-old child, Ruby, were surrounded by Southern Poverty Law Center officials as they left. None of them would discuss details of the case, citing the confidentiality of Youth Court proceedings.MORE
Reproductive Justice: Abortion
via Alas a Blog… My New Job I had SERIOUS trouble deciding what to quote here. So I suggest that you go read. EVERYTHING. Its that important.
So, I’ve taken some of my time at work to learn about this state’s current restrictions on abortion care for minors. How it plays out in the courts is probably very different from how it plays out in your mind, and I wanted to lay out some information I found pretty interesting.
In my state, minors are required to notify their parents. They are not required to have parental consent, only notification. The notification has to occur before the procedure. Both parents have to be notified. There is a judicial bypass procedure, where the minor can go to court and petition a judge to allow her to bypass the requirement for notification. Before working here, that’s about all I knew. Probably that’s all most of you know.
Just because a service is required by law doesn’t mean there is anybody available to provide it… Lots of judges refuse to process judicial bypasses. It’s not a requirement; judges are not forced to take every case presented. Many judges have no idea how to process a judicial bypass — they’ve never been trained.
…
The law does not clearly state how to establish maternity or paternity. However, the law does clearly state rather extensive punishments for the clinic or doctor who performs an abortion without having established maternity or paternity of the minor. Thus, clinics may enact excessive bureaucratic measures to ensure beyond any legal doubt that a minor’s parents are actually a minor’s legal parents. So, you can (and do) have the situation where a girl’s mother and father come to the clinic with her, but do not have IDs, social security cards, or birth certificates, so the clinic sends the girl to the courthouse, since she is legally unable to notify her parents, who are standing next to her.Naturally, it gets worse
Another Post about Parental Notification How teens deal with the system as Privileged and Underprivileged and why rape notification laws were never set up by legislators to actually work. And also, the factthat our society is so supremely anti-woman that the damned department that is supposed to carry out the bypass laws to allow for abortions has to hide the fact that they do so.
The Abortion Healthcare Christmas Edition: Everybody Ain’t the Virgin Mary
You see Mary of Nazareth was special. She was unique. She was not like Jezebel the Harlot or Eve the Disobedient who in Pastor Montgomery’s opinion was the primary reason we have sin in the world and why women should sit quietly in the church.
…As a child I thought how amazing it would be to accomplish the ultimate role of a woman which is birthing a baby and still remain pure in the eyes of God, a virgin.
But, of course, I was a deeply wounded girl child who thought these thoughts as a way to survive being a little black girl in my family. I now know as a recovering wounded girl child that conceiving and having a baby as a single black working class woman is not a divine “you are highly favored among all other women” experience. If anything it is the opposite of divine. It is deeply marginalizing. And in society’s eyes it’s downright evil. The worse sin you could ever commit in a white supremacist patriarchal capitalistic society as a black girl or as a black woman is to make hardworking tax payers fund your fatherless child who will probably end up in jail further burdening the good hardworking tax payers. So, I realize that some women by virtue of their class, sexuality, and race could never embody the divinity albeit the “privileges” of Mary of Nazareth. Everybody ain’t the Virgin Mary. Everybody cannot immaculately conceive and then give birth and have their son become the Messiah because some women and their children are not valuable. Some women are figuratively without the divine favor that Mary had making their ability to conceive or not to conceive a political game where current senators and house members can decide to throw them literally under the bus in order to pass a lack luster healthcare bill denying federal funds for abortions. Once again, everybody ain’t the Virgin Mary. As a caveat, I do know the story of Mary and how King Harold (i.e. the State) was hoping to kill her baby (i.e. the Messiah), however, Mary still had God’s divine favor (i.e. white privilege and class privilege) working on her behalf.
Generational shift for U.S. Hispanics on abortion
A 2007 joint survey by the respected Pew Forum on Religion and Public Life and the Pew Hispanic Center shows that 65 percent of first-generation U.S. Hispanics believe abortion should be illegal. But among second-generation U.S. Hispanics like Ana, that percentage drops to 43 percent.
Not to mention that Nebraska is making getting an abortion ridiculously harder, ostensibly now based on some rather dodgy science about fetal pain, while Utah seems to be out to criminalize miscarriages.
Utah’s “Criminal Miscarriage” law:
* expands the definition of illegal abortion to include miscarriages
* removes immunity protections for women who have or seek illegal abortions
* assumes women are “guilty of criminal homicide of an unborn child” if a pregnancy ends after “intentional, knowing, or reckless” behavior.But even among states that punish illegal abortions, this “Criminal Miscarriage” law is unique. It doesn’t punish individuals who perform illegal procedures; it punishes women.And yes. It gets worse. LIFE IN PRISON worse.
Reproductive Justice: Fighting the good fight
Reminding us that religion is not only made of the loud and pious rightwing: here’s the Religious Coalition for Reproductive Choice
What are the basic principles guiding the Religious Coalition for Reproductive Choice?
As people of faith, we
• seek a society that values human life and human dignity and honors individual conscience.
• respect the value of potential human life while remaining firmly committed to women as responsible, moral decision-makers.
• believe the ability to make moral decisions—including about reproductive issues—is the very basis of an individual’s dignity.
• seek to correct the conditions that underlie the high rate of unintended pregnancy and abortion, through responsible sexuality education, affordable family planning services, and high-quality, accessible medical care.
• will continue to protect the right of individuals to follow their own religious views in reproductive decisions and decisions about family formation.
• strive to make justice a reality by furthering the medical, economic, and educational resources necessary for healthy children, families and communities:
Quality, affordable healthcare & insurance
Prenatal & postnatal care, with an emphasis on reducing infant mortality
Quality adoption & foster care services
Education & training for jobs & careers
Good jobs at a living wage
High quality childcare & preschool education
Proper nutrition
Safe, affordable housing
A clean environment
Freedom from violence
Policies that enhance family well-being & give priority to family relationships & needs
Respect in the community & nation for diversity of religious & cultural beliefs & practice>MORE
On Doulas An early linkspam I did on an alternative to hospital births.
A doula…
- Recognizes birth as a key life experience that the mother will remember all her life…
- Understands the physiology of birth and the emotional needs of a woman in labor…
- Assists the woman and her partner in preparing for and carrying out their plans for the birth…
- Stays by the side of the laboring woman throughout the entire labor…
- Provides emotional support, physical comfort measures, an objective viewpoint and assistance to the woman in getting the information she needs to make good decisions…
- Facilitates communication between the laboring woman, her partner and clinical careproviders…
- Perceives her role as one who nutures and protects the woman’s memory of her birth experience.
Being a Radical Doula:How pro-choice advocacy and birth activism go hand in hand.
When a woman is giving birth in an American hospital, the doctors, nurses, and extended medical team are almost wholly focused on the status of the fetus inside of her–constantly employing technologies to monitor it and drugs to regulate it, allowing fetal well-being to be their dominant concern. When we think of a woman with an unintended pregnancy (and this could be the same woman, in a different phase of her life), a similar logic applies. Anti-choice activists don’t trust women to make responsible decisions about their lives and ability to parent; they instead focus on the potential life inside a woman, and place all emphasis on the future of the fetus rather than on the future of the woman. Anti-choice activism and overly-medicalized birthing practices are both based on a lack of trust in women. Consider the many restrictions imposed on birthing women: rules regulating out-of-hospital midwives, mandatory waiting periods for abortions, forced C-sections, and biased pre-abortion counseling are all examples of how people do not trust women (or their support networks) to make responsible decisions about family well-being.
What is unique about the role of the doula is that she gets to be one of the only people in the birthing process exclusively focused on the woman. She focuses entirely on how the woman is feeling, providing accompaniment and support through a process that can be scary and lonely, particularly in a hospital. Studies show the positive effect that this kind of unconditional support and attention can have on both the mother and her child. That’s the logic that really connects the birthing and the pro-choice movements–if we support women and their decisions, everyone will fare better, including children.MORE
From California Latinas for Reproductive Justice …
1. Making the Case for California Latinas’ Reproductive Health and Justice Policy
2. Taking a Stand: Making Health Care Reform Work for Latinas and Women of Color.PDF
Specific Groups that are active
Asian American
SAFIRE
Latina/o
California Latinas for Reproductive Justice
Multiracial
SPARK: Reproductive Justice Now! Coalition of orgs. based in Georgia. See their The Georgia Access Guide: Reproductive Health for Reproductive Justice which “provides a listing of hundreds of reproductive health resources through out Georgia. It also provides educational information on reproductive health and justice issues. It is the only guide of its kind in Georgia.”
Sistersongs archive of member and affiliate orgs
The Doula Project “The Doula Project is an NYC-based organization that provides free compassionate care and emotional, physical, and informational support to people across the spectrum of pregnancy.” (Including abortion)
Transpersons Health Care Clinics
Southern Reproductive Justice and Trans Alliance
Books
The Prochoice Public Education Project: Reproductive Issues
Undivided Rights: Women of Color Organizing for Reproductive Justice
Killing the Black Body: Race, Reproduction and the meaning of Liberty
Conquest: Sexual Violence and the American Indian Genocide
Film
Third Wave: The March for Women’s Lives
Blogs and Websites
Living with our fertilty: an alternative approach
Young Women’s Empowerment Project
New Voices Pittsburg Myspace and Facebook
This is of course by no means as comprehensive as it should be. If you have any articles, links or anything else, leave them in the comments, will ya?
And now a word from our sponsor…
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Reproductive Justice Linkspam: A Starting Point
Utah’s criminal miscarriage law is no surprise – Gerardo Flores, a Texan boy, is serving a life sentance for a similar event:
http://en.wikipedia.org/wiki/Gerardo_Flores
Expanding this approach to women and not just the men who help them miscarry is just the natural progression.
An overview of pregnant inmates shackled during labor and delivery.
Also, I’m not sure if I can dredge up the link to a discussion I saw recently about doulas– some of them are excellent, but, as with any other human interaction, it can go wrong. In particular, there was an account or two of doulas who had very definite ideas about how childbirth ought to go, and pushed hard for them.
I’m confused. I mean, I would think that most of the people who supported shackling a woman are old enough to have families of their own. Which implies that they have been in a delivery room in their lives, either as a mother or a father. Which means they are well aware of how absolutely asinine it is to tie a woman down to the freaking bed during labour.
The only spokesmen (I’m disapointed the article didn’t include more explanation for the idiotic thinking that would defend this practice) made it sound like the issue wasn’t even about safety but escape. Seriously? Given the choice between an escape risk for somebody guilty of check fraud and a shackling somebody who has a medical need to be able to move freely, they chose the former?
Which implies that they have been in a delivery room in their lives, either as a mother or a father.
SiF, shackling women during labor is idiocy for sure. But this comment causes me to wonder what percentage of non-medical professional men have been in a delivery room? I was present for both my kids’ births (1 Caesarian, one VAC). But I wonder what the actual percentage is?
First, I’d like to see what the figures look like if we remove the conflation of foreign-born citizens, resident aliens and illegal aliens from this. I imagine that you’d see that foreign-born citizens (who are also immigrants) and resident aliens are much less likely to be in low-wage jobs with no health insurance and have limited English skills than illegal aliens are. For example, IIRC you can’t become a citizen without demonstrating at least conversational English skills.
Having done that: do you hold that all these things listed above are entitlements that the American taxpayer should be forced to provide for all 3 of these groups? If so, and if this is an issue of justice, then where is the justice to the taxpayer?
It seems to me that pro-life activists place their emphasis on the life of the nascent child because that is the life that is in immediate danger of being ended. Reducing the quality of that life to zero takes precedence over the more incremental effect of the birth on the quality of life of the mother. Making the choice to end that life is viewed as an abdication of the responsibility that parents hold for the lives of their children.
Add this under reproductive coercion: when doctors refuse to sterilize women in their twenties, or even thirties, who are certain that they will never want children. No matter how long the woman has been resolved to live without giving birth, if she is under 35 it is extremely hard to find an Ob/Gyn who will operate. Their excuse is always that the woman might change her mind and sue them later.
You see, women are so indecisive that they can’t be trusted to make decisions that will affect their lives for the long term. A court would be sure to find that the doctor should have protected her from her own fickle autonomy (hmm, wasn’t there a Supreme Court decision recently that touched on this theme?). Also, while her fallopian tubes are still passable, there’s still hope that this “unnatural” unmaternal woman could later see the light of the call to true female fulfillment: fertility.
Just wanted to thank you for including issues around pregnancy and childbirth under reproductive justice. This gets overlooked far too often, even in feminist circles.
It’s in fewer million-dollar NICU bills for premature babies who, being natural born U.S. citizens, are eligible for Medicaid. Given how invested you are in other people’s fetuses, I presume you wouldn’t take away the respirators of babies whose human life-support system couldn’t quite get them all the way there.
If this were a matter of law I’d oppose it; it is not the government’s business to interfere in what a woman does with her own body. But a physician has a right to refuse to provide a service, especially in a non-emergency situation. It would be interesting to see how often such a lawsuit has been brought, what the results were, and how much it cost the physician not just in cases where they lost the case but even when they won. From the physician’s viewpoint, how does the risk of performing the procedure compare with the gain?
And now that I think of it; what effect does performing the procedure have – if any – on the physician’s malpractice insurance premiums? Which are pretty high already for a Ob/Gyn.
But a physician has a right to refuse to provide a service, especially in a non-emergency situation.
They should have a moral right to refuse service, along with a legal right to lose their license for refusing that service. Just like pharmacists who refuse to fill birth control prescriptions.
La Lubu –
Should you lose your contracting license (or whatever state-issued certifications you use in your trade) because you decline to take a job building, I dunno, a porn theater or an HQ for my radical anti-abortion group?
Should Amp’s wedding chapel lose its business license if it declines to host a wedding for some notorious right-wing homophobe?
Re tubal ligation: I’m conflicted but I think that my position may be the opposite of La Lubu’s. A physician who includes gyn operations in his/her scope of practice has no moral right to refuse to perform one on a patient seeking the operation for any reason other than s/he thinks that the operation is excessively dangerous. The reason Robert’s analogy doesn’t hold is that physicians take an oath that when confronted with a person in need of their help they will not consider whether the person is a good or bad person but only that they need their help. Thus, the person’s motives or the risk that she will sue later are irrelevant. Morally. On the other hand, I can’t think of any way to codify this legally that wouldn’t result in a very, very horrible mess.
I will refrain from telling horror stories about women having trouble getting very necessary abortions and tubal ligations for the moment, but suffice it to say that even in a hospital where we have a physician who is very willing to help women seeking these procedures it can be difficult.
On the one hand, it’s not a good idea (morally speaking) for a doctor to try to insinuate their own beliefs onto their patients. On the other hand, that’s often part of their job, just like it’s your psychiatrist’s job to prescribe you the medicine they think will help, and not the medicine that you found on Google.
Morality aside, there’s certainly no legal way which could realistically force doctors to do that sort of thing.
Me, I’d solve it with money. A doctor who does all OB services EXCEPT for abortion or ligation is making it more difficult for women to get those things, because the doc is competing in the busy profitable market (checkups, tests, etc.) and making it less likely that other OBs can provide the services. not all towns can carry more than one OB.
It’s even more true with a hospital. hospitals have big areas of relative exclusivity.
I’d just allow doctors (or hospitals, or pharmacists) to opt out of anything they want. But they’d have to pay into a fund which would help provide those services to those in need. they can do it, or they can help someone else do it, but they can’t foreclose availability.
I like this idea, but how does it play politically in a system where not only do we not have public funding for abortion but now we can’t have public subsidies for privately purchased insurance policies from companies that cover abortion? I can’t imagine Catholic hospitals actually being forced to pay into a fund that covers abortion or sterilization or whatever.
Alternatively, we can let people be free people and have their own freedom of conscience. Absurd, I know.
Should you lose your contracting license (or whatever state-issued certifications you use in your trade) because you decline to take a job building, I dunno, a porn theater or an HQ for my radical anti-abortion group?
Funny you should think of it that way, because I don’t. I consider my obligation to be to the work itself: that everything works, that it is built to code and built to last, and that it looks good. I don’t really care if the future tenants share my politics. (fwiw, I consider an XXX theater to be on the same moral plane as a sports bar, and this being Illinois, it’s not likely your radical anti-choice group is going to have much “legs”—someone else will be renting that space when your group fizzles out!).
A better analogy to my trade would be….an electrican that installs receptacles but won’t install switches?? I don’t know. That doesn’t really work. Maybe it takes another line of work….say, a dentist. The dentist that will fill cavities, but won’t provide teeth cleaning, flouride treatments, or sealants (you should have been brushing better, you sinner!). Ok….yeah….the analogy to my trade: an electrician that will install regular receptacles, but won’t install GFI receptacles (“you shouldn’t have that hair dryer in the bathroom to begin with, you sinner!”…”but….that’s what the GFI is for, so I won’t get electrocuted!”…”LAZY! if you had a better haircut, you wouldn’t NEED a dryer!! And decent people do that kind of thing in the bedroom!!”).
See, preventing pregnancy is basic service for an OB-GYN. Filling prescriptions is basic service for a pharmacist. If someone isn’t willing to provide the basic services of their profession, why should they hold a license in it? I like Sailorman’s idea of charging an extra fee to those unwilling to provide the basic service…..but that doesn’t do a very good job of addressing the geographic component. Not everyone lives in an area where they have other choices for service. Unless that extra fee were high enough to subsidize the competition to open a full-service outlet….it would still leave many women high and dry.
Maybe the “market-based” solution is a different license classification; one that is color-coded for easy identification (like driver’s licenses). The “red” license holders would be those unwilling or unable to provide pregnancy prevention, “blue” license holders would be for the full-service providers. Then the customers are fully-informed who they want to spend their money on—for all their other care, as well as reproductive-related care (I wouldn’t buy aspirin from a pharmacy that was unwilling to dispense the Pill, diaphragms, spermicide, and/or condoms). The 98% of women who use birth control would be better informed on who they want to receive their hard-earned money.
Funny you should think of it that way, because I don’t. I consider my obligation to be to the work itself: that everything works, that it is built to code and built to last, and that it looks good. I don’t really care if the future tenants share my politics.
Your “better analogy” is a dodge. Say that you DID care if your future tenants share your politics. Are you obliged to work for them (“provide basic service”), or not?
And if you aren’t, what makes you more special than a doctor?
I’m a commercial freelance writer; damned if I’m obliged to work for anyone I don’t care to work for. I don’t see why anyone else should be less empowered.
Your “better analogy” is a dodge. Say that you DID care if your future tenants share your politics. Are you obliged to work for them (”provide basic service”), or not?
Yes, I am obliged to do the work, even if I don’t like them or their politics. If they hired me to install x, y, and z, I can’t just say, “I’ll install x and y, but z is immoral….you’ll have to hire someone else for that.” If I feel that strongly that “z” aspect of my job is immoral, and yet “z” is a basic function of my job, then I need to find another line of work.
But again, I don’t think lines of work like either yours or mine lend themselves to a comparison to the physician or pharmacist that refuses to handle birth control. Prevention of pregnancy is an important part of healthcare for women. If a person feels so strongly that he or she cannot provide that aspect of care, then he or she should enter another line of work.
Are you seriously suggesting that my employer should be prevented from firing me for refusing to perform an electrical installation that I deemed “immoral”, as long as I based my decision on religious grounds? I will agree with you that I am free to refuse the work. I will not agree with you that I should remain employed for doing so.
If you have an employer, then it’s his or her freedom I’m more concerned with; the point of decision. If you’re an independent contractor, you should be able to work for whomever you want. As an employee, you’re bound to your employer’s decisions, more than your own. Your right of conscience is expressed in that case by choosing the right employer; the counter guy at Dunkin Donuts doesn’t get to decide that transfats are evil and refuse to make them anymore. He needs to go work at Whole Foods or something.
And I think that people in a profession are the ones to decide, for themselves, what constitutes their line of work. You, a non-doctor, say prevention of pregnancy is part of the job of a physician; I, a non-tradesperson, say that spitshining the wainscotting is part of your job. Both the physician and the tradesperson need the freedom to tell their customers to kindly seek other professionals if those customers don’t like they way they do their job.
An analogy: the underlying purpose of a woman’s reproductive system is to nourish a fetus and produce a baby, just as the underlying purpose of a heart is to pump blood around the body.
Some people don’t want their reproductive systems to nourish a baby, or at least not right now; this is their right. Other people don’t want their hearts to pump blood because they’re ready to die; this is also their right. A physician is not obliged to reverse his or her training in the preservation of the function of the organs, to prevent their function, just because that’s what the patient wants. There are undoubtedly physicians who will perform that service; their choice.
But I am extremely uncomfortable with requiring them to do so. If you can require a physician to provide birth control, can you require him to provide medicine for assisted suicide? If not, why not?
I’m a commercial freelance writer; damned if I’m obliged to work for anyone I don’t care to work for. I don’t see why anyone else should be less empowered.
To put it bluntly, no one dies if you refuse to write for them. A woman who can’t get an abortion or tubal ligation may very well die as a consequence.
To put it bluntly, no one dies if you refuse to write for them.
Really? How about when I turn down the “Relief for Haiti” project, or decline to do speechwriting for Mr. Obama’s health care initiative?
“Oh, but someone else could write that!”
Well, someone else can perform the tubal ligation or the abortion.
I have a right to free speech; you do not have a concomitant obligation to listen.
I have a right to bear arms; you do not have a concomitant obligation to provide me a gun.
I have a right to terminate my pregnancy; you do not have a concomitant obligation to perform the surgery.
I have a right to control my own end of life (ok, I don’t have the LEGAL right in most places, but I do have the moral right); you do not have a concomitant obligation to buy me a bottle of sleeping pills, smother me with a pillow, or shoot me in the head.
I have a right to control my own fertility; you do not have a concomitant obligation to grow rubber trees, tap them for their viscous sap, build a condom factory, and give me a love glove.
Etc.
If you’re an independent contractor, you should be able to work for whomever you want.
And if you are a person—independent contractor or no—who receives a license from a state licensing board, a license that indicates the type of training you have received and your degree of qualification to practice the line of work you have chosen—-the state should have the right to either (a)yank your license for refusing to provide the services you are licensed for, or (b)issue a lesser form of license that clearly indicates to potential clients that the provider is either not able or not willing to provide full service.
Your driver’s license indicates what type of vehicles you are licensed to drive. Why shouldn’t a physician’s or pharmacist’s license indicate whether or not that provider is willing to provide pregnancy prevention?
An analogy: the underlying purpose of a woman’s reproductive system is to nourish a fetus and produce a baby, just as the underlying purpose of a heart is to pump blood around the body.
and
Some people don’t want their reproductive systems to nourish a baby, or at least not right now; this is their right…..A physician is not obliged to reverse his or her training in the preservation of the function of the organs, to prevent their function, just because that’s what the patient wants.
Robert. Is the physician obliged to treat the whole woman, or is the physician’s only obligation to that woman’s reproductive organs, as if they existed separately and apart from the woman? Is the physician’s training really to treat organ systems, and not the people to whom those organ systems belong? Also, to consider the function of her reproductive organs through the lens of….the physician’s personal ethical and or religious beliefs—-rather than those of the woman who is the patient?
Robert, this comment of yours illuminates the chasm of disconnect between the anti-choice movement and the pro-choice movement. Anti-choicers are considering the reproductive organs. Pro-choicers are considering the woman.
Tell me Robert…..what is the underlying purpose of a woman?
Keeping women from effectively exercising their human right to prevent pregnancy is limiting women’s freedom just as surely as preventing women from attending college or entering a trade or holding a job or receiving credit. The biggest risk factor for poverty for women is….having children. If the Pill, the morning-after pill, diaphragms, and IUDs were available without a prescription, perhaps this would be a moot point. Every Casey’s gas station in Illinois would sell at least as many versions of the Pill as there are versions of soda, and women would have rapid, convenient access to protection, thus maintaining their freedom.
Because let’s not be disingenuous, Robert. The folks who do not want to provide women with the ability to prevent pregnancy know damn good and well that this gatekeeping has the on-the-ground effect of limiting women’s freedom. They are operating from a worldview that women have an underlying purpose, a “place”, a place that they (we) should not be able to exercise our own freedom to leave.
Do they have the right to hold this belief? Do they have the right to practice a religion that subscribes to the view of women as a lesser form of human being? Yes, they do have this right. But they do NOT have the right to impose this view on others in the form of gatekeeping. Such persons should NOT control the keys to whether or not a woman can make the choice to prevent pregnancy.
This is a civil rights issue, Robert. Back in the day, colleges that received public monies were free to discriminate on the basis of race, creed, color, gender—anything. We (those of us who aren’t white males) were financially subsidizing our own oppression. And we still are. Physicians and pharmacists who refuse to provide pregnancy prevention are being financially subsidized by the 98% of women who disagree with them in the form of….publically-funded financial aid for them to complete their education, Medicare and Medicaid reimbursements, and yes, licensing as if they had a full-service practice.
Hey, I’m willing to compromise. My compromise is: no public monies to such people. And a limited-care license to indicate that they do in fact, give limited care.
Then those limited-service providers you have a soft spot for because you’re copasetic with their politics can make a choice on what is more important to them—their beliefs or the almighty dollar. And women can make an informed choice on who they want to serve them, based on the type of care they can be expected to receive—-full-service or limited service.
La Lubu said:
Say what? Find me any great number of OB-Gyns who argree with that! The ones I’ve run into view the basic service they provide as trying to ensure that women can a) get pregnant and b) have a live birth. I don’t know of any who consider preventing pregnancies as a basic service of theirs.
Plenty of specialists limit their practice – both in medicine and in other professions such as law and architecture – to a sub-specialty. Plenty of plastic surgeons handle breast augmentation but don’t touch facial reconstruction. Plenty of lawyers limit their practice to incredibly narrow areas and refuse to take cases that might be of great help to someone else. It might be a lack of expertise, or a lack of desire to assist the aims of the people who wish to bring the legal action. That doesn’t mean that the professional’s licence or their paycheck should be attainted.
La Lubu:
A woman has a right to do what she can to prevent pregnancy. She has no right to require anyone else to get involved in that effort. A woman’s right to prevent pregnancy is no more special or privileged than any other right.
I am curious as to whether anyone can point out an area where the license of a professional is dependent on the professional’s willingness to provide a particular sub-specialty of that service.
La Lubu:
Why? You stated that the purpose of a license from the State is
Neither of these has anything to do with whether or not you choose to provide that service, or any specific aspect of it. Someone who refuses to perform tubal ligations – or vasectomies – has the same level of training and qualification to perform medical services as someone who is willing to perform them. So why should the State restrict or attaint someone’s license for reasons that have nothing to do with how that license was earned?
Your driver’s license indicated what type of vehicles you are qualified to drive. It has nothing to do with that kind of vehicle you are willing to drive. I could go out and in about 6 months get a CDL permitting me to drive a semi-trailer truck. I would not be obliged to start driving one. And if I decided to drive semis and someone who owned a truck company put a pro-Christian message on their trailers I’d have every right to refuse to sell my services to them.
This is a civil rights issue, Robert.
It certainly is. It is an issue of whether or not someone can be coerced to act against their will, to perform an act that is against their religious or moral beliefs. It is an issue of whether or not someone can be coerced to perform an act whose potential financial risks they believe exceed the potential financial reward.
Say what? Find me any great number of OB-Gyns who argree with that!
RonF, are you trying to tell me that the OB-GYNs of suburban Chicago are not fitting their patients with diaphragms or IUDs, and not prescribing birth control? Are you kidding me? I don’t know one woman who has received either her BC scrip, her IUD, or her diaphragm from a general practitioner. Not one. In fact, I don’t believe GPs around here do diaphragm or IUD fittings. There are nurse practioners who do that, but they all serve in OB-GYN offices.
Again, this is not a “sub-specialty”. Pregnancy prevention is not an uncommon part of the practice. Ninety. Eight. Percent of women prevent pregnancy by means other than abstinence. Rarely do you see that kind of consensus by the general population on anything.
Physicians and/or pharmacists who are unwilling to assist their patients in the prevention of pregnancy need to go into another line of work. Dermatology. Sports medicine. Some other form of practice. Because any person who believes that it is a sin to prevent pregnancy, to the point where they refuse that service to patients, cannot practice objectively with regards to their female patients. In no way, shape or form can they separate their beliefs from the health and well being of the patient. And in the crunch moment, when one or the other has to give, they will select their personal belief over the health and well being of the patient. And that is unacceptable.
I’m under the impression that you are against the idea of my license compromise. If that is the case, I’d be curious to know why.
(and my apologies to unusualmusic for the thread derail.)
It is an issue of whether or not someone can be coerced to act against their will, to perform an act that is against their religious or moral beliefs.
How is it an act of coercion to have a coded license that would clearly indicate whether or not the practioner was willing to provide that service? The practitioner would still be free to practice to practice every other service. And the patient would know instantly whether or not that practitioner could be counted on to provide that service. No fear of any surprises from the practitioner.
Really, this would be no different from any other form of consumer protection—think anti-“bait-and-switch” laws. Or are you against those, too?
I don’t have a problem with requiring physicians to label what services they provide (consumer protection and all that), but I suspect that those providing abortion services are not going to be keen on effectively being required to advertise that. It’s a dangerous world for those people.
At heart, the right to practice medicine and receive a license (unlike the right to speech) is not a guaranteed right under our Constitution. That’s why the government can toss me in jail for unlicensed practice of medicine if I go ahead and treat people, even though I may be doing something which is identical to what a doctor would do.
So if we’re talking in reality language and not theory language: the government can do whatever the fuck it wants w/r/t medical licensure, INCLUDING requiring certain actions from those seeking licenses. The “right to do what you want” permits all people to go be bricklayers instead of doctors, if they don’t like the deal. And it’s not only doctors.
In my own profession, for example, licensing is often contingent on accepting the possibility that you will be assigned a case by a judge, and expected to do your best on it. Don’t like that? Don’t become a lawyer. If you want to be able to pick and choose who you come into contact with? Don’t open a place of public accommodation. You are not allowed to be a lawyer and claim an exemption from the pro bono clause; you are not allowed to be a hotelier but refuse to rent rooms to blacks.
And that makes perfect sense. Y’all are certainly allowed to have what morals you want, by all means. But you can’t demand that government follow your morality. And you’re certainly not allowed to claim that the two (having morals vs. demanding that others follow them) are in any way equivalent. To use the language I so often hear, that is trying to turn a right into an entitlement.
So in summary: The government can’t force someone to provide abortions. But they can require that they do so in order to get a license. Put your wallet where your morality is, and all that.
By the way, I don’t agree with La Lubu either. Just because women have a right to an abortion doesn’t mean that the government has an obligation to provide it for them. A doctor who refuses to provide a medical service isn’t violating anyone’s civil rights by doing so.
However, the government can certainly CHOOSE to provide abortion services for its citizens (or to incentivize the provision of abortion services.) And in making that choice, the licensure requirements of doctors or hospitals is a perfectly fair target.
O.K., good point on BC and all that; I got a little excited. Look upthread – the context of services we are talking about is not fitting women for diaphragms, it is performing tubal ligations. I would guess that few OB/Gyns think of that as a basic part of their services. The premise was that at least some of them are refusing to provide such due to their opinion that the risk of a lawsuit is greater than the reward from performing them.
And the patient would know instantly whether or not that practitioner could be counted on to provide that service.
They’re going to know that instantly anyway. If you are looking to get one done I’d presume that you don’t just announce that after you’ve made an OB/Gyn appointment and then shown up; you’re going to note that as the purpose of your appointment when you call to make it. If it’s a situation where you already have a relationship with a practicioner then they’re going to say “Nope, I don’t do that” and you can ask for a referral, just like when my wife at one point thought that one of our kids was going to be acephalic and we considered an abortion. Her OB/Gyn said “I don’t do that” and offered to give us a referral if that turned out to be the situation (thank God it wasn’t).
I haven’t see the compelling case made why a service provider who does not wish to provide a single service among the many services that various such providers provide should have to have that noted on their license. Where else is this done? What legal precedent is there for this?
Sounds to me like you want a scarlet letter branded on them because you don’t like their politics – or their caution (note that the original premise was a fear of financial risk, not a moral objection).
What legal precedent is there for this?
Nurse practitioners perform most of the same functions as an MD, but not all. There are licenses for other professions that indicate particular scopes of work, and all without prohibiting anyone from practicing a particular profession—they’re just obligated to practice within the parameters of the particular license classification they hold.
Sounds to me like you want a scarlet letter branded on them because you don’t like their politics – or their caution (note that the original premise was a fear of financial risk, not a moral objection).
I would prefer to spend my money with someone who I trust to provide me with all of the medical care I likely need—but it’s not just about voting with my wallet. It’s also about not having my medical records in umpteen different places (and I think the risk of identity theft is not anywhere near as great as the risk of misplaced or mis-entered records—the more your medical records are passed around, the more likely it is that someone is going to enter the wrong information or code, with possible harmful or fatal results). It’s also about not having to make a mad scramble to find another physician when time is of the essence. In downstate Illinois, we don’t have as many physicians as you have in Chicago, and finding one that is open to new patients or is willing to see you in a crisis can be damn-near impossible.
I’d like to see the declaration of the parameters of service connected to the license because it would mandate that the practitioners be open and honest. Having it connected to their license provides for disciplinary procedures if they renege on the service they have agreed to beforehand—no more cagey answers, no more “tacit understandings”—it’s all up front. Because the reality is, you don’t get time to “interview” your physician, and it’s impossible to do before you actually see one. No one does “interviews” or answers those types of questions over the phone. Most people (myself included) have to lose pay when taking a day off to see the doctor. Why should we have to do that on several different occasions while we doctor-shop to find someone who fits our needs?
As for referrals, you have no idea the degree to which doctors don’t want to recommend another doctor. The modern form of referral-giving is: you, the patient, pick someone you would like to see, and your doctor will then see if that person is accepting new patients. If not, you pick another name, and so it goes. If you ask a physician, “who would you see, if you had this problem?” you get the answer, “oh, any of those people are qualified” (meaning: the whole phone book section of that specialty). You, the patient, not knowing anyone in the medical field, are put in the position of picking names out of the phone book. That has been my experience, and the experience of literally everyone I know. RonF, in your wife’s case, that was different because of the ramifications. A woman looking for a physician who is willing to perform a tubal ligation on someone under 40 with no children is going to have a different experience.
Also: physicians in the OB-GYN specialty often work in group practice. I would like to know beforehand if any physicians in that group don’t share the parameters that my doctor and I agree are appropriate for me—because in that line of work (especially the OB side), doctors pinch-hit a lot. My physician was not the one who performed my (emergency) C-section, for example. I have no plans for getting pregnant, but if I did get pregnant in the future, I would want any doctor with a hard-core pro-life personal philosophy the hell out of my presence, and especially out of my operating room. I have the classic “c”—vertical cut. That’s the only way I can give birth now, and if something were to happen that would force the doctor to choose between saving my life and saving the baby, I want a doctor who will pick me, full stop. Having a different license classification could allow me to say, “I only want “A” and “B” license holders to care for me in the event that my physician is unavailable; under no circumstances do I want “C” or “D” physicians seeing me.”
Different licenses that specified which of those services were being provided would give patients a hassle-free, fear-free indicator on who they can rely to administer their care.
Speaking of legal precedent, there are pretty strict parameters on who gets conscientous objector status in the military. There are physicians and pharmacists who readily prescribe or provide birth control to married women, but refuse to do so for single women. It’s not the act of family planning they object to, but rather who is doing the family planning. Sorry, but that’s not a moral objection. That form of parsing is not allowed in CO status—your moral objection has to be across the board.
I haven’t seen a compelling argument for why a physician shouldn’t have a different license code, considering that this is a huge hassle right now for patients. What could possibly be the objection to having a code that indicated say, willingness to provide voluntary sterilizations for adults? Why should a woman have to find out (after losing a day’s pay) that the physician is not willing to perform a tubal ligation….even though she indicated verbally beforehand that “yes, when you’re ready, I will do that” and when it comes to crunch time, the physician made her own determination that the patient isn’t “old enough” —-despite the patient being of full legal authority to enter into her own contracts?
I was going to comment to this post saying that I feel much more comfortable supporting reproductive justice than the traditional pro-choice position which seems to boil down to: middle-class, able-bodied white women should be able to have as many abortions as they want. But then I read the comments and found a discussion about… women being able to prevent or terminate pregnancies as much as they want.
OK, I concede that La Lubu supports working-class women of color also having access to birth control, sterilization and abortion, but I don’t see anyone else even touching on those issues. And the whole point of the post was that reproductive justice doesn’t start and end with whether medical professionals are willing to perform abortions and provide birth control!
We’re just rehashing the abortion “debate” again. *sigh*
That’s still not the same. The difference between a nurse practicioner and a physician is that the nurse practicioner is trained and qualified to do a sub-set of what a physician does. We are talking about different licenses for people who are equally qualified to perform a range of services but choose to do a particular sub-set of that range. It’s not the same thing.
Besides, you don’t know if any one provider does all the things that said provider is qualified to do. If a given provider does tubal ligations, there may be something else they don’t choose to do.
How about when I turn down the “Relief for Haiti” project, or decline to do speechwriting for Mr. Obama’s health care initiative?
One major difference between the two situations is that it isn’t necessary to have one’s freelance writer on site to do the writing. So if you turn Obama down he has many options. Unlike, for example, a woman living in rural Montana (is “rural Montana” redundant?) who probably only has one gynecologist within a reasonable distance and if s/he refuses to do a procedure then she’s just out of luck unless she’s got the money to fly to Chicago or someplace. And is stable enough to do so.
More convincing, to me at least, is the underlying point that if you did take the Obama’s healthcare job you might, even if you had the best intentions, not do as good a job as someone who agreed with Obama’s position (assuming roughly equal writing abilities.) So, one could argue that it would be unethical for you to take the job. By analogy, an ob/gyn who thought that abortion was immoral might be unable to perform abortions well because his/her emotion would distract from his/her ability to perform the procedure.
Very well, then, but that begs the question of why a doctor who believes abortion and/or tubal ligation are immoral would ever become an ob/gyn. Sorry, but one woman in 3 in the US will have an abortion in her lifetime and virtually all of these abortions will be performed by gynecologists. Not an obscure issue or one an ob shouldn’t expect to run into. Why are they setting themselves up for ethical dilemmas when there are easy ways to avoid them? Go into another field. Or sub-specialize: go into maternal fetal medicine or gyn-oncology.
Finally, are there really that many ob/gyns out there refusing to do tubal ligation or just refusing tubal ligations to young women? If the latter, one could make an argument for an age discrimination suit.
To refuse to perform such an act, once you have accepted somebody as a patient, would be considered an egregious violation of professional ethics and also of licensure requirements for a doctor across most of the world. The healthcare professions in the western European tradition have developed with the expectation that their members operate as fiduciaries for their patients; that is, the professional is obligated to promote the patient’s health and well-being, as defined by the patient, even in opposition to that professional’s own interests.
In any case, the financial risk of being sued over sterilization, when the patient requested it in advance, is minimal. The malpractice-related financial problem ob/gyns have is the ruinous obstetrics premiums charged by the for-profit insurance companies. These charges increase yearly in massive disproportion to inflation or to actual malpractice awards. (Hmm, reminds me of for-profit health insurance companies). We regularly see news stories with lots of hand-wringing about how malpractice insurance costs are driving doctors to stop providing obstetric care. The only solution usually offered is tort reform, and no serious effort is made to enact it. No other reproductive justice issue even receives public mainstream hand-wringing.
It would also be an ethical violation to withhold care based on a paternalistic view of women’s nature–that sooner or later all women will want to have babies.
The AMA newsletter has an in-depth discussion in the “opposing viewpoints” format of the issue of provider conscience vs. patient autonomy at
http://www.ama-assn.org/amednews/2009/07/13/prca0713.htm
The consensus of both viewpoints, though, is that patients have a right to receive treatments which are medically appropriate and legal. The discussion is only over how to ensure that the medical resources are in place to allow patients to exercise that right. Kind of ironic, considering how hard ACOG fights to exclude the midwifery model of care from pregnant women’s options.
I think the issue of “conscientious refusal” would be very well served by separate licensing classes. Then patients would choose in advance what range of care they want, and doctors would minimize conflicts with patients. This is particularly important for hospitals and other medical facilities, where you may not necessarily be aware that a previously secular institution has been bought out by the Catholic church. Actually, I have a much bigger issue with institutions refusing care than with individual doctors or nurses. A hospital usually serves an entire community, and therefore should not impose a single ethical viewpoint on its patients, besides which, it is capable of hiring a variety of providers, unlike a small medical practice, which may consist of a sole doctor.
For a more in-depth exploration of conscientious refusal in the ob/gyn specialty, see
http://www.acog.org/from_home/publications/ethics/co385.pdf
Very well, then, but that begs the question of why a doctor who believes abortion and/or tubal ligation are immoral would ever become an ob/gyn.
Because they want to help women get pregnant, provide pre-natal care and assist them in delivering healthy babies.
Sorry, but one woman in 3 in the US will have an abortion in her lifetime
That seems rather high. Citation, please, and does it adjust for women who have multiple abortions?
Why are they setting themselves up for ethical dilemmas when there are easy ways to avoid them?
There already is an easy way for them to avoid the dilemma, whether it be ethical or financial. They simply refuse to perform the procedure.
RonF,
Google is your friend:
http://www.guttmacher.org/pubs/fb_induced_abortion.html
estimates 33% at current first abortion rates (I haven’t looked up the cite they give.
also:
http://www.johnstonsarchive.net/policy/abortion/uslifetimeab.html
which estimates 28% of women 18-64, but probably underestimates due to only counting legal abortions.
Look, I wanted to help out divorcing mothers and victims of domestic violence with their legal troubles, but I didn’t want to work 60 hours a week or use the legal system in ways that troubled my ethics just because I was hired to do so by a client. So I didn’t become a family law lawyer, or any kind of lawyer.
I wanted to change people’s hearts and minds by acting in and directing plays that challenged social mores, but I didn’t want to live job to job and deal with constant rejection and scrutiny of my looks and age and etc., so I didn’t become an actor or director (even after getting a BA and MA!)
If I had my way, I wouldn’t spend hours on boring administrative committees or participate in onerous “learning outcome reviews,” but I’m willing to do those things in order to have the job I have because I really like teaching in my field. If I wasn’t willing to do the parts I don’t like, I’d have picked another job. If the conditions of this job become personally or morally unacceptable to me, I’ll have to consider looking for another one, because I can’t just say to my employers “sorry, I don’t like this part of the job.” I can protest changes in conditions that I object to, and try to rally the support of my colleagues, but if the administration says “that’s the job” at the end of the day, that’s the job.
If you don’t want to do the whole job, don’t do the job. Just because you really like/care about some aspects of it doesn’t mean you should get to pick and choose and only do those parts.
I can’t sign on to the concept that we should require people to do services they don’t like. The right of someone to refuse to do something is far, far, greater than the right of a third party to require them to do it. Even if you’re the only OB in the state, you shouldn’t be forced to do an abortion if you don’t want to.
This is in keeping with certain other findings regarding the issue of “specific performance” of personal services. So when someone breaks a contract, you can sue them but you can’t generally get a court order to force them to do the work.
I don’t have any problem with requiring disclosure, i.e. require that every OB answer “yes” or “no” on a list of services that the government feels is important, and that the list be publicly available.
I don’t have any problem with requiring services as a part of admission into the field, i.e. that all new practitioners who want to become OBs are required to commit to providing abortion and ligation services, or not become OBs. Nobody has a right to become an OB, and they can choose for themselves whether or not they want to meet the criteria.
Look, I wanted to help out divorcing mothers and victims of domestic violence with their legal troubles, but I didn’t want to work 60 hours a week or use the legal system in ways that troubled my ethics just because I was hired to do so by a client. So I didn’t become a family law lawyer, or any kind of lawyer.
That’s looking at it from the back side. Consider that if you become a lawyer you are theoretically qualified to practice all different kinds of law, but you can (and generally do) limit your practice to particular kinds of work. No one can come in and demand that you handle a particular legal matter, nor does the state sanction you if you refused to handle particular kinds of cases.
I don’t have any problem with requiring disclosure, i.e. require that every OB answer “yes” or “no” on a list of services that the government feels is important, and that the list be publicly available.
As pointed out, that’s not going to be real popular with practicioners who provide abortions. It would probably decrease the number of abortion providers.
I don’t have any problem with requiring services as a part of admission into the field, i.e. that all new practitioners who want to become OBs are required to commit to providing abortion and ligation services, or not become OBs. Nobody has a right to become an OB, and they can choose for themselves whether or not they want to meet the criteria.
True. But where else does the State require the holder of a professional license to provide one particular subset of that service to people whether they desire to or not? Additionally, this is the State providing an even greater disincentive to become an OB/Gyn than currently exists – and there’s plenty of such.
I think the people pointing that out are you and Robert, neither of whom are prochoice, right? I realize you’re not trying to be a concern troll but I don’t know why you are arguing against this.
I’m not pro-communist either, Sailorman, but if Comrade George is about to inadvertently walk over a cliff in my sight, I’ll sigh and stick out my arm to stop him.
individ-ewe-al, you are right. My apologies to you and to unusualmusic, and to any other readers for my participation in the thread derail. I should know better than to carry it on that far.
So, let me bring it back around to the original intent of the thread: reproductive justice. One of the more frustrating aspects of trying to speak about it, for me, is encountering people for whom the concept is completely abstract—for whom justice is an abstract, and not an embodied concept. Because we all have bodies. We all live in the world in our bodies. We perceive and are perceived via our bodies. And our bodies exist in a kyriarchal plane where some bodies are more valued than others. And all the lines of bodily justice or injustice probably intersect the most when it comes to reproduction. Those whose bodies give birth (actually or potentially) exist on the front lines of ideological battles, both with and without our permission. Our bodies are the battleground, and we experience it as such. So, forgive me if I don’t have the patience for abstractions, because as someone whose body is never neutral, I don’t have the luxury of that abstraction.
RonF from up above asks: If so, and if this is an issue of justice, then where is the justice to the taxpayer? in regards to undocumented persons. I am not an undocumented person; my papers, as it were, are “in order”.
Yet when I received WIC (Women, Infants and Children—a nutritional program for at-risk families to ensure that children and/or pregnant or nursing women receive proper nutrition at the most crucial developmental point; WIC covers many more people than Food Stamps as the income requirements are more relaxed)—I was viewed as one of those people committing a gross injustice to the taxpayer. Even though I was a taxpayer.
See, I found myself with on-again, off-again employment after my daughter was born. My premature daughter, who received even special consideration under the WIC program for her medical diagnosis of failure to thrive. She had a g-tube installed, and at night Pediasure was pumped into her system in an effort to get her to gain. I was on unemployment insurance. I went to the grocery store with my WIC tickets, my money, and my daughter. WIC tickets pay for certain items (protein and calcium rich, mainly); the rest of the groceries were on my dime (even though unemployment benefits aren’t much, they’re enough to price most people out of food stamps).
Down through the aisles, I got to hear the sneers, and stifle my rage. All those years of being a “good taxpayer” amounted to exactly jack and shit in those moments. I was one of the Official Objects of Scorn. When I went to check out, the WIC items were placed first, for the convenience of the checkout person. More dirty looks, more sneers from the other customers. Who the hell do I think I am, buying pork chops? Why pork chops instead of hamburger? Or whatever.
And in those moments, I would think: how convenient. How convenient for the father of my child, who chose meth over his responsibility as a father (both for my girl and his two other children). He would never have the dirty looks and running commentary, the stifled, choked-in rage. He was a white man, and no one was looking at him thinking: “I wonder if he abandoned any children? I wonder how many?” It was my body in the line of fire. Mine. The responsible party.
Women’s work is……never done? Or never valued? Certainly not valued if a paycheck isn’t attached. But not just women. Anyone whose contributions to the greater good aren’t paid, or paid well, gets the short shrift. Like the contributions of immigrant labor—regardless of paper status. Those fruits and vegetables sure the hell aren’t picking themselves, those chickens aren’t cleaning themselves, that packaged meat in the grocery wasn’t born that way, and that labor is making someone rich. They get to bear the brunt of scorn, despite their labors. They watch the children of the rich and powerful…. while their own children….well, where’s the “justice” to the taxpayer, right? Bah.
Justice? or “Just Us?”
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Thanks, La Lubu, that’s really interesting about justice being embodied. I don’t feel very embodied myself, which is one of the big reasons it took me a long time to “get” feminism. (It’s true that my female body puts me at risk of pregnancy, and then I would have to face society’s reactions to pregnant bodies. That’s not something I think about very much; I regard it in much the same way as the risk that I could become disabled through illness or accident.)
I do want to raise a cheer for the concept that reproductive justice includes making sure that all mothers can feed their children. Hatred for mothers, and hatred for people who need social support, are really poisonous. You’d think that pro-life people could get behind this idea too, but the hatred, the sexism, racism and fear of the poor in practice seem to overshadow any commitment to saving lives.
I do want to raise a cheer for the concept that reproductive justice includes making sure that all mothers can feed their children. Hatred for mothers, and hatred for people who need social support, are really poisonous.
Not just reproductive justice but justice in general and common sense seem to me to favor the idea that we need to makes ure that mothers can feed-and house, clothe, educate, entertain, etc-their children. I’m not sure where this idea came from that raising children is something women are supposed to do automatically and without any support, but it seems pretty pervasive. Virtually any working mother will have horror stories about prejudice she experienced because of her decision to have children and continue working. Probably even Sarah Palin much as she wants to pretend otherwise.
You’d think that pro-life people could get behind this idea too, but the hatred, the sexism, racism and fear of the poor in practice seem to overshadow any commitment to saving lives.
I’m sure that there are pro-life individuals who want to improve the lives of mothers and children. But I’ve never heard of a pro-life organization making even a vague effort beyond some “pregnancy crisis centers” donating a diaper or two and calling it good. Any pro-lifers want to correct my impression?
And while we’re on the subject of racism, any commentary on the billboard that called black children an “endangered species”? Blacks are a separate species, apparently, in at least some pro-life minds.
I don’t know where it came from either. In fact, I don’t even know where I’ve seen it expressed. Can you tell me where you’ve seen this idea put forward?
RonF,
Every time there is a thread about this topic, you go on and on about what an injustice it is to you as a taxpayer to pay for someone else’s prenatal care, someone else’s food, etc. Abortion should be illegal, but society shouldn’t lift a finger to help out people who were irresponsible enough to have sex when they couldn’t support their kids. But no Ron, I don’t know where it comes from.
What chingona said. I’ll just add asking where this idea is is like a fish asking where water is: all over and part of the basic assumptions of society.
[As far as I know, Ron does not think that abortion should be illegal. So your consistency lock is well-formed, but aimed at the wrong person. – Apparently I was wrong about Ron’s position, so please disregard this para.]
If “women should do it themselves” is part of the basic assumptions of society, why do we have TANF? Food stamps? Medicaid?
I think that the basic assumption of society is that raising children is a lot of work and requires a lot of resources, and that’s why we culturally discourage people without support and resources from having children. People aren’t unhappy about teen pregnancy because they don’t think 16-year olds should be having sex, they’re unhappy about teen pregnancy because few teenagers have the resources or support structures in place to responsibly raise a child. Ditto for men and women who do not support themselves but rely on state assistance; I don’t think they should magically have free babies, I think they should refrain from having babies.
Me being unhappy about paying the bills for Alice and Frank’s irresponsibility isn’t the same thing as thinking that babies grow on trees and diapers are free. I’ve raised three kids. I know exactly how much work and money it takes. I don’t want A&F’s kids to starve just because their parents were morons, so I pay the bills.
But I want A&F to realize that they fucked up and are living on charity, BECAUSE THEY ARE, not to think how entitled they are to levy on strangers to pay the costs of their mistakes.
Actually, I do think that abortion should be illegal in most circumstances. However, failing that, I see no reason why anyone except the people responsible for the pregnancy should have to pay for it.
The couple of times that this has been set as an issue of “justice” I’ve asked where the justice is to the taxpayers. But few threads have used that word and outside of them I haven’t referred to the topic of justice.
However, the statement above is non-responsive to my previous statement. To say that the taxpayer is not responsible for paying for the raising of children is not at all equivalent to saying “that raising children is something women are supposed to do automatically and without any support”. Of course mothers should be supported in raising their children. They should be supported primarily by the children’s fathers, and after that by their and their husband’s families.
Show me where I’ve ever said that society shouldn’t lift a finger to help such women. Remember, however, that “society” != “government”. Government is a servant of society, not it’s whole and certainly not it’s master.
BTW; it’s of course quite hard to understand tone of voice in this medium. So I ask, do you agree that it’s irresponsible for anyone, male or female, to have sex if they are not prepared to take responsibility for the possible consequences?
I don’t think it’s reasonable to expect people to be abstinent if they don’t want children right now. I don’t think it was irresponsible for my sister-in-law to have sex with her husband, even though they did up getting WIC for about six months after their second, unplanned, child was born during a time that both of them could only find part-time work. (And yes, they were using contraception at time.)
I also include a few options in “take responsibility for the consequences” that you would deny people.
And Ron, the reason government provides help to the poor is because the majority of society wants government to fill that role. We used to rely only on private charity. Things were a lot uglier in this country then.
Here’s another thing. Liberals have a view of conservatives thinking “all those welfare mothers, being irresponsible & making babies, shame shame shame”. And to a degree that view has truth.
But the other thing is that having babies very often takes people who were perfectly functional adults or near-adults, working their way upwards on a healthy life path, and turns them into welfare mothers.
There are only three things that work to stop that from happening: (a) birth control, (b) abortion, and (c) abstinence by choice or necessity (all-girl’s school, etc.). (Since it is very difficult, to the point of futility, to impose abstinence by force over the course of an organism’s reproductive life, I will leave it out of the discussion.)
Liberals endorse (a) and (b), and either deriding or embracing (c) depending on their personal experiences/morality.
Conservatives are mixed on (a), abhor (b), and endorse (c).
I tend towards a pragmatic but harm-reductive position, myself: pro-a, pro-c, anti-b. YMMV.
And Ron, the reason government provides help to the poor is because the majority of society wants government to fill that role.
Fine. But recognize that such a thing is not a right. It’s a privilege. And the public has every right and even an obligation to decide what should qualify and on what basis.
Again; I was accused of stating that society should not support mothers with children. I might point out that I have in fact spent quite a bit of time helping single mothers raise their children by acting as a father surrogate over the last 18 years as a Scouter. What I have said is that the role of government – not society – should be limited. The responsibility for supporting a child belongs to it’s parents.
I don’t think it’s reasonable to expect people to be abstinent if they don’t want children right now.
I don’t expect people to be abstinent if they don’t want children at a given time. I do expect people to be abstinent if they can’t support children at a given time.
(And yes, they were using contraception at time.)
Given that she got pregnant anyway, I have to wonder about the methods they used and the diligence with which they used them.
I also include a few options in “take responsibility for the consequences” that you would deny people.
Details?
I don’t think it’s reasonable to expect people to be abstinent if they don’t want children right now.
Really?
“I don’t think it’s reasonable to expect people not to walk along the top of fenceposts if they don’t have the money and leisure to deal with a broken ankle.”
“I don’t think it’s reasonable to expect people to not drink alcohol if they don’t want to be intoxicated.”
It might be “reasonable” in the sense that, fallible and flawed people being what they are, of course some people are going to have sex who cannot responsibly deal with the consequences, of course some people are going to drink who ought not to, of course some people don’t check their health insurance status before running along fencelines.
But it’s not reasonable in the sense of expecting people to grasp causality, and not indulge in behavior that doesn’t cause consequences they aren’t ready to deal with. I do expect that of people. People who can’t reach that level of functionality are really letting the rest of us down. If you can’t get drunk, don’t drink. If you can’t deal with reproducing, however you will deal with it, don’t do the one thing that leads to reproduction.
There are a lot of things other than reproductive sex that people can do to express themselves sexually; that’s not a perfect solution but it’s better than nothing. Even if there was nothing in the universe but unprotected PIV sex, the causal responsibility remains.
More like, “I don’t think it’s reasonable to expect people not to drive automobiles if they don’t expect to die in a fiery crash.”
This Reason article puts your lifetime chance of dying in an automobile crash at 1 in 83.
Granted, the failure rate for birth control is greater than the failure rate for automobiles, but also 1) people tend to drive an awful lot more than they fuck, 2) the potential consequence is so much worse, 3) there’s no biological urge to drive, and 4) there’s no equivalent for abortion if you’re killed in an automobile accident. That is, there’s no last-minute ‘oops.’
Therefore, I don’t think this is an unreasonable analogy.
So how about it, Robert? Ready to stop driving?
—Myca
The analogy there would be “I don’t think it’s reasonable to expect people not to drive automobiles if they don’t take steps to prudently insure against the risks.”
Which, in fact, we do. Because people do wreck cars now and again, we require that people insure against the harm that they can do in an accident, including large sums for medical coverage for others.
Abortion, Ron.
I would consider having an abortion because you don’t feel you can support a child a perfectly responsible way to “take responsibility for the consequences.” But then, I also consider getting on WIC and using the hundred bucks a month that frees up to pay for a CNA course so that you can have steady, full-time work when the WIC runs out to be perfectly responsible.
No. That was risk of death, not risk of accident.
So, I ask you once again, are you ready to stop driving, or have you accepted your children losing their father and your wife becoming a widow?
—Myca
And are you absolutely sure that there is no way they would make use of any public program in the event of your untimely and unexpected demise? Because if you’re not 100 percent sure, maybe you shouldn’t have had kids. That would have been more responsible.
ETA: Okay. That was snotty. But getting back to the difference between liberals and conservatives. Conservatives have this idea that liberals don’t care at all about personal responsibility and expect everything just handed to everyone regardless of the amount of effort or work or planning people put in. I think everyone would be better off if they had kids when they were emotionally and financially ready, when their education was complete, etc., and I think people who don’t want kids at this time in their lives should make careful use of contraceptives if they’re having sex. However, I know that I’m not perfect and I’ve messed up and the only reason I haven’t had to “take responsibility for the consequences” is dumb luck. So when I look at someone who got pregnant when they didn’t want to be, I don’t see a “moron.” I see someone who was less lucky than I am. And I refuse to believe that makes me a better person. And really, I see this in everything in my life. My husband and I work hard for what we have, and we make sacrifices for our family. And yes, we pay our taxes and plenty of them, thank you very much. But there is a lot of luck and fortune in what we have as well – luck that we are even healthy enough to work, luck that we had families that encouraged us to pursue education, luck to have gotten off relatively lightly from our mistakes. So if someone else needs a hand, and especially if providing that hand now will help them be self-supporting again in the future, I’m happy for them to get that hand, and I don’t think I’m a better person than them for not needing that hand (yet).
There are only three things that work to stop that from happening: (a) birth control, (b) abortion, and (c) abstinence by choice or necessity (all-girl’s school, etc.). (Since it is very difficult, to the point of futility, to impose abstinence by force over the course of an organism’s reproductive life, I will leave it out of the discussion.)
I prefer a with b for backup for people who wish to be sexually active and fully endorse c for any who do not wish to be sexually active. My personal take on abstinence is that everyone should spend a period of their adult lives-maybe 6 months to a year-being abstinent and living alone. The reason for this is not so much to prevent babies or improve morality, but rather to demonstrate to people that they can live alone and survive. My theory is that once people know, by direct observation, that they won’t die or become ugly monsters if they don’t have a partner for a few months they’ll be more willing to walk away from bad relationships. Am I a conservative yet?
ETA: Re birth control: For the average risk woman, the safest form of birth control is barrier protection with abortion as a backup. Use of no birth control at all is the riskiest method until age 40, at which point smoking and using the pill takes over. Using the pill alone is still safer. Bottom line: pregnancy is dangerous.
If “women should do it themselves” is part of the basic assumptions of society, why do we have TANF? Food stamps? Medicaid?
The underlying message often given with WIC, food stamps, etc is “since this lazy woman can’t do it herself we, society, will graciously help her”. In other words, if you need any kind of aid in raising children then you have failed. To a certain extent, that includes even the aid of a husband or partner. How many women who have stayed home while their children are young have experienced prejudice when they went back to work? On the other hand, women who return to work have to deal with everything from snide comments about how greedy they are to work when they have small children to employers firing them for pumping breast milk on break, so maybe the message is that if you’re female you’re just screwed.
Given that she got pregnant anyway, I have to wonder about the methods they used and the diligence with which they used them.
I’ve written about it in the long and occasionally ongoing abortion thread here, but I am willing to publically discuss how I got pregnant while dilligently and correctly using the Pill, and how access to abortion made it possible for me to stay in school, finish high school a year early, go to college, blah blah blah blah look I have a PhD and thank you Roe v. Wade.
Woo for chingona! I second that.
Good question! As for me, I’ve accepted the possibility in exchange for the benefits of driving; I know that statistic is not individually applicable to me right now*, and I’ve insured in case I am out of luck.
*Common mistake: All people ON AVERAGE have a 1/87 chance of dying in a car crash over their entire life. However, I have made it well past my teen years. I am a good driver; I don’t drive if I’ve had anything to drink; I live somewhere that I can simply stay off the roads if they’re bad; I always wear my seatbelt; and I don’t speed or tailgate. MY chances of dying at this point are far, far, less than 1/87.
At heart, the “responsibility” thing seems to be at pretty great odds with the “free choice” and “own body” and “trust people to do what’s right for them” thing.
If you trust people and let them do what they want, quite a few of them will make choices which are not ideal from a societal perspective (and also not necessarily ideal for the individual, either.)
“Responsibility” in this context isn’t responsibility to YOURSELF. It’s responsibility to SOCIETY. And people aren’t necessarily very good societal members unless we push them (me included, of course.)
But what happens when people push others towards what they perceive as societal responsibility? What happens when people, say, encourage others not to choose parenthood at a young age, or encourage them to use a form of BC which is difficult to get wrong, or encourage them not to have kids at all if they can’t afford it? Why, then, this encouragement gets framed as coercion, and we’re all up in arms about how horrible it is to have ANY say in ANYONE’S life at all. Which is–hello!–pretty much what society is for, that kind of say… so we’re back to e problem again.
Sure, and also you’re a good driver, and you wear your seatbelt, and probably drive in a car with an airbag, etc.
In other words, you engage in risk mitigation behavior while engaging in an activity that is otherwise risky.
My point is that if you’re doing all of that stuff, then driving doesn’t have to involve accepting the possibility of your immanent death any more than having sex while using birth control must involve accepting the possibility of immanent pregnancy.
And, if, despite your excellent driving record, seatbelt, airbag, staying off the road when it’s raining, & etc, you were killed in a freak accident, I doubt seriously that there would be anyone, liberal or conservative, saying, “Well, what did he expect, getting behind the wheel?”
That difference there is what I would like people to pay attention to, because I think it has a lot to do with people who aren’t in danger of pregnancy passing judgment on people who are, but never looking at the risks they assume in their daily lives.
—Myca
Mostly, I’m a pragmatist. I’m broadly in favor of what works. I’m not opposed, for example, to the idea of encouraging people to use a form of BC which is difficult to get wrong (I assume you mean abstinence here), if there’s evidence that that works.
If the evidence seems to point to abstinence-only education actually being counterproductive, as it does, then I’m not in favor of that.
It’s like deciding that rather than teaching people how to drive, how to use a seatbelt, etc, we decided to tell 16 year olds, en masse, “DON’T DRIVE CARS! CARS WILL KILL YOU!”
This would not work, even though it is undoubtedly true that non-drivers very rarely perish in freeway collisions.
Keep in mind, I have no problem with teaching about abstinence along with comprehensive training on birth control and abortion. I have actually been assisting with a sex-ed class that does exactly that. I’m open to all options, it’s just that some of them seem to work better than others.
—Myca
Myca: Sure, I’ve got a chance of dying driving. And, like using birth control while having sex, I take the precautions that greatly up my odds of NOT having an accident so that they are nowhere near 1:87, which as Robert points out is a summary statistic which includes people who drive drunk, don’t maintain the brakes on their cars, etc. I also accept the responsibility of having to deal with what happens if those precautions fail and I do get in an accident; I don’t expect you to pay for it.
I also have to balance the risks of driving against the fact that if I abstain from driving I can’t make a living and my wife and I end up on the street as a burden on society. Whereas if you abstain from sex you can still live an otherwise normal life.
“Responsibility” in this context isn’t responsibility to YOURSELF. It’s responsibility to SOCIETY
You’re right to a certain extent, Sailorman. But with respect I ask you to consider that you’re forgetting one thing. It seems to me that the most important responsibility is that of the prospective parents to the child. The parents owe a child their love and care. They also owe it a secure environment to grow up in, including the material essentials of food, clothing, housing, etc., etc. If the two of them cannot or will not individually and collectively meet those responsibilities they shouldn’t be having children.
I know that I’m not perfect and that I’ve messed up. Sometimes the only reason I haven’t had to take responsibility for the consequences (why did you put that in scare quotes?) was luck – or perhaps better described as the garce of God. But other times it was because I prepared by taking precautions and by not engaging in given behaviors before I could deal with unanticipated or unwanted consequences. And plenty of other times I used good judgement and didn’t mess up in the first place. Just like you, I suspect. I thank God for the times when only good fortune saved me from bad things. But that’s far from the only reason that bad things haven’t happened to me.
Once again, that’s not your chance of getting in an accident, that’s your chance of dying in an automobile accident.
And I’m not sure how on earth you think you could take responsibility for ‘dealing with’ that. It seems to me that your friends and family will be the ones dealing with it.
Simply untrue. Or if it is true, then you have made it true.
—Myca
Myca:
With regards to sex education, I work with kids and I was educated as a biochemist. I believe that young people should get complete information on how their bodies work and the consequences of various actions. They should be completely instructed on all methods of birth control. That would include how they work, what the odds of failure arevand what are the most likely reasons and factors that cause those failures and how to guard against them. That would also include what risk factors there may be in using them outside of the risk of pregnancy if they fail (e.g., the effects of using hormonal birth control pills). Abstinence is one method of birth control and all of these things should also be taught regarding it.
I believe that they should also be instructed on the the moral debates regarding the uses of birth control and abortion. They can present the issues that some people think it’s O.K. and the reasons they give, and that some people think it’s wrong along with the reasons they give. They should also discuss the consequences of having kids when you cannot support them yourself; what resources are available for people who do that and what kind of life they live. That should also include what the costs to society are.
My local schools do something like this with the egg bit; kids are paired off and given a raw egg that they have to carry around, pretend to feed and diaper, etc., etc.
Now, that definitely doesn’t mean that they should be taught “this is right and this is wrong”. That’s the job of the parents and their spiritual leaders.
I buy life insurance so that if I get killed there will be resources available to help replace the income I generate. Of course that doesn’t replace a living, breathing person, but it’s something. The issue is not how my family deals with my death but what demands they put on others should it happen.
How would you propose that I make a living if I don’t drive? Technically speaking I could quit my job, move into the city where there’s public transport and then get a job in the city. But everyone cannot do that – there’s neither enough room in the city, enough public transport capacity nor enough jobs there.
Exactly.
Sure it does. I can still die driving. It’s probably one of the most dangerous things I do, though chainsawing probably beats it. I accept the possibility of my death in a car; having done everything that I deem reasonable to prevent it (and mitigate its effects) there’s not any point in dwelling on it. But if I happen to be discussing it, as now, I’m perfectly willing to admit that I may well die in a car someday, and that the chances are even higher for my kids.
Of course, this is really more of an interesting discussion. I’m far off a real comparison to BC.
No, of course not.
Have you slaughtered an animal lately? Built a house from raw materials? No? How are you eating meat and living in a house, then?
Nothing is “individual” any more. We live in a society which surrounds us. We have the ability to change the water in which we all swim. You can’t pretend that it doesn’t exist. And t doesn’t make any sense to demand that people work with society when they have something to contribute, but refrain from taking a single thing from society when they’re in need.
You could start your own business out of your home, move to a small town where you can walk to work (which is what my grandparents, very successful lawyers, did), start up an internet business, etc.
Yeah, sure, all of these are extreme lifestyle adjustments, but then, so is “just don’t have sex.” Heck, between the two, I’d rather live somewhere else than not have sex until I’m financially solvent.
—Myca
The lifestyle adjustment isn’t “don’t have sex”. The lifestyle adjustment is “don’t ejaculate into a woman’s unprotected and fertile vagina”/”don’t have a fertile man ejaculate into your unprotected and fertile vagina”.
“Don’t have sex” is a pretty tall hill to climb. Might still be the right thing to do, but it’s a pretty tall hill. “Don’t do this ONE SEXUAL ACT that leads to pregnancy”, much less onerous.
And of course, there are accidents – as with a car. Condoms break, pills fail. As with a car, people are capable of drawing the distinction between cautious and prudent behavior that nonetheless led to an accident, and driving topless and drunk at 124 mph past a school at lunch break.
Robert,
That’s sure as hell not what it sounded like you were arguing higher in the thread. I said I don’t think it’s reasonable to ask people to abstain from sex if they don’t want kids, not that I think having as much unprotected sex as you want is a great idea regardless of how you feel about having kids. And you go on this whole spiel about walking on fence posts and broken ankles and drunk driving. It sure as hell sounded like you think foregoing any penetrative sex, regardless of contraceptive arrangement, is a perfectly reasonable thing to ask of people.
And now all of a sudden all you’re asking people to do is use contraception when they’re having sex.
I don’t think you’ll find anyone here to argue that it’s good to not use contraception if you don’t want kids.
So to sum up, I have no clue what we’re even talking about anymore in this thread. But I pretty much agree with this:
Bingo.
I am quoting this entire post because it is so very true.
Hell, I’m even bolding a part of it.
—Myca
I find it fascinating that the discussion has gone in the direction of an assumption that postponing childbirth means not ending up on public assistance, when the average recipient of public assistance is….a woman with two children who is divorced (or unpartnered), who lost her job. Lost her job, and has run out of unemployment insurance, or doesn’t qualify for unemployment insurance because she quit her job (as my aunt did when she fled her crack-addicted, abusive husband, taking her four kids across several state lines in order to stay alive), or her unemployment insurance doesn’t pay enough because she had a low-wage job. Why did she lose her job? Outsourcing. Downsizing. Her own illness and/or disability. One of her children’s illness and/or disability. Loss of childcare. Those are the typical reasons. The example of my aunt fleeing domestic violence isn’t a typical case, but it was typical enough for Illinois and 25 other states to now allow domestic violence unemployment benefits (that wasn’t available back in the 90’s, when she needed it).
Look. Mostaccioli dinners, chili cookoffs, and bake sales aren’t paying anyone’s health care bills, and that form of charity isn’t going to keep a roof over anyone’s head or food in their bellies, either.
The conservative outlook in a nutshell: “I’ve got mine, screw you.”
The reproductive justice outlook: “We’re all in this together.”
No, I won’t find anyone here arguing against contraception. You argued that it wasn’t reasonable to expect people to refrain from sex if they can’t deal with the potential consequence. I argued that indeed it was, and I EXPLICITLY said that there were a lot of other forms of sexual expression that you could use other than the form of “sex” that leads to babies.
You not reading what I wrote is not me not writing it.
What happens when people, say, encourage others not to choose parenthood at a young age, or encourage them to use a form of BC which is difficult to get wrong, or encourage them not to have kids at all if they can’t afford it? Why, then, this encouragement gets framed as coercion, and we’re all up in arms about how horrible it is to have ANY say in ANYONE’S life at all.
The line between encouragement and coercion can be a fine one. Nonetheless, I doubt that you’ll find many people disagreeing with statements like “it’s good for young people to wait until they’re ready and financially secure before having children-we ought to encourage this.” The controversy in sex ed, for example, is all about whether teaching abstinence or safer sex is more likely to acheive the goal of fewer unwanted teen pregnancies, not about whether it’s a good goal to start with. The problem is that it becomes coercion or force quite easily. Lying about the effects of contraception (either efficacy or side effects) and abortion are methods of coercion that some pro-lifers use to attempt to coerce women into abstinence or childbearing.
Robert,
Right. That’s what I understood you to be saying originally. Don’t have PIV sex. Do other things.
Then you wrote:
Don’t have PIV sex, and don’t have unprotected PIV sex are worlds apart.
A 0.1mm latex barrier doesn’t seem like a world apart to me, but as you wish.
And what La Lubu wrote at 86.
I am, at this stage in my life, multiple levels of personal and private safety net away from needing public assistance. But if I took enough hits, I could get there. It would take a lot fewer hits to end up having to do some other things that most people would deem “irresponsible,” like foreclose on our house. And the decision to have a second child means both that we increase our chances of taking a hit (one more person in the family who could, potentially, come down with a devastating illness) and that we decrease the margin on which we operate, making it more likely that some other hit (long-term unemployment by one of the adults) would have broader repercussions.
And if any of those things happened, there would be no shortage of people lining up to say that we should have thought of that and we shouldn’t have had kids if we weren’t prepared to support them and meet our obligations. Even though when we had/have those kids we were able to support them and had planned for contingencies. It’s just that there are only so many contingencies that you can plan for and/or plan on occurring at the same time.
Robert,
Let’s review:
Here’s Ron:
If he had asked if it’s irresponsible to have unprotected sex if you’re not ready to deal with the consequences, I would have said yes, and that would have been it.
But he didn’t qualify sex at all.
So I said:
To which you responded:
The “one thing that leads to reproduction” is PIV sex, and it can lead to reproduction even if both parties take precautions.
So … either you didn’t read what I wrote or you read it and simply didn’t care that I was clearly making one point and instead proceeded as if I were making another point.
But you know, as you wish.
Most unplanned pregnancies happen because two people had PIV sex without precautions. But by no means all. Things happen:
Some women are simply hyperfertile and at risk of pregnancy even with precautions.
Sperm that is near the vagina has been known to find its way in without PIV. Rare, but it happens.
Birth control pills are less effective when used in combination with some other medications, most notoriously antibiotics.
Condoms break.
The most abstinent person in the world can become the victim of rape.
There is at least one case of PIV sex between a man who had a vasecomy and a woman with a tubal ligation resulting in pregnancy. If they didn’t take precautions, who did?
Just as the best driver can get in an accident and the safest car doesn’t protect from all injury, there are few precautions that can guarentee that unwanted pregnancy will never occur. Certainly, taking steps to avoid unwanted pregnancy is good, but assuming that they’ll never occur and that therefore no backup plan is ever needed is naive.
Certainly, taking steps to avoid unwanted pregnancy is good, but assuming that they’ll never occur and that therefore no backup plan is ever needed is naive.
True. I don’t argue that. What I argue is that the only morally acceptable backup plan starts with continuing the pregnancy to term.
Yes, but in a free country, women would be free to make that moral choice for themselves.
What I argue is that the only morally acceptable backup plan starts with continuing the pregnancy to term.
Why? Why is it moral and why is it THE morally acceptable plan? I would argue that under some circumstances it is a morally unacceptable plan. The most obvious situation being that in which survival of pregnancy is unlikely. Suicide isn’t a good solution to most crises.
Dianne, I agree with the general concept that if the chance of death to the mother is significantly greater than the normal risk of childbirth then abortion is acceptable.
Amp, the choice was made when the people involved decided to have sex in a fashion that chanced pregnancy.
In a free country, Person A does not get to unilaterally decide whether or not Person B lives or dies, even if Person B is completely dependent on Person A.
And the thread officially comes full circle.
RonF:
See, Ron, this is what I was talking about in the thread about Nigeria. Your assigning the status of personhood to a fetus is entirely a matter of faith–and even if you say your reasoning is secular rather than religious (and I don’t know that it is), it would still be a matter of belief rather than an objectively agreed upon scientific definition of personhood–and who is to say that your faith-based definition of personhood is any more or less correct than, say, the one that exists in Judaism, which is radically different? Yet you would, if you had the power, legislate for everyone according to your faith and you would call those whose practice violates your faith murderers, even though their faith–and I include secular faiths here–is different. I am not trying to argue with you that your faith is wrong or trying to get you to change your mind; I am just trying to point out the presumption and the assumption (in all honesty I experience it as unmitigated chutzpah) that is inherent in the statement I have quoted. That presumption, that assumption, is, it seems to me, the problem, both here, in terms of the debate over women’s reproductive choice and in what I was talking about in the other thread.
I agree with the general concept that if the chance of death to the mother is significantly greater than the normal risk of childbirth then abortion is acceptable.
Why does the risk have to be higher than normal? The risks of childbirth are, even in the best of circumstances, non-trivial. And what risk is “significant” for this purpose? Is, for example, being over age 35-a definite risk factor-enough?
In a free country, Person A does not get to unilaterally decide whether or not Person B lives or dies, even if Person B is completely dependent on Person A.
Actually, they do, if by “completely dependent” you mean physically dependent on that specific person. No one is forced to donate blood, bone marrow, or organs to another person even if they are the only compatible donor.
In the case of bone marrow donation the analogy is particularly troubling because if person A knows that s/he is a match for person B then person A must have registered in the marrow donation registry. That is, person A made a statement that if s/he matched with another person s/he would donate marrow (or peripheral blood stem cells, but we’ll say marrow for simplicity.) No one is forced to enter the registry. You can’t get drunk and accidently submit a tissue sample. There is no biological drive to register to donate marrow. Person A has given his/her consent to donate in a much more meaningful way than a person having sex has given consent to pregnancy. Yet if person A decides, for any reason, that s/he will not donate s/he is not forced. Even if the process of donation has already begun s/he can back out at any time. Even if person B will die without the donation. Is doing so moral? Should it be legal?