Frames, Exceptions and Anti-Choice Aims Exposed

Amie Newman

Finally, we heard a discussion about women's health that recognized the significance of private medical decision-making and the common ground solutions we can all work on together.

It was the exchange that reproductive and sexual health advocates had been waiting for.

Finally, a discussion about women’s health. This isn’t "special interest" we’re talking about. It’s a bit tiring to hear over and over again that my life and my body are so controversial that presidential candidates need to fight over them every time the discussion is broached. 

So, I held tight and waited when abortion was introduced into the debate last night. I waited for the same old argument. The tired lines about pro-choice vs. pro-life. I waited for the requisite line about how important it is to have a "culture of life" in this country and how both candidates stand up for the lives of the unborn. 

I didn’t hear that. I didn’t hear it because the argument has changed. And it’s thrilling. Instead of the meaningless "life" rhetoric and the tired anti-choice frames that lift the discussion away from women’s health and lives and away from women’s and families’ medical decision making power, we heard the phrases and frames that reproductive and sexual health advocates have been promoting for years. 

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Regardless of whether or not you felt that Senator McCain was unbearably out of touch on the issue, he used the word "decision" when referring to women faced with an unintended pregnancy and did not fall back on the word "choice" – a frame that, for many reproductive health advocates and providers, has never captured the situation well. Women have the right to make private decisions about their health and lives – it’s more than choice.

McCain: And it’s got to be courage and compassion that we show to a young woman who’s facing this terribly difficult decision.

Do you notice what else he did in that sentence? He focused squarely on the woman. Subtle, maybe. But words matter. McCain himself brought that up a few times last night when attempting to criticize Senator Obama for his "eloquence."

Words do matter. And Senator Obama’s words were even more astounding:

Obama: “We should try to prevent unintended pregnancies by providing appropriate education to our youth, communicating that sexuality is sacred and that they should not be engaged in cavalier activity, and providing options for adoption, and helping single mothers if they want to choose to keep the baby.”

Senator Obama’s choice of frames — "prevent unintended pregnancies," "appropriate education," "communication," "providing options," and "helping single mothers" — were made all the more powerful because this is exactly where the majority of Americans wishes the focus to be. There is no public benefit to an endless back and forth about the morality of women’s reproductive health decisions — when millions of women are faced with unintended pregnancies, lack of access to proper family planning, when our young people are desperate for clear guidance and education about their sexual health and sexual decision making and when we face public health epidemics like HIV and aren’t addressing the root causes of any of these critical issues. 

Senator McCain’s obvious frustration over women’s constitutional right to access abortion if their lives are endangered through the pregnancy may have been the most telling of all. 

McCain belittled the allowance in Roe v. Wade for a late term abortion during a health crisis for women by saying:

MCCAIN: Just again, the example of the eloquence of Senator Obama. He’s health for the mother. You know, that’s been stretched by the pro-abortion movement in America to mean almost anything.

That’s the extreme pro-abortion position, quote, “health.”

Senator McCain’s opposition to Roe v. Wade is no secret. He and his running mate support overturning Roe v. Wade, as they both oppose legal abortion in the United States. But since Roe v. Wade has provided millions of women in this country the opportunity to exercise some control over their reproductive health – and this is never more important than in the face of a crisis pregnancy – it’s worth dissecting McCain’s apparent disgust with allowing women’s "health" to remain a crucial factor in decisions about abortion. 

As Vicki Saporta, writing on Rewire, explains:

While the majority of women choose abortion care early in their pregnancies (89% of all abortions in the United States are obtained within the first 12 weeks – PDF), there are cases where a woman may need to obtain a later abortion in order to protect her life or preserve her health, including her mental health. Contrary to the speculation of some abortion opponents, a woman does not obtain a later abortion simply because she’s "having a bad day." These cases often involve severe fetal anomalies that can cause great emotional distress and be devastating to a woman’s psychological health.

As Emily notes, pundits across the airwaves and internet "tubes" were shocked:

"In a race in which millions of dollars have been spent for the votes of American women, McCain mock…the notion that late-term abortions should be allowed in cases where a mother’s health is threatened," the LA Times’s Cathleen Decker wrote after last night’s presidential debates.

Chris Matthews said:

You can’t belittle the health exception with regard to abortion. You can’t say the exception is ‘only her possible death.’

But if justifications for the health exception, pundits’ reactions to the importance of acknowledging how crucial a health exception is to women voters, and the actual law of the land are not enough to convince the anti-choice movement and Senator McCain of the medical and public consensus that later term abortions are defensible when a woman’s life is in danger, maybe women’s real life stories about their most personal and private experiences will do the trick? 

Susan Ito’s decisions were her own to make but it was by no means easy. And Susan’s story is heartbreaking. Would it have been made any easier if she had not been giving the "option" of living by Senator McCain or the anti-choice movement? 

I was toxemic, poisoned by pregnancy. My only cure was to not be pregnant anymore. The baby needed two more weeks, just fourteen days.

I looked at John hopefully. "I can wait. It will be all right."

"Honey. Your blood pressure is through the roof. Your kidneys are shutting down. You are on the verge of having a stroke."

I actually smiled at him. I actually said that having a stroke at twenty-nine would not be a big deal. I was a physical therapist; I knew about rehab. I could rehabilitate myself. I could walk with a cane. Lots of people do it. I had a bizarre image of leaning on the baby’s carriage, supporting myself the way elderly people use a walker.

We struggled through the night. "I’m not going to lose this baby," I said.

As William Saletan writes in Slate today, the old arguments are losing ground:

Look at the home page of the National Right to Life Committee, and you’ll see the kind of character-focused, us-or-them rhetoric that has pervaded the McCain campaign and the pro-life movement.

It’s hard to claim that one’s ideology is grounded in care and concern for public and individual good when women’s health is tossed aside as if it were nothing more than garbage.

Senator McCain’s reaction was not surprising, ultimately. It was simply revealing. Valuing women’s health and lives is not political posturing. Openly mocking an allowance for women to terminate a pregnancy in crisis or extreme situations if her health is in danger is. The anti-choice movement has fueled this. Stuck in rigid, reactive and retro ways, the anti-choice movement’s agenda was exposed last night. The balance that Roe v. Wade affords is something they are not at all interested in. There is no balance in this agenda –  the value of women’s lives and health will never measure up to their desire to ensure that women are disavowed of their ability to make personal and private decisions about their own bodies. 

William Saletan’s acknowledgment that Senator Obama’s focus last night on the "boring," technical aspects of the abortion discussion is ultimately better for this country is right. The real focus of the abortion discussion  – on health access and need, information and education – are not controversial issues. Respect for private medical decision making and strong prevention strategies, coupled with a focus on access to health care are hard to debate. Apparently ensuring that women’s health is taken into account when discussing abortion access is not.  

Roundups Law and Policy

Gavel Drop: Republicans Can’t Help But Play Politics With the Judiciary

Jessica Mason Pieklo & Imani Gandy

Republicans have a good grip on the courts and are fighting hard to keep it that way.

Welcome to Gavel Drop, our roundup of legal news, headlines, and head-shaking moments in the courts.

Linda Greenhouse has another don’t-miss column in the New York Times on how the GOP outsourced the judicial nomination process to the National Rifle Association.

Meanwhile, Dahlia Lithwick has this smart piece on how we know the U.S. Supreme Court is the biggest election issue this year: The Republicans refuse to talk about it.

The American Academy of Pediatrics is urging doctors to fill in the blanks left by “abstinence-centric” sex education and talk to their young patients about issues including sexual consent and gender identity.

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Good news from Alaska, where the state’s supreme court struck down its parental notification law.

Bad news from Virginia, though, where the supreme court struck down Democratic Gov. Terry McAuliffe’s executive order restoring voting rights to more than 200,000 felons.

Wisconsin Gov. Scott Walker (R) will leave behind one of the most politicized state supreme courts in modern history.

Turns out all those health gadgets and apps leave their users vulnerable to inadvertently disclosing private health data.

Julie Rovner breaks down the strategies anti-choice advocates are considering after their Supreme Court loss in Whole Woman’s Health v. Hellerstedt.   

Finally, Becca Andrews at Mother Jones writes that Texas intends to keep passing abortion restrictions based on junk science, despite its loss in Whole Woman’s Health.

Culture & Conversation Human Rights

Let’s Stop Conflating Self-Care and Actual Care

Katie Klabusich

It's time for a shift in the use of “self-care” that creates space for actual care apart from the extra kindnesses and important, small indulgences that may be part of our self-care rituals, depending on our ability to access such activities.

As a chronically ill, chronically poor person, I have feelings about when, why, and how the phrase “self-care” is invoked. When International Self-Care Day came to my attention, I realized that while I laud the effort to prevent some of the 16 million people the World Health Organization reports die prematurely every year from noncommunicable diseases, the American notion of self-care—ironically—needs some work.

I propose a shift in the use of “self-care” that creates space for actual care apart from the extra kindnesses and important, small indulgences that may be part of our self-care rituals, depending on our ability to access such activities. How we think about what constitutes vital versus optional care affects whether/when we do those things we should for our health and well-being. Some of what we have come to designate as self-care—getting sufficient sleep, treating chronic illness, allowing ourselves needed sick days—shouldn’t be seen as optional; our culture should prioritize these things rather than praising us when we scrape by without them.

International Self-Care Day began in China, and it has spread over the past few years to include other countries and an effort seeking official recognition at the United Nations of July 24 (get it? 7/24: 24 hours a day, 7 days a week) as an important advocacy day. The online academic journal SelfCare calls its namesake “a very broad concept” that by definition varies from person to person.

“Self-care means different things to different people: to the person with a headache it might mean a buying a tablet, but to the person with a chronic illness it can mean every element of self-management that takes place outside the doctor’s office,” according to SelfCare. “[I]n the broadest sense of the term, self-care is a philosophy that transcends national boundaries and the healthcare systems which they contain.”

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In short, self-care was never intended to be the health version of duct tape—a way to patch ourselves up when we’re in pieces from the outrageous demands of our work-centric society. It’s supposed to be part of our preventive care plan alongside working out, eating right, getting enough sleep, and/or other activities that are important for our personalized needs.

The notion of self-care has gotten a recent visibility boost as those of us who work in human rights and/or are activists encourage each other publicly to recharge. Most of the people I know who remind themselves and those in our movements to take time off do so to combat the productivity anxiety embedded in our work. We’re underpaid and overworked, but still feel guilty taking a break or, worse, spending money on ourselves when it could go to something movement- or bill-related.

The guilt is intensified by our capitalist system having infected the self-care philosophy, much as it seems to have infected everything else. Our bootstrap, do-it-yourself culture demands we work to the point of exhaustion—some of us because it’s the only way to almost make ends meet and others because putting work/career first is expected and applauded. Our previous president called it “uniquely American” that someone at his Omaha, Nebraska, event promoting “reform” of (aka cuts to) Social Security worked three jobs.

“Uniquely American, isn’t it?” he said. “I mean, that is fantastic that you’re doing that. (Applause.) Get any sleep? (Laughter.)”

The audience was applauding working hours that are disastrous for health and well-being, laughing at sleep as though our bodies don’t require it to function properly. Bush actually nailed it: Throughout our country, we hold Who Worked the Most Hours This Week competitions and attempt to one-up the people at the coffee shop, bar, gym, or book club with what we accomplished. We have reached a point where we consider getting more than five or six hours of sleep a night to be “self-care” even though it should simply be part of regular care.

Most of us know intuitively that, in general, we don’t take good enough care of ourselves on a day-to-day basis. This isn’t something that just happened; it’s a function of our work culture. Don’t let the statistic that we work on average 34.4 hours per week fool you—that includes people working part time by choice or necessity, which distorts the reality for those of us who work full time. (Full time is defined by the Internal Revenue Service as 30 or more hours per week.) Gallup’s annual Work and Education Survey conducted in 2014 found that 39 percent of us work 50 or more hours per week. Only 8 percent of us on average work less than 40 hours per week. Millennials are projected to enjoy a lifetime of multiple jobs or a full-time job with one or more side hustles via the “gig economy.”

Despite worker productivity skyrocketing during the past 40 years, we don’t work fewer hours or make more money once cost of living is factored in. As Gillian White outlined at the Atlantic last year, despite politicians and “job creators” blaming financial crises for wage stagnation, it’s more about priorities:

Though productivity (defined as the output of goods and services per hours worked) grew by about 74 percent between 1973 and 2013, compensation for workers grew at a much slower rate of only 9 percent during the same time period, according to data from the Economic Policy Institute.

It’s no wonder we don’t sleep. The Centers for Disease Control and Prevention (CDC) has been sounding the alarm for some time. The American Academy of Sleep Medicine and the Sleep Research Society recommend people between 18 and 60 years old get seven or more hours sleep each night “to promote optimal health and well-being.” The CDC website has an entire section under the heading “Insufficient Sleep Is a Public Health Problem,” outlining statistics and negative outcomes from our inability to find time to tend to this most basic need.

We also don’t get to the doctor when we should for preventive care. Roughly half of us, according to the CDC, never visit a primary care or family physician for an annual check-up. We go in when we are sick, but not to have screenings and discuss a basic wellness plan. And rarely do those of us who do go tell our doctors about all of our symptoms.

I recently had my first really wonderful check-up with a new primary care physician who made a point of asking about all the “little things” leading her to encourage me to consider further diagnosis for fibromyalgia. I started crying in her office, relieved that someone had finally listened and at the idea that my headaches, difficulty sleeping, recovering from illness, exhaustion, and pain might have an actual source.

Considering our deeply-ingrained priority problems, it’s no wonder that when I post on social media that I’ve taken a sick day—a concept I’ve struggled with after 20 years of working multiple jobs, often more than 80 hours a week trying to make ends meet—people applaud me for “doing self-care.” Calling my sick day “self-care” tells me that the commenter sees my post-traumatic stress disorder or depression as something I could work through if I so chose, amplifying the stigma I’m pushing back on by owning that a mental illness is an appropriate reason to take off work. And it’s not the commenter’s fault; the notion that working constantly is a virtue is so pervasive, it affects all of us.

Things in addition to sick days and sleep that I’ve had to learn are not engaging in self-care: going to the doctor, eating, taking my meds, going to therapy, turning off my computer after a 12-hour day, drinking enough water, writing, and traveling for work. Because it’s so important, I’m going to say it separately: Preventive health care—Pap smears, check-ups, cancer screenings, follow-ups—is not self-care. We do extras and nice things for ourselves to prevent burnout, not as bandaids to put ourselves back together when we break down. You can’t bandaid over skipping doctors appointments, not sleeping, and working your body until it’s a breath away from collapsing. If you’re already at that point, you need straight-up care.

Plenty of activities are self-care! My absolutely not comprehensive personal list includes: brunch with friends, adult coloring (especially the swear word books and glitter pens), soy wax with essential oils, painting my toenails, reading a book that’s not for review, a glass of wine with dinner, ice cream, spending time outside, last-minute dinner with my boyfriend, the puzzle app on my iPad, Netflix, participating in Caturday, and alone time.

My someday self-care wish list includes things like vacation, concerts, the theater, regular massages, visiting my nieces, decent wine, the occasional dinner out, and so very, very many books. A lot of what constitutes self-care is rather expensive (think weekly pedicures, spa days, and hobbies with gear and/or outfit requirements)—which leads to the privilege of getting to call any part of one’s routine self-care in the first place.

It would serve us well to consciously add an intersectional view to our enthusiasm for self-care when encouraging others to engage in activities that may be out of reach financially, may disregard disability, or may not be right for them for a variety of other reasons, including compounded oppression and violence, which affects women of color differently.

Over the past year I’ve noticed a spike in articles on how much of the emotional labor burden women carry—at the Toast, the Atlantic, Slate, the Guardian, and the Huffington Post. This category of labor disproportionately affects women of color. As Minaa B described at the Huffington Post last month:

I hear the term self-care a lot and often it is defined as practicing yoga, journaling, speaking positive affirmations and meditation. I agree that those are successful and inspiring forms of self-care, but what we often don’t hear people talking about is self-care at the intersection of race and trauma, social justice and most importantly, the unawareness of repressed emotional issues that make us victims of our past.

The often-quoted Audre Lorde wrote in A Burst of Light: “Caring for myself is not self-indulgence, it is self-preservation, and that is an act of political warfare.”

While her words ring true for me, they are certainly more weighted and applicable for those who don’t share my white and cisgender privilege. As covered at Ravishly, the Feminist Wire, Blavity, the Root, and the Crunk Feminist Collective recently, self-care for Black women will always have different expressions and roots than for white women.

But as we continue to talk about self-care, we need to be clear about the difference between self-care and actual care and work to bring the necessities of life within reach for everyone. Actual care should not have to be optional. It should be a priority in our culture so that it can be a priority in all our lives.