Throughout a long election campaign, the future of abortion rights
and the right to choose has remained a silent concern for many women
and men as the higher-profile issues of the economy and the wars in
Iraq and Afghanistan dominated debate. But the question on Roe v. Wade
put to the presidential candidates at the final debate on Wednesday
moved the issue front and center once again. It is an intensely
personal and relevant issue for women, and for most of us it is not an
It became central to my life a couple of years back, when my primary
physician refused my request to prescribe the morning-after-pill,
citing medical reasons that made no sense to me. I was in a better
position than most women in the United States. I was in a dual-income
relationship and had a steady job that serendipitously afforded me all
the information I needed to assess my situation.
I knew I had a number of options. I had the resources to seek out
another health care provider, and I would be able to afford a safe
abortion if it came to that. The only option I had ruled out was to
carry a potential pregnancy to term: we simply would not be able to
afford childcare and other expenses for a second child.
This, to me, is the real question of choice. As voters in
California, Colorado, and South Dakota are asked to decide on proposals
that would limit women’s access to abortion and contraception, there is
precious little public debate on whether actually having a child is
necessarily a viable choice, financially and professionally.
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For many, it is not. Federal law affords just 12 weeks of unpaid
maternity or paternity leave, and only for those who are eligible,
which excludes about 40 percent of American workers. There are no
allowances for time off to breastfeed. There are few public child care
options before primary school, and even private alternatives generally
will not take children under 2.
Perhaps most disturbing in terms of lack of support, 8.7 million
children in the United States currently have no health insurance. In
the eyes of the law, it would seem, physically giving birth is the only
consideration: you are afforded a short time to regain your strength
after the delivery, but are otherwise on your own.
Some — even advocates for choice — would say that if you plan to
depend on the government, you shouldn’t have a child in the first
place. But this argument also presumes that if there were public health
care and childcare, and provisions for family support, birth rates
would shoot through the roof, draining government coffers. Experience
from countries with much better maternity and child protections shows
otherwise. In my own country, Denmark, there are provisions that are
generous by American standards – 52 weeks of paid parental leave, child
care and public health care. But the birth rate also is quite low, 1.74
per woman in her lifetime, compared with 2.1 in the United States.
Support services are not the only factor in making a choice about
parenthood, but clearly in the United States, from a purely economic
point of view, fertility is not a matter of choice for everyone.
In the United States the lack of support for child care and parental
benefits also coexists with serious legal or financial obstacles to
accessing safe abortion services and even, at times, contraception.
Since 1973, both state and federal legislators have limited access to
legal abortion through burdensome regulation. Women with limited
economic resources face additional obstacles because abortion services
have been subject to a federal funding freeze since 1977 except in
cases of rape, or incest or where the mother’s life is in danger.
Furthermore, the majority of states do not provide health care funding
for abortion services that fall outside these exceptions.
In fact, fertility (and, by extension, choice) often comes down to a
class issue. While the overall fertility rate has stayed the same, the
number of children living in low-income families has steadily increased
since 2000. The point is not that poor women shouldn’t have children,
but that all women should have a real choice – and that means access to
information about contraception and abortion, and the support they need
to raise children.
In my case, I ended up finding an alternative health care provider, who prescribed me the morning-after-pill.
For me, this is more than a personal issue. I have made a commitment
to press for a real opportunity for choice for all women, including
access to safe abortion services for poor, adolescent, or otherwise
But choice also requires science-based sex education, contraception,
maternity and paternity benefits, and access to child care and health
care. The rationale behind polices such as Denmark’s is that rearing a
child is a service to all: reproduction, at its most basic, is the
reproduction of society. Both the personal and the collective nature of
that choice need to be protected by law and defended by the next