Commentary Human Rights

An Open Letter on the Importance of Reproductive Choice

Ann Furedi

Choice does not necessarily have to be in a name. But it needs to be at the core of our values, because respect for women's capacity to decide really does matter.

See here for further discussion of “choice” and reproductive justice language.

I want to thank Jodi Magee for her response article on how Physicians for Reproductive Health continues to “absolutely support the right to choose,” despite having dropped the word “choice” from its name. In the United Kingdom, we are the poorer because no organization quite like hers exists.

For us, reproductive health is now pretty mainstream. Our Royal College of Obstetricians and Gynecologists (RCOG) has a faculty dedicated to it. But we have no mainstream, national organization with professional clout and profile that stands up for a woman’s right to choose.

Maybe this is why I’m alarmed when I read the arguments that the concept of reproductive “choice” is passé and that we should instead adopt a language of health and justice. And maybe this is why I must seem pedantic, mulish, and annoyingly intransigent.

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For me, it is more than a matter of semantics. “Choice” means something specific. As I tried to explain in my essay,Remaking the case for a woman’s right to choose,” personal, individual “choice” in reproductive decision-making is something special and particular. It relates to the matter of who can make a decision, which refers to the agency and autonomy of individuals. When we talk about reproductive choices, we refer to the private matters that each of us must be able to resolve for ourselves. This is more than health, and extends even beyond equality and justice.

Perhaps here in the UK, some of us feel the importance of reproductive choice because none of us have ever known it. Regardless of our wealth, education, or standing, none of us can have a legal abortion in Britain because we decide, personally and for ourselves, that it is right.

British abortion law and practice has never acknowledged women’s reproductive choice. Our legislation was drafted in the 1960s to create conditions under which abortion could be delivered safely and regulated closely for the public good—that it should be a right for women was not even discussed. (Law professor Sally Sheldon documents this well in her 1997 book Beyond Control: Medical Power and Abortion Law). Our parliament, courts, and medical professionals have never accepted that women have the capacity to decide about abortion for themselves at any stage in pregnancy. Instead the law offers a legal defense for a doctor who decides an abortion is best for a woman’s health. As the Daily Telegraph noted in 1967, bishops, peers, and doctors supported the abortion bill because it “will give doctors the freedom to make the best choice for the mother, her established family and the embryo within her” (emphasis added).

That legacy of medical patronage remains today. Even now, an abortion is unlawful unless two doctors certify “in good faith” that it meets grounds relating to a woman’s health.

This means we have a law that allows for the protection of the health of the pregnant woman but denies her the right as a person to decide on her own reproductive destiny. A doctor can agree to an abortion because the woman’s health will be damaged by her pregnancy, but not because she simply does not want a baby. A doctor can agree to an abortion because she believe her patient’s fetus is at severe risk of a serious abnormality, but not because her patient does not want to have a child who has Down syndrome.

Our law works for women because our doctors frame unwanted pregnancy as a medical health issue. They say that denying an abortion is bad for mental health, or that statistically birth is riskier than abortion. And of course this is true. But any “pro-choice” doctor will tell you he or she finds this demeaning and degrading. It’s a fragile and tenuous framework in which competent and capable women must claim they “cannot cope” with a child.

“Choice” cannot simply be folded into the fabric of health, because not all of the choices we need to defend are those that accord with our views of health—sometimes they are just about what people want.

It has been argued that abortion is seldom a matter of choice; choices are never “truly free,” but are shaped by circumstances. But consider this: A pregnant woman who gets a prenatal Down syndrome diagnosis, is offered an abortion, and is struggling to decide her pregnancy’s future may feel she has “no choice” as to her decision. But she has a different sense of “no choice” than a woman who literally has no choice, because such an abortion would be illegal. The one thing worse than having to decide between two things you don’t want is not being able to decide at all.

Jon O’Brien of Catholics for Choice put it well when he explained how our circumstances, our access to resources, give context to our decisions but do not fix them for us:

Choice, at its core, recognizes that oppression influences, but does not dictate, our choices. By grounding itself in the idea that each person has a right to bodily autonomy, to determine the course of his or her reproductive life regardless of circumstance, choice respects individual conscience.

This is important because not all women in the same circumstances will want the same thing. It is important because the decisions that we make express what we feel and who we are.

We, each of us, make decisions according to our values, and this is important to us. The decision a woman makes about not being able to bear another child because it will impoverish her family may not feel like a “choice,” but it is a decision of a different order to a decision by her doctor that she cannot bear another child regardless of what she wants. It matters who takes the decision. Agency is everything—even when the outcome of the decision is the same. A woman who decides her poverty means she must have an abortion is in a different situation than a woman who is told she must have one. Society removes personal decisions from those who are not competent to make them; when decisions about abortion are taken away from women, the status of competent, rational adults is taken away too.

The value that doctors accord to choice—that is, to woman’s autonomy—shapes the way we are treated. When you value a woman’s choice, you respect her right to make a decision you think is wrong, perhaps a less-than-healthy choice, but one that is nevertheless hers and not yours. Here in the UK, we increasingly see people’s choices narrowed because someone else decides what is right for them. Emergency contraception is under-promoted and overpriced, lest women should choose to rely on it too much. Long-acting contraceptives are promoted heavily because doctors agree they are “better,” and are concerned that women continue to choose less effective methods. Regulatory guidance tells us that women should leave our abortion clinics with a method of contraception, regardless of what the woman wants.

Choice does not necessarily have to be in a name. But it needs to be at the core of our values, because respect for women’s capacity to decide really does matter.

To borrow again from O’Brien:

To be pro-choice is to dedicate oneself … to making the legal, political, social, and economic changes necessary to ensure that this true freedom of choice is available to each person. Choice does not negate social justice; indeed, we believe that true freedom of choice compels us to advocate for policies that ensure that everybody, regardless of their situation, has equal access to safe, compassionate, and comprehensive reproductive health-care options.

For the first time in decades, in the UK we are starting to engage a new generation campaigning for choice. The notion that people should, and can, have the freedom to make destiny-changing decisions for themselves is a very big idea. It needs a very big voice, and we’re glad to hear Jodi Magee say Physicians for Reproductive Health is still part of the choir.

News Sexual Health

State with Nation’s Highest Chlamydia Rate Enacts New Restrictions on Sex Ed

Nicole Knight Shine

By requiring sexual education instructors to be certified teachers, the Alaska legislature is targeting Planned Parenthood, which is the largest nonprofit provider of such educational services in the state.

Alaska is imposing a new hurdle on comprehensive sexual health education with a law restricting schools to only hiring certificated school teachers to teach or supervise sex ed classes.

The broad and controversial education bill, HB 156, became law Thursday night without the signature of Gov. Bill Walker, a former Republican who switched his party affiliation to Independent in 2014. HB 156 requires school boards to vet and approve sex ed materials and instructors, making sex ed the “most scrutinized subject in the state,” according to reproductive health advocates.

Republicans hold large majorities in both chambers of Alaska’s legislature.

Championing the restrictions was state Sen. Mike Dunleavy (R-Wasilla), who called sexuality a “new concept” during a Senate Education Committee meeting in April. Dunleavy added the restrictions to HB 156 after the failure of an earlier measure that barred abortion providers—meaning Planned Parenthood—from teaching sex ed.

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Dunleavy has long targeted Planned Parenthood, the state’s largest nonprofit provider of sexual health education, calling its instruction “indoctrination.”

Meanwhile, advocates argue that evidence-based health education is sorely needed in a state that reported 787.5 cases of chlamydia per 100,000 people in 2014—the nation’s highest rate, according to the Centers for Disease Control and Prevention’s Surveillance Survey for that year.

Alaska’s teen pregnancy rate is higher than the national average.

The governor in a statement described his decision as a “very close call.”

“Given that this bill will have a broad and wide-ranging effect on education statewide, I have decided to allow HB 156 to become law without my signature,” Walker said.

Teachers, parents, and advocates had urged Walker to veto HB 156. Alaska’s 2016 Teacher of the Year, Amy Jo Meiners, took to Twitter following Walker’s announcement, writing, as reported by Juneau Empire, “This will cause such a burden on teachers [and] our partners in health education, including parents [and] health [professionals].”

An Anchorage parent and grandparent described her opposition to the bill in an op-ed, writing, “There is no doubt that HB 156 is designed to make it harder to access real sexual health education …. Although our state faces its largest budget crisis in history, certain members of the Legislature spent a lot of time worrying that teenagers are receiving information about their own bodies.”

Jessica Cler, Alaska public affairs manager with Planned Parenthood Votes Northwest and Hawaii, called Walker’s decision a “crushing blow for comprehensive and medically accurate sexual health education” in a statement.

She added that Walker’s “lack of action today has put the education of thousands of teens in Alaska at risk. This is designed to do one thing: Block students from accessing the sex education they need on safe sex and healthy relationships.”

The law follows the 2016 Legislative Round-up released this week by advocacy group Sexuality Information and Education Council of the United States. The report found that 63 percent of bills this year sought to improve sex ed, but more than a quarter undermined student rights or the quality of instruction by various means, including “promoting misinformation and an anti-abortion agenda.”

Roundups Politics

Campaign Week in Review: ‘If You Don’t Vote … You Are Trifling’

Ally Boguhn

The chair of the Democratic National Convention (DNC) this week blasted those who sit out on Election Day, and mothers who lost children to gun violence were given a platform at the party's convention.

The chair of the Democratic National Convention (DNC) this week blasted those who sit out on Election Day, and mothers who lost children to gun violence were given a platform at the party’s convention.

DNC Chair Marcia Fudge: “If You Don’t Vote, You Are Ungrateful, You Are Lazy, and You Are Trifling”

The chair of the 2016 Democratic National Convention, Rep. Marcia Fudge (D-OH), criticized those who choose to sit out the election while speaking on the final day of the convention.

“If you want a decent education for your children, you had better vote,” Fudge told the party’s women’s caucus, which had convened to discuss what is at stake for women and reproductive health and rights this election season.

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“If you want to make sure that hungry children are fed, you had better vote,” said Fudge. “If you want to be sure that all the women who survive solely on Social Security will not go into poverty immediately, you had better vote.”

“And if you don’t vote, let me tell you something, there is no excuse for you. If you don’t vote, you don’t count,” she said.

“So as I leave, I’m just going to say this to you. You tell them I said it, and I’m not hesitant about it. If you don’t vote, you are ungrateful, you are lazy, and you are trifling.”

The congresswoman’s website notes that she represents a state where some legislators have “attempted to suppress voting by certain populations” by pushing voting restrictions that “hit vulnerable communities the hardest.”

Ohio has recently made headlines for enacting changes that would make it harder to vote, including rolling back the state’s early voting period and purging its voter rolls of those who have not voted for six years.

Fudge, however, has worked to expand access to voting by co-sponsoring the federal Voting Rights Amendment Act, which would restore the protections of the Voting Rights Act that were stripped by the Supreme Court in Shelby County v. Holder.

“Mothers of the Movement” Take the National Spotlight

In July 2015, the Waller County Sheriff’s Office released a statement that 28-year-old Sandra Bland had been found dead in her jail cell that morning due to “what appears to be self-asphyxiation.” Though police attempted to paint the death a suicide, Bland’s family has denied that she would have ended her own life given that she had just secured a new job and had not displayed any suicidal tendencies.

Bland’s death sparked national outcry from activists who demanded an investigation, and inspired the hashtag #SayHerName to draw attention to the deaths of Black women who died at the hands of police.

Tuesday night at the DNC, Bland’s mother, Geneva Reed-Veal, and a group of other Black women who have lost children to gun violence, in police custody, or at the hands of police—the “Mothers of the Movement”—told the country why the deaths of their children should matter to voters. They offered their support to Democratic nominee Hillary Clinton during a speech at the convention.

“One year ago yesterday, I lived the worst nightmare anyone could imagine. I watched as my daughter was lowered into the ground in a coffin,” said Geneva Reed-Veal.

“Six other women have died in custody that same month: Kindra Chapman, Alexis McGovern, Sarah Lee Circle Bear, Raynette Turner, Ralkina Jones, and Joyce Curnell. So many of our children are gone, but they are not forgotten,” she continued. 

“You don’t stop being a mom when your child dies,” said Lucia McBath, the mother of Jordan Davis. “His life ended the day that he was shot and killed for playing loud music. But my job as his mother didn’t.” 

McBath said that though she had lost her son, she continued to work to protect his legacy. “We’re going to keep telling our children’s stories and we’re urging you to say their names,” she said. “And we’re also going to keep using our voices and our votes to support leaders, like Hillary Clinton, who will help us protect one another so that this club of heartbroken mothers stops growing.” 

Sybrina Fulton, the mother of Trayvon Martin, called herself “an unwilling participant in this movement,” noting that she “would not have signed up for this, [nor would] any other mother that’s standing here with me today.” 

“But I am here today for my son, Trayvon Martin, who is in heaven, and … his brother, Jahvaris Fulton, who is still here on Earth,” Fulton said. “I did not want this spotlight. But I will do everything I can to focus some of this light on the pain of a path out of the darkness.”

What Else We’re Reading

Renee Bracey Sherman explained in Glamour why Democratic vice presidential nominee Tim Kaine’s position on abortion scares her.

NARAL’s Ilyse Hogue told Cosmopolitan why she shared her abortion story on stage at the DNC.

Lilly Workneh, the Huffington Post’s Black Voices senior editor, explained how the DNC was “powered by a bevy of remarkable black women.”

Rebecca Traister wrote about how Clinton’s historic nomination puts the Democratic nominee “one step closer to making the impossible possible.”

Rewire attended a Democrats for Life of America event while in Philadelphia for the convention and fact-checked the group’s executive director.

A woman may have finally clinched the nomination for a major political party, but Judith Warner in Politico Magazine took on whether the “glass ceiling” has really been cracked for women in politics.

With Clinton’s nomination, “Dozens of other women across the country, in interviews at their offices or alongside their children, also said they felt on the cusp of a major, collective step forward,” reported Jodi Kantor for the New York Times.

According to Philly.com, Philadelphia’s Maternity Care Coalition staffed “eight curtained breast-feeding stalls on site [at the DNC], complete with comfy chairs, side tables, and electrical outlets.” Republicans reportedly offered similar accommodations at their convention the week before.