The Guardian - 4 April 2012
The recently declared "war on women" or "war on religious freedom" - depending on which side of the political aisle you find yourself - is the most recent issue du jour, but the challenge with focusing on the politics of women's health is that it tends to mask what's really going on in America, right now. There is, in fact, a war on women - and it's not a political question; it's a civil rights issue.
This is something more than an esoteric issue for me, personally. I am the very lucky father of a baby daughter; but this summer, when my wife and I were expecting, we were hit with a troubling, potentially devastating piece of news: genetic, pre-natal testing had discovered an elevated risk that our child had a genetic disorder - one that in our moral universe would have given us little choice but to consider terminating the pregnancy.
Luckily, everything worked out fine and our daughter is a healthy and happy three-month-old. But what if the news had not been so good; what if, as parents desperate for a child, we had been forced to end the pregnancy. It would have been a horrible and traumatic decision.
In the state of Texas, however, under a law passed last year, it would have been even worse. As the reporter Carolyn Jones wrote about recently in the Texas Observer, we would have been subjected to something akin to emotional torture. Under the provisions of the new law, all women who want to have an abortion are forced to wait 24 hours before they undergo the procedure. No exceptions.
Jones, whose fetus was diagnosed with a genetic disorder and who was terminating her pregnancy, was obliged, under Texas law, to undergo a sonogram, to listen to a doctor describe her afflicted fetus, and to have explained the health dangers of having an abortion. While a woman with an "irreversible abnormality" would be subjected to all the law's provisions, only in rare circumstances (such as rape and incest, or involving minors) are a doctor's legal obligations waived. Thus, the vast majority of Texas women, including those without a partner or a support network, and regardless of their reason for seeking an abortion, are to be subjected to these onerous requirements - in order to have a medical procedure that is legal in the United States.
To be sure, since the landmark US supreme court decision in 1973 that legalised abortion, there have been unceasing efforts to restrict the full expression of abortion rights. Abortion providers have been harassed, threatened ands in some cases, murdered. State legislatures have nibbled away at abortion rights - waiting periods here, partial birth bans there - but nothing like what we've seen over the past year. The Texas law is very much at pace with these developments.
According to Elizabeth Nash, who tracks reproductive health issues at the Guttmacher Institute, it has been a record-setting year with highest number of abortion restrictions proposed and enacted in recent memory. In a usual year, says Nash, 900-1,000 bills on reproductive health are introduced in state legislatures relating to reproductive health. Half of these deal with abortion restrictions. Last year, 1,100 pieces of legislation were proposed, and more than 600 would seek to further restrict abortion rights.
As a result, last year alone, 92 anti-choice proposals became law; the next highest total was 35 in 2005. It is said Nash, "a free-for-all on abortion". Moreover, the types of law that are being proposed are more intrusive and demeaning to women then anything seen in recent years.
"Ten years ago, you would never have seen a bill mandating ultrasounds," said Nash. "Now, it is seen as a typical abortion bill. Same in provisions around medicated abortions, such as the 'morning after' pill."
In Virginia and Idaho, bills that would have required invasive, transvaginal ultrasounds for all pregnant women were stopped; but in Pennsylvania, this legislation is still pending.
While these abortion provisions are concerning, what's important to understand is that this is only one part of the assault on women's rights. The more insidious shift is the growing attack on birth control. Since the 1965 supreme court decision, Griswold v Connecticut, which fully legalised birth control, the use of contraception has been widely-settled law. Today, approximately 99% of American women use some form of birth control.
But this year, ten states have sought to place restrictions on birth control usage. The most onerous is perhaps the (recently defeated) legislation in Arizona that would force women to explain to their employers or insurers why they sought to have their insurance plans pay for contraception services.
Michelle Goldberg, author of The Means of Reproduction: Sex, Power and the Future of the World, drew parallels for me with what she called the "unprecedented attacks" on Planned Parenthood, an organization that provides healthcare services to millions of women. Because PP performs a small percentage of abortions, however, it has recently become a favorite target of conservative and anti-choice politicians. Mitt Romney has spoken of ending federal support for the group. In Texas, conservative Republicans were so desperate to end support for the organization that they passed a law forbidding the group's participation in Texas' Medicaid women's health program.
Since federal law prohibits states from discriminating among family-planning providers, the move had the effect of ending federal funding for the program, which supplied 90% of its financial support. This is happening at a time when Texas, like most American states, finds itself increasingly cash-strapped. The pernicious outcome of this decision is that 130,000 low-income women will find it much harder to receive access to the cancer screenings, contraceptive services and basic healthcare that Planned Parenthood has long provided.
In general, however, the attacks on birth control have shown an uglier side to the debate over women's health in America. It's one thing to voice moral qualms over abortion; it's quite another to seek legislative means to punish women for the use of birth control, or to use attacks on abortion to curtail women's access to basic health services. It's small wonder that recent public opinion suggests President Obama has reaped significant political benefit from this latest political imbroglio, with new numbers that suggests he is now trouncing his Republican rival, Mitt Romney, by 18 points among female voters.
But why is all this happening now? Part of it is, undoubtedly, political. Jill Filipovic, who tracks these issues for the blog Feministe, told me that having a Democratic president in the White House has traditionally spurred "a lot more state action on abortion and a lot more hostility toward women and abortion providers". But the other chief cause for this uptick, says Filipovic, is that the anti-choice movement has moved "so far to the right".
Certainly, there is little question that the Obama administration's stance on not exempting religious employers from the obligation to offer and pay for contraceptive services under their employees' health insurance plans added fuel to the fire. But it also exposed the growing conflation in the anti-choice community of birth control with abortion - and the efforts to restrict access not just to the latter, but also to the former. While the religious freedom issue spurred conservative activists, many of the current attacks on reproductive health pre-dated the White House's position on this provision of the healthcare law.
In a very real sense, the recent debates in the United States over birth control are illuminating events, teachable moments about the challenge confronting American women's right to basic health services. Yet again, the frame is political. While the pundit class spends its time talking about who is most likely to benefit from Washington's latest political fight, the actual human costs and consequences are all too often obscured.
We know, for example, that unimpeded access to birth control is a win-win - for women, for men and for society as a whole. Women's access to reproductive health services helps them have longer careers, better-paying jobs and greater economic and social freedom. When procreation decisions are planned, it generally means lower rates of poverty, lower rates of child abuse and more time for children spent with two parents, rather than one. To turn back the clock on reproductive health is to turn back the clock on five decades of social and cultural change - which might actually be the point for birth control opponents and anti-abortion campaigners.
Because of the obvious impact of women's health issues on women, these larger societal benefits are often ignored or given short shrift. Indeed, the issue of protecting women's reproductive rights is one that is almost exclusively discussed by women, and is one on which men's voices are rarely heard - even in the pro-choice community. Says Goldberg, for many men, abortion is seen as a "side issue" or nuisance topic - even among progressives. As with many men, it took a very personal experience to drive home, for me, the notion that laws designed to restrict abortion rights or prevent access to birth control are issues central to the dignity of American women and the preservation of their basic civil and human rights.