Health Equity

Equity Matters: Politics, Healthcare & Inequity, Part 1 Women’s Reproductive Rights

Vol. #23 September 2022

September 21, 2022

There are increasingly more laws being passed that dictate how medical professionals provide care to individual patients and limit the information that can be shared about medical options. These laws are especially alarming because they are coming on the heels of progress towards greater personal rights. These sentiments are not new but rooted in a long tradition of attempts to control the choices and bodily autonomy for women, people of color and those who identify as LBGTQ+.

The fight for safe, accessible birth control is one example of this. Margaret Sanger opened the first birth control clinic in New York City in 1916. She was thrown in jail within a year for “maintaining a public nuisance.” Her conviction is eventually overturned with an acknowledgement from the court that limitation on the distribution of birth control is unconstitutional. Yet, after the first birth control pill was approved by the FDA in 1960, it took a court ruling in 1972 to guarantee access to unmarried women. Until that time, it was legal to deny an unmarried woman an FDA approved medication based on the government’s view that unmarried women should be celibate until marriage. The idea that women had agency to make decisions about their own bodies that may contradict the view of many in power was so strong, it took decades to reach full access to birth control - a life changing option for women of childbearing age.

It is also clear throughout history that this paternalistic control over women’s bodies is even more severe for women of color. Forced sterilization was legal for certain women in the early 1900’s. In the 1970’s the Indian Health Service sterilized thousands of Native American women bringing the birth rate from 3.7 children in 1970 to 1.8 in 1980, compared to a reduction from 2.42 in 1970 to 2.14 in 1980 for white women.[1] Those in power- mostly men at that time – found it acceptable to take a major life decision away from thousands of women based on misguided racist and sexist ideas of what was best for society.

Since the 1970’s, there has been progress. Roe v. Wade guaranteed the right to abortion. Title X created government funded family planning and contraceptive services for low-income women, and the Affordable Care Act guaranteed birth control free of charge. However, when Congress or the Supreme Court grants women, or any group rights, those rights can also be repealed. There are many examples of this including the Hyde Amendment passed in 1976, which bans the use of Medicaid funds for abortions in almost all circumstances, the 2014 Supreme Court ruling that allows for religious exemptions to the ACA mandate that covers contraception and the 2019 Executive Order that barred federally funded family planning centers from discussing abortion as an option for pregnant women. The latest, and most blatant example is the recent Supreme Court ruling overturning Roe v. Wade.

When the Supreme Court overturned Roe v. Wade, it did far more than allow states to ban abortion. It also gave governors, state legislators and law enforcement the power to influence personal medical decisions well beyond banning abortions in early pregnancy. Since the Dobbs decision in June, there have been numerous examples of physicians waiting to treat ectopic pregnancies, until women are in immediate danger of dying; a young child, who was a victim of rape forced to travel out of state to terminate her pregnancy; and choices taken away from families when pregnancies have the potential to be deadly for the mother or the fetus. If we look back before Roe, there are thousands of examples of women dying from unsafe abortions and while giving birth when it was medically unsafe to carry the pregnancy to term. There are also examples of lives derailed or ruined because of lack of reproductive freedom. Women, families and medical professionals deserve the freedom to make educated decisions about what is best for their health, the health of their family, and their patients.

These are fights that public health and women’s rights advocates have fought and won before. There is a renewed call to action to change laws that endanger the health of women particularly those living in poverty and women of color.

Women’s reproductive rights is not the only example of laws directly impacting personal medical care. Next month, we will address how this is affecting healthcare for transgender youth.

[1] Our Bodies Ourselves. A brief history of birth control in the US. A Brief History of Birth Control in the U.S. - Our Bodies Ourselves Today.

For more Equity Matters, visit Foundation Publications.

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