In August of this year the National Advocates for Pregnant Women, along with over a dozen medical professionals, academics, and legislators, submitted an open letter to two Madison County, Indiana prosecutors urging them to drop charges against a woman who experienced a stillbirth in her home. Kelli Leever-Driskel, who was arrested and charged with involuntary manslaughter and feticide after seeking medical attention, is one of countless pregnant people who are criminalized while pregnant thanks to the societal trend to resort to punitive measures when addressing the behaviors of certain populations as opposed to framing them as issues concerning public health.
Some similar examples include pregnant people “who fell down a flight of stairs, delayed having cesarean surgery, had a home birth, used a controlled substance (including ones prescribed to them), experienced miscarriages and stillbirths or who gave birth to a baby who did not survive,” as explained by Lynn Paltrow, founder of the National Advocates for Pregnant Women, and examined in further detail through a historical and sociological lens in a groundbreaking 2013 study.
Magnifying the Issues
Unfortunately, tragedies like these are often not included in conversations about reproductive justice because they are overshadowed by another topic deeply impacted by the landmark 1973 SCOTUS decision: abortion. Be that as it may, there are socially constructed and material, tangible things that impact the lived experience of people who must navigate intersecting oppressions while also finding ways to survive and thrive in the world.
When it comes to issues concerning reproductive justice these things include, but are not limited to, lack of access to affordable birth control and/or emergency contraceptives, minimal or nonexistent sexual health education, and patriarchal norms that lead to feelings of shame and guilt regarding sexuality. The abortion debate has dominated conversations regarding reproductive justice, especially as of late given worries about the overturning of Roe, to an alarming degree. Much more is at stake and we run the risk of losing sight of the true costs of sociopolitical tunnel vision if we don’t change the course and substance of the conversations.
Access to Services and Information
The number of websites that offer purchasing options for birth control and emergency contraceptives are increasing but, for many, the prices are still too high. According to Planned Parenthood, “improved access to birth control is directly linked to declines in maternal and infant mortality” and “one third of female voters have struggled to afford prescription birth control at some point in their lives, and as a result, used birth control inconsistently”.
Additionally, access to safe abortions is limited in many states which puts the safety and health of countless pregnant people in danger. In some regions of the country, pregnant people are forced to travel sometimes hundreds of miles to receive safe care and those are only people who can afford the trip. Aside from financial or locative barriers to access affordable birth control and/or emergency contraceptives, there are psychological, cerebral barriers as well.
Everything we believe about birth control, and reproductive justice as such, is directly influenced by our unique personal circumstances. Be it one’s race, class, region, religion, spoken languages or otherwise, the amalgam of factors that make up our identities impact how and what we believe, according to what moral guidelines we judge things by. Further, one could argue that another barrier to access stems from a negative response to false or misleading information about birth control and emergency contraceptives, consider it epistemic sabotage.
(This is certainly a global issue with different implications depending on the geopolitical region but the focus of this article will stay national. There is no intention to silence other narratives, only to amplify preventable public health issues in a country that prides itself on liberty and freedom.)
Sexual Health Education and Prevention
According to the Center for Disease Control (CDC), three in ten teens are sexually active and of those 3, about 57 percent of them did not use a condom the last time they had sex. For some, that could be due to access. For others, the reasons for engaging in risky sexual behaviors could be linked to issues related to mental health. Either way, these statistics reveal preventable health concerns that impact youth and adults alike.
Data on sexual violence and sexually transmitted diseases in adults highlight the alarming reality of widespread abuse and trauma as well as what the CDC refers to as “steep and sustained increases in STDs in recent years.” According to organizations like Peer Health Exchange, one’s health and well-being are influenced by more than just access to preventative care with respect to issues concerning sexual health. Access to inclusive sexual health education positively impacts “sexual and mental knowledge, skills, and help-seeking behavior.”
The combination of perpetuated patriarchal norms and an overwhelming lack of inclusive sexual education for young people, especially in low-income communities and communities of color, results in startling statistics like those previously mentioned. Lack of funding for comprehensive sexual health education options could correct these problems but stigma and tradition prevent this from happening. A tradition that is violent, stemming from patriarchal norms and attitudes.
Patriarchy and Responsibility
The burden of reproductive responsibility has overwhelmingly been shouldered by women and non-cis-men. Proof of that is abundant, but even the fact that options for birth control for people with uteruses are many and options for people with testes are few and far between highlights where society places responsibility. Some argue that the dismantling of patriarchy would result in epic forward strides in the fight for reproductive justice.
“Imagine if men could see reproductive justice as their battle to fight—not from a place of chivalry, but from a duty to humanity,” asks OB-GYN and former anti-abortion advocate Willie Parker who now advocates for access to safe abortions after unpacking the dangerous consequences of perpetuated patriarchal norms. In a 2015 study researchers argued that patriarchal culture negatively effects girls’ and women’s decision-making with respect to reproductive health and also acts as a “barrier for women’s decision-making authority, and hence a barrier to women’s sexual and reproductive health.”
Given that individuals and their beliefs do not exist in a vacuum, and men who benefit from patriarchal culture while also violently securing positions of power have existed for centuries, popular opinion and legislative measures are deeply influenced by patriarchal norms and impact various aspects of people’s lives. With respect to reproductive health, the effects of this are boundless. From internalized patriarchy to anti-feminist expectations related to femininity and sexuality, the way women and non-cis men view their bodies, behavior, and options when it comes to sex and sexuality is often tainted by patriarchy.
Majority cis-men legislators and politicians limit conversations about reproductive justice to issues related to abortion from the House floor to passed legislative measures and as a response other issues related to reproductive justice don’t as much attention. Other historical factors are also to blame for an abortion- and “pussy”-centric reproductive justice rhetoric but the fact that actual laws being passed in increasing amounts revolve around abortion doesn’t help the situation.
Where To Go From Here
The antiquated “pro-life” versus “pro-choice” debate has injected within generations of could-be inclusive reproductive justice activists and advocates an unhealthy dose sociopolitical tunnel vision. It is no coincidence that the topic of abortion has remained the most popular for people on both “sides” of the debate within reproductive justice circles, legislation, and the United States political imagination.
There are much larger and more universal issues that have led to countless reproductive justice-related crises in the United States and beyond: the societal realities that are responsible for the conditions of possibility for pregnancies, unwanted and otherwise. By conditions of possibility I mean the relationship between 1) the many aspects of one’s lived experience that impact what we do, think, and believe and 2) the systems and structures that we navigate as members of a global community.
Roe: From the Past to the Future
While possible developments like the overturning of Roe are worth fearing and preparing for it is important to keep in mind all that is at stake. Beyond the topic of abortion, there are myriad issues concerning the criminalization of pregnant people that an unyielding focus on abortion hides. It is more than just the criminalization itself that should be a topic of concern; it is also the overarching societal mechanisms at play that influence and impact behavior, especially during times of crisis.
Reproductive justice requires an intersectional approach that recognizes that laws and societal norms do not exist in a vacuum. On the structural and interpersonal level there are multiple factors that impact actions and belief systems. When thinking about and considering solutions to problems regarding reproductive justice it is important to keep in mind the violent histories that birth legislation as well as the carefully-designed systems that seek to control our lives.