Doctors for the rich, coathangers for the poor?

Yesterday marked the 37th anniversary of Roe v. Wade. It is among the most controversial Supreme Court decisions in U.S. history, and each year those for and against legalized abortion face off in what seems to be a never-ending battle.

As I am fiercely pro-choice, I can accept that some women believe abortion is wrong. But I will never accept the right of the government to take this choice away from women–well, to take the choice away from poor women. What is often missed in the debate is this: women of means will always have access to abortion while poor women may be forced to make life-threatening decisions should abortion be made illegal or otherwise inaccessible.

I was reminded of just how dire things were for women with unwanted pregnancies prior to Roe v. Wade as I watched a screening of The Coathanger Project in Arlington, Va., yesterday. And, I was surprised to learn a generation of young women make no connection between coathangers and abortion. Coathangers have been a symbol of the form of dangerous self-induced abortions many desperate women in the United States once performed, and that women around the world still perform.

According to the Guttmacher Institute, which works to make advances in sexual and reproductive health worldwide, roughly half of the three million pregnancies in the United States each year are unintended. By age 45, more than half of all American women will have experienced an unintended pregnancy; one-third will have had an abortion. Worldwide 60,000 to 80,000 women die annually from unsafe abortions with an additional 5 million suffering injury.

Women, particularly poor women, are shortchanged again and again. Despite the fact that women bear future generations, we are given little support in doing so. One need only look to the stalled health care bill currently before Congress to see just how low a priority is given to women’s health. Pelvic exams, domestic violence screening, counseling about sexually transmitted diseases, and birth control itself were not initially on the list of basic benefits all insurers must cover. In its fact sheet on contraceptive use, the Guttmacher Institute notes that virtually all women (98 percent) aged 15 to 44 who have ever had intercourse have used at least one contraceptive method.

“Without publicly funded family planning services, the number of unintended pregnancies and abortions occurring in the United States would be nearly two-thirds higher among women overall and among teens; the number of unintended pregnancies among poor women would nearly double.” – Facts on Publicly Funded Contraceptive Services in the United States, Guttmacher Institute, February 2009

Whether abortion will be covered remains to be seen. The health care bill may be dead in the water. But, as it is, poor women and those in the military are expected to pay for abortions out of pocket since Medicaid and military hospitals are prohibited from funding abortions while wealthy and middle class women with health insurance do not face similar restrictions.

At the same time, some would have the government take things a step further. Numerous politicians have proposed legislation that would control the fertility of women as a condition of welfare eligibility with forced birth control or sterility. Just don’t ask the government to pay for said birth control. (Many health insurance plans didn’t cover birth control until women discovered they were covering prescriptions for Viagra. Thank you Viagra.)

This puts poor women in a damned if you do, damned if you don’t position. What right do we to have to control when or if a woman bears children simply because she has the misfortune to be poor? Some may argue that people choose to be poor. Unfortunately, in reality, being poor is more often a circumstance of birth. Rather than blame those who are born into poverty (or to suggest that the poor do not have the right to have children–no, we won’t go there) we need to be holding our government accountable for perpetuating a system that traps people into generational poverty.

According to the Bureau of Labor Statistics, in 2008, there were 2.2 million workers earning wages at or below the minimum wage. And more than half of the 37 million people in this country living in poverty in this nation are women.

Attempts to control women’s reproduction at the expense of her health and personal freedom come from all sides. A recent report by NARAL Virginia, found 72 percent of the Commonwealth’s crisis pregnancy centers receiving state funding relay medically inaccurate information to pregnant women. The year-long undercover investigation found that many of the centers, under the guise of being a health clinic, provided inaccurate, and potentially dangerous, information–one investigator was told “the AIDS virus is smaller than the holes in condoms.”

“Despite knowing that their clientele is sexually active and requesting birth control and contraceptives to prevent future unintended pregnancies, these centers choose to only promote abstinence. One investigator, asking about how to engage in safe sexual activity was told, ‘Sex is like jumping on a bed when your are young–it’s really fun until you crack your head open.'” – Crisis Pregnancy Centers Revealed, NARAL Virginia, January 2010

It is one thing to be up front with women when telling them why you believe abortion is wrong. It is quite another to use deceptive practices and scare tactics to prey on women in a vulnerable position, particularly college students, young single women, minorities and those who do not have health insurance or financial means. Further, suggesting that birth control will not work to prevent pregnancy or sexually transmitted diseases borders on criminal negligence.

And crisis pregnancy centers are not the only use of public dollars to fund a political and religious agenda set on controlling women’s reproduction. Despite the Obama administration’s elimination of $150 million for abstinence-only programs, the Senate’s health-care reform legislation would reinstate $50 million.

Of course such disregard for women is not restricted to abortion and birth control. The needs of pregnant women, including those who planned for and want their babies, are also ignored. Doctors routinely put their needs above the needs of their patients when it comes to labor and delivery, from unnecessary cesarean sections to refusal to allow a VBAC (vaginal birth after cesarean) to the American Medical Association’s longstanding recommendation against home birth.

Ladies, and gentlemen, it is time we all stand together and demand something better.

By Jennifer E. Cooper