Choice, not Chance

by zic

In November 2012, a splattering of headlines declared that the UN called contraception a universal human right. in a new report, By Choice, not by Chance

When a woman is able to exercise her reproductive rights, she is more able to benefit from her other rights, such as the right to education. The results are higher incomes, better health for her and her children and greater decision-making power for her, both in the household and the community. When women and men together plan their childbearing, children benefit immediately and in their long-term prospects.

This is the first time the UN had ever referred to contraception as a universal human right; and the report’s Executive Summary, written by Dr. Babatunde Osotimehin, the executive director of the UN’s Population Fund, lists the compelling outcomes that justify viewing reproductive or family planning rights as a universal human right, one with implications for women, children, and also men. But our fraught debates about religious rights vs. reproductive healthcare indicate reproductive-healthcare rights are not perceived as universal in the United States, reproductive rights are not accepted as an inalienable right, and there is no compelling force behind the UN’s suggestion that should be.

Many people, organizations, and nations perceive reproductive healthcare as trampling natural moral law. Andrew M. Greenwell, Esq. responded to Dr. Osotimehin as in Catholic Online:

 “Family planning is a human right,” wrote Dr. Osotimehin.  “It must therefore be available to all who want it.  But clearly this right has not yet been extended to all, especially in the poorest countries.  Obstacles remain. Some have to do with the quality and availability of supplies and services, but many others have to do with economic circumstances and social constraints.”

By this latter, Dr. Osotimehin certainly has in mind the Catholic Church and the natural moral law.  He has previously commended Melinda Gates, and her decision to use Bill and Melinda Gates Foundation to expand the reach of artificial contraception in the heartland of Sub-Saharan Africa and South Asia in direct contravention to the Catholic Church’s moral teachings.

Dr. Osotimehin seeks to spend an extra $4.1 billion a year to make family planning available to anyone who wants it.  “Family planning is still more akin to a privilege enjoyed by some rather than a universal right exercised by all.”

Dr. Osotimehin is morally obtuse:  “Women who use contraception are generally healthier, better educated, more empowered in their households and communities and more economically productive. Women’s increased labor-force participation boosts nations’ economies.”  He is oblivious to how contraception tramples traditional values, social conventions, and, what is more, the natural moral law.*

He does not seem to care about the vice such contraceptive technology institutionalizes and normalizes, and how it mars human sexuality.  He is nothing but a mouthpiece for a secular liberal worldview.

It’s “obtuse,” Greenwell says, to help expand contraception use; it’s obtuse to lessen the social constraint. I can’t help but wonder what he thinks of the rape or sexual coercion that one out of three women experience. I wonder what he thinks of Savita Halappanavar, who painfully died of sepsis in an Irish hospital in 2012 because the staff refused to abort her pregnancy. Was this tragic loss in keeping with the morals of social constraint? I he doesn’t really consider the thousands of women in Ireland banished from their families to group homes where they delivered their illegitimate babies, and who were then sold into indentured servitude, forced to leave their newborn infants behind. I imagine he holds high regard, rightfully, for the good-hearted the nuns who nursed these women through their pregnancies and deliveries, who cared for, raised, and buried their bastard children in unmarked graves, because (despite the hyperbole) their charges were baptized and buried in accordance with the social restraint reserved for bastard children.

Social restraint can lead to evil outcomes, too.

Here in the United States, we are blessed to be one of the first places where a majority of women have had general access to modern reproductive health care,  including contraception and abortion. Griswold and Roe v. Wade opened the doors for reproductive healthcare as medical privacy, but social constraints still present significant barriers for many women, particularly for women who live in poverty. PPACA, or Obamacare, requires identifying the essential healthcare needs particular to women that had been underserved; and it mandated providing basic, preventive services without co-pay, for services where women’s essential needs went unmet. And thus the contraceptive mandate was born; a legal compulsion to end discrimination against women in health insurance to cover women’s reproductive healthcare needs that aligns with the UN’s call to consider reproductive rights as a universal human right.

I’ve lived through this change; I was born in 1960, the last “official” year of the baby boom. I think it would be pretty safe to attribute the end of the baby boom to birth control pills, which were approved for use in the United States in 1960 after a breathtaking race for a scientific breakthrough in hormonal contraception.

My great grandmother died in childbirth. It’s likely some of you have grandmothers or great grandmothers who did, too; maternal death being common up through the end of the 1800s. Thankfully, maternal health care has advanced radically, and we don’t live in Emily Bronte’s Wuthering Heights world, where all the mothers are either already dead or at risk from of pregnancy and birth.

My grandparents all came from big families, of four or more children; my paternal grandmother had nine brothers and sisters. I’m the middle of seven pregnancies my mother had, and my peers in school also had big families; back in the day, being an only child was weird. As families got smaller, women could get educations and enter the work force, one of the primary factors leading to the growth in the US economy over the last 50 years:

My mom gave birth to my oldest sibling in the early 1950s. She was just barely 16, and had just finished her freshman year of high school. An abortion would have been a dangerous and illegal affair; girls “went abroad” only if they were wealthy enough. They had polite shotgun weddings if they had family that marginally stood up for them. Failing that, they became mothers with bastard children, pretty much abandoned by society. My mother had a second child a year after the first, and a third two years later, a girl born with “severe spinabifida” — the family terminology – my mother told me they didn’t feed her in the hospital, and she starved to death after three days. Then I came along, born in 1960, the year of the pill, and the end of the baby boom. Another sister died two years after me, also from severe spinabifida, also likely from starvation. The next boy would also have died just a year or two earlier. He was born with a birth defect, not spinabifida, and after major surgery (done without anesthesia,) he survived; and the last of of her children was healthy, though we lost my baby brother from an allergic reaction to the AIDS cocktail in the late 1990s.

According to the CDC, “The average fertility of women in the United States was about seven children at the beginning of the 19th century, it declined slowly and by 1960 it was 3.7 children per woman. Fertility in the United States dropped to its lowest point in 1976 at an average of 1.7 children per woman and has remained relatively stable at around 2.1 children per woman.” My mother had seven children, the first at 16 and the last when she was 34. Now she’s 75 and a great-grandmother, and during her lifetime, family size has dropped significantly, to an average of 2 children. The rate of teenage pregnancy, abortion, and birthrate  has declined significantly since peaks in the 1990s:

1960 was the year things changed in so many other ways. Before, very few women become doctors, lawyers, politicians, business owners. During WWII, women had shown they could run factories to build tanks and planes, but those who worked went back to being maids, waitresses, teachers, nurses, secretaries, and most went back to the home and settled in for the Ozzie and Harriet life. When the pill hit the markets, a woman’s right to vote was barely a half-century old. That last is important to remember, because women’s rights rests on two thousand years or more or religious and social tradition that dictates women must be chaste and sexless to everyone but her husband, or she will potentially burn in hell. Her private property rights were flimsy and often non-existent. One of our most sacred social ceremonies, the wedding, stars the bride on her big day as her father gives her to her husband, a transferal of property. Before the awakening in the mid 1800s, women’s voices are almost completely missing from our written history and literature; more than two thousand years of words written down by 99.999% men, who often mansplain stuff they know nothing about.

You can’t have read this far without expecting something on the Supreme Court’s Hobby Lobby decision. My strongest objection to the Supreme Court’s decision is the misappropriation of conscience. A woman’s conscience, to do as she sees fit in accordance with her beliefs, is her own — particularly when she’s exercising her right to make private medical decisions about legal medical services. Funny thing is the data shows when women have the right to contraception, moral outrage to the contrary, women have demonstrated that, for the most part, they act morally.

Belief in any religion is voluntary. Community religious norms of female sexuality can be coercive (purity promise or you’ll burn in hell), and sometimes lethal (honor killing of rape victims or failure to perform a live-saving abortion), and As Greenwell shows above, religious social conservatives clearly understood that their religious norms are in conflict with the UN’s declaration. Contraception is a universal human right because it’s part and parcel of the right to bodily sanctity; and without it, women can never be fully equal. The weight of history provides evidence of thousands of years without women partaking of that history except as bystanders, reflections of the men who held the power.

It’s easy to be distracted by the question of “who pays,” because the Greens framed this as an exercise of their religion by refusing to pay for insurance they consider morally objectionable because it may cause an abortion. But this is not just a question about who pays. It’s a question about “who says.” It’s about who’s morally responsible, about just who is committing women’s perceived sins. The question extends beyond Hobby Lobby, to who is complicit in sin by doing something like providing comprehensive reproductive coverage, under the guidelines of U.S. law. The Greens are players in a long game about setting legal precedents about who says what kind of reproductive rights women can have. Their side would have that say shaped by their religious beliefs.

Ironically, women use contraception responsibly. We get all het up about the girlz gone wild, but the average family size of seven when my mother was in her childbearing years has dropped to two, which is how many children I have. Women’s responsibility is proven by the drop in teen pregnancy, family size, abortion, and by increases in education, career success, and economic well being.

The numbers of unmarried mothers are distressing, but calls for considering other things, including the importance of all people’s exit rights from marriage, the burden here on men to be better fathers and husbands, and a justice system that turns far too many fathers into felons for non-violent crimes. It is unfair to hold a discussion about single mothers without also considering the barriers to contraception and legal abortion so many women face, since this falls predominately on the poorest women in the US.

The numbers of unmarried mothers are distressing, but there’s some burden here on men to be better fathers and husbands. Women at least no longer need to spend their lives trapped in bad marriages, and we should also blame the justice system for turning far too many fathers into felons for non-violent crimes. It is unfair to hold a discussion about single mothers without also considering quite a few other things, including the importance of all people’s exit rights from marriage, and the barriers to contraception and legal abortion so many women face.

So my objection here is not about a question of access – we can achieve access to contraception with a myriad of different ways. My objection is to the war on the right to access, and that war flows mostly from religious belief, firmly established with Hobby Lobby’s victory in court.The weight of all history previous to the pill proves the point that without contraception, women cannot be equal. I don’t care what Greenwell writes or if the Greens tell their employees that they think certain forms of contraception are sinful; they have the right to free speech But I take deep offense when anyone tries to enshrine infringements on women’s human rights into law.

Women’s equality is a very new and precious thing. It’s a change that disrupts, no doubt. And I do feel some sympathy for those who feel threatened by that disruption. But my sympathy doesn’t dint my clear view of the kind of dignified, orderly, responsible life that was impossible before modern contraception. The data shows that it’s a change for the better, too – fewer maternal deaths, fewer infant and child deaths, fewer unplanned pregnancies, fewer abortions, and better economic outcomes.

Women have demonstrated they have, overall, great ability to exercise wisdom in controlling the Wuthering Heights of their fertility. Despite social constraints, women have historically tried to control their reproduction, often in ways that led to their own impairment or death. In communities and states like Texas, were there are high barriers to contraception, women in the United States are also taking matters into their own hands; everywhere, they are still attempting to exercise their own agency over their bodies. Judicial overreach that protects the Greens’ freedom to exercise their religious beliefs risks appropriating women’s reproductive rights based on belief instead of science. To borrow a word from Mr. Greenwell, it’s trampling women’s right to moral self-determination.

My preferred outcome, given what we have for a political system, legal precedent, and statute would be for employees working for corporate objectors to be covered by the government and or insurance companies in a way that seems seamless to the employee; while corporate objectors pay for their objection with a tax penalty exactly as real, non-corporation people pay a tax penalty when they decline to purchase health insurance, thus offsetting the rent-seeking objectors are placing on everyone else. There are two conflicting obligations here, first, not to overtly intrude on someone’s religious practice while second, not to violate another person’s universal human rights. I suspect any resolution that shifts burden from employers to insurers or government might not be will not ease the burden of conscience for some observant business owners opposed to any contraception.

With the advances in modern medicine, we consider the decline of maternal death a great achievement, and most people agree that a threat to the mother’s life provides justification to end a pregnancy. No one wants to see women die like Savita Halappanavar died. We celebrate the declines in infant mortality, as well. I’ll always be haunted by the brutal deaths-by-starvation my two infant sisters, and am grateful for the medical advances that both help identify severely deformed fetuses and help save their lives should their mothers opt to give birth to these children.

I live, every day, with the knowledge that had my mother had access to reproductive health care, including contraception and abortion (and I wish she had), neither I nor my siblings would exist.

Ironically, had contraception been available, there’s also a good chance she would have avoided pregnancy without it; ignorance plays a role in her story. Fourteen and just a few months into menarch, my mother said she asked her mothers where babies come the year before she got pregnant, when her mother gave birth for the last time. “The Indians bring it,” her mother told her, “but they break my leg, so I have to go into the hospital for two weeks.” This is sex education circa 1950, that golden era so many people want to revive. My mother wasn’t taught how to keep her body healthy, she was taught she was supposed to date from this group of good boys, but not that group of bad boys.

Unlike my mother, I chose to marry when I was 20. Contraceptives were readily available, but many of the things ACA calls for today weren’t yet on the market. Becaue of chronic migraine, I opted for less reliable methods, and I got pregnant. We’d been together for nine years, married for five, and would have waited longer, by choice. We decided fate had made the choice for us. Thanks to an inflationary bubble on malpractice insurance for ob/gyn’s in the 1980s, I still lived with indecision and agony over the pregnancy. Doctors were quitting the practice because if increasing premiums, and a lot of women without my high-risk family histories had trouble finding doctors. Because of my mother’s reproductive history, I couldn’t find a doctor; I was an insurance risk, and maternal insurance coverage was optional. Finally, my awesome doctor agreed to deliver my baby if I’d agree to have an amniocentesis, so at 16 weeks, a technician held an ultrasound paddle to my tiny baby bump, and my doctor stuck a giant needle through into my uterus next to the fetus we could see floating on the screen. Tiny heart, fluttering. Spinal measurements, good. But sixteen weeks is far, far too early to see neural-tube defects, and the costly genetic profiling in a 1980’s medical lab took ten long, long weeks to receive; putting an action based on the results of the genetic testing I was required to receive at the end of my second trimester or the beginning of my third. My choice would have been made with consideration of my two sisters, starved after nine months of pregnancy; I would have aborted, and it would have been likely been a late-term abortion. This is a tremendously difficult thing to consider, something I cannot imagine any women taking lightly, something it appalls me that so many people think women do take lightly.

We cannot change what was, I can’t give my mother back her innocence by undoing myself, and I can’t imagine life without my eldest. Yet if I could give my mother the agency to make these choices for herself, in accordance with her own conscience, I would opt to never have been.

To be forced or coerced into pregnancy because someone else’s beliefs interfere with her self-determination absconds a woman’s control of her body. Even worse, it’s absconds with her moral agency; and recognition of that agency is tenuous at best; 2012, when the UN first called contraception a universal human rights, was just a few days ago; 1960 too recent to have aided my mother. Universal rights aren’t earned, but if they were, the facts show that for the most part, women who have access to contraception and reproductive healthcare reproduce responsibly.

Thank you to Jason Kuznicki for his help editing this, any errors you find were introduced with my re-write. His efforts made this a much better piece. (And editors, feel free to correct the grammatical ones, please. I rely on the kindness of editors.)

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