If Oz is the common ground of culture wars, Will Saletan is the Tin Man. He doesn't need brains, he doesn't need courage, but the guy needs a heart.
Will is a provocative writer on subjects I spend a lot of time thinking about -- abortion, contraception and reproductive technologies. As a professional in the field of reproductive and sexual health, I generally appreciate his thoughtful, outsider perspective. But every now and then he writes something that makes me double down on my commitment to a pro-choice perspective.
Today it is this recommendation:
"For liberals, that means taking abortion seriously as an argument for contraception. We should make the abortion rate an index of national health, like poverty or infant mortality."Abortion as a rationale for contraception? Why not women as the rationale for contraception? Why not children as the rationale for contraception? Why not healthy sex as a rationale for contraception? My support for birth control education and services is grounded in my belief that everyone has to make their own decisions when it comes to the most intimate, important, life altering aspects of human experience - sexuality, pregnancy and parenting - regardless of whether I agree with their decision or not.
Take the 2000-2001 Guttmacher Institute finding that of 10,000 women who had abortions:
"...28 percent said they had thought they wouldn't get pregnant, 26 percent said they hadn't expected to have sex and 23 percent said they had never thought about using birth control, had never gotten around to it or had stopped using it. Ten percent said their partners had objected to it. Three percent said they had thought it would make sex less fun."
Will Saletan concludes this is a "failure to teach, understand, admit or care that unprotected sex can lead to the creation - and the subsequent killing, through abortion - of a developing human being."
Will is right. This statistic is a story of failure and it is not simply one of access. But Saletan's solution shows a failure of imagination and of compassion. In these statistics I hear the voices of women who lack basic information about their own bodies' reproductive cycle. I hear the voices of women who had sex when they didn't want to. I hear the voices of young women who have not yet learned how to distinguish their desire for affection or affirmation or even their desire for sex in a way that lets them take control of their destiny. I also hear the voices of women who have not yet learned to respect their own body and their capacity to give life, but I do not hear any woman saying "I didn't know abortion would end a life or potential life."
For me, the value of this work is not solely about reducing abortions, or even unintended pregnancies. It is about creating a sense of ownership among women and men -- old and young -- about their own body and their relationships with others because this ownership is a key to healthy bodies -- bodies free of substance abuse; healthy relationships -- relationships free of coercion or violence; and healthy children -- children who are born to parents who are ready to commit to their obligations as providers, caretakers and role models.
Yes, we all should be more thoughtful and deliberate about our sexual and reproductive lives. Speaking for myself, though, I'm not motivated to do this when some elite white male points his finger at me and says, "What is wrong with you? Why don't you see the world the way I do? If you would only do what I think is right we could all be in Oz." So Tin Man, don't forget to ask for that heart. And maybe a little humility.
Related Posts
There has been a surprising amount of chatter about what President-elect Obama should, or more often should not, say and do when it comes to the "hot button" issue of abortion; namely nothing. That's a shame because I believe President-elect Obama can teach us all a thing or two about respecting the choices that other people make in their lives and carrying that respect through into our public policies.
I don't know what decisions the incoming administration will make when it comes to health care policies, but the principles that will inform those choices are clear. The President-elect's choices will demonstrate a grasp of the facts as we know them and not just as we wish them to be. They will be grounded in his faith in people's ability to make change in their lives. And they will be infused with a vision for change that asks people to pitch in and work harder and look after not only ourselves but each other.
What could this mean for policies related to abortion, pregnancy, parenting and prevention? At the least, we can expect to see a greater national and international commitment to information and services that help individuals prevent unwanted pregnancy or disease. An emphasis on education that helps young people develop respect for themselves and cultivate healthy relationships with others. We can expect to see nomination of justices who respect individual autonomy and privacy. We can expect proposals for health care reform to include the full range of reproductive health care services a woman might need throughout her life. We may even see policies that expand opportunities and resources for women who want to carry a pregnancy to term but need to heal from the injuries of violence, trauma or addiction.
And we can expect something more. Throughout his campaign, Senator (now President-elect) Obama demonstrated his ability to use the bully pulpit to reshape the discourse of political "wedge" issues. This election season showed the public is ready for a conversation that respects their intelligence, provides vision, and helps us all move past the old divisive and frankly tired arguments. Among voters and advocates alike, there is a weariness of the same old contentions that get us nowhere, make enemies out of those who may disagree, and don't represent the real individuals who are most affected by our policies.
For a start, what if we -- as policymakers, advocates, and the electorate -- took seriously President-elect Obama's challenge to purge the condescension and judgment from our political and public discourse? What if we stopped the name calling, stopped belittling deeply held beliefs about life, marriage, commitment and what it means to be human; stopped shutting our eyes to the fact that sometimes life doesn't turn out like we planned and we struggle to live up to our own ideals?
When it comes to the complex issues of abortion, sexuality, pregnancy, and parenting, we could have a debate that acknowledges that each one of us wrestles with making sense of these intricate subjects. We could have a debate that recognizes it is not just "those women" who have abortions, but that any woman who is pregnant may be faced with circumstances that lead her to conclude she cannot have another child and that she is unprepared to place a child for adoption. We could have a debate that moves beyond the question of whether abortion should be legal and instead tackles the persistent and troubling disparities in birth outcomes for African-American and Caucasian women.
We can only do this if we uphold what one of my colleague calls the "sacred authority" of an individual to make his or her own decisions at the center of our policymaking. But, as President-elect Obama reminds us, we cannot afford to rely only on a libertarian or individualist world view. To realize and truly respect decision making, we have to work together to create more opportunities and options for people to aspire to change their circumstances and live with health and dignity.
Our dire economic reality may allow only limited progress on some of our most pressing domestic policies. But this is a time when changing our attitudes and our discourse will lay the groundwork for a generation of policy change. We can't afford to judge each other, and if we truly want to "look out not only for ourselves but for each other," let's foster respect and support for a woman's decision making, and further our understanding of the role each of us and our institutions can play to help individuals live up to their own beliefs and ideals. I know President Obama isn't looking forward to starting in-depth public conversations on contentious cultural issues, but when the subject comes up, we have a leader who can help us move forward.
]]>A bit of background: At the suggestions of some of my fellow RH Reality Check writers, Amy Harmon of the New York Times contacted me at the end of last week to ask whether things like prenatal tests might change the debate over abortion. Her subtext question was where would we [pro-choice advocates] draw the line between acceptable and unacceptable reasons for ending a pregnancy?
I was happy to take this call because the Reproductive Health Technologies Project has given a lot of thought to whether and how we think genetic tests offered during or before pregnancy should be made available. We put together a statement on this subject (PDF) after a year of internal discussion and external consultation with bioethicists, genetic counselors, patient groups, and advocates in disability rights, social justice and reproductive health.
In the interview I embraced the impulse to draw the line between what is acceptable and what is not. We all do that for ourselves everyday—it is a basic condition of being human. Sometimes, because this is a less than perfect world, where we draw that line depends on the circumstances we are in. In the case of abortion, these circumstances include the quality of our intimate relationships, the existing demands of a young family or an ailing parent or spouse, the realities of a limited income, or the need to get our feet on the ground before taking on the responsibility of becoming a parent.
Every person's circumstances are different and our society is built on the premise that people should be able to practice their own morality or faith. So in a society as rich and diverse as ours it seems inappropriate, indeed maybe even wrong, to impose my moral sensibilities and values on someone else. These are life changing decisions. How can I tell someone they have to do what I think is best for them? That is the essence of the pro-choice mission, so "no" I said to Ms. Harmon, "I don't think these tests will change the debate over abortion."
That boiled down into a pull quote "an abortion-rights group said it couldn't define the line, ‘firm and clear.'"
Insert Homer Simpson "d'oh!" head slap here. (To be fair, the direct quote makes it clearer that my problem is imposing that definition on someone else.) I should have seen that coming. Our refusal to set limits is part of what makes people believe abortion rights advocates are out of step with the public.
However strong the demand for a simple answer, I cannot step away from the principle that it is individual women, in the context of their lives, their families, and their communities, who must make the decision about which child to have or when. Banning a specific use of a technology does not guarantee the desired outcome of every child loved and cared for regardless of their genetic makeup. That is a much larger task.
While I cannot make the decision for someone else, I can redouble my efforts to ensure that those decisions are made in an environment of opportunity rather than limitation. Ironically, I met someone later that day who works with a disability rights organization. She told me that for the first time ever, the average cost of renting a studio or one bedroom apartment nationwide exceeds the average monthly social security insurance payment received by someone with a disability.
So, if I had it to do all over again, I would have said "These tests probably won't change the abortion debate, but I hope they spark a more meaningful debate about what kinds of supports we are prepared to offer to individuals and families living with disabilities." This incident also led me to reach out to the American Association of People with Disabilities and the Disability Policy Collaboration to learn more about their policy and educational priorities so that I may more knowledgeably advocate for those priorities.
]]>Kirsten Moore is President and CEO of The Reproductive Health Technologies Project (RHTP).
This was the best Halloween ever. No tricks, just one big treat. After three long years of denial and delay, the new ‘dual label' packages of Plan B were shipped out last week. That means sometime this week, those of us who are 18 and over and have identification to prove our age should be able to walk into area pharmacies and buy Plan B without a prescription. There is a difference of opinion within the reproductive health and rights community about whether this current situation constitutes a victory. Recently I was involved in a lively email exchange with a colleague who takes strong issue with my use of the word "victory" to describe the Plan B decision. He rightly points out that "the FDA's approach [to Plan B] violates fundamental principles of bioethics, including beneficence, autonomy, and justice." That it does. And I will continue to fight to make sure that when the moment is right, the FDA and Barr roll back the unwarranted restrictions on access to Plan B. In the meantime, though I am celebrating the fact that Plan B will be easier to get for many and that we arrived here with the Administration's begrudging acquiescence. Why do I believe this?
]]>Kirsten Moore is President and CEO of The Reproductive Health Technologies Project (RHTP).
This was the best Halloween ever. No tricks, just one big treat. After three long years of denial and delay, the new ‘dual label' packages of Plan B were shipped out last week. That means sometime this week, those of us who are 18 and over and have identification to prove our age should be able to walk into area pharmacies and buy Plan B without a prescription. There is a difference of opinion within the reproductive health and rights community about whether this current situation constitutes a victory. Recently I was involved in a lively email exchange with a colleague who takes strong issue with my use of the word "victory" to describe the Plan B decision. He rightly points out that "the FDA's approach [to Plan B] violates fundamental principles of bioethics, including beneficence, autonomy, and justice." That it does. And I will continue to fight to make sure that when the moment is right, the FDA and Barr roll back the unwarranted restrictions on access to Plan B. In the meantime, though I am celebrating the fact that Plan B will be easier to get for many and that we arrived here with the Administration's begrudging acquiescence. Why do I believe this?
The Reproductive Health Technologies Project has advocated for better awareness of and access to emergency contraception since 1992. We are not a membership organization, we do not provide services, and we do not take money from drug companies. We got involved simply because it made good sense and frankly, because at the time, few others in the women's health community, particularly pharmaceutical companies, were prepared to do so, so we set out to make easier access to EC a common sense, common ground issue in the overly heated abortion debate.
We knew an over-the-counter (OTC) switch - although the right thing to do from a public health perspective and one that was ultimately endorsed by groups like the American Academy of Pediatrics and the American Medical Association - was a high profile political gamble, but we thought "Bring it on. This is one we can win." We had confidence that with science, facts, and process on our side, we could navigate opposing beliefs and opinions, settle differences fairly and move forward in a diverse society.
And for one brief moment in December 2003 when experts went through the process of critically evaluating the science and the facts and hearing from interested parties, including those who opposed the switch, at the FDA's Advisory Committee meeting, we thought we had prevailed. Some of my colleagues (and I'm sure you remember who you are) were not shy about letting me know that my optimism was naïve. They were right - at least for a time.
Looking back, it shouldn't have been a surprise that our ‘common sense, common ground' strategy wasn't enough because ultimately this wasn't just a debate about abortion - the dispute over how EC works notwithstanding. As others have written it was also an early sign that our political opposition would start going after contraception and sex. But I think the debate over easier access to EC exposed a fundamental underlying difference in worldviews that helps explain different positions on issues of sex and contraception as well as abortion: whether and how much we, as a society, trust each other to do the right thing.
Those who oppose easier access to EC believe you can't trust women, you really can't trust men, and you certainly can't trust young people. In their world, Plan B gives everyone an excuse to behave irresponsibly and avoid consequences. In my world, Plan B simply gives people a second chance to avoid an unwanted pregnancy which is good because I believe people try to do the best they can and even when they don't - or when their best wasn't good enough - they can own up to their mistakes and try to do better next time.
The FDA's decision on August 24 to ease access to Plan B emergency contraception was long overdue and an important advancement for women's health. Of course much more has to be done to ensure any woman who needs EC can get it in a timely manner and in a way that does not insult her intelligence or autonomy. But the fact that we got a decision at all - not to mention one that had President Bush's blessing, albeit begrudgingly - make it a highly significant political victory.
Why did the political calculus at last tip in our favor? Well, probably not because the Administration believes in a second chance. After all, who needs a second chance when you're so damn sure you're right. More likely, the Administration didn't know what to do with the mess it had made. When it chose to ignore longstanding widely accepted processes for drug approval it found itself fighting not just women's groups but also scientists and physicians, and even disinterested politicians who don't like to see their colleagues dismissed out of hand. Scoring points with a political minority was not enough to outweigh the continual drip, drip of embarrassing detail provided in depositions of current and former FDA staff taken by the Center for Reproductive Rights as to how the FDA's decisions never matched its own review of the evidence.
So as OTC Plan B begins its journey to pharmacy shelves, I am celebrating. And waiting to see what this week will bring both with Plan B and in the larger picture of women's access to reproductive health care services across the country - undoubtedly a mix of bright spots and trouble spots. That's okay because the Plan B journey reminds me I am a glass half full kind of person. While my faith in science, facts, and process meant nothing to the Administration or political opponents in Congress, it turns out that the general public shared my faith. So whatever happens today, I will get up on Wednesday ready to keep working for a political world in which we try harder to understand and respect different points of view and, when necessary, prepared to give people a second chance to help others succeed.
]]>Kirsten Moore is President and CEO of The Reproductive Health Technologies Project (RHTP).
When state legislatures are passing abortion bans; when women are being denied access to birth control; when laws are enacted to criminalize pregnant women's behavior, it is easy to understand why some advocates and strategists believe the way to regain momentum is to focus on prevention of unintended pregnancy and abortion to highlight the extremism and hypocrisy of our political opposition.
Certainly, exposing the opposition's agenda will motivate some, but I believe we can and must do better. To really change the tone and direction of the abortion debate in this country, we have to acknowledge that most people are ambivalent about abortion. That's okay; uncertainty doesn't mean anti-choice. We should recognize - and indeed celebrate - that abortion is not the same lynchpin in women's equality that it once was. We must renew our efforts to build a policy agenda, organizing strategies, legal framework and long term message strategy that reflect the "pro-child" side of our "pro-choice" mission that will connect with people's hopes and aspirations for their future and their family's future.
]]>Kirsten Moore is President and CEO of The Reproductive Health Technologies Project (RHTP).
When state legislatures are passing abortion bans; when women are being denied access to birth control; when laws are enacted to criminalize pregnant women's behavior, it is easy to understand why some advocates and strategists believe the way to regain momentum is to focus on prevention of unintended pregnancy and abortion to highlight the extremism and hypocrisy of our political opposition.
Certainly, exposing the opposition's agenda will motivate some, but I believe we can and must do better. To really change the tone and direction of the abortion debate in this country, we have to acknowledge that most people are ambivalent about abortion. That's okay; uncertainty doesn't mean anti-choice. We should recognize - and indeed celebrate - that abortion is not the same lynchpin in women's equality that it once was. We must renew our efforts to build a policy agenda, organizing strategies, legal framework and long term message strategy that reflect the "pro-child" side of our "pro-choice" mission that will connect with people's hopes and aspirations for their future and their family's future.
Abortion is No Longer Effective Shorthand for Women's Equality
Let's start by acknowledging that as a class, the position of women in the United States has improved; our view of ourselves, our potential, and our future has expanded dramatically. Of course discrimination, gender stereotypes and biases still exist - particularly for poor women and women of color - but as a society we have largely accepted that women have a right to a future outside of their home and an identity independent of wife and mother.
Many of us in the pro-choice movement believe that abortion and the right to control our reproductive lives is at the center of that power and that potential. Thirty years ago, when biology was a woman's destiny, it was. But today, with more and better birth control options and greater acceptance of different family structures, including single parenting, abortion is something that should be available when other options fail. It is a means to an end that comes with lots of nuance, consequences, and shades of gray.
Abortion is Not Just About a Woman
Embracing that nuance means putting abortion into a bigger frame than a woman's "right to choose." Neither the individual aspect of that frame nor the choice part accurately captures the ways women make decisions about whether to carry a pregnancy to term, nor the barriers that many face when making those decisions.
While, it is true that our opposition has successfully fetishized the fetus, it is also true that Roe v. Wade struck a balance between the interests of the woman and the fetus. Technological advances are changing the public's perception of that balance. In a 2005 survey conducted by RHTP, four in ten respondents, including one in five who describe themselves as "solidly pro-choice," agreed with the statement, "Now that I've seen a sonogram picture, I feel more supportive of restrictions on abortion." Rather than ignore the value people place on a fetus, on pregnancy, why not work with that?
Beginning the Next Chapter in the Story
By respecting the conflicting feelings people hold about abortion, we will connect strongly with the so-called "abortion grays". By acknowledging that - thankfully - most women don't make the decision to end a pregnancy alone, we can ask for understanding and empathy. By reminding people that the decision to become a parent is one of the most important any one can make, we can ask them to respect a woman's decision if she is not ready to become a parent; we can remind them this is why we need to keep abortion available.
Most important, by tapping into the aspirations around pregnancy and being a parent, we can begin the real work of strengthening the ability, the capacity, and the right of each person to shape a future for oneself and one's family in our communities, our country, and our world. And that is where the next chapter begins.
While advocacy and support for policies which seek to reduce the rate of unintended pregnancy and the need for abortion are an integral part of the pro-choice movement's mission, it is time to go further. We can build support and resources for women who are trying to get out from under a substance abuse problem or a violent and coercive relationship. We can seek better information about ways to reduce exposure to toxins in everyday products that make it harder for women and men to conceive when they want to. We can hold our governments accountable for providing a secure environment that will enable families and local communities to thrive.
To recapture our movement's role in delivering on the hopes and aspirations of so many, we must align ourselves with a broader progressive vision that delivers on the value of caring for others while simultaneously upholding individual autonomy.
]]>Editor's note: A version of this article will appear in Conscience Magazine next month. RH Reality Check would like to thank our friends at Catholics for a Free Choice for sharing it with us.