This is the first installment in a two-part roundtable about the effects of Roe v. Wade as the case’s 40-year anniversary comes to a close. Part two, featuring essays from scholars whose work is based in Germany and Africa, respectively, will be published tomorrow.
Women of the World Unite?: U.S. Politics of Reproduction at Home and Abroad
by Risa Katzen
40 years after Roe v. Wade, abortion still raises a host of questions with no easy answers. What are the limits of a woman’s right to make her own reproductive decisions? When should the unborn be afforded legal rights? When is it appropriate for the government to intervene in family planning?
Since our answers to these questions are grounded in our intuitions about reproductive rights generally, I’d like to use Roe’s 40th anniversary to consider a broader history of reproductive freedom in the United States. In my mind, three often obscured points loom large:
1. A woman’s ability to safely terminate an unwanted pregnancy is directly linked to her socio-economic status.
2. Restrictions on reproductive freedom can take several forms—limiting women’s access to safe abortions is only one of them.
3. These two themes play out in international as well as domestic contexts because of U.S. foreign aid requirements.
Before the Supreme Court handed down Roe, race and class conditioned American women’s reproductive options. Even when abortion was a crime, the question was never whether women in the United States could end unwanted pregnancies, but rather which women could do so safely. Take, for example, abortion statistics from the Great Depression. Historian Leslie Reagan found that 84 percent of white, middle-class women who terminated pregnancies in the 1930s did so through physician-induced abortions and that 91 percent of them reported good health following the procedure. Low-income and black women had fewer options. They relied on self-induced abortions at a much higher rate, roughly 76 percent of which resulted in medical complications or death. Today, even pro-choice narratives often gloss over the facts about who, exactly, did most of the suffering and dying when abortions were illegal.
Before Roe, poor women and women of color confronted other infringements on their reproductive freedom. For black women in particular, the quest to control their own reproductive destiny was more tied to challenging state policies of forced sterilization than to ensuring abortion access. In the Jim Crow South, limiting the fertility of black women worked to shore up white supremacy: the most famous example of this phenomenon is probably civil rights activist Fannie Lou Hamer, who went to a Mississippi hospital in 1961 to have a tumor removed and came out with a hysterectomy. But Hamer wasn’t alone. In 1960, roughly 60 percent of black women living in Sunflower County, Miss., had been sterilized at some point in their lives. Only the concerted effort of civil rights activists, exemplified by Hamer herself, ensured that this practice would be stamped out for good.
American efforts to police the intimate matters of indigent women also crossed national lines. Like black women living in Southern states, Latin American, African, and Asian women confronted powerful campaigns designed to limit their reproductive potential. In the 1960s, concern over exponential population growth encouraged the U.S. State Department and American NGOs to participate in a transnational campaign to limit fertility rates in the “Third World.” The consequences of U.S. support for this aggressive form of social engineering proved devastating.
Take, for example, U.S. involvement in India’s family planning program: In 1966, President Johnson refused to grant additional food provisions to Indians unless the country’s leaders “got their population numbers under control.” Desperate for U.S. aid, Indian officials continued promoting the use of cheap IUDs, even after reports linked them to pain, bleeding, uterus perforation, and ectopic pregnancy. The Indian government even took to conditioning grants of money and food to those who agreed to sterilization. By the late 1970s, the government ushered its citizens into sterilization “camps” without any compensation whatsoever. Despite the United States’ commitment to the Universal Declaration of Human Rights—a document that emphasized the equality of all human beings regardless of “race, class, sex…or other status”—American reproductive policies abroad unleashed forces that betrayed these principles.
The complex history of reproductive freedom before Roe can improve our understanding of family planning policies today. In 2013, the United States is still a country that provides greater reproductive freedom to women with financial resources than those without them. A woman living in Kansas, Wyoming, or Texas, for example, might have to travel 150 miles to get to the nearest abortion clinic. At that point, she will have to find lodging near the clinic in order to fulfill a compulsory two-day waiting period. She might then be subject to parental consent requirements and an ultra-sound. A woman with greater means can simply travel further, to a state with fewer restrictions, and avoid these obstacles. Thus, restrictions on abortions since Roe aren’t, in fact, limiting all American women’s access to the procedure. They’re placing a significant burden on poor women’s shoulders.
The trajectory of American foreign policy regarding reproductive health care reflects these developments. Just as judiciaries around the country struck down state policies of forced sterilization within the United States, the country’s commitment to “population control” abroad increasingly fell into disrepute. Probably the most significant factor that encouraged politicians’ change of heart was that in the late 1970s and 1980s, the rate of population growth began to stabilize. As it turned out, educating women living in the developing world—not coercing them into using modern contraceptive devices—proved the most effective way to reduce fertility numbers. With improved education and greater access to employment opportunities outside subsistence farming, many women chose to bear fewer children.
Unfortunately, just as Americans abandoned their global “population control” campaign, the New Christian Right championed its anti-abortion agenda in foreign policy circles. Today, the Helms Amendment prohibits recipients of aid from using U.S. funds to perform abortions, even in countries where the practice is legal, and even in cases of rape or incest. More disturbingly, every Republican president from Ronald Reagan to George W. Bush imposed a “gag rule” prohibiting organizations that receive U.S. foreign aid from even discussing abortion. It’s hard not to be disillusioned by these developments. Time and again, poor women keep finding themselves on the losing side of history.
Four decades after Roe, debates over reproductive rights aren’t getting simpler or less emotionally fraught. The rhetoric of “choice” remains of limited analytical utility. First trimester abortions are legal, but other social hierarchies like race, class, and nationality shape women’s reproductive options. The choices at a woman’s disposal continue to serve as an index of her vulnerability. Since I began with a few difficult questions, I’ll end with another: What would the world be like if the resources put into debates over reproduction went instead toward improving the welfare of poor women and children?
Risa Katzen is a PhD candidate in U.S. history at Stanford University.
From "more people, more power" to "bearing fewer, bearing better": Controlling Reproduction in China
by Yvon Wang
Chinese men and women in the past, like their counterparts in many agrarian societies before the 20th century, saw being fruitful and multiplying as a critical life goal. Children were a form of insurance against old age and a potential avenue of upward social mobility for the whole family. Having plenty of them was a countermeasure to high childhood mortality rates. Statistics are unreliable, but most historians agree that, when leaders of the new Republic of China government took over the country from the last emperor in 1912, they were putting themselves in charge of about 400 million people. This was the largest population of any polity in the world by far; it was over four times the U.S. census figures of that time.
Some Chinese parents-to-be chose to end pregnancies with methods that often posed fatal dangers to mothers; infanticide, almost always of girls, was also common. These ways of limiting fertility, just like the need for heirs, were common all over the world before reliable forms of contraception were widely available. But in China, heightened competition for scarce resources had escalated along with the population during the 18th and 19th centuries, and despite punitive measures by the state (for example, sentencing the providers of fatal abortifacients to death), such practices were widespread.
By the turn of the 20th century, a new generation of Chinese intellectuals and policymakers had begun to see these burgeoning masses as a detriment not just to China's internal stability, but also to the nation's geopolitical clout. Eugenics was widely touted by leaders in medicine and social science. They endorsed both "positive" eugenics to increase the numbers of the genetically gifted—who also usually happened to be financially well-off—and "negative" eugenics to reduce growth among the "defective." But abortion was illegal as a paid service. Some eugenicists even viewed contraceptives on the open market as detrimental to their goals, since it was almost always the elite who were supposed to especially endeavor to reproduce their superior genes that sought most strongly to control their fertility.
However, political disarray and war through the first half of the 20th century meant that any official line on fertility control was virtually impossible to enforce, much less a rigorous regime of selective reproduction. The result was that women continued to risk their lives by paying for illegal abortions, including procedures in which acupuncturists inserted six-inch-long acupuncture needles into the patient's abdomen.
After the Chinese Communist Party took over the Mainland in 1949, policy on families and reproduction became much more deeply integrated into everyday life. Formally instituting "free marriage," for instance, was one of the earliest of the CCP's massive reform measures. But during the Maoist years—the 1950s through the 1970s—the party-state was preoccupied with rehabilitating the economy, shoring up political control, taking sides in the Cold War, and conducting massive campaigns and purges, most infamously the Great Leap Forward and the Cultural Revolution. So the People's Republic did not clearly mark out a consistent agenda for its citizens' reproductive lives until after Mao's death, when trade and diplomacy with the West was opened anew.
When leaders did turn their attention to birth control, however, they did so with a hard-line approach. In the late 1970s as in the early years of the century, improving the "quality" of China's people was seen as necessary for becoming fully modern and globally competitive. Nine years after Roe v. Wade, a new PRC constitution made birth planning an obligation for all citizens. Provinces and local governments began to more strongly enforce the "one-child policy." Propaganda slogans such as "have fewer kids, plant more trees" hand-painted on the walls of village houses were a common sight in the eighties and nineties.
The policy's problems are well known. Some women were forced to have abortions; both men and women have been sterilized; combined with the spread of technology providing information about a fetus's sex, stringent birth rules may have helped create the sharply disproportionate ratio of men to women in China today. On the other hand, there were many exceptions to the "one-child policy," depending for example on where the parents lived, whether they had siblings, and the sex of their firstborn. Rural couples who had one daughter could, after three or four years, legally try again to have a son.
The government has also been inconsistent—or, to put it more positively, adaptable. In the late 1980s, there was some measure of relaxation in the policy, followed by a new tightening in the early '90s. For the last 20 years, the PRC has emphasized reforms to clean up the program's administration. And, just in November of this year, a major easing was announced: where previously a second child was allowed only if both parents were only children themselves, now only one parent had to meet this requirement.
While some of the effects of the "one-child policy"—nationwide abortion access, widely available contraception, reduced physical and care-giving burdens on women—might appeal to supporters of Roe, the PRC's intervention in the reproductive lives of its citizens is, of course, diametrically opposed to the ideals of personal reproductive choice that Roe's proponents have strongly emphasized. Just because birth-control pills and condoms can be readily and legally gotten in even tiny rural towns does not mean that sexual exploitation, prejudice against women and sexual minorities, or sexually transmitted infections have disappeared in today's China. Public discourse about sex remains focused on cross-sex, married couples of comparable age and background.
Considering the Chinese case alongside the American one complicates our usual stories about abortion, contraception, sexual freedom, and the right of choice. When we remove ourselves from the microcosm of American politics, we glimpse larger, global problems. Population increase really does put pressure on the world's resources. The inability to decide one's own sexual and reproductive future really does count as a trespass on human rights. And yet even when decisions are possible, they can come with disturbing consequences, like sex-selective abortions by Chinese parents against girls.
Reliable birth control and safe abortion procedures are revolutionary technologies, but they by themselves cannot guarantee a solution to anything. That much is abundantly clear from the legacy of Roe v. Wade in America—as well as just a glimpse at their very short histories in China.
Yvon Wang is writing a dissertation on pornography in early twentieth-century China at Stanford University.
Photo via marinaurquidi/flickr.
Part Two tomorrow.