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| A protester holding a sign that says, "Health care is a human right." Image source. |
Occasionally I see "pro-life" people advocating for the idea of a comprehensive pro-life ethic. Typically when people use the term "pro-life", it means "abortion should be illegal" and that's it. But, those who have a comprehensive pro-life ethic say that's not good enough. Pro-life can't just mean you care about protecting an unborn baby's life, but the moment they're born, you don't care any more. People who are truly pro-life are anti-war. They oppose the death penalty. They want gun control. They support universal health care.
I like that. If you're gonna be pro-life, be that kind of pro-life person. Provided, of course, that you recognize that abortion may be necessary to save a pregnant person's life. The most obvious cases are where the pregnancy is causing a life-threatening medical problem- but abortion may save someone's life in a less direct way than that. Domestic violence victims are more at risk of being murdered by their abuser if they are pregnant.
Usually I put "pro-life" in scare quotes because it's not about life at all, it's just about banning abortion. But hey, if you really do have a comprehensive pro-life ethic, I won't even put it in scare quotes. You really are pro-life.
I'm thinking about how to conceptualize something similar for pro-choice ideology.
I always felt like the pro-choice movement wasn't really *for* me, because I have kids and I'm happy being a mom. Sure, I can help out the movement by talking about how my experience of pregnancy was so bad, and no one should have to go through that if they don't want to- but it's not *for* me. It's for women who want to have sex but not have babies. Right?
(Note, though, that a high percentage of people who have abortions already have kids. [This data from 2019 says it's 60%.] The stereotype of the slut who just wants to have sex with whoever, and hates children, is not at all representative of who is actually getting abortions.)
Anyway, when I watched the video from the Democratic National Convention this year, and saw Kate Cox there representing Texas, along with Cecile Richards, former president of Planned Parenthood, that really affected me.
(If you haven't heard about Kate Cox, here's her story: She was pregnant, and then found out her unborn baby had a health problem and would not survive, and that for the sake of her own health and her ability to have another pregnancy in the future, it would be best for her to have an abortion. But she lived in Texas, and it was a whole ordeal which was in the news, about whether of not the state of Texas would let her have an abortion. Eventually she went to a different state and had an abortion. This situation was very shocking because of how clear-cut it seemed to be- Cox was basically a "perfect victim"- she's white, married, she's already a mom, and it was a wanted pregnancy. And there was no way her unborn baby would be able to survive. And still, Republican politicians in Texas did not allow it.)
The video from the Democratic National Convention serves as an update on what happened to Kate Cox after that. She got pregnant again, and fortunately, this pregnancy has not had any massive problems like that, and she's looking forward to a healthy baby who will be born in January. And everyone cheered. Everyone is happy for her. The former president of Planned Parenthood is happy for her. (Here's a link to the video- but I'll warn you it's sad to watch because everyone is talking about Kamala Harris being president, but that is not gonna happen.)
Seeing that video, I was struck with this thought, "what if the pro-choice movement really is about choice?" Here's someone who wants to be pregnant, wants to have a baby, and she gets pregnant and decides NOT to have an abortion, and as pro-choice people we celebrate that. In Cox's case, actually, she wanted to have another child, and an abortion was a necessary step on the way to reach that goal- because the complications in her pregnancy meant that there was a risk she would be infertile. She wanted to have another baby, and having an abortion was a means to get there.
Maybe that's what it's about.
In the "pro-life" movement, they talk about pro-choice people as if pro-choice people just really love killing babies, and twirling our mustaches evilly or something. But what if the pro-choice movement is actually like this: It's not about celebrating abortion as a good thing in and of itself. (Actually, in an ideal world, nobody would be in a situation where they need an abortion.) It's about being able to choose the life you want for yourself, and sometimes abortion is needed in order to get there.
So we want to protect people's right to have an abortion, if they want to. And in the same way, we want people to be able to have babies, if they want to.
If we want to be comprehensively pro-choice, that requires a whole lot more than just "abortion is legal."
What if someone wants to have a baby, but for various practical reasons they feel like it's not really possible, and their only real option is to have an abortion? This is not okay. To be truly pro-choice, we need to address the problems that restrict people's choices in this area. It is very expensive to pay for prenatal care and hospital bills for childbirth- being truly pro-choice means supporting universal health care. It means society needs to implement policies that will help people get out of poverty- everything about kids is expensive, and that's one of the big reasons people have abortions.
And remember earlier I mentioned that victims of domestic violence are more likely to be murdered if they are pregnant? If we say "okay, then they can get an abortion, for their own safety", that is NOT GOOD ENOUGH. No one should be in a situation where they have to choose between their pregnancy and their safety; that's terrible. What changes does society need to make to keep people safe from abuse? We need to advocate for all those things, in order to be truly pro-choice.
But let's take it farther than that.
I always hear politicians saying "women can make their own choices about their bodies." This is nothing more than a euphemism for "abortion is legal" (or, possibly, "abortion is legal and accessible"). I don't like that. I want to live in a world where "women can make their own choices about their bodies" means exactly that.
Certainly that includes abortion access, but it includes so much more than that.
Let's start with giving birth. Giving birth is scary, and some people have traumatic experiences, or problems come up- and I sometimes hear moms reassuring each other by saying "the only thing that matters is that the baby is born healthy."
I disagree with this.
If you have a traumatic birth experience because the medical staff don't respect your right to make informed decisions about your own body, that is not okay. That matters. If people tell you that your trauma doesn't matter because your baby turned out fine, they're wrong.
For example: if people are pressuring you to get an epidural during childbirth, or to not get an epidural, that's NOT COOL. It should be your decision.
I've heard about hospitals which recommend C-sections to birthing women at a higher rate than is necessary, because that's what's more convenient for the hospital. (This is an issue in China- I don't know about in the US.) For a C-section, the hospital can control the timing and the entire process. When there are lots of women giving birth there, it's hard to allocate rooms for all of them, and you don't know how long it will take to have a natural labor and vaginal birth- it's easier to just do C-sections.
But a C-section is a major surgery; you shouldn't do that unless there's a good reason.
Another example about giving birth: VBAC. (Vaginal birth after C-section.) This means that in a previous pregnancy, the person gave birth via C-section, and now in their current pregnancy they would like to try to give birth vaginally. Vaginal birth is better in terms of the recovery process for the birthing person- but VBAC is riskier than a vaginal birth in someone who doesn't have a C-section scar. The scar might rupture during labor. You need to be aware of the risks of trying this. You need a doctor with experience.
All of this should be included in what people mean when they talk about "women can make decisions about their own bodies."
And so many other aspects of pregnancy. When you're pregnant, you always get random people trying to police what you eat, or telling you you're gaining too much weight... Emily Oster's book "Expecting Better" (which I reviewed here) was all about giving pregnant people the data they need to make choices during pregnancy, because typically that data isn't really available. It's about making choices during pregnancy, but I'm not talking about abortion. Even though this is for people who are NOT having abortions, it's an important pro-choice area.
And let's talk about breastfeeding and "making choices about your own body." Many people are pressured to breastfeed, or pressured to not breastfeed, or shamed and treated like they're a "bad mom" because of whether or not they breastfeed. Not cool. First of all, don't judge people for this. But, more important than that is people need to have the resources and support they need if they want to breastfeed. You need information about what to do- it's not straightforward. Maybe you need a lactation consultant who can give you hands-on instruction. If you have a full-time job and you want to pump milk, you have to buy a pump, and you need your boss to give you break time during the day, and a private room where you can pump.
Breastfeeding isn't something you can just do all in your own power- you need to be in an environment that has the necessary resources and support.
Okay, let's expand this pro-choice ethic to other areas of women's health care.
I've heard some women talk about being prescribed birth control when they were teenagers, because of acne or some other problem like that- not because they were having sex. And, looking back on it, they are unhappy about how they had to deal with a lot of bad side effects from the birth control hormones, and they feel like they didn't really have a choice. It was just "well we tried various things and they didn't solve your acne problem, so the next step is to take birth control" and that's that, and as a teenager they didn't have a real choice.
I've also heard that it's very painful to get an IUD inserted, and it's common that doctors don't inform patients about the pain, or offer any anesthesia or pain medication. Not cool. Are the people who talk about "women have the right to make choices about their own bodies" going to do something about this?
Or the many other scenarios where women's medical issues are not taken seriously by doctors. Being comprehensively pro-choice means having a society where women really are given the support and resources and information they need to make medical decisions for themselves.
But actually, this shouldn't just be about women, and/or people who can get pregnant. Everyone, of any gender, should have the freedom, information, and resources to make medical decisions for themselves.
This is something I've blogged about before, in the context of the question "what should consent look like for children in a medical setting?" I'm very interested in the concept of consent as it relates to health care.
You may have noticed that this "comprehensive pro-choice ethic" is in no way the opposite of a "comprehensive pro-life ethic." There's a huge amount of overlap. Many policies, such as universal health care, very obviously belong in both. People who are truly pro-life and people who are truly pro-choice should all advocate for universal health care. I mean, I don't want to spin this as "we have so much in common so let's just forget about abortion and focus on those other things instead"- I do think abortion access is very important. But being pro-choice shouldn't only be about abortion. It should be about "the right to make choices about your own body" in all health care areas.
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This post is part of the October/November 2024 Carnival of Aces. The topic is "sexual healthcare."
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Related:
What Pregnancy Taught Me About Being Pro-Choice
"Expecting Better": Asking the Right Questions About Pregnancy
"Life's Work" (read this book and become even more pro-choice)
On Gynecologists and Angry Turtles
Doctors (part 3 of Autism & Teaching Kids to Protect Themselves)
"Afraid of the Doctor" (I read this book because I have medical trauma)
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