Today is the 35th anniversary of the Roe v. Wade decision and NARAL Pro-Choice America has asked all of us in the blogosphere to write posts about why it’s important to vote pro-choice. Welcome to Blog for Choice Day 2008. Here are my thoughts.
“Childbirth is, by definition, a loss of control over the body . . . but in the hospital, the surrender is usually of the body to the provider. Women often lose control over what’s done to the body, rather than over what the body does.”
–Jennifer Block, Pushed: The Painful Truth About Childbirth and Modern Maternity Care (165) .
Today, I am terrified of being pregnant or giving birth in the United States. I am not frightened of the physical experience of being pregnant. Nor am I intimidated by the difficult moral decisions I may face if that pregnancy is unplanned or if something goes tragically wrong. I am not afraid, as Jennifer Block so eloquently puts it, to “lose control over [what my] body does” when pregnant. No.
What wakes me from nightmares, sweating, in the early hours of the morning is the knowledge that, as a pregnant woman, I will lose my right to determine what is done to my body. What knots my stomach is the knowledge that, under current legal precedent, when I become pregnant I could be stripped of my rights to bodily integrity—including the ability to consent to or refuse medical procedures. What terrifies me is the knowledge that as a pregnant woman I could, at the discretion of a doctor or a judge, be treated as an individual whose medical decisions and right to self-determination have no merit, whose personhood is less worthy of consideration than the personhood of the developing child I carry within my body.
I didn’t always feel this way. When I hit puberty and began to menstruate I was awed (as I still am) by my body’s new capacity to sustain pregnancy and give birth to a child. The women whom I knew and read (thanks Mom!) described women’s reproductive lives in feminist terms: they placed women, their laboring bodies, and their self-determination at the center of pregnancy and birth narratives.
Over the last twelve years, however, I have been forced to recognize how fragile my right to bodily integrity and self-determination is. I have gotten the message loud and clear from politicians, judges and activists: My personhood is conditional. My body is not my own. I am one broken condom, one impulsive sexual encounter, one sexual assault, one anti-abortion, conscience-ridden pharmacist away from becoming less than a person in the eyes of the law.
The modern political and legal struggle over abortion rights, and reproductive rights more broadly, has developed a hyper-focus on the question of fetal rights  and the definition of when life begins . We have forgotten to consider an equally important question: regardless of how we determine when human life and constitutional rights begin, when do women’s basic human rights end? I ask this question of anyone who supports anti-abortion, fetal rights policies: do I somehow become less of a person in the eyes of the law the moment I become pregnant?
The right to bodily integrity is fundamental to our social contract here in the United States. The belief that we are all separate beings, existing within our own skin, and that no one has the right to violate our separateness without our consent, has been built into our legal framework. This respect for the human right to bodily integrity is so profoundly important to our legal and social framework that it actually supersedes our right to live. No one can be compelled against their full and free consent to give of their body for another human being–even if that other human being will die as a result of consent being withheld.
As Jennifer Block writes, “there is never a situation where the court can compel an adult to undergo a medical procedure for the perceived benefit of another human being” (255). We may make the case that it is the ethical thing to do, to donate blood or to put our own lives at risk to rescue someone from drowning. But despite making a moral argument that it is the right thing to do, we don’t compel individuals to perform these tasks: they must make the final decision themselves. At no point does their body cease to be their own.
Yet pregnant–and even potentially pregnant–women find that this basic right to bodily integrity is routine breached by medical professionals, politicians, and judges who determine what they may or may not do—or choose not to do–with their bodies. Marsden Wagner, former Director of Women’s and Children’s Health of the World Health Organization, documents in Born in the USA  the way in which pregnant women’s decisions regarding their own medical care are routinely ignored. Women who have expressly stated their desire for non-interventionist births are subjected to drugs without their knowledge, mutilated by unnecessarily episiotomies, or denied the right to attempt vaginal births after cesarean section. These practices are contrary to basic legal rights nationally and many human rights standards worldwide.
As Melody Rose details, in her book Safe, Legal, Unavailable? , in the thirty-five years Roe v. Wade has technically protected women’s right to terminate a pregnancy, opponents of abortion and women’s rights have chipped away at women’s legal standing by creating a systematic network of regulatory policies and legal restrictions . While the developing child–and even the potentially fertilized egg –slowly gains legal rights to constitutional protection, women are jailed to protect a fetus, punished for what they put into, or do with, their bodies , forced to continue pregnancies against their express wishes or made to seek the permission to end those pregnancies from lovers , estranged parents, or hostile judges . They are denied birth control  and punished for its failure. They are denied the right to choose where, with whom, and how they give birth or denied the right to birth at all .
An entire class of people are being stripped of their right to bodily integrity simply because of the bodies with which they were born. Increasingly, women are told not only that their rights are less important than the rights of the fetus they carry, but that they are too ignorant or vulnerable to make their own medical decisions. Last year’s Supreme Court ruling, Gonzales v. Carhart , is only the latest example of the misogynistic paternalism  that has come to characterize the legal and political landscape of reproductive justice. As Sarah Blustain wrote last year in The American Prospect:
The finding of activist conservative judges or radically anti-abortion legislatures, no matter how local, help accrue new definitions of the unborn that make it incrementally easier to successfully ban abortions. Perhaps even more troubling is the idea that these cases could slowly build a new judicial and legislative definition of women, as a childish and barely competent moral decision-maker for whom legal abortion becomes a menacing option from which she needs protection .
Access to safe and legal abortion may only be one small part of the landscape of reproductive justice , but it is a crucially important one. As Linda Paltrow has pointed out, anti-abortion activists have succeeded–through their focus on fetal rights and paternalistic protectionism–in establishing a precedent of abusive intervention into the lives of women and their families:
At least one federal court has said that sending police to a woman’s home, taking her into custody while in active labor and near delivery, strapping her legs and her body down, to transport her against her will to a hospital, and then forcing her without access to counsel or court review to undergo major surgery [cesarean section] constituted no violation of her civil rights at all. The rationale? If the state can limit women’s access to abortions after viability, it can subject her to the lesser intrusion of insisting on one method of delivery over another 
This is why I lie awake at night wondering if I’m brave enough to become a mother. I know that to become pregnant in the current legal climate will mean that I wake up every morning with the knowledge that my right to bodily integrity may be violated by doctors and politicians who disagree with my medical decisions, and that many judges will uphold those violations in a court of law.
I vote pro-choice because I believe that to legislate away women’s meaningful access to a full range of reproductive options–from birth control to abortion to the right to give birth where, with whom, and however she chooses–is to effectively curtail our ability to participate in the political and social life of the nation .
I vote pro-choice because I believe that the freedom of consenting adults to form sexually intimate relationships, whether or not they can–or desire–to have children, is a basic human right, not a privilege.
I vote pro-choice because I believe pregnancy, childbirth, and the decision to start a family should be a responsibility fully and freely chosen, not a punishment for sexual expression.
I vote pro-choice because I believe in women’s ability, as women and as human beings, to make practical and moral decisions regarding our health care and family lives.
I vote pro-choice because I believe pregnant women have the same rights to bodily integrity and full and free consent as any other human being.
I vote pro-choice because I don’t want to be forced to choose between motherhood and my own human rights.
Most of all, I vote pro-choice because of my belief in the radical notion that women are people.
*applauding* >>Awesome, awesome post. It’s a very sad and scary thought, that women are often regarded as worth less than the fetuses they carry and treated like imbeciles who need to have their decisions made for them. It’s disgusting and I really hope that women, especially pregnant women or those soon to be, will remember that doctors don’t ‘let’ or ‘allow’ you to do things with your body or your birth. You own your body and should be making all decisions about what happens to it. Informed decisions. Don’t trust your OB to know and do what is best for YOU. Their only concern is a healthy baby and avoiding malpractice lawsuits. Many use scare tactics and threats to bully women into submission and it’s absolutely horrible. >>The process of going through pregnancy and birth has made me aware of just how little most women actually know about their bodily rights and how to fight for them. Gathering information, building a support system and standing strong in the face of arrogant ‘professionals’ who claim to know best is key. >>I just hope more women will opt for less interventionist prenatal care and have homebirths — it’s so empowering to trust your body to work as it is. We aren’t broke and we don’t need fixing or saving.
The Legal Feminist said:
Thank you.>>I don’t have an intelligent or even coherent response to this post, I’m so emotionally moved. It’s very powerful and I hope you don’t mind if I forward it to friends.
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Thank you, both, for your kind words. And legal feminist, of course you’re welcome to pass along the link . . . I’m honored that people are reading it! This is my first real foray into more public blogging, and it’s lovely to have people respond.
thougthful post. I found it searching the terms pregnant women and body integrity. >>As a birthing woman, doula, Certified birth educator wholeheartedly agree with much of what you pose to your readers.>>I’m currently considering carrying a child through IVF for a friend that lost her uterus (forced and frightend into an induction, which caused the rupture of her uterus, killing her child and cuasing her to undergo an hysterectomy at the ripe old age of 26) but what I am finding is that I don’t have rights as a person or the right to self determined birth if I am carrying a child that I am unrelated to.>>I’m ready to chuck the whole idea for lack of options for fear of being persectued and prosecuted and forced to give up my rights of personhood SHOULD the parents change their mind about where the birth may take place. >>My own were born at home. Cheers. You have a new reader!
Thanks, anonymous! >>Partly as a result of the events of this last year, and writing up this post, I just signed up for a doula workshop in my area. I’m really excited about learning how to support women’s birth agency.>>Best wishes as you’re trying to make decisions about carrying your friends’ child.
I’m not. She and her husband wanted to control too much. I can understand why: their loss of control over their own reproductions…>>but trying to exert control over mine just isn’t going to happen.>>Reserach your trainings well! Some of the more well known (DONA, for instance) are known by insiders for tying your hands when it comes to making a stand for women IF that stand goes against hosptial policy. CBI, ALACE and BFW are known for being woman-centered. ALACE is the most established of the 3 of those.>>GOOD LUCK!
Thanks for the tip, anonymous! I’m aware of some of these tensions. The introductory workshop this summer I’m taking is DONA-affiliated, but if I end up wanting to take the training further, I’ll definitely look into some of the other organizations you suggested. >>I’d love to chat via email with you more about your doula / birth educator experience, if you’re willing. You can reach me at email@example.com.
Anna,>>It’s always interesting to see how some of the hard-core right-wing, pro-life types actually line up with the radical feminists. Bear with me. 🙂 >>A lot of earth-friendly, body-friendly people are starting to look at NFP – it’s easier on the body than the Pill, cheaper, and doesn’t have the environmental aftereffects. >>Likewise, I remember talking to a woman at a Walk for Life who had given birth to her three children at home. She said that the hospital itself can cause problems: stress reduces and can even stop contractions. Doulas and midwives can determine beforehand if the baby is in the correct position for delivery (and if the birth will be problematic). Otherwise, there’s actually less pain when you deliver at home, your body does what human bodies have done for millions of years, and it’s apparently a much better experience.>>So – if you’re looking for political support for at-home birthing, please don’t neglect the other side of the spectrum. A lot of people are with you on this one!>>I will note that the loss of control in hospital births has little to do with pro-lifers. OB-GYNs pay the highest malpractice premiums of any specialty. They are the most likely to get sued. When they are sued, the damages are often astronomical – and no attorney wants to defend the doc who wound up with a dead baby.>>When actual labour and delivery come around, doctors have a huge incentive to ensure that it happens with minimal damage to the infant. As a tort matter, there’s a higher likelihood of being sued if something happens to the kid than if something happens to the mother. >>No matter what, they have to make it look like they were in control of the situation, that any negative sequelae are not their fault. Sadly, that translates directly into a loss of patient autonomy. It is not a loss of female autonomy qua female autonomy, but an effort to control a high-liability situation.>>Again, if you’re looking for political support to help birthing women retain autonomy, don’t forget to look to those who would make it harder to sue doctors. That is a fundamental part of the underlying problem. >>A final thought, again on the match-up between your discussion of at-home birthing and the conservative viewpoint: for women in rural areas, at-home birthing would be an excellent option. The nearest (halfway decent) hospital to me, when I was at school, was an hour to an hour and a half. Given how unpredictable labour and delivery are, no woman (and her husband) are going to want to make that drive if they can avoid it. Rural areas are also notoriously short on qualified, skilled physicians – especially OB-GYNs. >>The political red/blue map could be a proxy for population density. There are a lot of people who are trying to preserve a rural, small-town way of life, who would love to make it easier for women to be there and to give birth in a safe environment.>>More later.