Putting the “Freedom” back in “Reproductive Freedom”

[caption id=”” align=“alignright” width=“200”] Norplant[/caption]
by Alyssa Goldstein
Anyone who’s been paying attention to the news and to the presidential campaign probably knows that this is an increasingly scary time to be an American woman. Not only are many states passing laws which are making abortions difficult or impossible to obtain, but even contraception has become a contentious political issue. If this doesn’t terrify you, it should. Reproductive rights are basic human rights, and infringements upon them are nothing less than attempts to assert ownership and control over women’s bodies and sexualities. I believe this strongly enough that if I weren’t so viscerally grossed out by blood and body parts, I’d go straight to med school and become an abortion provider.
Yet even in this age where the rights to obtain contraception and abortions are under attack, it’s still important to keep in mind that for many women in this country’s history (particularly poor, Black, mentally ill, and American Indian women), the right to refuse contraception and abortions have been as important as the right to obtain them. This is something that many feminists (particularly the white, upper-middle class ones like myself) tend to forget. Fortunately, I was lucky enough to read Dorothy Roberts’ Killing the Black Body for a sociology class last year. Roberts reminds us that birth control can be used to oppress women as easily as it can free them. Indeed, the Nazi eugenics programs had their precursors in the United States, and advances in contraceptive technology were a driving force behind these programs. The practice of sterilizing poor women and women of color without their knowledge or consent continued through the 1970s.
Roberts details the dark history of Norplant, a group of capsules implanted in the arm that releases contraceptive hormones for a five-year period (Norplant has since been replaced by Implanon, a single capsule that is effective for three years). Contraceptive implants have many benefits: the user does not have to remember to take it, it is 99% effective, and its effects are reversible once the implant is removed. However, like any type of hormonal contraception, it can have side effects, some of which are very severe. Nonetheless, policy-makers all over the country saw in Norplant a valuable opportunity to reduce the population of the poor, black “underclass.” Their proposals ranged from mandating Norplant for women who get state funded abortions to requiring it for all women on welfare, though no state legislature has enacted these policies.
Instead, Norplant came to be the contraceptive method of choice for distributing to teenagers in schools to prevent teen pregnancy. While this seems like a worthy goal, Roberts points out that these initiatives overwhelmingly target poor black teens who in many cases are coerced into using Norplant, are not educated about its many health risks, and who do not have the opportunity to make the regular doctors’ visits which are the prerequisite for using Norplant safely. Unlike contraceptive methods like condoms or birth control pills, Norplant is controlled by the medical provider rather than the patient. Many women whose Norplant insertion was covered by Medicaid found that they had to pay for its removal themselves. Roberts quotes “a physician’s directive issued by the state of Oklahoma [that] discloses the government’s purpose of coercing poor women to keep the implants in place for as long as possible:”

It is not the intent of the Department to cover removal of the Norplant system prior to the expiration of five years unless there is documented medical necessity. Payment is not intended to be made for the removal of the contraceptive for the convenience of the patient, minor menstrual irregularities, or for the purpose of conception.

Forcing women to continue taking contraceptives that they don’t wish to take is no more “pro-choice” than forcing them to carry a pregnancy to term. Contraception and abortion alone do not guarantee our freedom -- when combined with racism, hatred of the poor and coercive state control, they can be powerful tools of oppression. Those of us who are pro-choice must not only work to ensure that contraceptive technologies are safe and available, but that they are not used to inflict harm.