Document 48: "Plank 21: Reproductive Freedom," from National Commission on the Observance of International Women's Year, The Spirit of Houston: The First National Women's Conference (Washington, D.C.: U.S. Government Printing Office, 1978), pp. 83-86.
p. 83
PLANK 21
REPRODUCTIVE FREEDOM
We support the U.S. Supreme Court decisions which guarantee reproductive freedom to women.
We urge all branches of Federal, State, and local governments to give the highest priority to complying with these Supreme Court decisions and to making available all methods of family planning to women unable to take advantage of private facilities.
We oppose the exclusion of abortion or childbirth and pregnancy-related care from Federal, State, or local funding of medical services or from privately financed medical services.
We urge organizations concerned with improving the status of women to monitor how Government complies with these principles.
We oppose involuntary sterilization and urge strict compliance by all doctors and medical and family planning facilities with the Department of Health, Education and Welfare's minimum April 1974 regulations requiring that consent to sterilization be truly voluntary, informed, and competent. Spousal consent should not be a requirement upon which sterilization procedures are contingent. If the patient does not speak English, appropriate staff must be found to explain the procedures and HEW regulations in the primary language of the patient.
Particular attention should be paid at all levels of Government to providing confidential family-planning services for teenagers, education in responsible sexuality, and reform of laws discriminating against unwed parents and their children.
Programs in sex education should be provided in all schools, including elementary schools.
Federal, State, and local governing bodies should take whatever steps are necessary to remove existing barriers to family planning services for all teenagers who request them.
Each school system should assist teenage parents with programs including child care arrangements, that will encourage them to remain in school, provide educational and vocational training leading to economic independence, and teach prenatal health and parenting skills.
Background:
"Each year, before the Supreme Court decision was handed down, physicians had to treat about 350,000 women suffering from complications arising from illegal abortions. Each year, some women die…"
Decisions relating to childbearing are rightfully the responsibility of the individual woman.
It is the woman's body that carries and nurtures the embryo and fetus. It is the woman who experiences the physical and psychological changes of pregnancy. It is the woman who has the discomforts and sometimes the medical complications that may accompany childbearing. It is the woman who feels the pain of childbirth. It is the woman who may suffer postpartum depression. And it is the woman who bears the major responsibility of caring for and raising the child and who often must leave school or her work to do so.
Every woman, regardless of her age, economic condition, race or ethnic origin, education, marital status, rural or metropolitan residence, is entitled as a fundamental human right to have readily available the means of controlling reproduction. As the World Plan of Action adopted in Mexico City acknowledged, the "exercise of this right is basic to the attainment of any real equality between the sexes."
The Supreme Court decision In its historic (Rowe v. Wade) decision of January 22, 1973 affirming the right of a woman to choose abortion, the U.S. Supreme Court held that the constitutional right of privacy "is broad enough to encompass a woman's decision whether or not to terminate her pregnancy."
The decision, written by Justice Harry Blackmun and concurred in by six other justices, cited the hardships a State could impose upon a pregnant woman by denying her this choice:
"Specific and direct harm medically diagnosable even in early pregnancy may be involved. Maternity, or additional offspring, may force upon the woman a distressful life and future. Psychologically harm may be imminent. Mental and physical health may be taxed by child care. There is also the distress, for all concerned, associated with the unwanted child, and there is the problem of bringing a child into a family already unable, psychologically and otherwise, to care for it. In other cases….the additional difficulties and continuing stigma of unwed motherhood may be involved. All these are factors the woman and her responsible physician will consider in consultation."
While holding that the right of personal privacy includes the abortion decision, the Supreme Court decision also ruled that "this right is not unqualified and must be considered against important State interests in regulation."
Accordingly, the court held that for the first three
months of pregnancy, the abortion decision must be left to the woman and her
physician. In the next stage, approximately the second trimester, the State "in
promoting its interest in the health of the mother, may, if it chooses,
regulate the abortion procedure in ways that are reasonably related to maternal
health." It is not until the stage of
p. 84
Before the Supreme Court issued its decision, most States had anti-abortion laws dating back to the 19th century. Protection of the woman's health was the major concern behind enactment of these laws because, before aseptic surgical techniques were developed, abortions were developed, abortions were extremely dangerous and sometimes fatal, even when performed by physicians. Today, however, with a variety of techniques available and with abortions more available to women in the early stages of pregnancy, abortion is safer than childbirth.
Throughout the period when State antiabortion laws were in effect, an estimated one million American women were having abortions each year. About 10,000 of these women, usually white, middle-class, or rich women, succeeded in having abortions performed legally in hospitals. The great majority had to resort to bootleg abortionists. Prohibition of abortion was no more effective than the constitutional prohibition of liquor. In fact, illegal abortions were so common and profitable that they were said to be the third largest source of criminal revenue, following only narcotics and gambling. (D. Lowe, Abortion and the Law, cited in The Rights of Americans, edited by Norman Dorsen.)
Maternal deaths Each year, before the Supreme Court decision was handed down, physicians had to treat about 350,000 women suffering from complications arising from illegal abortions. Each year, some women died as a result of those complications. In 1972, according to the Abortion Surveillance Report of the Government Center for Disease Control in Atlanta, when an estimated 550,000 legal abortions were performed, 88 abortion-related deaths were reported. Of these, about 63 were associated with illegal abortions. In 1975, when just under 900,000 legal abortions were performed, related deaths were down to 44.
As abortions have become more readily available, the trend is toward earlier, and therefore, safer abortions. In 1975, approximately 87.9 percent of all legal abortions were performed at 12 weeks or less, when the medical risk is slighter than in continuing pregnancy.
"Elimination of dangerous illegal abortions removed the main single cause of maternal deaths," the Planned Parenthood Federation of American reported in 1973. Effective use of contraception was another factor in reducing maternal mortality rates, it said, citing evidence that contraceptive practices improved markedly, "perhaps related to the contraceptive counseling provided in facilities performing abortions."
The report cited data from New York State, where, following State legalization of abortion, there was a
p. 85
Planned Parenthood noted that "about seven in 10 of the legal abortions of New York residents would have taken place anyway—most of them illegally—in the absence of the new law. In other words, the primary impact of legalizing abortion is to make safer, less expensive and more open a procedure which would have taken place anyway."
Constitutional amendment Some abortion opponents favor so-called "right to life" amendments to the Constitution that would define the unborn as a "person," either "from the moment of conception" or at every stage of its biological development.
The Supreme Court held, however, that a fetus is not a person. "We need not resolve the difficult question of when life begins," its decision said, "When those trained in the respective disciplines of medicine, philosophy and theology are unable to arrive at any consensus, the judiciary, at this point in the development of man's knowledge, is not in a position to speculate as to the answer."
Medicine does not define when the "moment of conception" occurs. Is it when the egg is fertilized, or some five to eight days later when the process of implantation occurs? The state of pregnancy itself cannot be determined with certainty until some three weeks after implantation occurred.
Philosophers and theologians hold a variety of views on when human life begins, with some contending that it is the undefined "moment of conception," others holding that it is when the fetus is viable, and still others supporting the view that it begins with live birth.
Lawyers have pointed out that conferring personhood on the unborn would create legal chaos. A memorandum prepared by Planned Parenthood attorney Harriet Pilpel noted: "Presumably the state could enjoin a safety regimen on every woman from the moment she conceived (assuming anyone could figure out what that moment was) and hold her accountable criminally and civilly for any injury the fetus suffered." In criminal law, she said, an individual committing a lesser crime that incidentally resulted in the miscarriage of a woman might be held guilty of murder; in general tort law, if a pregnant woman were in an accident, someone acting in behalf of the fetus might sue for negligence. As legal persons, unborn fetuses might inherit property, even if never born alive, or they might be counted as dependents for income tax purposes. All Americans could cite their gestation period to claim that they have instantly aged by seven to nine months, which would affect everything from birth certificates to death certificates, voting age, retirement, pension systems, insurance policies, etc.
Attorneys cite the potentially mischievous consequences of the ambiguously worded "right to life" amendments as evidence that the moral and religious concerns of people who oppose abortion are not subjects that can be appropriately dealt with in legal terms, particularly in a society with constitutional guarantees of separation of church and state.
Ban on Medicaid Despite the constitutional guarantee of the right to abortion, in recent years antiabortion forces have been increasingly successful in restricting access to abortion through congressional, State and local actions. Some hospitals refuse to perform abortions and many women do not have access to abortion services in their local areas. In 1977 the Supreme Court ruled that States may decide not to fund abortions. Congress and a number of State legislatures have passed laws to prevent use of Medicaid funds for abortion, even though these funds are available for the full scope of medical services, including childbirth. A House committee recently attached an antiabortion rider to a pregnancy disability bill, and similar riders were being proposed for other legislation.
The result of these restrictive actions is that Medicaid recipients must either accept compulsory pregnancy and motherhood; face the dangers of cheap, amateurish or self-induced abortions; or worry about increased danger to their health caused by the delay while they try to raise the money for an abortion. The Government Center for Disease Control has reported the death of one woman who could not get a Medicaid-funded abortion, and other deaths have been reported among women who have resorted to back alley abortionists.
Women most severely affected by these restrictions are members of minority races, since they are disproportionately represented among the poor who rely on Medicaid for their health care.
(For comments on sterilization, see HEALTH plank background.)
Support for birth control Most women prefer not to rely on abortion as a method of reproductive control, but they insist that it must be available to them as a choice. The most effective way to reduce the number of abortions is to provide safe, failproof contraception and to make sure that it is available to all fertile women and men.
The health consequences of unwanted and mistimed childbearing have been amply demonstrated. They are especially serious for teenagers and the poor, for whom pregnancy is inherently more risky. Babies born to women in these high-risk categories are less likely to survive and are more likely to have birth defects, mental retardation, and other long-term handicapping conditions.
p. 86
The health and social benefits of family planning are well documented. Research indicates that the timing and spacing of births and the number of children born into a family are probably the most influential determinants of maternal, infant, and even longterm family health.
Yet only two percent of the money spent on research by the National Institutes of Health is earmarked for research in human reproduction and development of new techniques for fertility reproduction.
Teenagers and pregnancy Sexual activity is beginning at an increasingly early age. Teenagers account for almost half of the out-of-wedlock births in the United States. Their birth rate is higher in the United States than in 18 other countries; they have higher rates of death during childbirth; and their babies have a higher death rate during the first year of life. (Many of these statistics come from a 1976 study, 11 Million Teenagers, What Can Be Done About the Epidemic of Adolescent Pregnancies in the United States, the Alan Guttmacher Institute.)
Most teenagers do not use birth control, and several studies note that those who visit birth control clinics have usually been active for at least a year. Two doctors from Johns Hopkins University, John F. Kanter and Melvin Zelnick, in a study of teenage pregnancies reported a "pattern of having sex, becoming pregnant, and then going on to use birth control."
Ideally, education about reproduction and responsible sexuality should be provided at home by caring parents. Yet most young people do not receive adequate information. Dr. Robert C. Sorenson, author of Adolescent Sexuality in Contemporary America, interviewed more than 400 teenagers in 1973. Sixty-eight percent of the girls and 80 percent of the boys said their parents did not tell them about birth control. The Draper World Population Fund Report says that most sexually experienced teenagers who have not used contraceptives have a confused idea about the risks of pregnancy. Nearly 40 percent of those studied believed that pregnancy could not occur because they were too young or had infrequent intercourse.
Despite the acute need to create opportunities for teenagers to discuss their concerns and anxiety about sexuality and the need for increased knowledge about reproduction, contraception, and health hazards, only six States and the District of Columbia require the teaching of family life and sex education in the schools. In many areas, lack of parental consent and other barriers stand in the way of teenagers who want contraceptive information and services.
Teenage mothers Pregnancy is the most common reason for teenage girls to drop out of school. Without a high school education and some kind of skill, the teenage mother will be unable to support her child, and she may be its sole support. One-third of all babies born to teenagers are born out of wedlock, and teenage parents who are married have a higher divorce rate than older parents.
Until very recently most programs for pregnant adolescents and teenage mothers were designed to supply emergency aid for prenatal and early postpartum care, but once a girl became a mother, she was left to her own resources. Centers that offer comprehensive programs on a continuing basis can "reverse the terrible statistics of teenage pregnancy," according to Eunice Kennedy Shriver, reporting on such a center in Baltimore. The young mothers were given practical vocational training. Counselors helped them care for their babies and build solid family relationships with their own parents, and with the young fathers when that was possible. Two years later, less than one percent of the girls enrolled in the program had become pregnant again compared with the average of 20 percent repeat pregnancies for teenage mothers in general.
The right to choose Public opinion polls show majority support among both American men and women for the right to choose abortion. Women who assert their right to control their own bodies oppose compulsory abortion, compulsory pregnancy, or compulsory sterilization. In a secular democracy founded on concepts of individual rights and diversity of viewpoints, the right of American women to reproductive freedom must be fully protected.
 |
 |
 |
| Previous Document |
Document List |
Next Document |