Contraception, Historical Amnesia, and a Call for Reproductive Justice

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As the 2012 GOP presidential primary draws closer to selecting a nominee for the general election, the topic of women’s reproductive rights is quickly becoming a central focus of the discourse regarding social issues in America today.  Indeed, legislation introduced at the state level that restricts access to abortion increased 42% in 2011 from the previous year[1].  Partly in response to the landmark policy set forth by the Obama administration requiring employers and health insurance companies to provide free access to birth control for all women, republicans have been emphasizing their “family values” platform.  Each of the republican primary candidates argue that the new policy is simply one more way that President Obama seeks to expand government mandates into the private sector.  GOP pundits have rallied their conservative base, employing rhetoric regarding women’s sexuality that is so shockingly antiquated that they have left the majority of liberals, progressives, and even moderate voters aghast. [youtube]X17upt9bdu8[/youtube]

The recent backlash against the Susan G. Komen foundation in the wake of the organization’s decision to remove funding from reproductive and primary health provider, Planned Parenthood, demonstrates that progressive voters are also prepared to respond with action when reproductive services are threatened.  In fact, a new Quinnipiac poll published by Politico shows that the majority of Americans (54%) agree with the new Obama contraception policy[2].  However, as voters begin to mobilize to protect reproductive health advances gained by feminist activists throughout the sexual revolution, as well as the new policy introduced by the Obama administration, it is important for progressives to be honest about the race and class-based dimensions of the modern history of birth control in America in order to move forward with a health care system that emphasizes reproductive justice.  At the same time, it is critical that the rhetoric used by republican political candidates regarding women’s sexuality and reproductive rights presents an severe material threat to the livelihood of women throughout the US.

Although women have utilized methods to control their reproduction for thousands of years, the modern understanding of the term “birth control” most commonly refers to the oral contraceptive pill, which uses hormones taken by mouth to prevent pregnancy.  However, sex educator, nurse, and activist Margaret Sanger initially coined the term “birth control” to include a variety of contraceptive practices that emphasized reducing the number of pregnancies that women were often faced with in the early 1900s.  Sanger founded the first birth control clinic in America, was repeatedly arrested for distributing illegal material that instructed women in birth control methods, and founded Planned Parenthood of America.  While Sanger’s contributions to the development of contraception are significant, her support of negative eugenics science is much less known and complicates the historical narrative of reproductive rights.  Although Sanger was vehemently against the Nazi application of euthanasia for the “patently unfit,” she did support programs of coerced and increased contraception including compulsory sterilization for “feeble-minded” populations, including people with hereditary diseases and developmental disabilities.  Sanger’s position on race also had a troublesome impact on the early development of reproductive freedom, as she believed that light-skinned races were superior to dark-skinned races.  Some may argue that eugenics has been delegitimized in modern science; however, the principles of eugenics have been systematically reproduced and enacted in relationship to women’s reproduction in a multitude of ways throughout the last century.

For example, the overtly eugenic practice of forcibly and coercively sterilizing women of color had devastating impacts in the 1970s.  Several reports surfaced from Native American women who were unknowingly sterilized after visiting Indian Health Services (IHS) for reproductive health care.  Many women reported entering surgery for appendectomies that then received “incidental” tubal ligations.

The Bureau of the Census noted that between 1960 and 1980 a sharp decline in birth rates occurred among women from a variety of tribes across the country.   As a result of these reoccurring incidents, the Government Accounting Office (GAO) released an investigation on November 6, 1976 into the practice of sterilization by four branches of IHS (all of which were receiving federal funding from the US government).   The report stated that 3,406 native women had been sterilized in a matter of three years at these locations.  This figure would represent the equivalent, per capita, of sterilizing 452,000 non-Native American women at the time.  Researchers believe that anywhere between 25-50% of the total population of Native American women were sterilized between the years of 1970 and 1976[3].  Many indigenous scholars and activists argue that this practice represents a continuation of the colonialism and genocide that was practiced against Native Americans by early US settlers.  It is absolutely essential to the current discourse on women’s access to contraception that these examples of eugenic policies are recognized as a major part of the history of reproductive health in America.  If progressives truly support the reproductive freedom of all women, this freedom must also include the ability of women to control their right to have children.

The eugenic influence on reproductive technologies is not simply a matter of the past and continues on in more recent examples.  For example, the hormonal implant contraceptive, Norplant, originally approved by the US Food and Drug Administration (FDA) in 1990 as well as the Depo-Provera shot were both regularly lauded by many reproductive rights activists and health providers for providing women with more choices for contraception.  However, these groups both overlook the fact that these methods have both been associated with increased physical risk to the user including and a history of unethical testing practices on poor women and women of color.  In fact, reproductive justice scholar-activists argue that using Norplant or Depo-Provera is not often a “choice” for many women.  Both forms of birth control have been used in court judgments as a punishment for women convicted of a crime, who are required to use the methods as a part of their parole agreements.  In many states, Medicaid regularly covered the surgical implantation process of Norplant but would not cover its removal, leaving many poor women without any resources to have the device removed even if they suffered adverse medical reactions.  The intersectional feminist reproductive justice organization, Committee on Women, Population and the Environment[4] points out:

Policy-makers, doctors and the mainstream media alike consider both Norplant and DepoProvera tailor-made "choices" for "irresponsible" women—poor, young women of color, mothers on welfare, and the "less educated"—because, as Time magazine put it, "unlike condoms, Depo-Provera is a set it and forget it birth control method."  In other words, the methods are foolproof ways to keep the "underclass" from reproducing themselves.

Due to the tremendous number of lawsuits filed by women adversely affected by Norplant, the device has been discontinued in the US but has continued to be a popular method that is promoted by the United States Agency for International Development (USAID) to control population and the reproduction of poor women in developing countries.

As the 2012 general election approaches and the topic of women’s reproductive health continues to be a divisive social issue, it is important for progressive voters to recognize and engage with the complicated history of birth control in America.  Even today, the non-profit organization Project Prevention presents itself as a resource for mothers who are looking to recover from alcohol and drug addiction.  However, in reality, the organization coercively sterilizes women who are desperate and addicted to drugs in exchange for cash.  A troubling and unethical practice that continues to persist even 40 years after the forced sterilization of thousands of Native American women under the banner of “reproductive health services.”    In contrast, reproductive justice activists claim that women deserve the right to have children, not have children, and to parent the children we have in safe and healthy environments.  According to the seminal women of color reproductive justice organization, Sistersong[5]:

Reproductive justice represents a shift for women advocating for control of their bodies, from a narrower focus on legal access and individual choice (the focus of mainstream organizations) to a broader analysis of racial, economic, cultural, and structural constraints on our power.

While the current mainstream discourse from both sides of the political aisle have drastically different viewpoints on how women’s reproductive health and sexuality should be addressed by the US government, neither will be able to adequately address the needs of all women without a much more complex engagement with the intersecting dimensions of race and class in relationship to the development of reproductive technologies and practices



[1] http://www.guttmacher.org/media/inthenews/2012/01/05/endofyear.html

[2] http://www.politico.com/news/stories/0212/73198.html

[3] http://cbhd.org/content/forced-sterilization-native-americans-late-twentieth-century-physician-cooperation-national-

[4] http://cwpe.org/

[5] http://www.sistersong.net