Being pro-choice simply isn’t going to cut it anymore.
We’ve been having the same conversation about reproductive rights since Roe v. Wade, and it’s not moving us forward. Pregnancy and abortion care have been separated as issues and services because we’ve let anti-choice zealots dominate the conversation with stigma and shame. Anti-choice movement leaders and politicians have taken control of the narrative, and as progressive, pro-choice advocates, it’s time for us to take back the conversation and move to the next level.
In the same way pregnant people seeking abortion care have the right to access information about all of their options and make independent decisions about whether or not to have an abortion, pregnant people who plan to give birth deserve the same level of bodily autonomy. You deserve to be able to make an informed decision about where and how you give birth and about the model of prenatal care that’s right for you. You deserve a provider who respects you enough to ask what you want and seeks solutions to complications and tries to prevent and reverse conditions like gestational diabetes. If you’re a lesbian couple, or a single person, or a polyamorous couple, or a trans person, or any person, you deserve information about how and when to build your family. You deserve a supportive, caring environment in which to manage your reproductive life, access care and give birth.
At CHOICES, a reproductive health center and abortion provider in Memphis, we’re doing something radical. We’re opening the country’s first nonprofit clinic to offer fully comprehensive services including abortion care, LGBTQ+ inclusive fertility assistance, transition-related care for transgender people, integrated mental health services, prenatal care and a midwife-led birth center. All of these services, and your right to access them, center around bodily autonomy. At the same time, many of the people who need these services are part of marginalized groups who are constantly subjected to systemic oppression. Abortion, birth, LGBTQ+ family planning, trans health care... these issues are all connected, and the fight for reproductive rights cannot exclude any of them.
Newly pregnant people frequently feel alienated at their first prenatal appointment. Messages around “what is best for the baby” often dominate the conversation. Of course, fetal health is important, but what about what’s best for the mother? Where does she fit in? Some pregnant patients are not offered genetic screening until their pregnancy is advanced enough that they no longer have a choice about whether or not to terminate a pregnancy. Far too often, pregnant patients feel like they are at the mercy of the medical system and excluded from the decision-making process, especially if there is a complication.
These injustices regarding pregnancy and birth care are especially prevalent for people of color and people experiencing poverty. In Memphis in 2013, 32.8 percent of black women and 38.4 percent of Latina women reported their prenatal care was insufficient. This is more than double the 14.5 percent of white women who reported receiving insufficient prenatal care. Furthermore, the percentage of low-birth weight babies born to black women in our county (14 percent) is twice that of their white counterparts (6.3 percent). This gross inequity is born out across health care data, and if we care about bridging that gap, we all need to care about birth justice.
Abortion, birth, LGBTQ+ family planning, trans health care... these issues are all connected.
We recently cared for a patient who had suffered through two painful, complicated pregnancies that resulted in a premature birth and a stillbirth. When she became pregnant for a third time, she decided to have an abortion. While she was snuggled up with a blanket and a heating pad in the recovery area with an abortion doula holding her hand, she said, “If someone had taken care of me like this when I was pregnant before, I might have felt like I could handle trying to go through with it this time.”
Every single patient deserves to be treated with respect and regarded as a whole human being, not just an appointment type.
This is the midwifery model of care. It is not symptom management or procedure-based. It holds patients’ ability to decide for themselves what is right in each season of life as inviolable. Using this holistic, relationship-based paradigm, we can work with our patients to create life-long health that will ripple through our community. The old system has racist, misogynistic, violent roots. It’s time to rip those roots away and replant a new system that values holistic choice over situational choice and paves the way for a new culture of health and equality.
The choice in pro-choice refers to the choice to “stay pregnant or have an abortion.” That’s not good enough. Regardless of whether your pregnancy ends in abortion, miscarriage or birth, you have the right to information, education, respectful care and autonomous decision making about your body. Abortion rights and birth justice belong in the same conversation. Trans health care and fertility treatment belong in the same conversation. It’s all about bodily autonomy and the right to control your own body.
We feminists are reclaiming birth and prenatal care. It’s time for a new conversation. It’s time to move ourselves from pro-choice to pro-choices.
For more about CHOICES Memphis, see MemphisCHOICES.org.