Women's Health Research Institute

The history of reproductive rights and policy in the United States is undoubtedly fraught with complexity. For many years, women have struggled for reproductive agency and control over their bodies and have often been met with fierce resistance on both the individual and collective level. But this resistance–in the form of government policies and limited or nonexistent access to contraceptives and other reproductive technologies–was much stronger for women of color, cognitively disabled women, poor women, and for those generally cast into the realm of “the unfit,” compared to white women. As recent as the 1960s, African American and Latina women were subjected to coerced sterilizations, often without realizing what procedures they were undergoing.

In her book Choice and Coercion: Birth Control, Sterilization, and Abortion in Public Health and Welfare, Rutgers professor Johanna Schoen delves into this reality, revealing the barriers to reproductive justice faced by women from the 1920s to the 1970s. Such barriers included lack of family planning services, reproductive health facilities, and the myriad socioeconomic forces that prevented already disadvantaged women from getting the information and care they required.

When programs did emerge in the 1920s and 1930s that could grant access to birth control and other technologies, they did so via state-sanctioned initiatives that often came with a price. In North Carolina, for example, state officials began offering birth control through public clinics, while at the same time, social workers threatened expectant mothers on welfare with sterilization and coupled financial support with coerced use of birth control. Reproductive agency was policed by state and local governments for the sake of impeding reproduction of the poor and the uneducated, who many believed to be lacking both “the motivation and intelligence to use contraceptives” of their own volition.

Class and race also had significant affects on women’s access to reproductive health resources. Sociologist Carole Joffe of UC Davis and Willie J. Parker of Physicians for Reproductive Choice and Health address the intersection of race and reproductive health care in their paper “Race, reproductive politics, and reproductive health care in the contemporary United States.” Joffe and Parker note that starting in the early 20th century, physicians and lay allies fought for legalization of birth control and abortion, and since then, reproductive rights organizations have worked tirelessly to pave roads to reproductive health services for disadvantaged women who had been, figuratively, landlocked.

But Joffe and Parker go on to assert that while the world of sexual and reproductive health is “a complex terrain,” it is, simply, characterized by “particular implications for people of color in a white-dominated society.” To be sure, they cite that black women have abortions nearly four times as often as white women, and that the contemporary reality of African American is characterized by “high rates of unintended pregnancy, low use of the most effective forms of contraception, deep poverty, inadequate educational opportunities, unacceptable levels of intimate partner violence and, very often, lack of support from their churches.”

Joffe and Parker conclude that these conditions necessitate an overhaul of comprehensive health care for these women that includes both abortion and family planning services. Parker–speaking as a member of the African American community and as a provider of women’s healthcare–posits that, to effectively combat issues within underprivileged and African American communities, changes within the community must take place. These changes should include more comprehensive and accurate health education, promotion of individual and collective health literacy, and more proactive engagement among religious figures (because of the importance of religion in the community).

Despite the many changes taking place in women’s reproductive health and the ground gained by fierce proponents of reproductive justice, the most vulnerable populations in the US–women of color, women in low income areas–require unique attention from both policymakers and healthcare providers. Joffe and Parker conclude that while education and health resources will certainly buttress the improving condition of otherwise hindered populations of women, policymakers should be cognizant of creating a society “that enables all women and families to have the children they want, the resources needed to raise them, and the ability to prevent or end pregnancies that they do not want.”