Why Women Will Lose on Abortion – and the Price We Should Extract for Doing So

By June Carbone*

As the Supreme Court considered Roe v. Wade, my generation debated abortion. For many college-aged women, it was a rallying cry. We heard tales of deaths in back alley rooms. We struggled with the mixed messages of the early sexual revolution – good girls don’t, but how good are co-eds supposed to be? We were mystified by the advice on contraception. The pill was rumored to cause cancer, diaphragms were not completely reliable, men supposedly didn’t like condoms, and we learned to be wary of what might be in the drinks at late night parties. Few women of that era did not have at least a restless night or two contemplating the prospect of an unplanned pregnancy and what it might mean for the children we would have. Many of us came to the conclusion that the decision to have or not have a child was a profoundly moral decision and one we were not ready to entrust to anyone but ourselves.
Today, women’s lives are different. Over the course of the last thirty years, I have often thought about contraception and almost never about abortion. The difference between the two is why the fight to insure health care coverage of abortion is likely to be a losing issue, and why we should make contraceptive coverage the new rallying cry in the fight to preserve reproductive rights.

For most women, contraception is the daily decision, abortion the fallback we hope never to use. For those on the other side of the sexual revolution, contraception is part of the rite of passage to adulthood and an integral part of married, even more than unmarried, life. The changes in contraceptive effectiveness from my college years are subtle, but important. Where before the pill was the great innovation, today it is the availability of long-term injectibles you don’t have to think about. IUD’s have become safer; condoms more important for preventing disease. And for the not entirely intended or sometimes unconsented encounter, the morning after pill is the first line of defense. Unintended pregnancies and abortions dropped significantly for the college educated in the nineties and more effective contraception was the biggest reason. Yet, effective contraception can be expensive; an IUD can cost as much as an abortion and many health plans don’t cover them. Today, unintended pregnancy is a marker of race and class; unintended pregnancy rates for college grads dropped in the nineties by twenty percent while rising for the least educated women by 29%.
These changes in unintended pregnancies change the meaning of abortion. Those of us who are pro-choice appreciate the fact that it is legal and available, but we rarely think about using it for ourselves or our daughters. Since the publication of my book with Naomi Cahn, Red Families v. Blue Families, many women have shared their stories with us and most of those stories are about a single, difficult decision over the course of a lifetime – the wanted pregnancy that threatened the mother’s life, the unintended pregnancy at the worst possible moment, the hereditary disease that would give the affected fetus a short, painful existence. In the face of these decisions, cost – and health care coverage — was never mentioned.
The sad story underlying the abortion issue in the U.S. is the women who have abortion coverage now are the ones who can afford an abortion without medical coverage. Taking away or expanding that coverage will not make a difference in the decisions they make, and they will not take to the streets to preserve health care coverage of an expense they hope never to incur.
We should be worried, however, that the most effective contraceptives may be unaffordable for the women who need them most. After all, taxpayer dollars already pay for 40% of all births in the U.S. because of the incredibly high rate of unintended pregnancy among the women eligible for Medicaid assistance. It is time to make universal contraceptive coverage at least as important as the effort to deny women coverage of abortion. After all, even the new Miss USA agrees with us. During the interview portion of the pageant, the winner, Rima Fakih, was asked whether she believed birth control should be covered by health insurance, and she said yes, pointing to its high cost. She emphasized that “birth control is just like every other medication,” and that it’s amazing that it is not covered by insurance even though Viagra prescriptions are. Most of us know where our Congressman stands on abortion rights; let us make sure we are equally aware of where our representatives’ position on contraceptive coverage.

*CoAuthor of RED FAMILIES v BLUE FAMILIES: Legal Polarization and the Creation of Culture (Oxford 03/10)

4 responses to “Why Women Will Lose on Abortion – and the Price We Should Extract for Doing So

  1. I cannot recall the exact phrasing from Simon De Bouvier, but it is something like: Autonomy in procreating is the necessary condition of a woman's equality in civil society….One either gets that, or one don't…Not sure what exactly – other than the regressive quality of the Missouri Legislature, and the pariah status assigned to women who choose abortion as their best of only bad choices – prompted Professor Carbone's post. The matter hovers in my peripheral vision – Teabaggers Against Choice are resurrecting (it must be dialectical) Black Supremacist propaganda that abortion rights are the Man's Conspiracy to Keep the The Brother Down, and repeating the lies that Sanger was a racist, etc., to lure the descendants of American slaves and those with similar skin tones away from the Dems (as feckless as they usually are) and back to the Partee that now defends segregated private clubs in places like …. Kentucky.Any father who has been with the mother of his children, ill from complications in pregnancy, is obligated to keep an eye on this, and as I like to add: Get a firearm, and learn to use it.Death panels were a fiction; Breeding Police are a wish ….

  2. Saw this today, sort of answers my earlier question "Why this post now?"http://www.nytimes.com/2010/06/03/health/policy/03abortion.html?th&emc=th"At least 11 states have passed laws this year regulating or restricting abortion, giving opponents of abortion what partisans on both sides of the issue say is an unusually high number of victories. In four additional states, bills have passed at least one house of the legislature….." and etc.In one of my favorite little films, "Max", the art dealer (John Cusack) describes what he finds to be the young Hitler's artistic genius: It's the future seen as a return to the past, and it's kitsch.If only we could be assured that what's happening is kitsch, and will stay kitsch….

  3. As an over 50 woman who's been living outside the States for the past 30+ years now, I must say that my thinking about abortion and contraception has deepened over the years, taking on more nuance along with my political and historical education.I have not kept up with current American attitudes about this issue. They no longer interest me for many complicated reasons, not the least of which is my current immigrant status (not expatriate…). My training as a shrink gave me access to some of the research which is going on… on the fetus.Whether we (women…) like it or not, more and more sophisticated scientific research is making the fetus… more and more sophisticated and human, too. LESS and LESS, a clump of cells. Earlier and earlier on in pregnancy, too. And, given that… emotions are obviously going to kick in. Making things difficult. Changing what is acceptable, and what is not. I don't know how old you are. I am a baby boomer.The ONLY generation to at least start out 1) WITH the pill 2) WITHOUT sexually transmitted disease. The prospect of one long party with no consequences for my teenage self.The.. paradise didn't last very long, though.Somehow… birth control is just NOT medication like any other medication… It is unrealistic to think of comparing it with Viagra too. It's not in the same league… IN PEOPLE'S MINDS. In… WOMEN'S minds, particularly.And when they show up in my office, feeling a little bit… GUILTY about it, or upset, or just not keen on what they've been told is right, well, I see the effects of the propaganda on this subject.Like.. when I was waiting to get pregnant with my first child, I saw the effects of the spin slogan "A baby WHEN I want, IF I want."Not true. Life doesn't work that way. It probably never will. You can certainly STOP a baby from arriving, but you CAN'T MAKE it come. The two are not symetrical..PRETENDING that life will work this way, well, this is rather naive, I believe."We" have come full circle from pre twentieth centuy attitudes towards the sacredness of motherhood, and women's reproductive role.It is my experience that… the social body swings from one extreme to the other. INDIVIDUALS can learn how to think and to reason, but the social body can NOT.It is swinging back in the opposite direction now…Whether we like it or not, moreover. Now, the unfortunate thing about overly militant and LEGALISTIC attitudes towards contraception and abortion, in my book, is that they paradoxically induce GUILT in women who are not CONFORMING to what they perceive as being "the right way to think and behave".If we are truly interested in (individual) women's liberation ?, how can we stridently dictate to people what to believe or how to behave ? It is the "stridently dictating" that induces backlash. Every time.And there are times when… legislating on sensitive, private issues has serious drawbacks.. even with the very best intentions. As for the punishment of the poor…The poor are being punished across the books and in every domain in the U.S. Access to abortion and contraception is subordinated to the politics of punishing the poor for being poor. Whose growing numbers are a continual reminder of the… FAILED American dream.I'm not sure that it is about… being a woman. It is about… being poor, period.

  4. Damn right, Dave. My body either belongs to me or it belongs to the state. And lefties need to get over their gun phobia.