Early last summer, I attended a rally in downtown Chicago, as anti-abortion groups celebrated the Supreme Court ruling in favor of Hobby Lobby. The decision in Burwell v. Hobby Lobby Stores, Inc. allowed some for-profit companies to deny insurance coverage for what they viewed to be “abortifacients,” which include intrauterine devices (IUDs) and emergency contraception or “the morning after pill.”
The smell of sunblock filled that small corner of Federal Plaza as a tall, athletically built man on the brink of middle age led a crowd of about 60 in singing “The Battle Hymn of the Republic.” The man was Eric Scheidler, who heads the Pro-Life Action League, a grassroots anti-abortion group headquartered in Chicago. Dressed in a cranberry polo shirt and khaki shorts, he looked more like a summer camp counselor than a leader of a religious freedom rally.
He introduced Emily Zender, the executive director of the Illinois Right to Life. A 26-year-old woman took the stage.
“Providing contraceptives is not health care, it’s tyranny,” she shouted to the crowd as Scheidler stood behind her clapping and smiling proudly. He told me after the rally that as a father to six daughters, this is the kind of message wants the other side to hear.
“The idea that their capacity to become mothers is a disease that needs to be cured is utterly wrong,” Scheidler said. “That they need medical treatments in the form of birth control pills struck me as both a father and as a pro-life activist as outrageous.”
I am a woman in my late 20s. I use longterm birth control to prevent pregnancy. I have never thought of my fertility as a disease. I was raised Catholic and went to an all-girls Catholic high school, so I’m no stranger to anti-contraception rhetoric. Still, I was taken aback by Scheidler’s comment. Did he really think that women who take birth control feel diseased? I was surprised, but I shouldn’t have been.
The medicalization of birth control is a gatekeeper blocking true reproductive autonomy in the United States. What started as a clever loophole to get past strict morality laws is now being used by social conservatives to hold women at the mercy their employers, doctors and lawmakers.
Here’s a brief history.
On March 3, 1873, Congress passed what became known as the Comstock Act, which banned the distribution of “obscene and elicit” material, including contraception. However, doctors could provide condoms to treat or prevent disease; this allowed men to have sex with prostitutes without the risk of venereal diseases. It was still illegal to provide contraception to a married man he meant to use it with his wife to prevent pregnancy.
Margaret Sanger was a nurse who had fled to Europe in 1914 after being indicted for violating the Comstock laws by distributing information on reproductive health. She returned to the U.S. for the trial but the charges were eventually dropped. But she didn’t quit. She was tired of seeing women die from risky, at-home abortions and dangerous pregnancies. So in 1916 she defied the law again and founded the first birth control clinic in America. She was arrested nine days later for distributing obscene and illicit material and for being a public nuisance.
Sanger was sentenced to 30 days in a workhouse. Upon her release, she was even more determined to change laws regarding contraception. Sanger lost the final appeal to the New York Court of Appeals in 1918, but the language of the court’s opinion, written by Frederick Crane, provided a small victory for those in favor of family planning. It referred to the exemption in the Comstock Act allowing doctors to provide condoms to men to prevent disease:
“It is broad enough to protect the physician who in good faith gives such help to a married person to cure and prevent disease. ‘Disease’ by Webster’s International Dictionary is defined to be ‘an alteration in the state of the body, or some of its organs, interrupting or disturbing performance of the vital functions and causing or threatening pain and sickness; illness, disorder.’”
Since pregnancy easily fits that definition, doctors were legally allowed to provide contraception despite the Comstock Act. Of course, a lot has happened in the name of reproductive rights since 1918. For one thing, you don’t need a physician to purchase condoms anymore. But while women may have the right and ability to use contraceptives, in most cases, they can’t do so without the assistance or approval of another party.
In September, the American Academy of Pediatrics released a report recommending that Long Acting Reversible Contraceptives (LARC), intrauterine devices or subdermal implants, are the best option to prevent pregnancy among sexually active adolescents. These methods of birth control can cost well over $500, which is out of the price range of many Americans. While the Affordable Care Act aimed to make contraceptives more accessible by mandating that insurance covers them, some employer’s legal fights have undermined this effort.
Conversations on both sides of the reproductive rights debate illuminate the lack of autonomy that women in America have over their own bodies. A common reproductive rights slogan is that the decision to have an abortion is between a woman and her doctor. Recently, many women have come forward to publicly say they’ve had abortions. I’ve read many, and found them touching and informative, but I do not recall reading any accounts that said, “I was on the fence until my doctor helped me make the decision.”
It’s the 42 anniversary of Roe v. Wade, the 1973 Supreme Court decision that made abortion legal in America on the grounds of a woman’s right to privacy. Yet it seems that nothing about a woman’s right to an abortion is private. Conservatives have abandoned any hope of overturning Roe, fighting instead for stricter regulation of clinics through targeted regulations of abortion providers, or TRAP laws.
Mandatory waiting periods, on-site ambulatory services and admitting privileges at local hospitals can make operation costs too high for many clinics to stay open. Though most medical professionals deem these additional precautions unnecessary, TRAP laws continue to pass. For women who live in one of the 27 states most hostile to abortion (meaning the state has four or more restrictions in effect), terminating a pregnancy can be near impossible.
In 2014, sixty American abortion clinics closed, leaving only 551 nationwide, the lowest number in over 20 years. Though abortion is widely subject to these strict regulations, it isn’t treated like regular medical care. In most cases, women can’t just go to a hospital or her doctor for an abortion, she has to go to a clinic. When she arrives at the clinic, she will most likely be met by anti-abortion activists trying to convince her not to go through with it. These public protests and prayer vigils often succeed in closing clinics down or keeping them from opening. In November, Roseville, Georgia passed an ordinance banning abortion clinics within city limits because of the controversy they bring with them. A decision subjected to such public scrutiny is not private.
The 1918 Crane opinion was a tiny step; a glimmer of hope for women who had no safe or legal options to control their fertility. It was an allowance based on a technicality that trusted a man’s right to extramarital affairs, not a woman’s right to choose.
The medicalization of birth control means that a woman needs an intermediary to decide what’s right for her. If her fertility is a disease, then treatment should be adequately available. If it’s not a disease, then her desire to have children or not should be treated as nothing more than a private lifestyle choice.