Recently I came across a 6/2/14 blog post from Melinda Gates extolling her foundation’s emphasis on reproductive, maternal, newborn, and child health (they use the acronym RMNCH). Gates was bothered by the fact that many commentators see RMNCH issues as inextricably linked with abortion access/legality. She insisted that abortion should be discussed separately from other reproductive health issues, and she proudly announced that the Gates Foundation has no intention of funding abortion. Gates’ blog post drew protest from some feminists, including Daily Beast writer Sally Kohn, who posted “A Plea to Melinda Gates: Stop Stigmatizing Abortion.” Kohn pointed out that the Gates Foundation’s head-in-the-sand policy on abortion comes at a time when, according to World Health Organization figures, each year approximately 20 million women resort to unsafe abortion and at the barest minimum 68,000 women worldwide die from the consequences.
Provision of effective contraception could certainly reduce these numbers, but it is absurd to act as if contraception will eliminate the need for abortion altogether. Contraceptives fail. Women’s circumstances change. A partner can leave or become abusive. A loved one might suddenly require intensive care. Any of a score of events could mean that a pregnancy, even one that was desired at one time, cannot be allowed to continue without hardship. And the fact is that once a woman has decided that continuing a pregnancy is not in the best interests of herself and her family, she is likely to terminate it by whatever means necessary, even possibly attempting the procedure on herself.
Gates is regrettably (if unconsciously) following in the footsteps of Margaret Sanger, the founder of Planned Parenthood. Sanger is often eulogized as the mother of modern birth control. However, as I discuss in Sex and Herbs and Birth Control (pages 182-188), in the first decades of the 20th century Sanger promoted “modern” contraceptives (which at the time consisted of ill-fitting diaphragms or spermicidal jellies) as the logical replacement for abortion. But these methods were unreliable, as Sanger knew. Moreover, a study in Sanger’s own clinic indicated that most women who discovered their condition when they came in requesting birth control did not carry their pregnancy to term but rather found some medical excuse for termination (doctors would often approve medical termination of pregnancy for the affluent) or else disappeared into the abortion underground. But Sanger refused to recognize the implications of these findings. Unlike more progressive feminists of the time, such as Drs. Marie Equi and Madeleine Pelletier (both of whom gave abortions to poor women themselves) and Mary Ware Dennett, Sanger stubbornly insisted that contraception could eliminate the need for legal abortion entirely. This was wrong then, and it’s wrong now. Melinda Gates is making the same mistake.
Gates appears to be avoiding the abortion issue for a couple of reasons. She herself is a Catholic and does not want to challenge the Church’s stance as many Catholics (for example, the group Catholics for Choice) have done. In addition, like Margaret Sanger, Melinda Gates seems to feel that by stigmatizing abortion her Foundation can avoid controversy and position itself in the mainstream. This approach worked for Sanger, in that she was able to attract some fairly conservative donors who would have balked at being associated with a “leftist” demand such as legalized abortion. (The infant Soviet Union immediately legalized abortion in 1918, so calls for legalization in the West were often branded as “communist.”)
But Gates is deluding herself. Abortion access is integral to any RMNCH strategy worthy of the name. And promoting abortion stigma, as Gates does, is not helpful to anyone who is truly interested in women’s reproductive health and wellbeing.