abortion access, Caesarian delivery, Catholic Church, Cuba, doulas, low-income women, natural birthing, Puerto Rico, reproductive justice, women of color
Recently I attended the National Women’s Studies Association meeting in San Juan, Puerto Rico. Among the dizzying array of panel presentations were two of particular interest to me. One focused on women of color creating organizations to support non-medicalized birthing options for poor women. The organizations, Birth Justice Project and Black Women Birthing Justice, sponsor classes for pregnant women in the California state prison system with the goal not only of obtaining better outcomes for their pregnancies but also training them to become doulas (informal birth assistants) after their release. The same panel featured a well-known Puerto Rican midwife, Rita Santiago, who was largely responsible for the resurgence of midwifery on the island. Historically midwives had handled virtually all births and most of the health needs of women and children in Puerto Rico. But when the U.S. assumed the colonial mantle of the Spanish at the beginning of the 20th century, the government and medical profession initiated a concerted campaign against midwives and in favor of hospital births attended by (largely male) physicians. These interventions had disastrous results for women’s health. Even now, Puerto Rican women have high Caesarian rates—approximately half of all babies on the island are delivered by Caesarian. These rates are well above the levels deemed acceptable by the World Health Organization. By comparison, Santiago noted that Cuba’s rates are low; about 8% of Cuban births are surgically managed, yet their maternal and infant mortality statistics are far better than those of Puerto Rico.
Another fascinating panel was organized by the Chicago Abortion Fund (CAF). CAF began thirty years ago with the goal of providing money for low-income women to obtain abortions after the Hyde Amendment cut off federal funds for the procedure. But they have branched out and adopted a reproductive justice (RJ) framework for their activism, which situates abortion access in the context of general health equity for low-income women and women of color. According to a CAF brochure, the broader orientation is necessary because “The mainstream reproductive rights movement has, in some instances, …been elitist and has ignored the needs of women of color and low-income women.” CAF has developed an abortion access toolkit that is widely used by other RJ-oriented activists around the country.
A poignant aspect of the abortion issue was brought to light in the discussion that followed the presentations. A young Latina woman in the audience asked how one deals with feelings of guilt about having an abortion. She is a high school student in a state that mandates so-called abstinence-only sex education, and she said that this, combined with the religious proscriptions drilled into them by Catholic and fundamentalist Christian parents, renders her and her peers unable to easily access birth control, terrified and uncertain where to turn when pregnancy results, and obsessed with the notion that they are betraying their culture or committing an unforgivable sin if they attempt to get an abortion.
The panelists were sympathetic, and CAF’s Latina intern said that she had suffered the same guilt when she terminated her own pregnancy. The advice offered by her and other panelists went along the lines of: remember that it’s your body and your life; you’re the best judge of what is right for you at this time. Certainly these statements are reasonable and can go some way toward assuaging guilt. However, I suggested an additional line of reasoning that might have some effect, especially on the young woman’s Catholic peers and (possibly) on their families. Namely, I pointed out that restrictions on abortion are relatively recent. Until 1869, when the Catholic Church banned the procedure, the Church had a flexible attitude toward abortion. I noted that Catholic saints and theologians (for example, St. Bridget, Hildegarde of Bingen, and Thomas Sanchez) and even a Pope (Peter of Spain, who became Pope John XXI) tolerated abortion, and some developed abortifacients themselves. I don’t know how much this information helped the young woman. But I am convinced that a significant component of making women of similar backgrounds more comfortable with their reproductive decisions is the disseminating of information on the wide acceptance of abortion in many cultures and circumstances both now and in the past.