“If these laws were in place a few years ago, I legitimately might not have had kids.”
That’s what my close friend, E., said to me the other day. She had just read about a Missouri bill that would make abortion a felony if the patient had an ectopic pregnancy. Ectopic pregnancies are life-threatening and require immediate surgery. The alternative is death. In fact, ectopic pregnancies are the leading cause of maternal mortality in the first trimester, accounting for upward of 15 percent of maternal deaths.
E. already has two children. She and her husband had considered having a third child, but these reproductive restrictions are enough to scare her away from such plans: “If I was on the fence about having more children, I’d cut my losses and stop now rather than risk a pregnancy complication from which I can’t get life-saving care.”
To be clear, abortion restrictions have been around for decades —— and the most marginalized of people have been impacted by them. E., who is white and has good health insurance, is indeed privileged. Black, Indigenous, People of Color and low-income women have long been denied comprehensive reproductive health care. Black women are already more than three times more likely to die in pregnancy than white women, and the religiously rooted Hyde Amendment has denied abortion care for those receiving federal Medicaid for nearly 50 years, with only a minority of states picking up the costs. This means that low-income people seeking to end unwanted pregnancies must raise hundreds of dollars for abortion care or turn to private abortion funds, if they can find them, for support. The Hyde Amendment particularly impacts Indigenous women on the Indian Health Service Plan and those on Medicaid. A study by the Kaiser Family Foundation revealed that 56 percent of reproductive-age women on Medicaid live in a state that likewise bars state funding for abortion care.
The current onslaught of abortion restrictions only exacerbates these inequalities. This year to date, 39 state legislatures have filed more than 230 abortion restriction bills. And in 2021, the United States enacted more than 100 abortion restrictions — a record. Marginalized women will suffer the most.
And yet, the decision to have children in the face of these reproductive restrictions undoubtedly impacts women of all socioeconomic levels. E. is just one example. She further explained that she decided to get a tubal ligation so she would “never have to worry about accidentally getting pregnant again … because you know that birth control is next.” (She’s not wrong — many people are already struggling to obtain contraception, since anti-abortionists have rolled back contraception under the guise of “religious freedom.”)
Her comments reminded me of Jenny Brown’s book, Birth Strike: The Hidden Fight Over Women’s Work. Brown explains that it isn’t just the religious extremists who are anti-reproductive rights, but elite policymakers also want to expand the workforce without expanding worker benefits. Women in the United States are responding by not having children — or having fewer children. In fact, since 2008, with the exception of 2014, the U.S. birth rate has declined every year. Brown’s book describes how, lacking sufficient access to child care, family leave, health care, and male participation in child care, American women are conducting a spontaneous birth strike.
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Indeed, there appears to be an overlap between religious anti-abortion legislators and those who are against expanding health care and worker benefits. For example, anti-abortion former House Speaker Paul Ryan urged women to have more babies to (allegedly) save the economy from collapse: “We need to have higher birth rates in this country.” And yet, such politicians want higher birth rates without expanding access to child care, paid maternity leave and affordable health care. In the Religious Right’s mind, such public health programs are unnecessary because women should be stay-at-home mothers. For instance, according to Focus on the Family, a fundamentalist Christian organization founded in 1977, stay-at-home motherhood is preferential.
Now don’t get me wrong: I have nothing against mothers who want to stay at home instead of returning to the workforce. Indeed, with the exorbitant prices of day care, many women choose this as an economic option. Others choose to stay at home simply because they prefer to do so. I celebrate both choices — as well as the choice to have dads be the stay-at-home parent. However, such decisions should be made free of social, economic, political and religious coercion. How can we be in that place when abortion is under attack, yet the same anti-abortion legislators who are restricting abortion are also restricting sex education, contraception and sterilization? That isn’t choice — that’s coercion.
I am reminded of the ever-important Reproductive Justice framework. Reproductive Justice, a term coined by a group of Black activists, health care workers and advocates in 1994, means “the human right to maintain personal bodily autonomy, have children, not have children, and parent the children we have in safe and sustainable communities.” As SisterSong, a South-based national membership organization, explains, Reproductive Justice is not just about abortion. It’s about “contraception, comprehensive sex education, STI prevention and care, alternative birth options, adequate prenatal and pregnancy care, domestic violence assistance, adequate wages to support our families, safe homes, and so much more.”
As secular activists, our aim should be to build a country where people can choose to have children or not have children based on their own decisions, not as pawns in religious or economic schemes. Comprehensive reproductive rights is foundational to human rights. Secular voices are key to fighting for those rights.