Reproductive health is a state/church issue

Note: This is the farewell column from FFRF Anne Nicol Gaylor Reproductive Rights Intern Barbara Alvarez. FFRF wishes to thank her for all her wonderful work and writing on abortion rights.

There are many ways in which religion proves detrimental to reproductive health.

Instead of adhering to evidence-based science, extremists — relying on religious texts, dogma and ideological values — endanger women’s lives and violate their human and constitutional rights to comprehensive care. This is especially harmful when such dogmas are codified through legislation. Laws regulating health care in a secular nation must follow science, not religion.

The World Health Organization defines reproductive health as “a state of complete physical, mental, and social well-being and not merely the absence of disease and infirmity, in all matters relating to the reproductive system and to its functions and processes.” Furthermore, reproductive health means that people not only may have a safe and satisfying sex life, but that they “have the capability to reproduce and the freedom to decide if, when and how often to do so.”

Reproductive justice, a term coined by a group of a dozen Black women working in the reproductive health and rights movement, refers to “the human right to maintain personal bodily autonomy, have children, not have children, and parent the children we have in safe and sustainable communities.” Effectively, reproductive justice declares that reproductive health is a holistic issue and cannot exist without equity and accessibility. The United Nations further declares that sexual and reproductive health is connected to human rights. It notes that violations include denial of access to reproductive health services, delivery of poor quality services, subjection of women’s access to services to third-party authorization, forced sterilization, forced virginity examinations, forced abortions and early marriage. Importantly, the United Nations explains that many of these violations are due to “deeply ingrained beliefs and societal values pertaining to women’s sexuality.”

Religion is a major factor in these harmful beliefs and societal values that become codified through destructive legislation. This analysis will specifically explain why reproductive health is a state/church issue by examining legislation and practices related to abortion, contraception, sterilization, sex education and menstrual health in the United States.

One of the most obvious examples of obstruction of reproductive health concerns abortion rights. Abortion became legalized nationwide in the United States with the 1973 Supreme Court decision of Roe v. Wade. While Roe legalized abortion, it did not guarantee accessibility.  Religiously motivated politicians and leaders capitalized on that fact. Some of the most consequential anti-abortion legislation decision was passed soon after Roe and is in still in effect today.For example, the Church Amendment, which was passed shortly after Roe v. Wade, permits any physician at a public hospital to refuse to perform an abortion or sterilization if it is against the provider’s religious or moral beliefs. Since then, 47 states have passed “conscience clauses” that mirror the Church Amendment.

Beyond “conscience clauses,” reproductive health barriers exist in religiously influenced amendments to the federal appropriations bills. The most egregious assault on abortion care is the Hyde Amendment. Enacted in 1976 and sponsored by Rep. Henry J. Hyde of Illinois, a staunch, lifelong Roman Catholic, the Hyde Amendment is a discriminatory provision that denies federal funding for abortion care. This means, almost without exception, that women on Medicaid, as well as women on the Indian Health Service Plan, Peace Corps volunteers, those on federal worker health care plans, and women in federal prisons and the military, are ineligible for receiving subsidized abortion care unless their residential state uses its own funds to pay for abortions. (This is the case only in 16 states.)

Since abortion can cost anywhere from $500 to $3,000, abortion has become largely inaccessible to low-income women.

Hyde was known for his extremist religious and anti-abortion rhetoric. He frequently referenced his fear of the “final judgment” and “what happens in eternity” as his motivations for anti-abortion legislation. For denying safe abortion care to millions of women through the Hyde Amendment,  the Catholic Church heaped praise on Hyde, declaring him to be “an example of a Catholic layman who took seriously the lay vocation to transform the world.”

It is a testament to the callous and uncaring treatment of women and their autonomy by Congress that the Hyde Amendment passed with bipartisan support for nearly 50 years.

Like the Hyde Amendment, the Helms Amendment is a harmful addition to the appropriations bill. Enacted in 1973, this permanent part of the Foreign Assistance Act prevents the use of U.S. foreign assistance funds for the performance of an abortion as “a method of family planning” — with no exceptions for rape, incest or maternal health. The amendment was introduced by Jesse Helms, a senator from North Carolina well known for his racism, such as his support for segregation and attempts to prevent Black voters from casting ballots. He was also a Christian nationalist who fought to restore school prayer and claimed that “Christianity is higher than religion” and “is the meaning of America.”

An analysis from the Guttmacher Institute, a pro-choice research organization founded in 1968, determined that repealing the the Helms Amendment would result in 19 million unsafe abortions and 17,000 fewer maternal deaths each year.

The Mexico City Policy takes the Helms Amendment one step further. Commonly known as the Global Gag Rule, this policy was first introduced by President Reagan in 1984. Reagan, who the Religious Right has referred to as “Father of Pro-Life Movement,” declared at a March for Life rally: “We’re told about the women’s right to control her own body. But doesn’t the unborn child have a higher right, and that is to life, liberty and pursuit of happiness?”

The Global Gag Rule prohibits U.S. funding to any foreign nongovernmental organization that so much as mentions “abortion.” This means that millions of women around the world are cruelly denied life-saving abortion services, information, counseling, referrals and advocacy. Repealed by Democratic presidents, the Global Gag Rule has been reintroduced by executive order with every Republican president since 1984. The Trump administration expanded it from foreign NGOs to all U.S. global health assistance, which covered work in projects related to HIV/AIDs, nutritions, malaria, water and tuberculosis. Beyond this, the Trump administration expanded it further to apply to subrecipients of “gagged” organizations, even if they do not directly receive any U.S. foreign assistance.

Research has shown that the Global Gag Rule increases the prevalence of unsafe abortions, tragically leading to approximately 68,000 maternal deaths per year. Trump’s unprecedented expansion of the Global Gag Rule, although repealed by President Biden, will undoubtedly serve as a blueprint for future Christian nationalist administrations unless legislation is passed to prevent this.

In addition to these amendments, the Supreme Court and federal courts have become a battleground for religion and reproductive health care. Most recently, Trump, who ran on Christian nationalist positions, appointed more than 220 federal judges to lifetime positions. Many of these judges are chosen in part because they are combative toward reproductive health and rights. This clears the way for courts to approve harmful Targeted Regulation of Abortion Providers (TRAP) Laws, including mandatory ultrasound viewing, 72-hour waiting periods, and unnecessary admitting privileges to hospitals.

Indeed, the future of abortion care is perilous. In 2021 alone, anti-abortion restrictions are slated to be at their most prevalent since 1973. In one week alone, 28 anti-abortion bills were enacted.

Disturbingly, this trend is being echoed at the local level. Eight city ordinances in Texas have now declared themselves to be anti-abortion zones. Lubbock, Texas, is the largest city to enact such an ordinance, threatening the Planned Parenthood clinic in Lubbock, and forcing area women to travel 5.5 hours to the nearest clinic (until the state ban went into effect on Sept. 1 and outlawed most abortion care everywhere in Texas).

Beyond the continental states, U.S. territories face their own unique restrictions. Currently, after the island’s sole abortion provider retired in 2018, women in the U.S. territory of Guam do not have access to abortion care, unless they can afford the costly and time-intensive trip to Hawaii.

In June 2020, the Supreme Court ruling in June v. Russo upheld precedent against Targeted Restrictions Against Abortion Providers regulations, commonly known as TRAP laws. Since the face of the high court changed to an ultraconservative majority, this precedent is imperiled. Specifically, Justice Amy Coney Barrett, a Christian nationalist who has been open about her anti-abortion views, replaced pro-choice Justice Ruth Bader Ginsburg, providing anti-abortion activists, legislators, and religious leaders with hope that abortion will soon be criminalized. For example, the ultraconservative Supreme Court has upheld Texas’ draconian six-week abortion ban, the most restrictive ban in the country. In the latest hearing for Dobbs vs. Jackson Women’s Health Organization, the Supreme Court signaled its intent to turn abortion legislation back to the states. This decision could overturn Roe v. Wade or could render its guarantees virtually meaningless over time.

While federal funding for clinics that provide comprehensive reproductive health care services and information is under attack, Crisis Pregnancy Centers receive millions of tax dollars to spread religion and false information about health. With more than 3,000 centers across the United States, these locations pose as health facilities and often are located directly across from abortion clinics in efforts to lure women. Crisis Pregnancy Centers are an arm of the anti-abortion protesters who often turn to harassment, stalking, death threats and violence at abortion clinics. In 2018, violence against abortion clinics hit a record high that coincided with newly enacted or introduced state abortion restrictions. The deadly Jan. 6 Capitol insurrection included many well-known anti-abortion extremists.These centers not only dissuade women from receiving abortions, but they use medical disinformation and religious propaganda to spread lies about contraception, sexuality and reproductive health. The American Medical Association Journal of Ethics has declared Crisis Pregnancy Centers unethical, because “the religious ideology of these centers’ owners and employees takes priority over the health and well-being of the women seeking care at these centers.”

Nevertheless, the Supreme Court has ruled that Crisis Pregnancy Centers are protected by the First Amendment and religious freedom. Additionally, over $30 million in tax dollars have gone to Crisis Pregnancy Centers. Even while the Trump administration gagged true health care facilities, like Planned Parenthood, from receiving Title X funding because they provide or refer patients for abortion, religiously rooted Crisis Pregnancy Centers have received tax money to spread disinformation.

Accessible and affordable contraception would greatly reduce the prevalence of abortions. In fact, research found that contraception accounted for an 86 percent decline in teen pregnancy and its use is a key driver in declines in unintended pregnancies and abortion. Beyond pregnancy prevention, contraception (such as birth control pills) is used for a variety of health reasons. For example, a study from the National Survey of Family Growth found that birth control pills are used by women to alleviate menstrual cramps (31 percent), and for menstrual regulation, such as treating pain and side effects (28 percent), treatment of acne (14 percent) and treatment of endometriosis (4 percent).Nevertheless, anti-abortion religious groups deny science and favor ideology. For example, in June 2020, the Supreme Court ruled on a case known as Little Sisters of the Poor v. Pennsylvania. This case included objections from an order of Catholic nuns who did not want to adhere to a workaround employed by the Obama administration to permit employers to notify the government or insurance company that they would not provide birth control coverage for religious reasons, so the government could take over that cost. And, yet, religious objectors persisted. Groups like the order of Catholic nuns contended that the workaround was insufficient and that it “amounted to authorizing the use of their plan for birth control.”

The high court ruled that employers with religious or moral objections do not have to provide insurance coverage for contraceptives under the Affordable Care Act. Without subsidized coverage, 75,000 to 125,000 women could pay $600 to $1,000 per year for oral contraceptives; longer-term options like IUDs can cost significantly more. As such, numerous women are denied access to contraception because of the religious views of others.

Additionally, studies have shown that comprehensive sex education programs greatly reduce unintended pregnancies and abortions. Nevertheless, only 13 states require that sex education be medically accurate. Furthermore, 26 states focus on abstinence sex education programs. Beginning in 1981, shortly after televangelist Jerry Falwell founded the Moral Majority, Congress passed the Adolescent Family Life Act, also known as the “chastity law,” to encourage students to delay sex until marriage. More than $2 billion has gone to funding anti-science education, including for Title V Abstinence-Only-Until-Marriage. These programs exclude demonstrations and information about contraception, even though there is no evidence that denying information prevents sexual activity.

As a result of the lack of science-backed information, the United States has far greater teen pregnancy rates than other developed countries. For example, U.S. teens are two-and-a-half times more likely to give birth than teens in Canada, four times more likely than teens in Germany and Norway and nearly 10 times likelier than teens in Switzerland.

Additionally, abstinence-only education propagates harmful gender roles and concepts of purity, and teaches young women to be ashamed and ignorant of their bodies.

A comprehensive sex education program includes information about menstruation, or the vaginal bleeding that occurs when a woman sheds her uterine lining each month when she is not pregnant. This process is a natural part of a woman’s menstrual cycle that lasts for typically three to five days and occurs for roughly 40 years of a woman’s life.However, major religions across the world attribute menstruation to uncleanliness and use religious texts to justify discrimination against women and girls. For example, Leviticus 15:18-33 declares that women who are menstruating are unclean for seven days and that anything they touch will also be unclean. Islam also commands people to stay away from women who are menstruating and Buddhism and Hinduism prevent women from entering temples during menstruation.

As a result, menstruation is a cultural taboo that can lead to “period poverty” whereby girls and women miss school or work because they lack access to menstrual hygiene products. In fact, 23 million girls in India drop out of school every year when they start menstruating. Women in countries like Nepal are exiled to “menstrual huts” as they are considered “unclean” during their menstrual period. In these crude huts, they are at risk for physical assaults, snake bites, freezing temperatures, and suffocation from lack of ventilation. In the United States, one in five girls misses school because they lack menstrual products. Supporting subsidized feminine hygiene products would be a much-needed step toward dismantling religion’s harmful impact on menstrual health.

Like abortion, sterilization is a deeply personal reproductive choice. Tubal ligation, informally known as “getting your tubes tied,” is an extremely safe and effective procedure that permanently prevents pregnancy by blocking or closing the fallopian tubes. John Hopkins Medicine reports that serious problems occur in less than 1 in 1,000 women undergoing tubals. And yet, this simple procedure is weaponized for religious purposes. For example, women in Puerto Rico had the highest sterilization rate in the world by the 1970s as the result of an imperialistic effort to curb poverty and socioeconomic inequalities. With heavy Roman Catholic influences, sterilization was regarded as more worthy of forgiveness than contraception or abortion. In fact, the Catholic Church viewed sterilization as a one-time offense that could be forgiven in confession. As a result, one-third of all Puerto Rican mothers were sterilized in a procedure so common it became known as “La Operación.”And yet, Catholic hospitals throughout the United States prevent women from exercising their bodily autonomy and receiving voluntary sterilization. Since Catholic hospitals abide by the Ethical and Religious Directives, rules written by the U.S. Conference of Catholic Bishops (an all-male organization), Catholic health facilities restrict abortion, sterilization and contraception. Specifically for tubal ligations, the directive states:  “Direct sterilization of either men or women, whether permanent or temporary, is not permitted in a Catholic health care institution.” This religious mandate greatly impacts the health of millions of women across the United States as Catholic hospitals continue to gobble up prime health-care real estate.

For example, Catholic hospitals are often the dominant health care facility in rural and low-income areas. This means that Catholic hospitals that receive billions of taxpayer dollars can deny evidence-based medicine to their patients based on ideology — not science. Additionally, 21 percent Catholic hospitals do not disclose their Catholic identity and only 24 percent cite the ethical and religious directives that they follow.

In Freedom From Religion Foundation’s home state of Wisconsin, Catholic hospitals have grown by 13 percent and researchers have determined that it is the only state in the country where Black women are more likely to deliver their babies in a Catholic institution than in a non-Catholic one.

As a result, women are denied basic reproductive health care procedures, including sterilization, because of the proliferation of religiously affiliated health care facilities that impose dogma —not science — on their patients.

Religion stands in the way of women’s reproductive health in the United States. Consequently, women are unable to exercise their constitutional and human rights to sufficient health care.However, upholding secularism in reproductive health care is no small endeavor as politicians are incentivized by donations from religiously rooted anti-choice organizations. For example, top recipients from groups like Susan B. Anthony List, an anti-abortion organization, use religion to drive their policies — not science or public opinion. Robin Marty, communications director at the Yellowhammer Fund, a Southern reproductive justice group, describes the financial landscape: “It starts with the deep pockets of Catholic churches and ends with small religious organizations and individuals quite literally paid to shame women, lobby lawmakers and protest outside of abortion clinics.”

The United States is a nation founded on the separation of state and church. However, religion is invoked as a rationale to strip away women’s bodily autonomy. Science does not support reproductive health restrictions. Rather, science and international governing bodies like the United Nations point to the need for comprehensive reproductive health care. Religious ideology infiltrates legislation, threatening the health and well-being of millions of women across the country. Secular action is needed more than ever.