Medicine, the ‘pill’ and the struggle for reproductive rights

Jun 1, 2005

Last September, Suzanne Richards went to a pharmacy in Laconia, New Hampshire to fill a prescription for emergency contraception and was told that the pharmacist would not fill it, nor would he direct her to a pharmacist who would. By the time she found a pharmacy, the optimal time for taking the pills had passed.

Neil Noesen, a pharmacist in Wisconsin, refused to fill a 2002 prescription for oral contraceptives. He then refused to return the prescription to the patient. In February 2005, Noesen was reprimanded by an administrative law judge.

In 12 states, current laws permit or are broad enough to allow pharmacists to refuse to dispense medicines that violate their “conscience.” This has given anti-abortion pharmacists the opportunity to deny women basic reproductive health care, like birth control pills.

So far, the “pharmacists for life” represent isolated anti-women activists that luckily most women will not encounter. But right-wing forces emboldened by their connections to the Bush administration are trying to use these fringe pharmacists as a rallying cry for those who are doing everything possible to erode women’s reproductive rights.

Women should be able to avoid unwanted pregnancies. No anti-abortion pharmacists or their reactionary accomplices in the government can eliminate the desire of women to control their bodies.

The demand for reproductive rights means providing access to safe, affordable contraception and also includes the right to medical care that makes healthy pregnancies possible, as well as access to safe, legal abortions. This demand goes back to the 19th century, and was championed by feminists, socialists and radicals alike.

New technology provides breakthroughs

As often happens in history, meeting demands for reproductive rights—a key component of the women’s rights and women’s liberation movements—has been greatly facilitated by new developments in medicine and technology. One of the most significant achievements was the hormone-based oral contraceptive, known by millions as “the pill.”

The 1960 introduction of the pill in the United States made it possible for women to effectively control contraception without relying on her partner’s consent. The decision to use it was hers alone.

Initially, state laws required that women be married and legally emancipated. A requirement age of 21 existed in most states. Over the next eight years, state court battles struck down the age and marital status restrictions. Advocates for access to contraception used the national draft age of eighteen as justification to throw out the old restrictions. The lower age allowed women to consent to medical treatment and obtain the pill.

Interesting studies have correlated the advent of the pill and the later age of the first pregnancy to increased enrollment of women in colleges and better paying jobs due to earlier participation in the labor force (Goldin, Claudia and Katz, Lawrence F., “Career and Marriage in the Age of the Pill”). One hundred fifty years ago society generally had no understanding of conception, and the idea that men created life was widely accepted. Since then, women’s rights, globally, greatly progressed with the development of effective birth control.

Racism vs. reproductive rights

The very medical and technological advances that have made reproductive rights a reality for many women have also been the source of some of the most shameful attacks against women. Because reforms in the United States have been won under capitalism, they bear the marks of exploitation, racism and sexism that are characteristic of the society as a whole.

The most notable example of this was personified by Margaret Sanger—the woman who coined the term “birth control.” Sanger, like many women’s rights activists after the turn of the 20th century, was closely allied with the socialist movement and deeply influenced by the Russian Revolution. These early feminists were brave and determined. They opened clinics, went to jail, battled religious zealots, disobeyed the laws about dissemination of contraceptives and educated women about their bodies.

But as time passed, Sanger turned her back on the working class movement. She pinned her hopes on the bourgeois medical establishment, and embraced the eugenics movement that sought to “improve” humanity by breeding and limiting the populations of poor, Black and immigrant communities. Her own arrogant, racist and crude statements only helped to legitimize brutality.

For example, in 1939, Sanger and her associates launched the infamous “Negro Project.” The project was designed to build birth control clinics in poor Black communities to keep down the rising Black population. Sanger explained, “the poorer areas, particularly in the South … are producing alarmingly more than their share of future generations.”

Loretta Ross, National Coordinator of the Sister Song Women of Color Reproductive Health Collective, discussed the contradiction of racist eugenics in the guise of women’s rights in a 1998 essay entitled “African-American Women and Abortion.” “When we demand control over our own bodies,” she wrote, “we must not depend solely on our history of slavery, our African traditions or even on a colorized white feminist analysis. We need to support abortion rights from an analysis that is built from a strong and shared understanding of how the forces of racism, sexism, homophobia and economic oppression affect our lives.”

Even the testing for the pill was tainted by racism and colonialism. In order to conduct a large-scale trial for the Food and Drug Administration, U.S. doctors Gregory Pincus and John Rock administered massive doses of birth control hormones to over 6,000 women in Rio Piedras, Puerto Rico. The women living under U.S. colonial rule were never told about the experimental nature of the drugs they were given.

The drug tests on Puerto Rican women were only one side of the campaign against working class women on the island. Racist “population control” enthusiasts imposed a sterilization campaign in Puerto Rico, to the extent that by 1974, 35 percent of Puerto Rican women of childbearing age—some 200,000 women—were permanently sterilized. This represented the highest per-capita rate of sterilization of women in the world.

The views of population control advocates coincided with the fears within the U.S. ruling circles of the world’s poor and working classes. In 1977, Dr. R.T. Ravenholt, Director of the Population Office of the U.S. Agency for International Development, recommended that one-quarter of the world’s women be sterilized. He explained, “population control is needed to maintain the normal operation of United States commercial interests around the world. Without our trying to help those countries with their economic and social development, the world could rebel against the strong United States commercial presence. The self interest thing is a compelling element. If the population explosion proceeds unchecked, it will cause such terrible economic conditions abroad that revolutions will ensue. And revolutions are scarcely ever beneficial to the interests of the United States.”

The capitalist health care system is based upon profit. Medications are developed and distributed to benefit shareholders, ensuring they receive the highest return on their investment.

An overall struggle

The campaign to expand women’s reproductive rights starts with making sure that all women have access to reproductive medical care—free, on demand and without fear of harassment or judgment.

One recent undertaking, called the Pharmacy Access Partnership, is designed to expand the medications that would be available directly from the drugstore, without a prescription but not “on the shelf.” Studies are being conducted to determine whether pills, patches and other contraceptive devices could be available after a conversation with the pharmacist following a prescribed protocol. For many women, this would be easier and cheaper than an appointment with their doctor. This plan would provide more women with access to contraception.

Most important, though, the struggle for women’s liberation needs to be rooted in the working class—free of racism and national chauvinism. Reproductive rights need to be seen as part of the overall struggle for working women—the right to a job on the same terms as men, guaranteed child care and maternity leave and health care.

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