Developing a Reproductive Rights Agenda for the Next Century by Kathryn Kolbert. From Reproductive Laws for the 1990s, A Briefing Handbook, Women’s Rights Litigation Clinic, Rutgers Law School, Newark.
This is a call for a reproductive rights agenda for the next century. It suggests a process for developing a comprehensive approach to reproductive rights issues and outlines an agenda that can serve as a starting point for further discussions. Defining our goals is essential to achieving them. By taking the time now to articulate our vision of the future and grapple with the many hard questions that surround reproduction – questions about sexuality, childbearing and parenting – we can develop and build a consensus about the basic premises of our work. We will then be better able to set priorities and develop collective strategies to achieve our goals.
1. FREEDOM AND LEGAL RIGHTS TO MAKE VOLUNARTY DECISIONS
Our law[s] and social institutions must enable women to make voluntary, thoughtful, and deliberate choices about their own sexuality, childbearing, and parenting and must respect the decisions that women make for themselves and their families.
All persons must have the legal right to make voluntary and informed decisions. Our legal system cannot be used to deprive women of equal access to a full range of reproductive options. Nor can it be used to coerce women’s reproductive behavior or choices, regardless of age, ancestry, creed, disability, economic status, marital status, national origin, parental status, race, sex, or sexual orientation.
2. COMPREHENSIVE, QUALITY, AND AFFORDABLE HEALTH CARE AND HUMAN SERVICES
A. A Full Range of Reproductive Options
Women must have access to the full range of safe, effective, and affordable birth control methods, and medical research must develop better, safer methods. Men as well as women must assume responsibility for birth control, and technologies must be developed that will enable them to do so.
Women who find themselves pregnant must have access to quality counseling to determine their reproductive choices. If they choose to terminate their pregnancies, they must have access to all safe and affordable abortion methods and related health services at or near their homes or jobs.
Women who choose to carry a pregnancy to term must have access to quality prenatal care, genetic screening and counseling, childbirth and postpartum care, and pediatric care for their children.
Pregnant women, especially poor women and women in Black, Hispanic, and Native American communities who are experiencing a crisis of drug and alcohol abuse, must be provided reproductive health, maternity, and addiction services in an environment that is supportive and free of stigma. They must be fully informed of the risks to themselves and their infants in a way that is caring and nonpunitive and that helps them to deal with additional problems of poverty, poor housing, and male violence.
All women must have access to confidential and quality care for sexually transmitted diseases. Women who are HIV positive or at risk for AIDS who are or may become pregnant have the same right to noncoercive counseling and choice as women with other disabilities or possible fetal impairments. AIDS testing, like prenatal diagnosis, should be offered on an anonymous or confidential and voluntary basis and within a program of counseling and education that respects all persons’ rights to express their sexuality.
B. Comprehensive Care
Because reproductive choice includes the ability to care for as well as bear children, comprehensive health care and human services must be available to all families. Whether offered through public or private health programs, the services must be physically accessible – to disabled and rural women, to those dependent on public transportation, to those who work nights – and must be affordable to all.
C. Safe and Quality Care
Health and human services including all reproductive health services should focus on health, wellness and the prevention of problems, as well as on the cure and amelioration of problems, and should be provided in a culturally supportive manner, in an environment that is free from violence, deception, and fraud. Women should define their own needs and be enabled through the use of these services to make positive changes in their lives.
Medical practitioners must not adopt unnecessary or invasive practices that endanger women’s lives or health and must not use their power or authority to coerce reproductive decisions. For example, procedures such as sterilization, hysterectomy, amniocentesis, ultrasound, Caesarean section, or electronic fetal monitoring should be used only when medically appropriate. To prevent further medical abuse, the crisis in malpractice and liability insurance which has forced medical practitioners to adopt unnecessary or invasive practices in order to protect against legal liability must be addressed without leaving women unprotected.
D. Informed Consent and Informed Refusal
Principles of informed consent and informed refusal must be an intrinsic part of the decision making process and must be backed up by supportive counseling. Only when women have full knowledge about the ramifications of accepting or rejecting a particular health option, including explanations of medical procedures and their risks and benefits in understandable terms in the woman’s own language, can decisions be voluntary. At the same time, women must have the option of refusing particular types of information – e.g., the sex of the child after amniocentesis. In addition, informed consent must not become a pretext for harassment or discouragement of a particular reproductive choice, such as abortion or sterilization.
3. SEXUALITY, REPRODUCTIVE, AND LIFE SKILL EDUCATION
Women, particularly teenage women, often become pregnant because they lack essential knowledge about sex, pregnancy, and contraception. Persons of all ages must have sufficient information about their sexuality and reproductive health to make intelligent decisions about sexuality, childbearing, and parenting. Information about how their bodies work, varied forms of sexuality, contraceptives, and sexually transmitted diseases must be provided to all persons at accessible locations, in a manner that is understandable and age-appropriate. Men as well as women must be taught that they have equal responsibility to be well informed about and to participate fully in choices related to sexual behavior, reproduction, and parenting.
But education about sexuality and reproduction is only a part of the solution. Women, especially young women, often choose to become mothers because they have no realistic possibilities or advancement in society. Our educational system must provide women with the opportunity to set ambitious goals for their future, and the background to make these goals a reality, enabling women to choose motherhood when it is the best choice for them.
4. FREEDOM TO EXPRESS ONE’S SEXUALITY, AND TO ADOPT VARIED FAMILY ARRANGEMENTS OR LIFESTYLES
If women and men are coerced or socialized into heterosexual relationships, or if childbearing or childrearing is permissible only within heterosexual relationships, then people’s ability to make intimate decisions about reproduction, as well as about sexuality and parenting, is constrained. Society must not discriminate against, stigmatize, or penalize persons on the basis of their sexuality or sexual preference. Moreover, varied forms of sexual expression including heterosexuality, bisexuality, and homosexuality must be accepted as normal human responses, with positive meaning and value.
Women must be free to say no to sexuality, childbearing, and parenting as they are to choose these options. Women must be free to express their sexuality in whatever noncoercive forms they choose, without recriminations, without effect on their value in our society or their self-esteem, and without fear of becoming pregnant if they do not wish to be so.
Varied forms of family and living arrangements must be acceptable choices. When women choose to parent outside of marriage, or to live collectively or inter-generationally, these choices must be respected. The legal barriers to and social stigma of unwed parenthood, inter-racial childbearing, or lesbian motherhood must be eliminated if true reproductive choice for all women is to be an option. Moreover, since pressure to have children is often brought about because there are few other acceptable adult-child relationships, we must encourage alternative forms of adult-child interaction.
5. ECONOMIC EQUITY AND REPRODUCTION
In order that all persons have equal opportunity to become parents, they must have the means to do so. The economic barriers to alternative forms or reproduction, such as the cost of adoption, donor insemination, in vitro fertilization, or embryo transfer must be lessened for low-income women through fee reduction or subsidies.
If we want a society in which children are truly an option, women must have the economic means to raise their children – to provide adequate food, clothing, and shelter, and quality child care and education. We must work to eliminate the feminization of poverty that today so limits women’s reproductive options and work to create jobs and a welfare system that afford dignity to all and which is free from coercive childbearing policies. Without an economy and social services that support women, women are unable to support their children and families; responsible parenting is possible only in a society that provides the necessary resources for parents.
Public policies must be enacted that will ease the burdens of working parents, caught between responsibilities of job and home. In addition to quality, affordable child care services, a reproductive rights agenda requires gender-neutral pregnancy and child care leave provisions and flexible work schedules available without penalty to fathers as well as mothers. To make these provisions available to all working parents and not just the most privileged, leave time must be paid. Corporate and governmental employers should be encouraged to initiate internal education programs, similar to those currently under way regarding sexual harassment, to change employee attitudes about male and same-sex partner participation in prenatal and child care tasks.
6. FREEDOM FROM VIOLENCE
Because fear of violence by a spouse or partner and fear of sexual assault limit everyone’s ability to make intimate decisions, all persons must be free to choose whether, when and with whom they have sex and have children, and to raise their children without fear of sexual assault, abuse, violence, or harassment in their homes, on the streets, or at their jobs.
7. FREEDOM FROM REPRODUCTIVE HAZARDS
All persons must be free from reproductive hazards within the environment, in their homes, and at their workplaces. Rather than attempting to repair the effects of reproductive hazards by treating infertility or disease or by banning fertile women from hazardous worksites (and consequently from higher paying jobs), we must eliminate the hazards.
8. FAMILY LAW AND SERVICES
In order to enable all persons to freely form the arrangements in which they parent, they must be able to establish and terminate these arrangements without economic and social penalty. Fair and equitable marriage, domestic partnership, divorce, child support, and child custody laws must be available and enforceable by women whose marriage or other family arrangements have dissolved or proven inadequate. In the event of the death or disability of both of a child’s parents, governmental and community resources must provide for the well-being of the child. In the event of child abuse or neglect, governmental and community resources must provide necessary medical, social, and legal services to keep families together.
9. POLITICAL PARTICIPATION
All persons must have the full right to express their views and, through organized, collective, and non-violent action, to work actively for positive, systematic changes that will guarantee reproductive choice. Women must have the opportunity to be involved at all levels of the political process and within all political parties and be encouraged to take positions of leadership.
Kathryn Kolbert is the Constance Hess Williams Director of the Athena Center for Leadership Studies at Barnard College. A public-interest attorney, journalist, and visionary in the not-for-profit world, Kathryn brings to Barnard an extraordinary depth of experience in collaborative leadership, educational programming, and civil-rights advocacy. She has been recognized by The National Law Journal as one of the "100 Most Influential Lawyers in America,” and by The American Lawyer as one of 45 public- interest lawyers “whose vision and commitment are changing lives." In 1992, Kathryn argued the landmark case of Planned Parenthood v. Casey before the U.S. Supreme Court and has been credited with saving Roe v. Wade with what Jeffrey Toobin has called "one of the most audacious litigation strategies in Supreme Court history.”
Before joining Barnard, Kathryn was the President and CEO of People for the American Way and People for the American Way Foundation, two of the nation’s premier civil rights organizations. During her tenure, People For the American Way's Political Action Committee was cited by the National Journal as the most successful advocacy group of the 2008 election cycle.
For ten years, Kathryn oversaw a program on law and American life at the University of Pennsylvania’s Annenberg Public Policy Center. She was the executive producer of Justice Talking, an award-winning radio program distributed by NPR, and also directed an educational website called JusticeLearning.org, which received a Webby Award in 2005. Before she became a journalist, Kathryn enjoyed a long and distinguished career as a public interest attorney specializing in women’s reproductive rights. From 1992 to 1997, she directed domestic litigation and public policy programs for the Center for Reproductive Law and Policy, where she was a co-founder and vice president. She has also served as the State Coordinating Counsel of the ACLU's Reproductive Freedom Project in New York and as a Staff Attorney with the Women's Law Project and Community Legal Services in Philadelphia.
Kathryn graduated cum laude from Temple University School of Law, and received her undergraduate degree from Cornell University’s School of Arts and Sciences. She has lectured at colleges and universities across the nation and is a frequent commentator on constitutional and women’s rights issues in the national media.