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Don't Let Republicans Erase Vaginas From Women's Health

Without them, no health care system is complete

Orlando/Hulton Archive/Getty Images

Last week, I logged on to The New York Times to read its piece about right-wing women who are improbably eager for their party to get more aggressive in the battle against reproductive liberty and nearly spit out my seltzer.

The line that did me in was from Republican pollster Kellyanne Conway, quoted as urging conservative candidates to push back against Democrats who use the term “women’s health” in reference to contraception or abortion. “Women’s health issues,” Conway averred, “are osteoporosis or breast cancer or seniors living alone who don’t have enough money for health care.”

I’ve gotten downright inured to Republican men making gaffes about "legitimate rape" and female bodies that have "ways to shut that whole thing down," but here was a Republican woman blithely asserting that procedures like the one I had undergone just that morning—in which a doctor pushed a very long needle through my abdominal muscles, into my uterus, and into the amniotic sac surrounding the future kid I hope to carry to term—did not qualify as part of "women's health."

Some Republicans might at least be pleased that I am currently doing the proper female work of childbearing. But then again, the fact that I had had an amniocentesis to begin with was the result of calculations and history involving my advanced maternal age, which I reached by not reproducing during my 20s and early 30s (thanks to birth control which had to be specially prescribed due to clotting factors and fibroids). And of course, amnio is a diagnostic test that would, in part, help me decide whether to carry the pregnancy to term or have an abortion.

But this is all part of the point: When it comes to the complicated functioning of bodies and lives, procedures and prescriptions do not exist in vacuums, they are connected to a million other procedures and prescriptions … and they all add up to women’s health.

Does Conway, who is 47 and has worked as an advisor to Dan Quayle, Newt Gingrich, and Todd Akin himself, not know women who have had cysts or endometriosis, pap smears and HPV? Has she never befriended anyone who has had sex with someone they didn’t want to make a baby with or who has struggled with infertility? Has she not met people who have contracted an STD or had a miscarriage or a breach birth or a freaking yeast infection, all of which can require some combination of physician’s care, prescribed or over the counter medication, painkillers, and surgery? Does she think that American women believe that their health is comprised of breast cancer, osteoporosis and impoverished old age with nothing else going on from menarche to menopause?

It was particularly galling to read these assertions coming from another woman, but the strategy of erasing the female reproductive system from a larger definition of women’s health is part of a long tradition in conservative politics and policy-making. It’s been in place certainly since 1976, when the Hyde Amendment blocked Medicaid funds from being spent on abortion procedures. The Hyde strategy of suggesting that this particular medical procedure was not, in fact, a valid medical procedure by virtue of moral differentiation has held over time. Now some states, including Oklahoma and North Dakota, require women to purchase special separate private insurance riders should they imagine they might someday be in the position of needing or wanting to terminate a pregnancy.

These days, conservatives are busy applying the Hyde Amendment’s logic, that reproductive healthcare is different from human health, to ever-broadening areas of reproductive health. The Supreme Court’s Hobby Lobby decision extended it to birth control. There are the state legislatures working to prohibit state employees and Medicaid recipients from having other forms of contraception, including IUDs, covered by insurance.

“The anti-abortion movement has been very successful at separating abortion from other forms of routine medical care, stigmatizing the doctors who provide them and the women who seek them,” Michelle Goldberg, author of the 2009 book The Means of Reproduction, recently wrote in The Nation. “We’re currently in the midst of a coordinated attempt to do the same thing to birth control.”

But it’s not just the right that can get all stopped up around the language we use around female reproductive systems. This week the Times published a piece about reproductive rights activists on the left wondering whether or not to move away from the language of “choice” that has, in the decades since Roe v. Wade, signaled support for abortion rights. The term “choice,” writes reporter Jackie Calmes, has fallen out for favor thanks to “generational preference.”

Indeed, for most of my adulthood (I’m 39), I’ve experienced serious qualms about “choice,” and the loosey-goosey, non-specific interpretations that allowed literally any choice made by a woman to be framed as a feminist one. Even Sex and the City once lampooned the capacious meaninglessness of the term, having one of its lead characters, Charlotte, wail, about her choice to ditch her job to appease her vile first husband, “I choose my choice!”

I hated the Clintonian formulation that abortion should be “safe, legal, and rare” and have worried that leaders of reproductive rights movements were too hesitant about using the word “abortion” on television. I despaired when NARAL, which had historically been known as the National Association for the Repeal of Abortion Laws, then the National Abortion Rights Action League, changed its name in 2003 to the less-specific NARAL Pro-Choice America.

So I have been cheered in recent years by the generation of younger activists who have been far more open in their use of specific language around anatomy, sex, and reproductive life for women and men: the young people, some of them raised on campus productions of "The Vagina Monologues," who talk more freely than their predecessors about abortions, about IUDs and cervical caps and hormonal birth control methods, about sex and gender variety and anatomy. They amend not just the non-specific framework of “choice,” but more powerfully rebuke the conservative forces that would seek to put reproductive organs in a different basket from the rest of the human body.

I found it strange that the Times article on “choice” didn’t quote any young activists about their frustrations with the old language, so I called a couple of them to ask about their feelings on “choice,” “health,” and the words we use around them. What I heard was a complicated set of desires—the impulse to be more open and specific, yes, but to be open and specific about a far broader set of circumstances related to reproductive life than just abortion or contraception. For this breadth, they turn to a 20-year-old linguistic and activist framework that relies neither on the language of “choice” or “health;” it’s the “Reproductive Justice” movement.

“We inherited a lot of terminology from the really incredible people organizing what many would call the second wave of feminism,” said Alison Turkos, a 26-year-old reproductive justice advocate and co-chair of the NYAAF, the New York Abortion Access Fund. “When I see someone wearing a button or a bag that says ‘Pro-choice and proud’ I automatically know that she’s on board with abortion. But the Reproductive Justice movement has never been and will never be just about abortion. When I think ‘pro-choice’ I don’t hear anything about IVF, I don’t hear anything about adoption or surrogacy or gestational carriers. I think it’s very narrow. When I hear ‘Reproductive Justice’ I hear families of all shapes and sizes and races doing whatever they need to shape their families.”

There is a desire to be less guarded and euphemistic in how we talk about reproductive health. “I think talking about these issues more directly is really important,” said Renee Bracey Sherman, a 28-year-old Chicago activist currently living in Ithaca. “I’m very public about the fact that I had an abortion at 19 and I talk about it a lot and I say the word ‘abortion’ because I’m really frustrated with people and organizations who support abortions but who never say the word! If you can’t say the word ‘abortion’ it’s almost like you don’t support it even though we know that you do. So say it! I’m proud to have had an abortion and to talk about it!”

But the Reproductive Justice movement also seeks to take into account other kinds of specifics: the varied economic, racial, gendered, cultural and geographic needs of those who require legality, access, and social and policy support with regard to their health and reproductive life. “We, as young people, live multi-issue lives,” said Sherman. “We see the impact of dwindling access to health care, but also see families being separated due to immigration, a reduction in education—sex education, schools closing, loss of school lunches—and the choice framework just doesn’t encompass that. Reproductive Justice does.”

Whatever Kellyanne Conway or the Supreme Court says, women’s lives can never be reduced to one prescription or procedure that in turn can be neatly excised from the rest of their lives, the whole of their health. The abortions and IUDS and births and miscarriages and infertility and ability to nurse and care for a child without economic penalty and the big needles—they’re all part of a larger web that you can’t smooth over or obscure, no matter how many ways you try to define the women by ignoring the realities of the bodies they inhabit.