Bloodless Coup

Scary View of Future Past

It's about time to start tracking statistics on tubal ligations. An interesting chart from the UN shows contraception rates. Something many readers might not know is that female sterilization is considered as contraception in most population data.

So why did I link to a story about the abortion ban and criminalization in South Dakota, but write about sterilization?

The news from South Dakota, and from around the country, about the efforts of religious extremists to remove women's reproductive autonomy against the will of the majority of the population of the United States, has me thinking about Brazil. Thinking about the women I knew there, and many I didn't, and what they did to try to control their fertility in a political system that restricted their ability to make decisions for themselves. The ones who were lucky and had access to oral contraceptives, the many - also fortunate - who had IUDs, the less lucky who self-aborted with Cytotec. It has me thinking about the dual nature of sterilization, which has been used both to forcibly remove women's reproductive autonomy and a last resort for women who had neither access to contraception nor abortion, but could get the procedure tacked on while in the hospital to give birth. If they couldn't have the choice to decide how many more children they could have, they chose none.

It's been a few years since I had a graduate course on demography, and I was curious about the correlation between sterilization rates and abortion rates, wondering if sterilizations went up as abortion became more restricted. I started looking for some sources, and found this excellent excerpt from a book on global population control. The search did not turn up the kind of data I was looking for, but the Harvard link shows a great deal of complexity. It raised new questions too, as I was thinking about if the anti-abortion crusaders are really pro-natalist, if they understand the consequences of trying to force women to reproduce, and the potential consequences of success. The section on sterilization in India is eye-opening. Also worth considering, if one really cares about women's autonomy, is the consideration the article gives to post-sterilization regret, which is striking in comparison to the much lesser regret after abortion. Yet women will choose sterilization.

And when thinking about the dangers, injustices and loss of freedom for women that comes from the state intervening where it does not belong, the train eventually leads to Romania.

Bottom line: Even the Communists, the garbage stuck to the bottom of humanity's drain, never pretended that prohibiting women to make their own medical decisions was anything other than a coerced sacrifice to the altar of state ideology. If, in today's America, we reach a point where not only are female patients, and their families, subject to communist policies, but the policies are implemented under the guise of noble intentions and consequences [not only is the loss of control over your internal organs for your own good and you must accept it, you must also appreciate, and be thankful for, it], one must ask: What kind of America is this?

Furthermore, while the various efforts--marches, petitions, public statements, blog posts--to raise public awareness of the issues at hand by people who think female patients should be allowed to make their own medical decisions are commendable, I don't think they are very effective. Granted, the enormity of the negative impact of female patients losing the ability to have a say in what happens to their health and their life is difficult to convey in the abstract. Difficult, but not impossible. For example, here's a more realistic alternative. Regardless of your gender, beliefs, thirst for power, etc., next time you have to consent to a medical procedure, 1) refuse to sign the consent, and 2) insist that your doctor only perform the procedure after contacting your local politician and securing his/her permission. This should help put some things in perspective. As would complications from a septic abortion--the great clarifier. But I digress.

Romania.

The government responded in 1966 with a decree that prohibited abortion on demand and introduced other pronatalist policies to increase birthrates. The decree stipulated that abortion would be allowed only when pregnancy endangered the life of a woman or was the result of rape or incest, or if the child was likely to have a congenital disease or deformity. Also an abortion could be performed if the woman was over forty-five years of age or had given birth to at least four children who remained under her care. Any abortion performed for any other reason became a criminal offense, and the penal code was revised to provide penalties for those who sought or performed illegal abortions.

Other punitive policies were introduced. Men and women who remained childless after the age of twenty-five, whether married or single, were liable for a special tax amounting to between 10 and 20 percent of their income. The government also targeted the rising divorce rates and made divorce much more difficult. By government decree, a marriage could be dissolved only in exceptional cases. The ruling was rigidly enforced, as only 28 divorces were allowed nationwide in 1967, compared with 26,000 the preceding year.

Some pronatalist policies were introduced that held out the carrot instead of the stick. Family allowances paid by the state were raised, with each child bringing a small increase. Monetary awards were granted to mothers beginning with the birth of the third child. In addition, the income tax rate for parents of three or more children was reduced by 30 percent.

Because contraceptives were not manufactured in Romania, and all legal importation of them had stopped, the sudden unavailability of abortion made birth control extremely difficult. Sex had traditionally been a taboo subject, and sex education, even in the 1980s, was practically nonexistent. Consequently the pronatalist policies had an immediate impact, with the number of live births rising from 273,687 in 1966 to 527,764 in 1967--an increase of 92.8 percent. Legal abortions fell just as dramatically with only 52,000 performed in 1967 as compared to more than 1 million in 1965. This success was due in part to the presence of police in hospitals to ensure that no illegal abortions would be performed. But the policy's initial success was marred by rising maternal and infant mortality rates closely associated with the restrictions on abortion.

The increase in live births was short-lived. After the police returned to more normal duties, the number of abortions categorized as legal rose dramatically, as did the number of spontaneous abortions. The material incentives provided by the state, even when coupled with draconian regulation and coercion, were not enough to sustain an increase in birthrates, which again began to decline. As the rate of population growth declined, the government continued efforts to increase birthrates. In 1974 revisions in the labor code attempted to address the problem by granting special allowances for pregnant women and nursing mothers, giving them a lighter work load that excluded overtime and hazardous work and allowed time off to care for children without loss of benefits.

The Ceausescu regime took more aggressive steps in the 1980s. By 1983 the birthrate had fallen to 14.3 per 1,000, the rate of annual increase in population had dipped to 3.7 per 1,000, and the number of abortions (421,386) again exceeded the number of live births (321,489). Ceausescu complained that only some 9 percent of the abortions performed had the necessary medical justification. In 1984 the ,b>legal age for marriage was lowered to fifteen years for women, and additional taxes were levied on childless individuals over twenty-five years of age. Monthly gynecological examinations for all women of childbearing age were instituted, even for pubescent girls, to identify pregnancies in the earliest stages and to monitor pregnant women to ensure that their pregnancies came to term. Miscarriages were to be investigated and illegal abortions prosecuted, resulting in prison terms of one year for the women concerned and up to five years for doctors and other medical personnel performing the procedure. Doctors and nurses involved in gynecology came under increasing pressure, especially after 1985, when "demographic command units" were set up to ensure that all women were gynecologically examined at their place of work. These units not only monitored pregnancies and ensured deliveries but also investigated childless women and couples, asked detailed questions about their sex lives and the general health of their reproductive systems, and recommended treatment for infertility.

Furthermore, by 1985 a woman had to have had five children, with all five still under her care, or be more than forty-five years old to qualify for an abortion. Even when an abortion was legally justified, after 1985 a party representative had to be present to authorize and supervise the procedure. Other steps to increase material incentives to have children included raising taxes for childless individuals, increasing monthly allowances to families with children by 27 percent, and giving bonuses for the birth of the second and third child.

Although government expenditures on material incentives rose by 470 percent between 1967 and 1983, the birthrate actually decreased during that time by 40 percent. After 1983, despite the extreme measures taken by the regime to combat the decline, there was only a slight increase, from 14.3 to 15.5 per 1,000 in 1984 and 16 per 1,000 in 1985. After more than two decades of draconian anti- abortion regulation and expenditures for material incentives that by 1985 equalled half the amount budgeted for defense, Romanian birthrates were only a fraction higher than those rates in countries permitting abortion on demand.

Romanian demographic policies continued to be unsuccessful largely because they ignored the relationship of socioeconomic development and demographics. The development of heavy industry captured most of the country's investment capital and left little for the consumer goods sector. Thus the woman's double burden of child care and full-time work was not eased by consumer durables that save time and labor in the home. The debt crisis of the 1980s reduced the standard of living to that of a Third World country, as Romanians endured rationing of basic food items and shortages of other essential household goods, including diapers. Apartments were not only overcrowded and cramped, but often unheated. In the face of such bleak conditions, increased material incentives that in 1985 amounted to approximately 3.61 lei per child per day--enough to buy 43 grams of preserved milk--were not enough to overcome the reluctance of Romanian women to bear children.

In 1989 abortion remained the only means of fertility control available to an increasingly desperate population. The number of quasi-legal abortions continued to rise, as women resorted to whatever means necessary to secure permission for the procedure. Women who failed to get official approval were forced to seek illegal abortions, which could be had for a carton of Kent cigarettes.

Despite the obvious reluctance of women to bear children because of socioeconomic conditions, the Ceausescu regime continued its crusade to raise birthrates, using a somewhat more subliminal approach. In 1986 mass media campaigns were launched, extolling the virtues of the large families of the past and of family life in general. Less subtle were the pronouncements that procreation was the patriotic duty and moral obligation of all citizens. The campaign called for competition among judete (counties) for the highest birthrates and even encouraged single women to have children despite the fact that illegitimacy carried a considerable social stigma.

Critics call Amanda ill-tempered, hysterical, and worse for taking a collection of proposed restrictions on women's autonomy and following them through to their cumulative impact.

It's practically a full-time job to keep up with all the assaults on women's liberty and autonomy: Lies in abstinence education, Pro-natalist trolls at Pharyngula, not really about babies, anti-abortion activists also attack contraception and family planning.

Outright falsehoods employed in the attack on contraception? I've seen so many discussions that are full of misinformation, that Plan B causes abortion (it doesn't) that hormonal contraception, by thinning the uterine lining causes abortions (it doesn't).

And you think the idea that reproduction and nationalism in the United States couldn't be further from Romania? How about your patriotic duty to reproduce from Townhall? Because of course, you're not really a woman unless you are "capable of becoming pregnant"? Anti-contraception for married couples?

It's not even necessary to focus on the right to abortion or calls to patriotic reproduction to find calls to restrict women's freedoms, just because they don't deserve it: there the proliferation and normalization of MRA anti-woman rhetoric, argument about men's right to women's bodies, especially in marriage with patriarchal ideology and spousal consent.

Think the pro-birth madness can't get any weirder, that the crusaders won't be happy until everyone possible is knocked up? Think again: lawmakers who want to control (read: prevent) people who want to reproduce about which I also posted.

Think that at least in all of this the pro-natalists will want to protect women's reproductive systems - especially the all important cervix - and their lives? blocking anti cancer vaccine for fear it would cause promiscuity and Twisty's view of it.

I've barely grazed the surface of Dear Spinster Aunt Twisty who has her own view of all this, and haven't even started on the systematic picking apart of the policy implications by Scott Lemieux.

How can we possibly compare the US to the abuse of women's human rights in the worst communist state? The majority of the people in this country don't want that kind of control over women's - and men's - lives. The majority want to continue to make such decisions themselves, with their families, in consultation with their doctors, their God(s) or Goddess(es). Make no mistake about the crusaders. They don't care who you are, what you know, who you worship, if you worship, or whether or not you vote. They care more about their self-righteous, self-indulgent, authoritarian worldview.

And it might just be that to preserve their own reproductive freedom, women might freely choose to permanently forgo reproduction entirely, might risk their lives, to avoid submission to a government sanctioned religious ideology based on the control over and enforced inequality of women.

Posted by binky at February 23, 2006 07:39 PM | TrackBack | Posted to Reproductive Autonomy