Changing the Narrative: The Importance of Centering Choice

On September 14, Dawn Wooten, a former nurse at the Irwin County Detention Center in Ocilla, Georgia, filed a whistleblower complaint alleging there was a complete lack of protection against COVID-19. Wooten also testified that doctors at the center performed hysterectomies on detainees at alarmingly high rates. When speaking about one physician, Wooten stated, “everybody he sees has a hysterectomy.” Further, she claimed doctors conducted these sterilization procedures without proper informed consent. Her complaint noted that non-Spanish speaking nurses used Google Translate to convert materials from English into Spanish, and when detainees asked authorities why doctors insisted on sterilizing them, doctors, nurses, and officers gave them an assortment of different answers. Media coverage of Wooten’s complaint linked her allegations to other recent reproductive injustices targeted at migrant women, including 2017 reports that uncovered the Trump Administration’s policies restricting unaccompanied migrant minors from accessing abortions, sometimes even in the case of rape.

Four days after Wooten filed her complaint, Supreme Court Justice Ruth Bader Ginsburg died on September 18. Americans mourned the loss of a feminist leader, and the media centered their attention on women’s fears that the appointment of another conservative judge to the Supreme Court could end a woman’s constitutional right to an abortion. Within days, The New York Times, The Los Angeles Times, The Wall Street Journal, The New York Post, The Washington Post, The Huffington Post, The Cut, National Public Radio, and The San Francisco Chronicle all published articles focused on what Ginsburg’s death meant for the future of abortion rights in the United States.

By centering abortion in their coverage of Ginsburg’s death, the press perpetuated the narrative that restriction on abortion access is the most pressing form of reproductive injustice women endure today. This narrative is a vestige of the women’s movement of the mid-twentieth century, led by white, middle-class women, who often did not consider the reproductive issues minority women faced. While a woman’s right to an abortion is essential to her reproductive freedom, Wooten’s allegations confirm that poor women and women of color are subject to an array of reproductive oppressions, including policies and practices intended to curb their childbearing. Since the 1990s, to better reflect marginalized women’s experiences, reproductive justice activists have sought to expand the reproductive rights platform. Women of color developed the reproductive justice framework to spotlight the ways Black, Indigenous, and other minority women experienced reproductive health discrimination differently than white women. Advocates of reproductive justice have fought for safe, legal, and affordable abortions in addition to freedom from coercive sterilizations. A woman’s right to bodily autonomy from all perspectives is fundamental to reproductive justice.

If Wooten’s allegations are true, this is the latest example of coercive sterilizations targeted at poor and minority communities in the U.S., a practice directly linked to eugenics. Eugenics used Charles Darwin’s concept of natural selection and the belief that intelligence was hereditary to eventually advocate, by the early 20th century, for the sterilization of individuals whom society deemed “feebleminded” and ergo, “unfit” for reproduction. “Feebleminded” was a catchall term used to describe someone with low intelligence or to discreetly identify a young woman who exhibited sexual depravity.^[1] As a then-accredited science, state-run eugenics boards justified thousands of sterilizations. But by the 1940s, scholars began to criticize eugenics, demonstrating it was both faulty science and a justification for racism.^[2] Moreover, the Nazis’ use of eugenic theories to warrant the atrocities performed during the Holocaust led most scientists and government officials to officially distance themselves from eugenicists.^[3] Yet even as eugenics became discredited, some of its theories were simply reincorporated into the new population control and family planning initiatives. Moreover, some state eugenics boards continued to forcibly sterilize women and men. Poor populations of color were often the targets of these sterilization practices.

A closer look at Ginsburg’s legal career reveals that she, too, like reproductive justice activists, believed in centralizing a woman’s right to choose to have or not have a child. Before becoming a Supreme Court Justice, Ginsburg used her power as an attorney to defend a woman who North Carolina state officials coercively sterilized. Between 1929 and 1974, North Carolina’s Eugenics Board sterilized close to 7,600 people, the majority of whom were African American. During her years with the American Civil Liberties Union’s Women’s Rights Project, Ginsburg filed a federal lawsuit on behalf of one of these victims, Nial Ruth Cox. In 1965, Cox, an eighteen-year-old African American girl, became pregnant. Unless Cox’s mother Devora agreed to consent to her daughter’s sterilization, North Carolina public officers threatened to withhold her welfare benefits. After being assured that the procedure was reversible, Devora agreed, and a physician sterilized her daughter. Five years later, when Cox hoped to become pregnant again, a gynecologist informed her that the sterilization procedure was permanent. Ginsburg’s suit insisted the state pay Cox one million dollars in damages, and she asked the court to proclaim North Carolina’s program unconstitutional. While Cox did win damages, the court did not declare North Carolina’s eugenics program to be unconstitutional because, at the time of the ruling, it was no longer in operation. The court’s decision did not overturn Buck v. Bell, the 1927 Supreme Court case that ruled state-sanctioned sterilizations constitutional. Consequently, forced and coerced sterilization practices remain legal in the U.S.

In the 1970s, Ginsburg prepared a case she hoped would ensure women the right to decide whether to have children. Before Roe v. Wade secured women the right to a legal abortion, Captain Susan Struck, a nurse in the Air Force, became pregnant while serving in Vietnam. The Air Force offered Struck two options: she could have an abortion or leave the military. Although she arranged to have the child adopted, the military ordered Stuck to leave Vietnam and return to the U.S. In 1971, Ginsburg prepared to represent Struck in a Supreme Court case. She intended to argue that to guarantee gender equality under the law, women must have the right to choose to keep or terminate a pregnancy. But before the case made it to the Supreme Court, the Air Force changed its policies allowing Struck to keep her pregnancy and her position in the military. Later, in a discussion about Stark’s case, Ginsburg remarked, “I wish that would have been the first [abortion] case.” She argued that it would have allowed the Court to see the issue as “a question of a woman’s choice.”

Because the decision in Roe v. Wade transferred a woman’s right to an abortion from the state to physicians, many of the abortion cases since the historic 1973 decision have limited abortion access instead of expanding women’s rights. In 1980, the U.S. Supreme Court confirmed the constitutionality of the Hyde Amendment, which prohibited the use of federal Medicaid resources to fund a woman’s abortion.^[4] Later, in 1992, the decision in Planned Parenthood of Southeastern Pennsylvania v. Casey allowed states to place significant restrictions on abortion access, including mandatory twenty-four-hour waiting periods, parental consent, required reporting obligations on abortion-providing facilities, and enforced informed consent.^[5] These restrictions have made it more difficult for people with low incomes to access an abortion, and therefore, abortions have become less of a right and more of a privilege.^[6]

At Ginsburg’s 1993 Senate confirmation hearings, she declared her dedication to ensuring all people the right to bodily autonomy. When asked about a woman’s right to terminate a pregnancy, she told the committee the right to an abortion is essential to true gender equality. “The decision whether or not to bear a child is central to a woman’s life, to her well-being and dignity.” She added, “When government controls that decision for her, she is being treated as less than a fully adult human responsible for her own decisions.” Later in the questioning, when referring to a case that found the compelled sterilization of criminals unconstitutional, Ginsburg stressed “the importance of procreation to an individual’s autonomy. That applies to men as well as women.” True to her words, Ginsburg defended women’s reproductive freedom throughout her tenure on the Court.

Despite the 2020 election, President Trump and the Republican Senate leadership insisted on moving forward in appointing Amy Coney Barrett, giving the Supreme Court a 6-3 conservative majority and the most conservative Court since the mid-twentieth century. This shift on the Court could lead to additional restrictions on abortion access or conceivably the overturn of Roe. Additionally, Barrett’s appointment could put the Affordable Care Act (ACA) at risk. If the Court decides the ACA is unconstitutional, millions of women will lose vital reproductive services, including prenatal and postnatal care, free contraceptives, and access to abortion services.

To understand the full ramifications of Ginsburg’s passing on the future of reproductive freedom, we need to also consider what we learned from Dawn Wooten’s allegations. The inclusive reproductive justice framework must replace a narrative that centers abortion rights because, as Ginsburg demonstrated, true gender equality includes both the right to terminate a pregnancy and freedom from coercive sterilizations.

Justina Licata

Justina Licata is the Ainsworth Visiting Scholar at Randolph College, where she teaches classes on American culture and African American and women’s history. Her research, which examines the first subdermal implantable contraceptive device, Norplant, explores the history of population control, reproductive justice, and social policies in the 1990s.

• Justina Licata

  https://nursingclio.org/author/justina-licata/

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