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Carole Joffe: The Billboard Circus and the Abortion Wars

On International Women's Day, we offer this post from Carole Joffe, author of Dispatches from the Abortion Wars: The Costs of Fanaticism to Doctors, Patients, and the Rest of Us. Joffe is professor of sociology at the University of California-Davis and a Professor at the Bixby Center for Global Reproductive Health at the University of California-San Francisco, and she contributes to the blog at

Planned Parenthood Keeps Families Healthy sign from photo by clockworknate on Flickr The abortion wars rage relentlessly on, in the United States and elsewhere.

Consider the various abortion-related items in the headlines these first days of March. After months of wrangling and immense concessions from abortion rights supporters, abortion still has the capacity to derail Congressional passage of a health reform bill, as some House antiabortion legislators remain dissatisfied with the actually quite onerous funding restrictions of the procedure in the Senate measure. A woman in Nicaragua, the mother of a ten year old girl, is denied an abortion even though she is a suffering from cancer, and is not allowed to start chemotherapy as long as she is pregnant.

And antiabortion fanatics in state legislatures continue to pass laws that are truly hard to parody. The latest of these is a Utah measure which would permitted life imprisonment for a woman "whose intentional or reckless behavior" caused the death of her fetus—if implemented, this bill which would have the effect of making suspect every miscarriage occurring in that state. (Though the bill passed in the Utah legislature, its sponsor withdrew it for revision in the face of massive national criticism.

Indeed, one of the few genuine abortion parodies around-- the Onion's hilarious account of a law requiring women seeking abortions to first name the baby and paint the nursery-- is actually not that far removed from a real-life incident I recount in my book, Dispatches from the Abortion Wars. In this case, a pregnant woman with the life threatening condition of DVT (deep vein thrombosis, a blood clot in the leg), was scheduled for an in-hospital abortion. While hospitalized for a flare-up of her condition several days before her abortion, she was forced by an anti-abortion doctor to tour the newborn nursery!

Book Cover for Dipatches from the Abortion Wars
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But perhaps the most highly visible and sensational of the current clashes over abortion are the events now transpiring in Atlanta, where billboards posted all over the city are proclaiming that "black children are an endangered species." These billboards are part of a special "minority outreach" effort by the Georgia Right to Life organization, capitalizing on the fact that the abortion rates of African-American women are higher than those of Latina women and four times higher than those of white women. While arguably the slickest, the current Georgia campaign is only the latest in a longstanding effort by the anti-abortion movement and allies within certain sectors of the African-American community (primarily based within churches) to argue that abortion providers in general, and Planned Parenthood in particular, have "targeted" black women and are engaged in efforts at "black genocide"). A particular talking point of this campaign is the location of Planned Parenthood clinics in low-income, minority communities.

These conspiracy theories have been countered in several ways. Most fundamentally, it has been repeatedly pointed out, the reason that black women have higher abortion rates is that they have much higher rates of unintended pregnancy than other groups. The reason, for this, in turn, as Dr. Melissa Gilliam, herself an African-American gynecologist, has argued, lies in the larger health care disparities facing this community: not only lesser access to contraception, especially the more effective methods, such as pills, which are more expensive, but also the lower availability of quality primary care, effective sex education and so on.

Loretta Ross, the executive director of the Sistersong Women of Color Reproductive Health Collective in Atlanta, has forcefully responded to the charges of racism that are frequently made by antiabortion forces against Margaret Sanger, the foremother of Planned Parenthood. As she recently told the New York Times, "The reason we have so many Planned Parenthoods in the black community is because leaders in the black community in the '20s and '30s went to Margaret Sanger and asked for them." "Controlling our fertility was part of our uplift out of poverty strategy, and it still works."

Thinking about Ross' comment, it occurs to me that if Planned Parenthood did not locate its facilities in low-income neighborhoods (which by definition will include a disproportionate number of women of color), but only catered to women in the suburbs, then one might (rightfully, in my view) allege racism!

A point never acknowledged by those who seek to demonize Planned Parenthood is that only 3% of the organization's services involve abortions. The remainder includes basic reproductive health services such as contraception, cancer screenings, treatment of sexually transmitted infections, sex education, and in some affiliates, prenatal care. For many poor women in this country, Planned Parenthood has become, de facto, their only source of health care. When grandstanding legislators attempt to score points with their antiabortion constituents by cutting Planned Parenthood's state contracts, poor women in their sixties, as I report in my book, lose the opportunity for pap smears and breast exams.

Ideally, the Atlanta billboard fracas should be a teachable moment. The high rate of unintended pregnancies facing African American women in Georgia and elsewhere would, in a just world, offer irrefutable evidence of the need for the passage of a health care bill that assures primary care, including the most effective forms of contraception, to those currently without such care. Moreover, the unintended pregnancy rate should, ideally, open up a conversation about sexual violence, including birth control sabotage, that explains some portion of unintended pregnancies, as Ross also pointed out to the Times.

It is safe to say, however, that Georgia Right to Life, the sponsor of the billboard campaign, has no interest in addressing these larger issues. The website of the organization states: "The fundamental purpose of GRTL is to engage in actions that will restore respect and effective legal protection for all human beings from the moment of fertilization to natural death." (Quoted here.) What this means, in plain English, is that this organization, like numerous other antiabortion groups, has redefined the most effective forms of contraception-- IUDs, the pill—as "abortafacients." To be sure, even more readily accessible contraception, would not, in itself, address the many intertwined factors of poverty and racism that contribute to such poor health outcomes for women in the African American community. But the necessity to counter the billboard campaign-- which has captivated the media-- brilliantly distracts advocates from fighting these larger battles.

The only lesson to be drawn from this whole mess appears to be that the abortion wars show no signs of abating.