Increasingly, the public conversation about abortion has
focused on reducing the need for abortion as a way to find common ground. This is an important attempt to reorient a
debate [ ... ]
With this year's effort to enact federal health care reform,
more Americans are paying attention to questions of access than perhaps ever
before - and certainly since Roe legalized abortion 37 years ago. At the same time, arguments that one might
reasonably expect to hear principally from the right about one of the most
common medical procedures in this country - abortion - have taken position on
the center stage of the debate: most
notably the notion that government has greater responsibility to protect taxpayers
from supporting a procedure they oppose than it has to support women's health
and fundamental human rights. How has it
come to be that essential progressive answers to questions about the right to health
care and the role of government can be so different when it comes to
abortion? Looking toward the health care
system itself provides one clue: the isolation and exclusion of abortion within
federal policy mirrors the isolation and exclusion of abortion from mainstream
medical practice. Since 1982 a steadily
increasing number of abortions are provided by specialized clinics in urban
areas. This isolates not only the
abortion procedure, but the women who are having abortions, cutting off both
women and providers of abortion care from the millions of other patients and
health care professionals who are invested in the current health care reform
debate.
AAP and several of our colleague organizations are working
toward a different vision for abortion care, guided by our conviction that a
strong system of care is a diverse system that does not isolate abortion or
place sole responsibility on a single type of provider setting. We believe that
the broader engagement of health and social service providers will not only
lead to more equitable and sustainable access, but that it has political
implications as well. Service delivery
engages people at the level of the woman and her story - an essential lens
through which to view the ‘abortion debate' but one that is difficult to
achieve in political discourse.
Colleague organizations within and outside of the SRHR
movement are doing important hard work to pass health care reform that improves
and expands access to health care without diminishing reproductive decision
making and women's dignity and autonomy.
Nevertheless, sacrifices seem imminent. It is time that we revisit the intersections
between access/service delivery and politics/policy and look not only at the
impact of policy on practice, but at how practice has shaped - and could help change - contemporary
political realities.
From the Executive Director's Desk
Tuesday, 28 April 2009
Increasingly, the public conversation about abortion has
focused on reducing the need for abortion as a way to find common ground.This is an important attempt to reorient a
debate so entrenched that it arguably is no longer effective at mobilizing
needed change.
But we at AAP challenge many of the assumptions behind
abortion reduction and are not convinced it is the direction to take.For example, as Dr. Jackson and I point out
in
our
recent post on RH Reality Check, an abortion reduction agenda runs the
risk of attributing causality where it doesn't exist and oversimplifying the
reasons for-- and hence the policy
responses to -- abortion.
As women and those working closely with women deeply
understand, abortion is the result of multiple intersecting factors that
combine uniquely for each woman around her need for and ability to access
abortion care. These complexities are not beyond generalization, but demand a
nuanced approach at the program and policy level.
Like many matters of personal health and privacy, women’s
preferences for abortion care are complex. Each of us experiences the health
care system differently depending on where we live, our cultural experience, our
economic position, and who we are as individuals. When it comes to abortion, widespread stigma along with anti-abortion harassment and violence
can further shape our expectations of abortion care, narrowing our perceptions
of where and from whom we might receive this care as well as limiting our
access.
Increasingly, the public conversation about abortion has
focused on reducing the need for abortion as a way to find common ground.