Family Planning Isn’t a Condom and a Pamphlet
Sharon August 30th, 2011
Over the last two weeks, my family has considered or accepted two foster placements that fell through - both of them sets of five children. The first group consisted of five kids - 5, 4, 3, 1 and due any minute. The second consisted of five children 6 1/2 to 5 1/2 weeks. Both mothers were in their early 20s - the latter only 21.
Perhaps predictably, when I talk about these children (and we thought that the second group would be coming to us for the better part of a day), everyone’s first reaction is to be appalled at the fact that these young women have so many children that they can’t take care of. I understand that - and the degree to which these children play on every stereotype about poor women. Quite a number of people who heard about these kids spoke of the merits of forced sterilization - and those were some of the milder comments. Despite the fact that I understood where they were coming from, and certainly could wish for the sake of both mothers and kids that they would choose to limit future fertility, the reactions also frustrated me, because so much of the emphasis was placed on “get these women some birth control” and so little on creating circumstances that would enable them to make different choices.
This resonates with me for several reasons. The first was that instinctively, I felt very protective of these women - whatever their choices, they were going to be the mothers of children I cared for, and the rush to judgement bothered me on those grounds, regardless of its legitimacy or illegitimacy. The second was that the “get those women some depo-provera” reactions struck me as revealing more about the speakers and about the assumptions we make from a still-comparatively wealthy and secure perspective than they do about any particular external reality. Indeed, the circumstances of the poorest and most vulnerable women in America (and the poorest and most vulnerable people are almost always women and children) may have much more to do with our future than we think they will. In order to have a future where women have choices about their fertility, we will have to recognize that family planning doesn’t begin in the clinic - it begins well ahead of that.
Let’s think about what needs to happen for women to control their fertility fully, and to make “good choices.”:
1. They need to have the full ability to give consent - to say “no” and have that “no” respected. That means they must have men in their lives who wholly respect and support women, they must respect themselves enough to believe that their “no” should be honored. They must be safe from domestic violence and sexual violence in the whole of their lives. They must live in a society that supports women, including poor women and young women and women who are labelled negatively for their choices and one that believes in making them safe and helping them achieve consent.
2. The circumstances of women’s lives must be such that they do not have to trade sex for food, a place to sleep, basic comfort, safety, food for their children, or other needed supports, because those who depend on sex to get those things cannot say “no” or demand that contraception be used or safe sex be practiced.
3. Women need good access to medical care, both preventative and urgent. They need to not be afraid that doctors will report them to immigration, will criticize their lives or judge their bodies and lifestyles harshly. They need to be able to get medical care when they need it, without fear of losing a job because they took time off. They need to have accessible care in their communities in places they can get to with people who treat them well. They need to not have to walk through protesters and harassers in order to get basic reproductive and sexual health care. They need to have full access to a full range of medical care - including treatment for substance abuse and mental illnesses that cloud judgement.
4. Women need to be educated about risks and benefits, and have a balanced, non-condescending, respectful presentation of information in languages they can understand. They need to be able to afford reproductive and sexual medical care, and any devices or treatments they need. They need know how to use these things safely and well. At the same time, the power to control their bodies has to be placed respectfully in their hands - that includes the power of bodily integrity, the power to choose the kinds of medical care they will use, and the ability to make decisions about what they do and do not put in their bodies.
5. As children, girls and boys both need families to love and care for them, and to learn ways of receiving love and care that don’t involve giving birth to children. They need to know, as they grow, that some adult will continue to be there for them and that others will provide love and care into adulthood, that they will have a place in the world and don’t have to invent that place wholly and alone.
6. Boys need to be taught to respect women, to respect the integrity of women’s bodies, and that fathering is an active verb, not a sexual act. They need to see men who care for and nurture children. and to receive the message that they are fully responsible for their children and their partners. They need to be able to choose love actively, not sex reflexively, and to honor and respect women and men.
7. We must respect the right of women to make choices about their bodies that we would not make. ”Choice” does not mean “the requirement to have an abortion when everyone thinks you should” - any more than it means “no right to choose abortion.” ”Family planning” doesn’t mean “give all poor black teenage girls an IUD” it means “allow women to make decisions, and then respect them. That means allowing for people to choose differently than you would, and allowing for errors of judgement. Coercion does not make women freer, and it doesn’t enable them to make better choices - fundamentally a society that respects and believes in women doesn’t have to approve of every decision women makes, but it must respect their right to make it.
8. In order for men and women to make good choices, society has to model good choices. We cannot take the most vulnerable, poorest, least well-educated people in our society and say to them “you made lousy choices and we will judge you and punish you” - society’s choices in regard to its poorest people have not been good either. When we demand that people take responsibility for themselves, we must remember that someone failed to take responsiblity before - someone failed to adopt the 12 year old girl who eventually became a mother of five. Someone failed to provide funding for the drug clinics that might have helped her get off drugs. Someone taught the fathers and mothers the messages they learned about sex and children. A thousand of us might have stepped up at any time and changed the way this worked - and each of us did not. A whole society, a whole culture might have stepped up and offered more. Those choices deserve judgement too - and they deserve consideration as we enter an era of less wealth and fewer resources. We are, in the end, mostly held responsible for our choices - but who pays the price changes over time. Who will it be next time?
I don’t know either of the women in question - I may never meet either one. I do not claim that I know anything of their personal circumstances. I do know this, however, that if want to be able to care for our children in an era of diminishing resources, it will require sustained and conscious choice from all of us. If we want to take care of the most vulnerable in our society, if we want to enable future generations to do better, despite our difficulties, we must provide supports that our society presently does not for many poor women. As more of us become poor, as the future of our own sons and daughters is implicated, perhaps we can begin to do better - but we ought to have done better already, and must recognize the consequences of our own bad choices, both collectively and individually.
Sharon