Sterilization – Population Matters-USA

Well, the answer to the title’s question is “yes, no and maybe”.

First, I should define a “reproductive health desert”. It is an area without a provider of reproductive health. Thus, there are maternity, fertility, contraceptive and abortion deserts.

Cortez (Montezuma County) was a maternity desert for a brief period of time. The hospital’s administration closed down their birthing center. Outrage from the community pressured the management to open it up again.

There were a few years that we had sophisticated infertility services in Durango. Unfortunately, the two doctors who provided this care are gone. The OB-GYN doctors who remain can help couples with most fertility issues, but some folks will need to go to Albuquerque or elsewhere for more complex infertility problems.

There shouldn’t be a real shortage of effective contraception anywhere in the US now that OPill® is available to anyone with a uterus. Or without—I got a package of this over-the-counter birth control pill for an art project from Amazon. They didn’t quibble over my gender.

(More about Opill®: It is a birth control pill that is available without a prescription. The only contraindications are pregnancy or a history of breast cancer. It needs to be taken every day at the same time.)

However, there are women who don’t want to use hormones or aren’t regular in taking pills or cannot afford $20 a month. They may live in a county without a clinic that provides the full range of family planning methods—this is how “contraceptive desert” may be defined, and almost 20 million women live in counties that lack this care.

La Plata County is far from a contraceptive desert. Even though Planned Parenthood is closed, the health department (in the beautiful AXIS Health System building), many physicians, and midlevel providers are happy to prescribe desired methods.

Unfortunately, we do live in an abortion desert now that PP is closed. PP clinics in neighboring Cortez and Farmington do provide medication abortion care, however they are limited to 11 weeks gestational age. Regrettably, procedural abortions (those done in the clinic) are not available in the Four Corners area at this time.

While on the subject of abortion, I just read a reason that the religious right has chosen to fight against this important part of healthcare. It was written by a Methodist pastor, David Barnhart.

‘“The unborn” are a convenient group of people to advocate for. They never make demands of you; they are morally uncomplicated, unlike the incarcerated, addicted, or the chronically poor; they don’t resent your condescension or complain that you are not politically correct; unlike widows, they don’t ask you to question patriarchy; unlike orphans, they don’t need money, education, or childcare; unlike aliens, they don’t bring all that racial, cultural, and religious baggage that you dislike; they allow you to feel good about yourself without any work at creating or maintaining relationships; and when they are born, you can forget about them, because they cease to be unborn….

‘It’s almost as if, by being born, they have died to you. You can love the unborn and advocate for them without substantially challenging your own wealth, power, or privilege, without re-imagining social structures, apologizing, or making reparations to anyone. They are, in short, the perfect people to love if you want to claim you love Jesus but actually dislike people who breathe.

‘Prisoners? Immigrants? The sick? The poor? Widows? Orphans? All the groups that are specifically mentioned in the Bible? They all get thrown under the bus for the unborn.”

A small group of concerned people are working to bring back both medical and procedural abortion services to Durango, but it may take months.

The image above provides information about the article cited below.

Reproductive health abuses, especially coercion, have turned many people away from concern about human population. I agree: reproductive coercion should be shunned.

Examples of coercive actions include sterilization of both women and men in India—even though patients didn’t really know what was being done. Coerced sterilizations also happened in the early 20^th century in the USA—especially people who were who weren’t of the dominant race or were thought to be mentally or genetically deficient.

There were attempts to wipe out Native Americans, which started when Columbus “discovered” the New World, and may have continued into the 20^th century. This apparently happened at Indian Health Service hospitals, where a high proportion of Native women had their tubes tied. Fortunately, federal laws now require use of a special consent form that makes it difficult to perform sterilization procedure without real informed consent.

I have also read about Puerto Rican women being sterilized against their will in the past. When I practiced there in the 1980s, I saw no sign of coercive sterilization. In fact, the reverse was true. I remember Maria, who was desperate to stop having children. She couldn’t afford reliable birth control such as an IUD and pleaded with me to tie her tubes. Unfortunately, she didn’t have insurance and the hospital wouldn’t let me do the surgery unless they could be certain of payment.

That brings up the other side of reproductive coercion—women are often forced to bear, and raise, children that they did not intend to have.

Obamacare and many other programs will pay for contraception in the US. However, most governmental programs will not pay for an abortion when a contraceptive method fails. Unfortunately, unintended pregnancies occur with all methods, and some states prohibit abortion under any circumstance, including rape.

Since abortion has been tightly restricted or outlawed in many states, it has become impractical for countless women to obtain abortion care. Unfriendly laws have coerced many women to carry unintended pregnancies. Although networks exist to help women abort unwanted pregnancies, many people still aren’t able to make the choice they want.

A careful study of births in Texas found that abortion-limiting legislation increased unintended births. This research compared the number of births after Texas Senate Bill 8 (preventing abortions after 7 weeks of pregnancy) was in effect with the prior years’ births. They found that there were almost 10,000 more births in the relevant 9 months after SB8 took effect. Many of these excess births were probably unwanted because the women were coerced into carrying a pregnancy by their inability to access abortion care.

I predict that coercing women to bear and raise children will have bad effects on society. We know that people who result from unwanted pregnancies don’t do as well in life; they have more contact with mental health and with law enforcement agencies. We also know that Texas has one of the higher maternal mortality rates in our country, and forcing women to give birth is likely to cause the death rate to go even higher.I believe that the basis for antiabortion laws has little to do with the claimed religious beliefs; the states with the strongest “right to life” laws seem to have the weakest support of mothers and children after birth. I also believe that many people who advocate against abortion and for population growth do so for selfish economic reasons. Speaking of population growth, Nandita Bajaj, an expert on a cause of population growth—pronatalism—will be talking at Lifelong Learning in Durango on February 15^th.