Radical Doula

Last week was the 51st Annual UN Commission on the Status of Women, being held in New York City. I attended a parallel event to the commission, entitled Abortion Providers Attitudes toward Women, hosted by the Guttmacher Institute, Ipas, Human Rights Watch and Gynuity Health Projects.

It was a great panel, but there was one particular presentation that stuck out for me, and seem to have the most relevance here. Dr. Beverly Winikoff, the President of Gynuity Health Projects gave a talk entitled “Giving Women Choices: Access to New Technologies in Abortion.” I particularly appreciated the logic with which she began her discussion, which focused on the new technologies for “medication abortion” or the abortion pill (aka RU-486). She explained that we need to keep in mind that the technology exists such that presumably all women could simply have a set of pills in their medicine cabinets at home which could be taken if she had a late period, or discovered she was pregnant. She went on to say that it is a complicated and overtly hostile political climate which has prevented this from happening, even five years after the introduction of these abortion options. The nuances of this opposition are interesting, and very related to the pharmaceutical industry as well as provider issues, and even logic that argues that these technologies make abortion too easy.

What I think is interesting about this, and what connects it to the birth activist movement, is its focus on woman-centered care. Actually, this idea is not really woman-centered care, but woman controlled care. Because of such intense barriers and restrictions placed on access to reproductive health care services, particularly in relation to abortion, activists have begun to argue for policies which allow women to decide when to use them—removing the intermediary that is the physician or clinician. We have seen this effort with Emergency Contraception, which has recently been approved for access without a prescription (at least for women over 18). Here we see women taking control and autonomy over their reproductive health, with a possibility of making their own decisions in the privacy of their own home. I see a strong connection between this and the midwifery movement, which works to place the woman at the center of care, and the midwife-woman relationship one based on equality and mutual respect, rather than hierarchy and control.

Obviously there are drawbacks to these modes of access, mainly when the woman may not be seeing a provider at all. Both in the case of EC and the abortion pill, if a woman has had unprotected sex, she may be at risk of exposure to an STI and this necessitates follow up with a health care provider. It’s also easy to see why the anti-choicers are doing whatever they can to stop these technologies from becoming accessible, since that would conflict with their ceaseless fight to win back control of women’s bodies.