Thanks to Texas’ recent abortion ban, the nationwide attack on abortion is now receiving more attention than it has since the swath of attempted bans in the spring of 2019. But the movement is still small, fractured, and hamstrung by politics that have pulled many to the right and out of the streets. Access to abortion is one of the most basic requirements for the type of society that socialists fight for: free of gendered and racial oppression and free of the exploitation of the working class. We must do everything in our power to defend abortion unapologetically, with no restrictions or concessions, starting by joining the upcoming marches on October 2 ahead of the reconvening of the Supreme Court on October 4.
The movement has historically shied away from or denounced a “pro-abortion” position, but as Moira Geary argues below, these politics are essential to winning the fight and securing reproductive freedom for all.
Last month, I gave birth to my first child. While abortion was the last thing on my mind as I was trying to conceive, I thought more and more about it throughout my pregnancy because of what my experience taught me: our society does not care about pregnant people and values our fetuses above our own lives. Before I knew I was pregnant, I was scheduled for an exercise stress test to check on a potential heart issue. By the time the appointment came around, I was seven weeks pregnant. Although exercise is safe during pregnancy, and I had cleared this test with my primary doctor and notified the lab of my pregnancy, I showed up to my appointment to find that it had been canceled by the cardiologist without my knowledge. The manager of the lab explained that because I was pregnant, they were “not comfortable” putting me on a treadmill. Asked what was going to be done about my potential heart problem, the cardiologist told me I could “make an appointment if I have any further issues.” I, an adult human being, was denied care on the basis that someone felt, despite any evidence, that running on a treadmill might be harmful to my seven-week embryo.
Most people are familiar with the dietary and lifestyle restrictions recommended during pregnancy: don’t drink coffee or alcohol, don’t eat deli meat, don’t take x, y, or z medication, and on and on. I was very cautious during my pregnancy and attempted to do and consume only things that were safe for the development of my future baby until I realized that there was very little information beyond the standard “don’ts” (I first encountered this trying to determine which herbal teas were safe to drink). What’s more surprising, there is little evidence backing up even the basic prohibitions on alcohol and caffeine.
This is largely because research studies on the efficacy and safety of substances and procedures during pregnancy are severely lacking compared to studies on non-pregnant people. Researchers and drug manufacturers often give the justification that because pregnant people and fetuses are uniquely vulnerable, it is more dangerous to perform studies on them. However, as a doctor with the UCSF ASPIRE study explained in a recent webinar, the lack of data resulting from this patronizing exclusion of pregnant people is much more harmful than the safety data we would have if the research had been done. It means that pregnant people are left to make health decisions without sufficient evidence, and are often advised to abstain from interventions that could improve their own health because there is no data proving that it is safe for the fetus. In reality, the hesitancy to perform research studies on pregnant people has less to do with concern for their vulnerability and more to do with resources: including pregnant people in trials requires extra precautions and monitoring, and researchers must follow the pregnancy to its end as well as any children born for potential long-term effects. It means more work and more expenses, and the medical establishment would rather cheaply and quickly deliver new products and protocols than invest in equitable health outcomes for pregnant people.
An example with which anyone who has been pregnant in the past year is painfully familiar was the exclusion of pregnant people from COVID-19 vaccine trials. All three major vaccine manufacturers in the U.S. refused to enroll pregnant people, and people who became pregnant after signing up were kicked out of the studies. So, when the results came out promising that the vaccines were safe and effective for the general public, pregnant people—who are at higher risk for contracting COVID-19 and for severe illness and death from the disease—had no data to tell them if the vaccine was safe for them or their fetuses. Although the practice was overturned after a major outcry, many pregnant frontline healthcare workers were initially denied the vaccine. Guided by medical experts’ predictions and by the certain danger of COVID-19 infection, I and many other pregnant people chose to get the vaccine anyway. However, many other pregnant people chose not to be vaccinated out of concern for their or their fetus’s health, and there is currently a crisis of maternal death and stillbirth for the unvaccinated. The deaths of these pregnant people, which continue to happen, can be directly attributed to vaccine manufacturers’ disregard for their lives.
The way abortion is debated in this country—as a compromise between two entities with a right to life—gives pregnant people less bodily autonomy than corpses. Even when an organ transplant from a recently deceased person would save someone else’s life, that corpse must consent (by registering as an organ donor before death or the family consenting on the deceased’s behalf) to its body being used to sustain the life of another. It is a matter of biology that fetuses, whether they have “rights” or not, rely on their parent’s body in order to survive. This does not oblige the parent to continue a pregnancy, just as someone with a rare blood type cannot be mandated to donate blood to someone who needs a transfusion.
This disproportionate regard for fetuses over the humans carrying them is not just a matter of cultural belief, but a symptom of our sexist political and economic system. To employers and the ruling class, pregnancy is a question of producing more workers to be exploited, and working class women have historically been treated simply as their incubators. As Jenny Brown explains in her impeccably researched book Birth Strike, laws restricting contraception and abortion globally have always been tied to the ruling class’s desire for a higher birth rate. This is rarely understood or discussed even among militant pro-abortion sections of our movement, as the opposition in the U.S. appears to be a religious right-wing that simply wants to “control women”. But while pearl-clutching evangelicals and Catholics are convenient foot soldiers for carrying out the public anti-abortion battle, politicians and corporations are the real beneficiaries when working class people are forced to give birth and to raise more children than they want. The ruling class gets a larger pool of workers, driving down wages for everyone, while parents are pushed to perform more unpaid labor at home and to settle for lower wages and worse working conditions in order to provide for their children.
This is a critical argument that we as socialists must make in the movement because a narrow, ideological focus on fighting the religious right allows our real class enemies to avoid confrontation and continue legislating against reproductive freedom (in the form of abortion, contraception, and lack of sufficient healthcare for pregnancy and birth). The liberal understanding of the abortion issue as simply one of sexist ideology prevents people from drawing the right conclusions about who benefits, as evidenced by Texas Democratic state representative Donna Howard’s confusion over why corporations are not speaking out against SB8 to “keep employees in the state.”
The ruling class’s interest in keeping working-class people pregnant is even clearer when we recognize that gestation is labor and high-value essential labor at that. As Sophie Lewis details in her book Full Surrogacy Now: Feminism Against Family, the formal practice of surrogacy simply lays bare the labor relations that are inherent in every pregnancy. While surrogates perform this labor for the families who will receive their babies, all gestational labor benefits society as a whole: children go on to become workers, producing the things and performing the services that people need and from which capitalists extract a profit. As more gestational labor is done by fewer people in less time (that is, as the birth rate rises), the same thing happens as when a factory speeds up production: the employer class can squeeze more surplus labor value out of workers, who are left overworked and underpaid. Since gestation is labor, abortion is the refusal to perform labor, and when abortions are denied, the resulting forced pregnancies and births are quite literally forced, unpaid labor performed on behalf of the ruling class.
Abortion as a deliberate strike weapon has historical precedent: Angela Davis in Women, Race and Class discusses the suspiciously low birth rate among enslaved Black people in the U.S., likely due to abortions induced by herbs and other means. The accounts of some enslaved women admit to abortion and even infanticide to spare their potential children the horrors of slavery, while enslavers expressed concern and dismay that the birth rate was not higher. While Davis notes importantly that these were likely acts of desperation not to be conflated with the uncoerced, emancipatory abortion we fight for, they were nevertheless the withholding of labor that refused to reproduce a system of exploitation for the benefit of the slaveowners.
As socialists, we fight for a society that is truly democratic: one where everyday people decide how their workplace runs, what is produced and distributed, and how social problems are remedied—in Lenin’s famous words, where “every cook can govern.” And what is a more fundamental decision over which to have authority than what to do with your own body? The ability to have an abortion is a basic building block for all other matters of self-determination: choosing what work to do, where to live, who to be in relationships with, what education to pursue. This is true even in an ideal society but in our current society a lack of control over if, when, and how to have children can have even more dire consequences than alienation, including poverty, abuse, illness, and death. Legal abortion is a working-class issue, because legal or not, the rich will always be able to travel and pay for safe abortions as they did in the decades before Roe, while working-class people, disproportionately women of color, died from botched back-alley procedures.
Since abortion was made nominally legal in the U.S. with Roe v. Wade in 1973, we have had to fight to gain or maintain access to it. That fight has been at times larger, smaller, more or less militant, and there have always been disagreements between the liberal and radical sides of the movement, as evidenced by the still-hot debate over clinic defense. Our side is usually called “pro-choice,” a term that was adopted as a centrist counter to the anti-abortion side’s euphemistic and false “pro-life” moniker. The label insinuates, and is often followed by the explicit clarification, that “we are not ‘pro-abortion.’” In the wake of the recent Texas law imposing a de facto total abortion ban by empowering anti-abortion vigilantes, many have taken to social media decrying the ban by claiming they are “not pro-abortion,” but pro-woman, pro-survivor, etc. The resistance to being “pro-abortion” among people who claim to want it legalized is a testament to how deeply entrenched the abortion taboo remains. Advocates of the “pro-choice” line often defend it by claiming that they are not advocating for pregnant people to make one decision or the other, but no one is arguing that every pregnant person should get an abortion. Just as you might assume of someone who is “pro-blood transfusion” (and hopefully that is everyone), people with pro-abortion politics support the procedure being available to anyone who needs it without restriction or judgment. Importantly, neither “pro-choice” Democrats nor “pro-life” Republicans have given us the social protections, like paid family leave or universal early education, that would make childbearing a true “choice” for all and ensure care for babies after birth.
Activist groups like NYC for Abortion Rights, featured on a recent episode of NYC DSA’s podcast, are claiming the label “pro-abortion” and pushing back against the harm that decades of “pro-choice” politics have done to the movement. One of the dangers of the “pro-choice” line is that it avoids talking about abortion itself, which leads to misconceptions about who gets abortions, for what reasons, and what the procedure can look like. It is a common misconception that abortion is mostly for young childless women with unwanted pregnancies. In reality, any person who is pregnant, willingly or not, may need an abortion for reasons that range from personal choice to financial, mental, or physical health, to lifesaving medical necessity—and the boundaries between these reasons are impossible to define or legislate. This even includes anti-abortion picketers in surprising numbers (as Jenny Brown details in her 2019 book Without Apology), proving that abortion is a material rather than simply ideological issue. Circumstances typically considered “tragic”—rape, incest, fetuses that will not survive birth, or fatal illness in the pregnant person—have often been treated as “exceptions” that would make an abortion acceptable. Liberal sections of the movement often criticize bans with few or no exemptions, such as Texas’ SB8 law, for being particularly barbaric, but we must insist that the denial of abortion to anyone, for any reason, is always barbaric.
Even among “pro-choice” campaigners who want abortion to be legal without restrictions, these cases are often paraded to make the point that it is difficult to administrate abortion on a case-by-case basis (for example, to prove that you were raped), so it should be unrestricted only for the sake of the well-deserving few with tragic circumstances. This perpetuates the idea that abortion is a sad and shameful thing, albeit one that needs to be legal for practical reasons. It starts with a “preemptive concession” that cedes ground to the Right in the name of making a demand more “winnable,” but actually reinforcing the abortion taboo. This focus is regressive. Abortion access for a 25-year-old who had consensual, unprotected sex in a club bathroom is equally justified and important as for the 34-year-old mother of three whose fetus has no skull and will die at birth.
While focusing only on “tragic” cases is counterproductive, I believe it is important to understand the full range of abortion needs because it reinforces how inextricable abortion is from pregnancy itself, from healthcare, and from the lives of every person with a uterus and their families. The medical definition of “abortion” is when a pregnancy ends before the fetus can survive on its own and, accordingly, the medical term for a miscarriage is “spontaneous abortion.” In contrast to the way abortion is treated socially, there is a fine line and even overlap between what we know as a miscarriage, abortion, and delivery.
Texas OB-GYN doctor Danielle Jones outlines in detail on her YouTube channel how SB8 will put pregnant people at additional risk of injury, disease, and death. Among the cases Dr. Jones discusses are people on life-saving medication that causes birth defects, people who are suicidal because of their pregnancy status, and children whose bodies are not mature enough to safely deliver a baby. Where abortion is totally illegal or even restricted to lifesaving cases, there is a chilling effect on healthcare providers, causing them to wait longer to intervene because the patient is not yet close enough to death. In no other case would it be acceptable to require doctors to let a patient become sicker before using a lifesaving intervention such as a ventilator or blood transfusion. This is what led to the entirely preventable death of Dr. Savita Halappanavar in 2012 in Ireland where, until recently, abortion was illegal. A happily expecting mother, she suffered a partial miscarriage at 17 weeks pregnant, but doctors initially refused to completely remove the pregnancy because there was still a detectable heartbeat. By the time the heartbeat was gone several days later, they evacuated her uterus, but she had already developed a systemic infection that would kill her the next day. Biological reality, medical necessity, and each person’s values and wishes eschew the attempt to separate “abortion” from other medical procedures and to neatly categorize the reasons why someone might need one.
We must also shift the burden of justification from people seeking abortions to those trying to deny them: rather than why would someone need an abortion, let us ask: what would justify forcing someone to give birth? I was excited about and enjoyed my pregnancy and birth. Both were relatively uncomplicated, and it was still an extremely difficult, at times alienating, and self-sacrificial experience. I cannot imagine how traumatic it would be to be forced to go through it against my will. While people can and do have positive experiences of pregnancy and birth, agency, consent, and medical and social support (including abortion access) are prerequisites without which they can be horrific. To put this into perspective for those who have not been pregnant: My “easy,” routine pregnancy included losing the ability to climb stairs, my stomach and intestines being compressed into a fraction of their normal space (and the ensuing digestive consequences), and strangers as well as healthcare workers asking unsolicited questions about my body and my baby’s genitals on a weekly basis. My doctors were amazed at the lack of physical trauma I came away with after vaginally delivering a nine-pound baby, but my glowing success still required a two-day hospital stay, which I left in a wheelchair and what is essentially a diaper (the separation of the placenta leaves an open, bleeding internal wound the size of a dinner plate that takes weeks to heal).
While abortion is comparatively very safe, pregnancy and childbirth significantly increase someone’s risk of disease, injury, and death. This is worse in the U.S. than in other “developed” nations, where about 800 people die in pregnancy or childbirth every year. Black people are by far the most likely to die, at twice the rate of white people, meaning that denying abortions is a racist practice. When the state denies someone an abortion for any reason, they are imposing immense physical and emotional trauma as a punishment for becoming pregnant. While some people who are denied access to safe, legal abortions will give birth, others will resort to unsafe options to end their pregnancies. This may mean using potentially harmful substances with no medical oversight, seeking an illegal surgical abortion that could end in infertility or death, or even suicide. Unlike providing everyone with health insurance or housing unsheltered people, the issue of “legalizing abortion” requires no actual work on the part of governments; they simply need to stop enacting bans and restrictions that force birth on unwilling people. This was the initial goal of abortion activists in the decade before Roe: to entirely repeal the various state laws that outlawed or restricted abortion.
We are in a dire situation in terms of abortion access in this country, and our movement is suffering from the effects of years of setbacks and rightward-moving politics, even among the Left. Calls to action for an effective left strategy have been laid out in Jenny Brown’s Without Apology and Anne Rumberger’s recent article for Jacobin. It is more important than ever that socialists argue for these strategies and an unapologetic, pro-abortion stance because this is where decades of “pro-choice” hesitancy has gotten us: In the first five months of 2019, 479 abortion restrictions were enacted in 33 states. That accounts for more than one-third of the 1,271 abortion restrictions enacted since Roe v. Wade, in only 0.7 percent of the timespan. Another quarter of the total restrictions since 1973 were enacted between 2011 and 2015, in the wake of the right-wing “Tea Party” takeover of state legislatures. While many of these restrictions have been prevented from going into effect, Texas’ SB8 is now law after the Supreme Court refused to block it on constitutional grounds, outlawing practically all abortions in the state. This opens the floodgates for more of those dormant restrictions to go into effect and for the Supreme Court to completely overturn Roe.
It is open season on abortion access like it has never been before. As Sherry Wolf passionately declared at an NYC rally this month following the Texas ban, no one is coming to save us. If you consider yourself a socialist, consider it your duty to act now. You can start by attending your local march on the upcoming day of action to defend reproductive rights this Saturday, October 2.
Featured Image Credit: Photo by Ananda La Vita; NYC Pro-Choice March 1992. Modified by Tempest.
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Moira Geary is a socialist, new mom, and founding member of Chicago for Abortion Rights now living in NYC.