Abortion Access and Contraceptive Equity: A Matter of Reproductive Health, Rights, and Justice

by Dr. Krystal Redman, SPARK Executive Director
August 17, 2015

As we work progressively in the fight towards social and economic equality, we must continue to include the argument of; sexual and reproductive justice in order to takes steps towards achieving complete contraceptive equity, which includes access to safe and affordable abortion services. Contraceptive Equity is the freedom to choose the contraceptive choice that works best for oneself. Furthermore, that all options are available and affordable; including, access to adequate information regarding choice and patient-centered medical guidance. Contraceptive equity is only achieved through reproductive justice. In that, reproductive justice looks at the interconnectivity-transformational framework that links health, sexuality, and human rights to the social justice movement. Reproductive justice means having complete bodily autonomy over ones reproductive and sexual health, with supporting policies and legislation in place that protects an individual’s decision over her/his body. Meaning, all individuals should have the right and ability to access the contraceptive method they chose is best for them.

SPARK Reproductive Justice NOW! is a reproductive justice organization housed in the state of Georgia. SPARK works to remove barriers to variables that contribute to reproductive and sexual health disparities in Georgia, which encompasses lack of access to comprehensive healthcare, improving access to healthcare for women of color, LGBTQ youth and individuals of color, and all families. SPARK also works to uplift and support legislation and public policies that improve access to affordable, comprehensive reproductive healthcare, including access to abortion services. Our work is vital given that Georgia has some of the highest unintended pregnancy rates amongst black women and adolescents, and is even higher amongst LGBTQ youth.ⁱ The pregnancy rate for teenagers who identify as lesbian or as bisexual is two to seven times greater than their heterosexual counterparts.

Current state policies invalidate a woman’s right for complete autonomy over her body, while the deeper issue is that black women and adolescents (14-24 years old) have some of the highest unintended pregnancy rates in the nation. This is in part because they are least likely to have access to contraception, education, and services, and higher rates of poverty. These rates are parallel to abortion rates in our community. Due to inadequate access to reproductive health services, comprehensive reproductive health education, and healthcare coverage, which are systematic inequalities. Georgia’s public health position is a prime example as to why closing the coverage gap (Medicaid expansion) is imperative in Georgia.

Determining whether or not to have an abortion is never simple, given no circumstance exists within a vacuum. Our communities’ make these decisions based on the economic opportunities, health insurance status as well as family and social supports. Lack of access to services and coverage increases the complexity of the circumstances and robs women of their agency and contraceptive equity.

Abortion is one of the most common medical procedures for women; an estimated one in three women will have an abortion in her lifetime.ⁱⁱ Women of color and low-income women obtain abortions in disproportionate numbers, in part due to the variables listed previously. Since 1976, the federal government has included a provision in the budget, referred to as the Hyde Amendment, that bands abortion coverage for women who receive their health coverage through Medicaid, except in cases of rape, incest or to save the life of the mother.ⁱⁱⁱ Policies, such as the Hyde Amendment continue to act as deeper barriers to contraceptive equity and reproductive justice. Thus, further supports the argument that expanding restrictions on abortion coverage in the Affordable Care Act (ACA) and upholding access to abortion services in private health care is imperative. Unfortunately, abortion is the only health service singled out in ACA.

Abortion access and complete contraceptive equity is a human rights and social justice issue, which includes reproductive health, rights, and justice. Through addressing barriers to access to sexual and reproductive services, including abortion and contraception, and working to ensure that all women receive patient-centered reproductive health care, health care providers and policy makers can substantially improve the ability of women from all ethnic and socioeconomic backgrounds to make informed decisions about their fertility and bodies.

i Unintended pregnancy in the United States: incidence and disparities, 2006. Contraception. 2011;84(5):478–485.

ii-iii Guttmacher Institute. Abortion in the United States: Quick Facts. Retrieved 15 March, 2012 at http://www.guttmacher.org/media/presskits/abortion-‐US/statsandfacts.html