Lesson 8 - Lesson 8 Lecture Women's Health and Reproductive...

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Unformatted text preview: Lesson 8 Lecture Women's Health and Reproductive Rights The specialty of women's health is a fairly new field in medicine, yet feminists have been studying specific topics of health that are especially pertinent to women since the first wave of feminism. Activists during the second wave worked hard to raise the public's awareness about health issues specific to women. This lesson will focus on women's health in a broad sense, including women's reproductive rights. Women's Health: Medicalization An important theme in women’s health research is medicalization. Medicalization involves framing natural, normal, and healthy processes as diseases or disorders that require medical treatment and management. Through medicalization, women learn to surrender control and knowledge of their bodies to the “experts” – doctors or other medical professionals who “know better”. Various women’s health processes have been medicalized – menstruation (think of how Seasonale is marketed to do away with those pesky cycles), menopause, women’s mental health (PMS is now a disease listed in the DSM, for instance) and childbirth. Let’s consider the medicalization of childbirth to understand the power that the medical system has over women’s bodies and women’s choices (or lack thereof) about their health. Think about birth – what images and thoughts come to mind? Probably that birth hurts, women should just get the epidural, or better yet just schedule a cesarean section (C­section) and be done with it. Today, nearly 30% of women in the US deliver via C­section , and about 70% of women choose to have an epidural. This is not to say that there is anything wrong with having an intervention, in fact having a necessary C­section can save the life of a baby and a mother when nothing else is possible. The thing is, no other developed country has medical intervention rates this high, many have a C­section rate around 10% and an epidural rate of around 20%. Take the Netherlands , for example. They've got a C­section rate of 5% and a huge rate of homebirth. (Yep, that means they are actually pushing out their babies at home with a midwife!) You'd expect them to have a really high rate of infant mortality with all that homebirth, right? Wrong. They're right at the top in terms of healthy mamas and babies, and while it is difficult to compare countries because of different definitions of live birth, most researchers agree that the high level of intervention in the United States affects the infant mortality/morbidity rate. The US also has a higher rate maternal mortality than those countries. All this medical technology and intervention is actually hurting mothers and babies! So why are so many women choosing to have these medical interventions that compromise both her health and that of her baby? As usual, we've got to do a bit of digging and ask what is going on here and how is it related to gender and power in society? If we are curious as to who benefits, it's easy to see that Health Management Organizations, hospitals, doctors, etc. would all be raking in extra dough if women are having more expensive births. (Remember, someone has to pay for all of those gadgets.) So is this a conspiracy theory against the Medical Establishment? Well, not quite. After all, women are choosing these interventions; they are not exactly being forced to schedule their C­section at gunpoint. But why would women be making these choices in such high numbers, and what is different about America that encourages more and more women to opt for a highly medical birth? So is birth a feminist issue? Feminists have seen it as one, and have worked to change the American system of birth. They have suggested that the birth decisions women are making don't happen in a vacuum—we need to understand why trends happen and what they mean for women. Some people have said that the rising cesarean rate and the increased levels of medical intervention are the equivalent of a feminist jackpot… giving women more choices. Instead of accepting this as a fact, feminists encourage us all to wonder about what these birth options mean for women. Why does the US have this unbelievably high rate of birth intervention and an even higher rate of infant and maternal mortality? Why are American women increasingly electing unnecessary and sometimes dangerous interventions? Medicine and science have taught us many things about childbirth, but a total reliance on these technologies may not only be unhealthy but may in fact jeopardize the lives of babies and mothers. Part of women's health, much like childbirth, is a woman's ability to control her own body and to have adequate choices about her health. Feminists have termed women's ability to control their reproductive capacity "reproductive rights". When people talk about Reproductive Rights today, we tend to think about just one aspect of these rights: Abortion . Yet reproductive rights are much broader than this one concept. What are Reproductive Rights? To date, women in this country don't yet have full control over their reproductive capacities, which is why feminists are still fighting for reproductive rights. In the most basic sense, reproductive freedom includes the ability to control ever aspect of reproduction ­ including contraception, abortion, pregnancy, and childbirth. Until ALL women have complete control and freedom to control their bodies and freely determine their own health across their reproductive lifespan, the feminist movement will still need to focus on fighting for women's reproductive freedom. As we've talked about in other lectures, identity politics such as race/ethnicity, religion, sexual orientation, age, disability, and socioeconomic status all influence how much control women have over their bodies. For instance, even though contraception is widely available in many areas (especially on college campuses), many poor women are unable to afford contraception, especially because they are likely to not have health insurance (which sometimes, but not always, will cover part of the cost of contraceptives). In other words, disparities in women's health are often due to racial/ethnic differences, poverty, and women's identities. Women's health is intrinsically linked to their reproductive freedom. Imagine a time in the future in which women only become pregnant when they want to, when women can afford and have access to prenatal care, and when women can choose how, where, and when they want to experience childbirth. In contrast, currently about half (50%) of all pregnancies are unintentional, because contraceptives fail, because women don't have adequate access to them, or because they did not give consent to sex. Often women who become unintentionally pregnant do not receive prenatal care because they can't afford it or because they feel judged by their healthcare providers (e.g. single mothers). These women have very little chance of getting support as a new mother and often experience postpartum depression. Notably, we live in a society which spouts "Family Values" but does very little to actually support women and children. Birth Control & Contraception: Generally speaking, contraceptives are methods that are used to prevent pregnancy BEFORE coitus (intercourse) has taken place; birth control refers to any method that prevents live birth and includes the category of contraceptives. There are many different options for women and men to choose from when deciding on a contraceptive. Feminists consider it a victory that women have so many options today, given that contraceptives were either illegal or unavailable (particularly for unmarried women) even 50 years ago. Planned Parenthood is a great site to visit to learn about all the contraceptive options. Notably, no method of contraception is 100% effective at preventing pregnancy (besides abstinence) and ALL the methods of contraception have side effects, some of them quite worrisome. You'll note that an overwhelming majority of birth control methods assign responsibility to women. While some women may view this as empowering, it also suggests that men have less responsibility in preventing pregnancy than do women. If you've been following current events in the last year, you know that women's access to contraceptives is also being threatened. Take, for instance, the conscience clause which allows pharmacists to refuse to fill prescriptions for birth control pills or Plan B contraception (aka the morning after pill or the emergency contraception pill). How is a woman supposed to engage in safe sex if her prescription for birth control or Plan B may not be filled? And that assumes that she knows about such contraceptive methods given the state of sex education today, she may very well not! The research repeatedly shows that abstinence­only education doesn't delay the onset of sexual activity, but it does lead kids to engage in riskier sexual behavior like anal and oral sex without condoms because they just aren't getting full information. Yikes. Ok, so let's talk a little bit about abortion. Abortion has only been legal here for 33 years. It became legal after that monumental Roe v. Wade Supreme Court ruling and allowed women in every state access to safe, legal abortions and guaranteed their constitutional right to privacy. Unfortunately, ever since it was legalized, there has been a steady attempt to roll back the access to abortion that the Roe decision established. It started early on with the Hyde Amendment , which denied access to abortion for low­income women on Medicaid. That was followed by a number of cases which allowed states to establish additional legislation to limit access to abortion, and as a result we've seen many states adopt policies that require a mandatory waiting period or parental consent for a minor . In society where it is increasingly difficult for young women to have safe sex with access to full contraception and knowledge , it is problematic when abortion begins to be criminalized. Women who have resources (e.g. money, transportation) have better access to abortion, even if states continue to pass legislation that makes abortion illegal in certain areas of the country. Privileged women will be able to drive to a legal state or fly to a foreign country if they need a safe abortion. Women who are poor, particularly those who are young and/or those living in rural areas, will be disproportionately affected by illegal abortion. Rural women who do not have access to public transportation, poor women who do not have the resources to cross state lines and young women who do not have access to either capital or transportation will be the ones unduly impacted by the criminalization of abortion. Because if we look back through history or even around the world today and ask: What will women do if/when they don't have access to legal abortion? The answer is: they will have an abortion. Even. If. It. Is. Illegal. And it may kill them. Reproductive Rights ­ A Complex Issue It's frightening that in 2009, STDs and pregnancy are seen as the punishment for women's sexuality. Why is there still such a desire to control women's bodies and such a fear of allowing women access to basic reproductive healthcare and basic reproductive freedom in our society ? Access to abortion is about women having control over their own bodies and having the respect to make decisions that affect their lives . Access to abortion is one part of an ongoing struggle for women's equality, which is a part of the larger movement of fairness, prosperity and justice for both women and men. Feminists who are pro­choice are not pro­abortion ­ no woman WANTS to have an abortion. Yet, pro­choicers believe that if women are to be truly equal in this society, they must have full control over their own bodies and that WOMEN themselves, not their partner, doctors, or the President, know their situation and their lives the best . Women know whether or not they can handle becoming a mother. Pro­choice feminists ask: Why do we want to force women to become mothers when they know they can't do it? Thus, the abortion issue is NOT a simple matter; it's not a black and white issue ­ at least not from a feminist perspective. Women's health and reproductive freedom is intrinsically related to so many other aspects of their lives. WARNING: Be very careful in your forum discussion participation this week. We all have different opinions and beliefs on controversial issues like abortion. However, this is a feminist course and this class requires you to be respectful of others' opinions and ideas. If you feel as though abortion is too difficult for you to discuss without possibly offending someone else, don't post about it! Choose another topic from today's reading or lecture for your post. The syllabus if very clear that anti­feminist comments will not be tolerated and will result in your failure of the course! Quiz 14 Your response has been submitted successfully. Points Awarded Points Missed Percentage 4 1 80% 1. Which of the following is an example of reproductive rights? A. Women's right to obtain safe and reliable birth control B. Women's right to obtain accurate sexuality education information C. Women's right to terminate a pregancy D. ALL of the above All of the above are example of reproductive rights - see the lecture for more info. Points Earned: 1/1 Correct Answer: D Your Response: D 2. For women of color, the heart of their struggle for reproductive control involves resisting population control. True - On pg. 355 of WVFV, the authors assert that for women of color, resisting sterilization while simultaneously claiming their right to bodily self-determination is the central issue. Points Earned: 0/1 Correct Answer: True Your Response: False 3. In the past, poor women, women of color, women with mental illness and those who were incarcerated were likely to face forced sterilization. Though this practice is now illegal, the problem still remains. Scary but true. For details on forced sterilization see pg. 315 in WVFV. Points Earned: 1/1 Correct Answer: True Your Response: True 4. Which of the following most clearly summarizes the feminist critique of medicalization? A. Women are still less likely to occupy prestigious positions in the medical field. B. Because of women's complicated reproductive system, they deserve better regular care from today's healthcare system. C. Women are more likely to discuss their health ailments with a female doctor than a male doctor and the medical community needs to address this. D. Drugs are often tested on men and then scaled back for women--medical and drug studies should include more women. E. Many of women's biological processes are seen as illness and the health care system makes a bundle while treating the female condition. Medicalization is the process whereby normal functions of the body come to be seen as indicative of disease. See more in WVFV pg. 312. Points Earned: 1/1 Correct Answer: E Your Response: E 5. Emergency contraception works the same as "the abortion pill" FALSE! Emergency contraception is not the same as RU-486. See the reading "Improving access to emergency contraception" for more info. Points Earned: 1/1 Correct Answer: False Your Response: False Quiz 15 Your response has been submitted successfully. Points Awarded Points Missed Percentage 4 1 80% 1. Doctors practicing in countries with low infant mortality rates are more likely to intervene into the birth process. False -- They are actually less likely to intervene. Return to this week's web reading for more info. Points Earned: 1/1 Correct Answer: False Your Response: False 2. Physicians in our country can graduate from medical school without having delivered a single baby and can become board-certified in obstetrics and gynecology having never seen a normal birth conducted without interventions. Shocking but true. Visit this week's web reading for details. Points Earned: 1/1 Correct Answer: True Your Response: True 3. Most women attended by midwives in US hospitals are poor and African American. This week's web reading finds that most women using midwifery services are poor and African American and are generally less healthy than their middle and upper-class white counterparts. Even though this population is considered "high-risk" they are less likely to undergo cesarean section and other interventions because of their reliance on midwifery care. See the web reading for more info. Points Earned: 0/1 Correct Answer: True Your Response: False 4. NARAL is an organization that solely provides information about abortion to women. NARAL is concerned primarily with women's reproductive rights and therefore provides information on sexuality education, court legislation regarding women's health, reproductive rights issues specific to women of color, birth control options, etc. Points Earned: 1/1 Correct Answer: False Your Response: False 5. In "An Open Letter to a Diocesan Priest", the author talks about her experience with an unintended pregnancy. Which of the following is TRUE of her experience?: A. She is angered by the feelings of powerlessness that came from her Catholic upbringing that left her feeling unprepared to deal with the complicated situation of an unintended pregnancy B. She talks about her guilt as a result of her abortion C. She talks about her relief after giving the baby up for adoption D. All of the above are true The author became pregnant unintentionally twice - the first time she gave her baby up for adoption and the second time she had an abortion at 8 weeks. She feels as though she can never truly recover from giving her baby up for adoption, and she critiques the so called "prolife" stance of the Catholic Church because of their lack of support for her trauma associated with the adoption. Points Earned: 1/1 Correct Answer: A Your Response: A ...
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