October 27, 2011 — Summary of "The Paradox of Disability in Abortion Debates: Bringing the Pro-Choice and Disability Rights Communities Together," Jesudason/Epstein, Contraception, Oct. 13, 2011.
"There is an unfortunate paradox that arises when pro- and anti-choice advocates talk about disabilities," Sujatha Jesudason of Generations Ahead and Julia Epstein of the University of California Hastings College of Law's Center for Gender & Refugee Studies write in a Contraception editorial. "On one hand, reproductive rights proponents can portray disability as a tragic state that justifies abortion," while on the other hand, "anti-choice advocates proclaim their value for all life, including individuals with and without disabilities," Jesudason and Epstein state.
This paradox "places disability-rights advocates, generally a group that finds itself in the progressive political camp, on the same side as anti-choice advocates who are most usually associated with conservative political positions." Abortion-rights opponents have "never championed policies that provide services for people with disabilities and their families" and often do not support government programs that help families raising children with disabilities, they write. Meanwhile, abortion-rights advocates tend "to champion funding for the social services and support programs that meet all families' needs," Jesudason and Epstein state, adding, "A truth often ignored by anti-choice advocates -- that raising a child with a disability has financial repercussions for the child's family -- means that without such services, only the affluent can provide the support many children with disabilities require."
The authors continue, "So it seems that disability rights and reproductive rights can conflict and intertwine, particularly on the issue of later abortion." Reproductive health advocates "must work to improve how we understand and talk about the intersection of disability and abortion for women, families and society at large," Jesudason and Epstein write.
"In attempts to personalize difficult late-abortion decisions, some pro-choice organizations have recounted stories of families struggling with the 'excruciating choice' to terminate a wanted pregnancy because their fetus has received a diagnosis of disability," Jesudason and Epstein write, adding that the "focus is on the potential suffering a child with a disability will allegedly experience and inevitably bring on parents and other siblings." On the other side of the debate, antiabortion-rights groups "use much more empowering language about the experience of parenting children with disabilities and living as an adult with disability," according to the authors.
"Both approaches oversimplify the nature and complexity of disability and abortion, and neither is doing enough to provide families with the kind of support they need to have and raise children, whether or not they have disabilities," Jesudason and Epstein argue. "Reproductive-rights groups are not anti-disability, and they are well aware of the complex challenges women face in deciding to keep or terminate a pregnancy," Jesudason and Epstein explain, but a "better message would reflect core values of dignity, human rights and self-determination for all people and all families." Moreover, the "shared progressive values of the pro-choice and disability rights communities should have no place for oversimplifying disability as tragic, pitiful or inspiring; erasing the difficulties in obtaining abortion services; and discounting family support policy agendas and their critical importance in abortion debates," the authors add.
A New Approach
"A disability-rights approach highlights the social stigma attached to disability and the lack of environmental, social, political and economic supports for families raising children with disabilities and for adults with disabilities," while a reproductive justice approach "advocates for an affirmative role for the government to play in ensuring that all women have the social, political and economic power and resources to make the best decisions for themselves and their families," Jesudason and Epstein write.
The disability-rights method "positions the problem outside the person with a disability" by "focusing instead on the social and family supports needed to live with disability rather than" the condition itself, while the reproductive justice method tries to ensure that women "have the most accurate and comprehensive information possible, including realistic perspectives from individuals with the disability in question."
Suggestions for Nebraska
Jesudason and Epstein suggest five ways that reproductive-rights advocates can improve their messaging, specifically with regard to Nebraska's "fetal pain" law, which bans abortion after 20 weeks of gestation based on supporters' claims that fetuses can feel pain at that point.
The first suggestion is to use public message campaigns that are "values-based" and "family supportive," rather than debating the scientific accuracy of fetal pain or legal claims. "Attempts to draw medical or scientific lines mirror and reinforce anti-choice attempts to draw lines between good and bad women, and acceptable and unacceptable abortions," Jesudason and Epstein explain. They also recommend expressing empathy toward "families facing unforeseen decisions that are unique to each family and best made within a family," rather than "highlighting the 'pain and suffering' women and their families might experience" because of the decision.
Reproductive-rights advocates also should "shift the overall strategy from fetal anomaly, rape and incest as the messaging platform for abortion to ensuring that government provides the supportive and enabling conditions for families to make the best decisions for themselves," Jesudason and Epstein recommend. "Rather than assuming a libertarian, hands-off position for the government in these questions, reproductive-rights and justice advocates can push for a strong, proactive role for the government in providing a system for comprehensive information, ... as well as financial and physical supports for families to make the best decisions for themselves," they write.
In addition, advocates can emphasize and invest in laws that support better information and health services for pregnant women, such as the Prenatally and Postnatally Diagnosed Conditions Awareness Act. Lastly, the movement can encourage "deeper discussion about health and women's access to abortion based on a 'health' exception for the woman and the fetus in which we redefine the conception of 'health' to include human variation," and recognize disability as "a part of the whole human experience," Jesudason and Epstein write. They add, "By focusing so strongly on normative health, reproductive-rights advocates could end up supporting access to abortion for a very limited group of women."
Jesudason and Epstein argue, "If the anti-choice movement has been disingenuous in their portrayal of disability and abortion, focusing on the right-to-life rather than the right-to-live, the reproductive-rights movement has not necessarily lived up to its own highest ideals either." They write that the reproductive-rights movement "would be more in alignment with its own values of dignity, equality and self-determination for all by focusing on messages that embrace a diversity of families and advocating for public policies that support what's best for women and families." They conclude, "The disability-rights framework offers the pro-choice movement its best opportunity to shift the abortion debate from a medical argument about fetal pain and viability to a positive, potentially game-changing platform on overall human rights."