23. Reproductive and Sexual Freedom
As women gained greater political rights, they began attacking restrictions on reproductive freedom, with advocacy efforts peaking in the 1960s. Parallel to this work were significant scientific breakthroughs that made the practical objectives of the movement for reproductive freedom possible. Rights to privacy, contraception (birth control), and abortion were all focal points for women and their allies. Demand for reproductive justice was fueled by the belief that the government should stop judging and discriminating against women and men for their sexual choices. The free love of this era expanded opportunity and freedom for women.
Trigger warning: this section discusses rape and abortion.
How to cite this source?
Remedial Herstory Project Editors. "23. REPRODUCTIVE AND SEXUAL FREEDOM." The Remedial Herstory Project. November 1, 2025. www.remedialherstory.com.
After women won the vote in 1920, many battles for women’s rights remained, especially in the area of reproductive autonomy. These battles uniquely affected women and had yet to be addressed by either Congress or predominantly male state legislatures.
Reproduction has been one of the most significant and defining facets of women’s lives throughout history. In the mid 20th century, women pushed back against the laws of the late 19th century that worked to limit their options and choices. They advocated for new laws that addressed birth control, access to abortion, maternity leave, and childcare. All of these efforts expanded women’s ability to join the workforce in greater numbers, but it was an uphill battle that took decades. Women had to fight against prevailing social norms and gender roles, to redefine womanhood and femininity, and occupy a seat at the table where decisions were made regarding their lives.
Because of society’s hierarchical structure and because most laws are written to protect (male) lawmakers’ interests, few laws protected women and mothers prior to the mid-twentieth century. In marriage, women had some protections under laws that ensured the father would provide for his children, but outside of marriage women had few options. It wasn’t until 1950 that Wisconsin became the first state to enact a child support law that required fathers to provide financial support for their children. Even today, while child support laws are common, fathers are not required to provide support for pregnant mothers or help with hospital bills. Following Wisconsin, other states gradually implemented their own child support laws, but since this was before reliable paternity tests, it was difficult to establish paternity.
The patriarchal system in which elite men hold power and poor men and most women have little agency caused women to almost disappear in marriage. Married women could not open bank accounts without their husbands’ signatures until 1974, and women were designated as their husband’s wives on official documents such as passports. In the workforce, women still earned a fraction of what men made and there were few protections for women if they became pregnant. On the other hand, a man could have sex and not acknowledge the pregnancy, support the woman during the pregnancy and birth, and fail to provide for the child, leaving the risks and expense of childbirth and childrearing on the woman.
Divorce was extremely difficult for women to acquire. Established laws gave men more choice over when they could divorce. Traditionally, women relied on men for financial support, so divorce was often detrimental to women’s financial situation. Common reasons for divorce included adultery, abandonment, and cruelty, but proving these grounds was often challenging for women. Additionally, divorce proceedings could be costly, time-consuming, and required significant evidence and witnesses. Some states introduced laws that allowed women to petition for divorce on grounds of desertion or extreme cruelty. However, even with these provisions, women often faced significant legal and societal obstacles when seeking divorce. Furthermore, divorce often imposed a social stigma on women. These vestiges of 19th century ideology made women dependent on men to provide for them and their children. Divorced women were also at a disadvantage in terms of property rights, child custody, and financial support. It wasn’t until the 1970s that “no-fault divorce” became more common, but even this innovation did not solve the problem of financial hardship for many divorced women.
Moral and social convention dictated that women not engage in sex before marriage. Marriage theoretically provided a woman with financial stability and gave a man social status and sexual access. Once in a marriage, however, there were few options for women to leave, and there were repercussions for her socially and economically if she did. If a woman became pregnant out of wedlock, her refusal to adhere to social and moral conventions meant that the father of the child was not obligated to provide for her or their child. This created a system wherein women were punished or denied protections if they stepped out of line.
By the early twentieth century, women pressured state legislatures to enact laws that would make them better able to provide for their children without men. They also began to analyze the root cause of the problem: sex. If women could increase their control over pregnancy, they could have greater financial freedom and plan their lives around work, family, and children. This concept of control over your body is called “Reproductive Freedom.” Reproductive Freedom can’t exist if a woman has no ability to control what happens to her body. This is deeply important, especially for women for whom pregnancy carries health risks such as high blood pressure, preeclampsia, gestational diabetes, genetic birth defects, and more.
These are the challenges faced by women who have consensual sex. There are also cases where people are coerced and forced into sexual acts. This is called rape. Rape was too common, because the entire social and legal landscape was built to protect men and the power they hed over women. Today, one in four women have experienced attempted or completed rape.
For women of color, sexual abuse was a holdover from the culture of slavery throughout the United States. Enslaved women were “owned” by men who claimed access to their bodies and to any children born of sexual encounters between master and slave. Enslaved mothers had no choice over whether they had sex with the master and no rights to her children after they were born. In the decades after slavery, the rape culture persisted., especially in the former slave-owneing Confeeracy.
Reproductive Freedom is important for women when all the scales of the system are tipped to favor men. It protects women and ensures their children are raised in a supportive environment. What does Reproductive Freedom look like? Most advocates agree that it includes the freedom to have sex or not, access to contraception (birth control), access to abortion, parental leave to keep your job while you birth and raise an infant in its early months, access to affordable childcare, and tax breaks for single parents, among other things. These rights were the subject of battles fought during the late 19th century to today.
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Scientific Breakthroughs in Reproductive Biology
Scientists and their discoveries in the 20th century were crucial to understanding human reproduction. In the 1920s and 1930s women were also more represented in the field of embryology (the study of embryos) for a variety of reasons: the discipline often involved slow-moving fieldwork over several years that appealed less to publication-oriented male professionals and it involved a high degree of fine motor skills that women were assumed to possess.
The founder of developmental genetics, Salome Gluecksohn-Waelsch and her husband escaped Nazi Germany in 1933, settling in New York City. She was just one of hundreds of Jewish scientists to flee Germany on the eve of WWII. In America, she found employment at Columbia University as a “research associate.” In that role she published a number of papers that made clear the connection between genetics and embryo development, a novel contribution that established the field of developmental genetics.
These scientists worked together to promote the cause of women scientists. Jane Marion Oppenheimer was a friend of Waelsch and a professor of biology and the history of science at Bryn Mawr College. She was an embryologist whose experimental work focused on the embryo of the common minnow. In addition to her own rich career on regulation and differentiation in embryos, Oppenheimer supported her colleague by singing the praises of Waelsch’s work to Ernst Scharrer, who was hiring for the newly-founded Albert Einstein College of Medicine in New York. He hired Waelsch, giving her a full faculty position.
The most famous embryologist was Christiane Nüsslein-Volhard, who won the 1995 Nobel Prize in Physiology or Medicine for her work on how the genes in a fertilized egg form an embryo.
Born in Germany in the middle of WWII, she studied biology, physics, and biochemistry, eventually earning her Ph.D. through her work on genetics. She became interested in how genes controlled the development of embryos. She and her colleague, Eric Wieschaus, worked with fruit flies and determined how the shape of fly embryos was determined by a small number of genes. While these women worked to unlock the mysteries of how life is formed and developed, they shed little light on the moral questions that are debated around reproductive rights. Those discussions take place not in the lab, but in households and the halls of power.
Katharine Dexter McCormick, Public Domain
The Pill
In the late 1950s early 1960s, a scientific revolution made contraceptives easier and more effective. As early as the 1940s, Margaret Sanger, as president of Planned Parenthood, closely monitored and funded birth control research. Sanger's friend, Katharine Dexter McCormick, generously funded research for an oral contraceptive. McCormick was a women's rights advocate and a graduate of MIT. She contributed to the suffrage movement and League of Women Voters. After her husband's passing, she pledged $10,000 and later provided annual contributions exceeding $150,000 annually for contraceptive research.
The development of the oral contraceptive relied on ancient Aztec medical traditions. Russell Marker discovered the contraceptive properties of the Barbasco root, from which progestin was extracted and combined with estrogen by Gregory Pincus to create the first pill at the Worcester (Massachusetts) Foundation for Experimental Biology. McCormick funded initial clinical trials conducted by Dr. John Rock, a renowned gynecologist and devout Catholic. Rock's book advocating the acceptance of the oral contraceptive by the Catholic Church was unsuccessful.
To circumvent the restrictive laws relating to contraception in Massachusetts, Rock chose Puerto Rico for trials, where contraception was legal, birth control clinics existed, and trusted US-trained medical practitioners were present. Puerto Rican women desired effective birth control. The trials began in April 1956. The FDA approved the pill for menstrual regulation in 1957 and for sale in 1960. While this was an important milestone, it is important to recognize that these trials in Puerto Rico were problematic. As testing evolved from spermicides and jellies, which are far less effective, some scientists ascribed their lower success rates to Puerto Rican women’s presumed fecundity, hypersexuality, and lower intelligence. Though many Puerto Rican women wanted access to birth control, this also put them in direct contact with white American scientists who came to Puerto Rico with their own racial attitudes that were informed by decades of US imperialism on the island. In Puerto Rico, abuses ran rampant–by the 1980s, it was discovered that more than ⅓ of Puerto Rican women had been coerced into sterilization procedures–la operación–or permanent birth control.
Enovid, the first oral contraceptive, gained popularity, with one in four married women under 45 using it by 1965. Sanger's efforts established family planning as the norm, significantly reducing unintended pregnancies. The first pill had higher hormone levels than necessary, unlike current lower-dose pills and thus had numerous side effects. It took time for scientists to figure out the lowest effective dosages.
Estelle Griswold, Public Domain
Griswold v. Connecticut and Free Love
The 1960s saw great public liberalization on sexual issues. While extramarital sexual relationships had existed throughout history, they were often cast as promiscuous and penalized the women for any children that resulted from them. The 1960s saw a huge swing in public opinion toward sexual relationships outside marriage and a woman’s freedom to be sexually active on her own terms. The Free Love movement of the 1960s championed the idea that consensual sexual relationships should not be governed by law and should be entered into or ended at the discretion of the individuals involved. Women should be allowed to choose their partners without the pressure of life long commitment. Critics of the movement included those who felt it justified promiscuous behavior. Others, including feminists, saw Free Love as an extension of male dominance of women giving them the opportunity to have sex without commitment of marriage and the responsibility to support any children that came from sexual relations.
Free Love was seen as promiscuous partially because it required contraception or risked pregnancy. Contraception was illegal throughout the US because of the 19th Century Comstock Laws that prohibited the mailing and dissemination of contraceptives. Estelle Griswold, who was the executive director of the Planned Parenthood League of Connecticut at the time, and Dr. C. Lee Buxton, a physician and a professor at the Yale School of Medicine, sought to challenge the Comstock Laws at the Supreme Court. Recognizing that married couples had the strongest case, they represented three couples with compelling circumstances, including life-threatening pregnancies and stillbirths, but their initial lawsuit, Poe v. Ullman, was dismissed by the U.S. Supreme Court because they lacked standing to bring the case.
Determined to force the issue, Griswold opened a Planned Parenthood clinic in New Haven, where she and Buxton openly provided contraceptives. This led to their arrest and prosecution, creating the grounds for a new case. The new case focused on a married couple in which the woman had health concerns that made pregnancy dangerous. Contraception, they argued, was necessary for them to enjoy the same marital relations as other couples without risking the woman’s life.
In Griswold v. Connecticut, attorney Thomas Emerson argued that the law violated the 1st, 9th, and 14th Amendments, focusing particularly on the concept of a constitutional “right to privacy.” In a landmark 1965 decision, the Supreme Court ruled 7-2 in favor of Griswold, recognizing a "zone of privacy" within marriage was protected by the Constitution. While it was a breakthrough in reproductive freedom, the logic used by the court was inherently patriarchal. The Court essentially ruled that a husband had a right to have sex with his wife and laws against contraception hindered that right in this case. This ruling not only invalidated Connecticut's contraceptive ban but also laid the foundation for future cases on privacy, reproductive rights, and personal autonomy, including Eisenstadt v. Baird which opened contraceptives to unmarried couples, Roe v. Wade which created a limited right to abortion, and Obergefell v. Hodges which legalized gay marriage.
American Psychological Association
Homosexuality remained controversial despite the marches and advocacy efforts of the gay community. Much of this was grounded in a belief that homosexuality was a mental illness. It was listed as one in the Diagnostic and Statistical Manual of Mental Disorders, also known as the DSM, a manual used by psychiatrists and psychologists to diagnose patients. Once again, science was used to challenge culture and law. In 1956, Evelyn Hooker, an American psychologist, published a paper in 1956 titled "The Psychological Adjustment of Homosexual Males." In this groundbreaking study, Hooker subjected self-identified homosexual and heterosexual men to an array of psychological tests. She then enlisted the expertise of professionals to discern the homosexual individuals and evaluate their mental well-being. The findings of this experiment, which subsequent researchers corroborated, challenge the notion of homosexuality as a psychological disorder.
Showing that homosexuals were not mentally ill was hugely important to the social movement, however it took a long time for the American Psychological Association to come on board. In 1973, the APA concluded that homosexuality was not a mental disorder. The APA struck it from the DSM.
Frances Kelsey receiving the President's Award for Distinguished Federal Civilian Service from President John F. Kennedy, in 1962, Public Domain
Thalidomide
In the 1960s a drug often prescribed to women to treat pregnancy discomforts, like morning sickness, was found to cause birth defects in babies. A television personality, Sherri Chessen Finkbine was expecting her fifth child when she took tranquilizers that her husband brought from England to relieve her nausea, the drug thalidomide. However, after reading an article about thalidomide that discussed its role in the birth of thousands of babies born without arms or legs, Finkbine became worried about the potential harm to her unborn child. Finkbine's doctor confirmed her fears, but at the time, there was no test to assess the fetus's condition. So, following her doctor's suggestion, Finkbine and her husband decided to quietly have an abortion. Abortion in Arizona was illegal, so they ended up traveling to Sweden. Her case was public and public opinion polls showed that 52% of Americans supported her choice under the circumstances.
The United States did not witness a pharmaceutical disaster on par with Europe’s related to Thalidomide because of one scientist at the Food and Drug Administration (FDA): Dr. Frances Kathleen Oldham Kelsey. Dr. Kelsey worked for the American Medical Association and eventually taught pharmacology at the University of South Dakota. In addition to her Ph.D., she also had her medical degree and briefly worked as general practitioner. It was in her first month in her position at the FDA that Dr. Kelsey was tasked with evaluating the drug thalidomide for approval in the United States. When the manufacturers of thalidomide submitted their information to Dr. Kelsey, she didn’t believe they had provided adequate data to show its safety and asked them to resubmit their application once they had effectively proved its safety. The manufacturers were frustrated by this woman’s attempt to slow their approval process for a drug that was already in widespread use in Europe. Instead of conducting the new tests and submitting a new report, the manufacturers attempted to pressure and coerce Dr. Kelsey into approval. However, she held firm–trusting her extensive expertise. This back-and-forth is what ultimately caused enough of a delay for word to spread of fetal anomalies and defects in Europe related to thalidomide use by pregnant women. After a congressional hearing on the matter, Dr. Kelsey was able to ensure that thalidomide would be banned in the United States. In 1962, just a year later, President John F. Kennedy granted Dr. Kelsey the President's Award for Distinguished Federal Civilian Service. She was only the second woman to ever receive the award. Kennedy acknowledged "Her exceptional judgment in evaluating a new drug for safety for human use…” In the immediate aftermath of the thalidomide disaster, Dr. Kelsey helped change laws about drug approval to protect the patient, ensure informed consent in clinical trials, and report adverse side effects to the FDA. In her long and distinguished career at the FDA, Dr. Kelsey eventually became chief of the Division of New Drugs, director of the Division of Scientific Investigations, and deputy for Scientific and Medical Affairs in the Office of Compliance. She retired in 2005, at the age of 90, after 45 years of service.
Dr. Kelsey received the President’s Award for Distinguished Federal Civilian Service from President Kennedy. National Library of Medicine, Images from the History of Medicine
Roe v. Wade
Reproductive freedom isn’t just about preventing pregnancy, it’s about the freedom to decide what happens to one’s body, financial future, and the choice to be a mom. Some people have argued that consenting to sex is tacit consent to be a mother, but the long history of the patriarchy shows that the same tacit consent has not fallen equally on men with fatherhood. Therefore some feminists argue that this argument is rooted in misogyny and a sexual double standard for women.
Abortion is a broad medical term that refers to termination of a pregnancy. It includes spontaneous abortions and induced abortions. Spontaneous abortions are often euphemistically referred to as “miscarriages;” however, in professional medical parlance (like the GTPAL acronym that defines a women’s reproductive medical history), the term is abortion. Induced abortions are what we socially think of as “abortion.”
When it comes to induced abortions, they can be performed at any stage of a pregnancy; however, according to data from 2020, 93% of abortions happen before 13-weeks gestation (within the first trimester). This is before the mother is noticeably pregnant, before the fetus can be felt moving around, and before fetal viability. Abortions before nine weeks are typically done using medications that block hormone signals to the pregnancy and cause the uterus to contract and expel the embryo, a term for the cells that eventually become a fetus at 9 weeks.
Statistically, 5.8% of abortions occur between 14 and 20 weeks of pregnancy, which is in the second trimester. Twenty weeks is the time when fetal movement can be felt. Induced abortions that occur in the second and third trimester almost always are performed because of potential health risks to the pregnant woman or fetus. As it stands, most prenatal screenings for fetal diseases or defects cannot be performed until the second trimester, thus delaying when it is feasible for a woman who discovers her fetus carries a disease to acquire an abortion. Less than 1% of abortions happen after 20 weeks and it is usually the result of an extreme, health related circumstance. These abortions are performed surgically and involve a doctor using tools to terminate the pregnancy.
In the politicized discussions around abortion, much has been made about the pain mothers and, or fetus’ feel during abortion. Studies have shown that for pregnant people, abortion is safer than carrying a pregnancy to term and birth. This was also true for most of US history. Pregnancy is not a health-neutral event and carries with it risks, including the risk of death. For the embryo or fetus, abortion ends the lifelike activity, but it is debated by professionals how painful this is and the evidence varies by when the abortion is performed. Public opinion polls have varied since the 1960s on abortion, most people agree it is ending life, but most also feel it’s different from ending the life of a child that has been born.
Throughout the early 20th century women and their doctors were put on trial for violating state abortion laws. By 1910, abortion was illegal in every state in the US. Some states had built in exceptions to save the mother’s life. The decision of when a mother’s life was in jeopardy was left to doctors, who were almost all men, and these standards were not universal.
Criminalizing abortion meant that more women turned away from qualified people to have abortions. Getting abortions under extreme circumstances by people willing to do something illegal, resulted in an increased death toll for pregnant women. Abortion was not inherently unsafe, illegal abortion was. In 1930, nearly 2,700 US women died from an illegal abortion, or one in five maternal deaths that year.
Doctors caught performing abortions were tried and lost their medical licenses. Increasingly, the press covered stories about women who had died from an illegal abortion. Women’s bodies were found in barrels, chopped up in suitcases, all after a botched abortion by someone unqualified. People began calling for abortion law reform.
Women began appearing in court to testify as to why they wanted an abortion in the first place. Abortion was so stigmatized that women never talked about it. Stories of safe, successful abortions were never in the press; however, stories about illegal abortions that resulted in death sold papers. Thus, the effect of criminalization was that women who were accused were forced to talk about it publicly. Women who believed they would never get an abortion listened to abortion stories and empathized with the mothers choice, given her circumstances. Criminalization forced women to talk about their darkest moments in a very public forum.
In 1955, Planned Parenthood called for a national conference on abortion. The few doctors who attended called for greater flexibility for doctors to perform abortions. These doctors had personally witnessed women dying from pregnancy-related causes were unable to help them or watched women carry babies who could not survive more than a few days.
Despite the stereotype of the young, naive, and sexually promiscuous girl being the ones who get abortions, studies showed that women who were already mothers were more likely to get abortions and that religiosity was not a factor. Women of all faiths got abortions.
In 1964, abortion law reform activists registered their first national group: the Association for the Study of Abortion (ASA). Then in 1966, a group of nine highly regarded California doctors faced a lawsuit for providing abortions to women who had contracted rubella, a disease that could harm unborn babies. However, doctors from all over the country rallied to support these doctors, with even 128 medical school deans joining their defense. As a result, one of the earliest changes to abortion laws in the United States occurred. California revised its strict ban on abortion to permit hospital committees to review and approve requests for the procedure.
Studies in the 1960s showed that poor women and their families were affected to a greater extent from abortion bans. One study examined low-income women in New York City and found that 8% had tried to end a pregnancy through illegal means. Additionally, 38% reported that someone they knew had attempted to get an abortion. Among the low-income women who admitted having an abortion, 77% said they had attempted a self-induced procedure, while only a small fraction 2% involved a medical professional at all.
With only limited support from doctors, women organized themselves to deliver abortion services. For example, the Abortion Counseling Service of Women’s Liberation was an underground organization of women in Chicago that offered abortions to low-income women who could not afford to travel to somewhere abortion was legal. Often just called the Jane Collective or just Jane, women learned of the service through word of mouth or through signs posted in the city or ads in newspapers: “Pregnant? Worried? Call Jane.” The women of Jane taught themselves the procedure and performed an estimated 11,000 abortions in the years before the Roe v Wade decision made abortion legal in all 50 states..
By the end of the 1960s there was a full fledged movement to repeal abortion bans. National Association for the Repeal of Abortion Laws (NARAL) was founded in 1969. NARAL became the first nationwide organization dedicated exclusively to advocating for the legalization of abortion. Left and right states were repealing or modifying their abortion stances. Alaska, Hawaii, New York, and Washington completely eliminated their laws prohibiting abortion, while 13 other states introduced changes that broadened the circumstances under which abortion was permitted. Instead of solely permitting abortion to save the life of the mother, these reforms allowed for abortion in situations where the pregnancy posed risks to the patient's physical or mental health, when there were fetal abnormalities, or when the pregnancy resulted from rape or incest. However, much of these changes were piecemeal and state by state. It would not be until 1973 that the question of abortion was answered federally.
The Roe v. Wade decision was a landmark ruling by the United States Supreme Court in 1973 that legalized abortion across the country. The case originated in Texas and involved a woman named Norma McCorvey, referred to as "Jane Roe" to protect her identity, who sought to terminate her pregnancy but was denied access to legal abortion under Texas law. In 1969, when McCorvey became pregnant, she was unmarried, financially struggling, and unable to afford to travel to a state where abortion was legal. This also wasn’t her first pregnancy. Texas law at the time prohibited abortion except to save the life of the mother or in instances of rape. McCorvey's lawyers, Linda Coffee and Sarah Weddington, sought a representative plaintiff who could best illustrate the difficulties faced by women seeking abortions. They aimed to demonstrate that the Texas law violated women's constitutional right to privacy. McCorvey's circumstances and her inability to access a safe and legal abortion made her a suitable candidate for the case.
Ultimately, building on Griswold v. Connecticut, the Supreme Court, in a 7-2 decision, held that a woman's constitutional right to privacy, as protected by the 14th Amendment, includes the right to choose whether to have an abortion. It established a framework based on testimony from doctors using the trimesters of pregnancy to determine when and how states could regulate abortion.
In the first trimester, the Court held that the decision to have an abortion should be solely between a woman and her doctor, with minimal government interference. Since the fetus was not viable and legal abortion in the first trimester posed few medical risks, the government’s right to regulate was limited. In the second trimester, the state has a legitimate interest in protecting the woman's health and may regulate abortion to some degree–particularly since second trimester abortions were more dangerous than first trimester abortions, and the fetus was approaching viability. Later court decisions would indicate that these regulations should not impose an "undue burden" on a woman's right to access abortion. In the third trimester, the state's interest in protecting potential life becomes more compelling, and it may prohibit abortion except when necessary to protect the woman's life or health. With the court’s decision in Roe v. Wade, the federal government granted women a right to bodily autonomy, to make their own decisions in family planning, and to engage in sexual relations with the same freedom as men.
It's worth noting that McCorvey never had an abortion during the legal proceedings. By the time the Supreme Court ruled in 1973, she had given birth and placed her child up for adoption.
After the legalization of abortion nationwide, Ms. Magazine, a feminist publication, ran a cover picture of Gerri Santoro, a young mother who died when her boyfriend tried to perform an abortion on her in a motel room. Santoro’s ex-husband was abusive. She fled from him with their children and started a new relationship; however, she never divorced her husband. Soon after learning she was pregnant with her boyfriend’s child, her estranged husband contacted her to let her know he would be visiting to see their children. Santoro was terrified that he would kill her or that he would use her pregnancy with another man to take their children away. She and her boyfriend tried to perform the abortion themselves, borrowing a medical textbook from the local library. When she began hemorrhaging blood, her boyfriend fled the scene. Ms. Magazine hoped that by telling Santoro’s story people would see how illegal abortion impacted individual women’s lives.
Abortion remained a divisive issue in American society and American politics. In 1976, Congress passed the Hyde Amendment to prevent federal funds from being used to provide abortions. The funds came from Medicaid, a government-sponsored insurance program that helps low income families. Women who receive Medicaid could not use that insurance to get an abortion. This restriction is still in place today and primarily affects the poor, Black, Latino, and LGBTQ+ communities that predominantly use Medicaid. Women in these communities face barriers to getting abortions that their wealthier sisters do not. Reproductive Freedom is only possible if the financial and social barriers to freedoms are removed.
GTPAL Acronym:
G - Gravida: # of Pregnancies
T - Term: # of pregnancies carried to 37+ weeks
P - Preterm: # of pregnancies that ended between 20-36 weeks, including live and still births
A - Abortion: # of pregnancies that ended before 20 weeks (abortion or miscarriage)
L - Living: # of living children of parent
10 weeks of embryotic development, Public Domain
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Geraldine Twerdy (Gerri Santoro) Circa 1955, Public Domain
Madrigal v. Quilligan
A key tenant of reproductive justice is the idea of consent, which continued to be a problem through the second half of the 20th century. Family planning initiatives tied to economic policies to end poverty, known as the War on Poverty, funded non-consensual sterilizations of primarily Black and brown women in the 1960s and 1970s.
Fannie Lou Hamer, for example, was an activist and a critically important participant in the Civil Rights Movement in the 1960s. She was a leading organizer of the Student Non-Violent Coordinating Committee (SNCC) which played an important role in voter registration drives. She was often one of the only women at the protests.
As a young woman, Hamer had seen a physician in Mississippi for removal of a uterine tumor, a minor procedure. Hamer left the hospital to find that the doctor had sterilized her without her consent. Hamer later stated, “[In] the North Sunflower County Hospital,...about six out of the 10 Negro women that go to the hospital are sterilized with the tubes tied.”
Some women were sterilized during Cesarean sections and were never told, others were threatened with termination of welfare benefits or denial of medical care if they didn’t “consent” to the procedure, others received unnecessary hysterectomies (the surgical removal of the uterus) at teaching hospitals as practice for medical residents. In the South it was such a widespread practice that it was called: a “Mississippi appendectomy.”
Madrigal v. Quilligan was a class action lawsuit brought by 10 Latina women in 1978 who represented more than 140 others. They argued that physicians at the Los Angeles County General Hospital coerced them during labor to consent to surgical sterilization. In some instances, the women were told they were consenting to C-sections. Some women agreed to the procedure because they were told they would die if they got pregnant again or that the doctors would not assist with childbirth unless they agreed. Some women were presented with consent forms in English, even if they could not read in either English or Spanish. In the most extreme instances, the women were not told they had this procedure done at all. They only found out later when they tried to conceive again.
The Madrigal case illustrates a convergence sex, gender, citizenship, language and culture. Even though the plaintiffs presented a compelling case, a judge ruled in favor of the physicians stating “the staff of a busy metropolitan hospital” had no way of knowing about these women’s “atypical cultural traits.”
In the Madrigal case, it was clear race and sexuality were central to making these women subordinated persons. In the context of the era, many white feminists were calling for access to birth control while minority women were calling for personhood, two very different focal points. For the most part, people of color and their parenting abilities were judged against standards based on white, middle class families. Often, they were found lacking by medical professionals and social workers.
Fannie Lou Hamer, at the Democratic National Convention, August 1964, Public Domain
Conclusion
Class and race background determined whether women had access to reproductive healthcare, whether they came into contact with state sterilization and birth control programs, and how they experienced sexuality and reproduction. Over the decades following Roe v. Wade the abortion rate in the country gradually declined after an initial jump, reaching a point lower than when it was entirely illegal by 2017. Experts believe the decline in abortions was due to the availability of reproductive health services, contraceptives, sex education, and other efforts that raised awareness of reproductive freedom. In other words, the less it was stigmatized and the more it was openly discussed, the less abortion was needed or used.
By the end of the 20th century so much about reproductive freedom remained unsettled. Would the court cases survive conservative opposition? Was the basis of these freedoms in the 14th Amendment’s privacy clause strong enough? Although contraception and abortion were legal, would women from diverse backgrounds and poor families be able to access and afford birth control and abortion? Would the stigma of abortion ever go away?
