More to do to Guarantee Reproductive Freedom

By Deborah Jacobs

Thirty-four years ago today the U.S. Supreme Court handed down its decision in Roe v. Wade, significantly expanding the ability of women across the country to decide when and whether to become a parent. The decision, while immensely important on its own, was only one step in this country's journey to true reproductive freedom. Three and a half decades later, we still have a long way to go toward the goal of equal access to safe and legal reproductive health care that not only protects individual rights and liberties, but that also fosters healthy, loving families and strong communities.

When and whether to become a parent is one of the most private decisions a person can make, and one that has a profound effect on all aspects of our lives. To participate fully in society, we must all be free to answer for ourselves whether we are ready and capable of being parents. Unfortunately, reproductive liberty is not a right we all share equally.

Through my work at the ACLU, I encounter countless women caught up in truly overwhelming circumstances, including poverty, abusive relationships, limited employment and educational opportunities and debilitating health conditions -- their own or a family member's. Standing alone, any one of these circumstances can be a substantial, preoccupying burden. If only life dealt us just one challenge at a time; almost invariably, our clients confront a number of these concerns simultaneously. Such circumstances make decisions about reproductive health care and parenting even more challenging.

As we commemorate three decades of reproductive freedom, it is fitting that we address what is one of the most fundamental needs upon which all other life conditions rest: the ability to access reproductive health care, from birth control to abortion to prenatal care to STD testing and treatment to sex education.

Reproductive health care is basic health care. And yet, the reality is that the disparity between the ability of rich and poor women to access reproductive health services continues to grow. According to a recent report by the Guttmacher Institute, in 2002, 16.8 million women needed publicly funded contraceptive care, yet only 6.7 million received such services. Fewer than half got the health care needed to assist them in deciding whether and when to become a parent.

Moreover, for the past 30 years - nearly as long as the constitutional right to abortion has been recognized in this country - Medicaid has, with few exceptions, denied poor women abortion coverage in its otherwise comprehensive health care program for low-income Americans. The result: women already struggling with scant resources do not receive the support they need to prevent unintended pregnancies and are forced to continue pregnancies against their judgment about what is best for them, their health or their families. In New Jersey, our laws preclude women on welfare from receiving financial assistance for any additional children they bear; people on both sides of the abortion fight agree that this punitive policy serves little purpose other than to harm poor women and children.

The inequities don't stop there. We also fail to provide young people with the information they need to make responsible and healthy decisions about sex and relationships. Instead of encouraging teens to delay having sex until they are ready and telling them how to effectively use contraception to prevent unintended pregnancies and the spread of STDs when they become sexually active, we spend precious resources telling kids to remain abstinent until married. A study just published in Public Health Reports makes clear that, whether we like it or not, engaging in sex before marriage is the cultural norm and has been for decades. Federally funded abstinence-only-until-marriage programs ignore this fact. Currently, more than $4 million of this funding comes into New Jersey, primarily to support programs in our poorest school districts -- including Newark and Camden -- leaving our young women and girls most at-risk for unintended pregnancy without the information they desperately need to protect their lives and make responsible choices.

On the 34th anniversary of Roe v. Wade, we must turn our attention to righting these inequities and ensuring that the fundamental right to decide without government interference whether and when to bear children is a liberty we all share.

Deborah Jacobs is executive director of the American Civil Liberties Union of New Jersey.

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