MedHums 101: Dr Caroline Rusterholz offers a historical perspective on reproductive rights that reveals the key role activism has always played in this area.
The overturn of ‘Roe v. Wade’ in the US has sparked worldwide outrage amongst sexual and reproductive rights advocates and campaigners. This attack is the latest in a long series of recent attempts at limiting reproductive rights in various countries in the Global North (for instance also Poland and Spain) while recent progresses have been made in the Global South, in Colombia, Mexico and Argentina. These attacks reveal the fact that reproductive rights are fragile and should never be taken for granted. However, the attacks have also triggered powerful counter-mobilisation, illuminating the key role that activism plays and has always played in this area.
Early 20th century: The advent of birth control and family planning
Following the definition of historian Maud Bracke, reproductive rights are a ‘set of principles protecting individuals’ rights in autonomously making decisions on whether, when and in what circumstances to become a parent’ (Bracke 2022, 752). This recognition of reproductive rights was the result of years of national and transnational campaigning and activism that began in the early 20th century (Bashford 2014; Bracke 2022; Connelly 2008; Luna 2020; Rusterholz 2020). It was through the activism of women that birth control and family planning clinics were originally set up in Western countries (Gordon 2002; Grossmann 1995; Pavard 2012; Rusterholz 2020). The birth control and family planning movements in the first decades of the 20th century made contraceptive advice essential for the stability of the family and for women’s health, arguing that birth control was a means to alleviate poverty and avoid backstreet abortions and unwanted pregnancies. Eugenics-related ideas of limiting the fertility of ‘unfits’, i.e. the physically ‘defective’, ‘the feeble minded’, those living in poverty, indigenous populations and immigrant women, also unevenly permeated these national movements and resulted at times in coerced birth control practices, such as forced sterilisations. But it was not until post-World War II that family planning information and access to family planning services became framed as human rights.
This shift occurred in the postwar years as fears over population growth were gaining prominence in a context characterised by Cold War tensions. Experts and politicians in Western countries, who historian Matthew Connelly has referred to as the ‘Population Establishment’, grew anxious about addressing global population issues. They feared that rapid population growth in developing countries would increase the risks of severe resource shortages and political instability, which they deemed a fertile ground for communism (Szreter 1993: Bashford 2014; Connelly 2008). As a result, international organisations were created with the aim of tackling this ‘population bomb’ through the spread of what was considered the ‘modern’ ideal of the family (a small nuclear family) via the dissemination of contraceptive information and devices. Organisations such as the International Planned Parenthood Federation (IPPF) and the Population Council were founded in 1952. In addition, five UN World Population Conferences were organised in Rome (1954), Belgrade (1965), Bucharest (1974), Mexico City (1984) and finally Cairo (1994) through the UN Conference on Population and Development. These organisations and conferences were pivotal in setting out a global agenda for family planning and population policy.
Women as key agents in reproductive rights activism
Recent research has started to uncover how women activists played a crucial role in arguing that the rights related to choosing if and when to have children were reproductive rights. They pushed for this recognition at the international level in the face of powerful opposition from conservative adversaries, such as the churches, conservative politicians, and partisans of state-enforced population policy.
Whereas IPPF has been described as heavily orientated towards population control, my recent work has shown that there was space for different approaches within the organisation. Women doctors and activists were instrumental in the creation of the IPPF but there existed tensions between funding members. Margaret Sanger, a strong proponent of population control, clashed with the Swedish, Dutch and British women members, who were in favour of addressing the sexual needs of individuals and were sensitive to the diverse attitudes towards sexuality among ‘the peoples of the world’. Education, rather than imposition, they believed was the best way of spreading family planning. In 1953, the constitution for the new federation was finalised and stressed knowledge of contraception as a ‘fundamental human right’ (Rusterholz 2020, 177-80). This reflected the view that family planning needed to become an international priority.
Maud Bracke has also argued that it was due to women activists in the UN, as well as other NGOs centred on improving the status of women, that reproductive rights began to be articulated in the 1960s and 1970s. These organisations were the UN’s Commission on the Status of Women, the International Council of Women, and the Women’s International Democratic Forum (WIDF). Moreover, this progressive articulation also started to critique the global family planning movement and its population-driven approach, as well as its coercive policies, in particular as a result of the involvement of women from Africa and Latin America (Bracke 2022; Crane 1994). From the 1970s, other organisations played a crucial role in advocating for reproductive rights. These organisations have been labelled as the Global Women’s Health and Rights Movement (GWHRM) by historian Paige Whaley Eager (2010). Amongst them were the International Contraception, Abortion, and Sterilisation Campaign, which was set up in London in 1978 and became the Women’s Global Network for Reproductive Rights in 1984, the International Women’s Health Coalition, founded in 1984 and based in New York, the Women’s Environment and Development Organization founded in 1990, and the Development Alternatives with Women for a New Era, founded in Bangalore in 1984. In addition, four UN World Conferences on Women were organized in Mexico City (1975), Copenhagen (1980), Nairobi (1985) and Beijing (1995). These organisations and conferences gradually adopted an intersectional perspective that situated women’s reproductive rights within a wider environment, taking into consideration socio-economic status, gender power relationships and the way that family planning programmes affected women differently based on race, class and age. Indeed, women from the Global South and Afro-American women argued that reproductive rights should guarantee not only un-coerced access to birth control methods and abortions, but also the right to have children. This opened up the path to future notions of reproductive justice.
The Global Women’s Health and Rights Movement was central in pushing for the recognition of sexual and reproductive rights at the Cairo conference in 1994. There, reproductive rights were articulated for the first time through the assertion that ‘all couples and individuals have the basic right to decide freely and responsibly the number and spacing of their children and to have the information, education and means to do so and the right to attain the highest standard of sexual and reproductive health. It also includes their right to make decisions concerning reproduction free of discrimination, coercion and violence, as expressed in human rights documents’ (International Conference on Population and Development 1994, 59). The following year at the Fourth World Conference on Women in Beijing, a Platform for Action urged governments to ‘[p]rovide more accessible, available and affordable primary health-care services of high quality, including sexual and reproductive health care, which includes family planning information and services’. This global commitment to ensuring universal access to SRH services influenced subsequent policy-making, as evidenced in the World Health Organisation’s development of new guidelines on SHR policy and services. Some of the international laws on SRH became paramount for evaluating national SRH policies.
Following this key statement, an increasing number of organisations started to frame reproductive rights in terms of reproductive justice. Influenced by attending the Cairo Meeting on Population and Development, which foregrounded human and women’s rights, twelve Black women working in the reproductive health and rights movement introduced the term ‘reproductive justice’ at a pro-choice conference on healthcare reform in Chicago. It was used to shed light on the ‘intersectional forms of oppression that threaten Black women’s bodily integrity’ (Ross 2017, 286; see also Ross et al. 2016). This term was chosen to replace the idea of choice put forward by the women’s rights movement, which was led mainly by white middle-class women. At this conference, Black women activists recognised that the terminology of ‘choice’ masked the experience of people of colour and those from marginalised communities and the structural, political, economic and environmental inequalities they faced in their reproductive lives (Ross 2017). The debates over the protection of abortion services and access to contraception had, to a large extent, overshadowed a complex realm of reproductive experience and ignored longstanding medical efforts to control or limit Black women’s fertility. What was needed was a new movement and a new theoretical framework. Reproductive justice was born and Women of African Descent for Reproductive Justice was created. Theorists and key activists Ross and Solinger have explained that ‘reproductive justice is the application of the concept of intersectionality to reproductive politics in order to achieve human rights’ (Ross and Solinger 2017, 79). It is based on three interconnected sets of human rights: the right to have a child under the conditions of one’s choosing; the right to avoid having a child through the use of birth control, abortion, or abstinence; and the right to parent children in safe and healthy environments free from violence by individuals or the state. Reproductive justice also advocates for better access to SRH services for LGBTQ communities.
Since then, an ever-expanding number of organisations have adopted a reproductive justice agenda and framed reproductive rights within the concept of reproductive justice. Today, reproductive justice is one of the most exciting new frameworks in which historians of sexual and reproductive issues can work to rewrite a history that has too often lacked a truly intersectional analysis.
Bashford, Alison. 2014. “Global population” in Global Population. Columbia University Press.
Bracke, Maud Anne. 2022. “Women’s Rights, Family Planning, and Population Control: The Emergence of Reproductive Rights in the United Nations (1960s–70s).” The International History Review 44:4: 751-771.
Connelly, Matthew. 2010. Fatal misconception: The struggle to control world population. Harvard University Press.
Crane, Barbara B. 1994. “The transnational politics of abortion.” Population and Development Review 20: 241-262.
Gordon, Linda. 2002. The moral property of women: A history of birth control politics in America. University of Illinois Press.
Grossmann, Atina. 1995. Reforming sex: the German movement for birth control and abortion reform, 1920-1950. Oxford University Press.
Luna, Zakiya. 2020. “Reproductive Rights as Human Rights” in Reproductive Rights as Human Rights. New York University Press.
Pavard, Bibia. 2012. Si je veux, quand je veux. Contraception et avortement dans la société française (1956-1979). Presses Universitaires de Rennes.
Ross, Loretta J. 2017. “Reproductive justice as intersectional feminist activism.” Souls 19:3: 286-314.
Ross, Loretta and Rickie Solinger. 2017. Reproductive justice: An introduction. Vol. 1. University of California Press.
Rusterholz, Caroline. 2020. Women’s medicine: Sex, family planning and British female doctors in transnational perspective, 1920–70. Manchester University Press.
Szreter, Simon. 1993. “The idea of demographic transition and the study of fertility change: a critical intellectual history.” Population and Development Review 19:4: 659-701.
Whaley Eager, Paige. 2004. “From Population Control to Reproductive Rights: Understanding Normative Change in Global Population Policy (1965–1994)”. Global Society, 18:2, 145-173.
About the author
Dr Caroline Rusterholz is a Wellcome Trust Research Fellow at the Faculty of History, University of Cambridge. She will soon join the Graduate Institute in Geneva as an Eccellenza assistant professor in order to carry out her new research project, Race and Sexual and Reproductive Health Charities in postwar Britain from a transnational perspective, 1960-2000.
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