The reproductive justice framework centers access, not choice. The current legality of abortion does not mean that abortion services are accessible to everyone. Class discrimination in the form of the Hyde Amendment, geographic distance and transportation barriers, lack of affordable childcare, transphobia in the healthcare system, and much more contribute to the inaccessibility of abortion services, particularly for people of color and low-income folks. Intersecting oppressive structures have reserved full access to reproductive healthcare for the most privileged in our society, and that has been the case even before Roe v. Wade legalized abortion in this country. And with recent legislative efforts in various states to effectively ban abortion services, it is important to remember that a ban is never a ban for everyone; in the context of these oppressive structures, abortion “bans” are inherently discriminatory. Individuals with class, racial, and geographic privilege – among others – have always had and will always have access to abortion services in one way or another. H*yas for Choice has acquired personal testimony that highlights how our own Georgetown University Hospital contributed to this reality, and sheds light on the institution’s hypocrisy in its so-called ‘ethical’ guidelines.
Steven Bavaria (SFS’ 69) writes [edited for length and clarity]:
ABORTIONS, GEORGETOWN HOSPITAL AND THE 1960's
(A Personal Reflection 50 Years Later)
"Abortions were ALWAYS available, even at prestigious Catholic hospitals, if you were wealthy, or well-insured, or well-connected.
"Many Americans have no memory of what life was like before Roe v. Wade, but I got an exposure to one aspect of it during the summer I worked at Georgetown Hospital in 1967. I was in the School of Foreign Service, class of 1969, majoring in international economics and knowing nothing about medicine. But I desperately needed a summer job and managed to land one in the medical records department at Georgetown Hospital.
"I worked normal daytime hours three days a week, but on weekends I worked the all-night shift. That involved physically walking every floor of the building in order to take what they called a ‘census’ of the hospital. Besides checking every room to see if it was occupied or not, so the business office could be sure they were billing appropriately, I also picked up all the charts of patients discharged that day (no electronic records back then) and took them back to medical records to be re-filed.
"Since it was late at night and re-filing was pretty boring work, I often took my time and actually read over the first page of the chart, which summarized what condition the patient had been admitted and treated for. Over the course of the summer, I couldn’t help noticing that virtually every patient admitted to the OB/GYN ward who was NOT delivering a baby was there for something described on the chart as a ‘D&C.’ Day after day, patient after patient having a procedure called a ‘D&C.’
"It was only sometime later that I learned that D&C stood for dilation and curettage and was, at that time, a not uncommon procedure for carrying out an abortion, or unfortunately in many cases, used to remedy or complete an attempted or botched illegal abortion (‘back alley’ or otherwise).
"Perhaps many of those hundreds of D&C patients whose files I handled that summer were women fortunate enough to have found their way to Georgetown Hospital either through their private doctor’s admission or via the emergency room, after they had experienced illegal abortions. Others, perhaps, were patients lucky enough to have doctors whose consciences allowed them to bend or break the rules and find ‘legitimate’ reasons why they needed a D&C while they were pregnant. And others likely were there to have D&Cs after miscarriages or for other conventional medical reasons.
"One can only speculate about the uncounted thousands who never managed to make it to a hospital at all after their illegal abortions, because of financial, social, family or religious limitations, and ended up seriously debilitated or dead.
"The pattern I noted must have been repeated in hospitals across the country. That mainstream Catholic hospitals like Georgetown were routinely carrying out abortions for well insured and/or well-connected people who knew the right doctors, as well as routinely cleaning up botched back-alley abortions for women fortunate enough to make it into their emergency room, needs to be broadly understood by a public that has little memory of life before Roe v. Wade.
"Until recently I had believed these traumatic medical experiences, that I witnessed only peripherally as I helped manage their paper trail, were a thing of the past for the women of America. What a tragedy that extremists are now making this nightmare a reality once again, and it points out the hypocrisy of the so-called ‘pro-life’ movement, whose concern for the ‘unborn’ (especially the ‘unborn’ of poor people) so outweighs its concern for the ‘born.’"
As this personal reflection attests to, access to abortion services was unequal and discriminatory even before it was legal. This inequality persists to this day, and will only worsen if new state abortion bans are instated or the Supreme Court chips away at the legal protections in Roe v. Wade. These inequalities in accessing abortion and other reproductive and sexual health services based on race, class, geography, ability, gender identity, and more demonstrates why it is imperative to turn our focus to reproductive justice and access, not simply rights.