Coercion in Reproductive Decision Making Occurs in Many Settings—and in Both Directions

Coercive Practices Range from Forced Abortion and Sterilization in China To Laws Impeding Women from Obtaining Abortion Services in the United States

Forcing a woman to terminate a pregnancy she wants is wrong, and so is forcing her to continue a pregnancy that she does not want, concludes a new Guttmacher Institute policy analysis. Each case violates women's basic human rights: the right to decide freely whether and when to bear a child and the right to have that decision respected by the government.

"Reproductive rights advocates have long stood for the principle that coercion in reproductive decision making—whether to prevent childbearing or to compel it—is unacceptable and should be unequivocally condemned," says Sneha Barot, author of the new analysis. "This principle applies across national borders and at all levels of government, whether it's local Chinese officials forcing women to terminate a wanted pregnancy or U.S. state legislatures passing increasingly coercive abortion restrictions to keep women from ending an unwanted one."

Barot traces the global history of reproductive coercion, finding that no matter what motivates such policies—like fears of a population explosion or implosion, the desire for more workers and soldiers, or religious orthodoxies—the reproductive self-determination and human rights of individual women are sacrificed. The analysis also describes coercive practices that were widely condoned in the United States during the early and mid-20th century, including the forced sterilization of women deemed "unfit" to bear children.

"Growing awareness among policymakers and reproductive health advocates of these repugnant practices resulted in firmly anchoring the official U.S. family planning policy—both domestic and international—in the principles of voluntarism and informed consent," says Barot. "And reproductive health advocates to this day remain acutely sensitive to the potential for coercion, for instance by ensuring that human rights, rather than numerical targets, were central to the recent London Family Planning Summit."

In stark contrast to this commitment to individual decision making, U.S. abortion policy has been going in the opposite direction, becoming more restrictive and coercive. The ideals of voluntarism and free choice have been increasingly co-opted and undermined by U.S. antiabortion advocates and state policymakers, who have enacted myriad "informed consent" laws that require women to receive inaccurate and biased counseling, undergo unnecessary procedures or endure mandatory waiting periods.

"These laws are intended to push reproductive decision making in one direction—toward pregnancy and childbearing," says Barot. "That such pressure violates the essence of anti-coercion policies has never been acknowledged by conservatives, who are quick to condemn coercive efforts to stop pregnancy."

At the federal level, the most notorious and harmful U.S. laws aimed at restricting voluntary decision making were enacted on the heels of the 1973 Roe v. Wade Supreme Court decision:

  • The Hyde amendment prohibits federal Medicaid funding for abortion services for low-income U.S. women, with exceptions only in cases of life, rape and incest. The law's proponents aimed to make it extremely difficult, if not impossible, for poor women to obtain safe abortion care. The Hyde amendment blocks approximately one in four Medicaid enrollees from having an abortion they otherwise would have if Medicaid funding were available, and this is seen as a victory by antiabortion activists, despite the law's unambiguously coercive nature.
  • The Helms amendment restricts U.S. foreign assistance for abortion "as a method of family planning." Overinterpretation of this policy has led to the withholding of any funding for abortions overseas, even in extreme cases such as rape, incest or to protect the life of the mother. Further, laws purportedly passed to prevent coercion in U.S. foreign aid have been twisted to impede contraceptive access. Under the 1985 Kemp-Kasten amendment, U.S. funding has been withheld from the United Nations Population Fund (UNFPA) for allegedly supporting coercive policies in China, despite multiple official investigations that have debunked this charge.

"Given the role played by socially conservative forces in the United States and globally in impeding family planning and reproductive health access, even as they decry forced abortion and sterilization, it is clear that their priority is not to protect free and informed choices," says Barot. "The decision whether or not to bear a child must be the woman's—not the government's."

Full analysis: "Governmental Coercion in Reproductive Decision Making: See It Both Ways," by Sneha Barot

For more information:

State laws and policiesTroubling Trend: More States Hostile to Abortion Rights as Middle Ground ShrinksState Abortion Counseling Policies and Informed ConsentAbortion in the United States (video)Abortion Worldwide (video)

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