Access denied: A different kind of de facto segregation

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It's interesting that "Blog for Choice" day falls right after Martin Luther King Jr's holiday. It has me thinking about intersections and parallels of civil rights issues. For those who've studied segregation, the terms "de facto" and "de jure" are familiar. They mean "in fact" and "by law" and they are used to describe the reality of segregation in the United States today. Segregation in schools, for example, has been illegal since Brown v. Board of Education in 1954 yet there is a great deal of de facto segregation in American schools.

I mention the terms because I think there is a similar phenomenon going on with access to abortion services. Abortion services, since Roe v. Wade in 1973 have been legal -- with restrictions -- across the United States, and states have not been allowed to ban abortion outright. (Note: some have come perilously close.) But, abortion services are not accessible in many places, and so there is a kind of de facto abortion ban over much of the country.

I think about this on "Blog for Choice" day, because the right to choose to have an abortion is not very real for the women living in the overwhelming majority of counties without abortion services, for whom the cost of abortion is not only the price of the procedure and any attendant health care costs, but also the price of the travel and the cost of days away from work.

Recently, the Guttmacher Institute published the results of its study, "Abortion in the United States: Incidence and Access to Services, 2005" (PDF) and they found that the rate at which women have abortions has continued to fall since 1990. In 2005 there were 19.4 abortions per 1000 women aged 15-44. For comparison, in 1990 there were 27.4 and in 1995 there were 22.5. In raw numbers, this means that 1,206,200 abortions were performed in 2005, about 400,000 fewer than in 1990. (Table 1, p. 9)

This all sounds like good news, and it may be good news. Reducing the number of abortions as a result of reducing the number of unintended and unwanted pregnancies is certainly a good thing. But the report also indicates that the number of abortion providers continues to drop (though that drop has slowed). Taking the whole country into account, 87% of counties have no abortion providers, and what part of the country you live in matters a lot. If you're in the northeast, where I am, you're the luckiest. Only a bit more than half of counties have no providers (and we're pretty densely populated, and counties are packed together, and transit options are not so terrible). If you live in the midwest, though, are among the least likely to have access. Ninety four percent of counties in the midwest have no abortion providers. Obviously that puts an enormous research and travel burden on the woman seeking an abortion. In the south 91% of counties have no provider and in the west 78% have none. (Table 3, p. 11)

Could this be among the reasons that, as reported in the New York Times this past December, the number of births per 1,000 women rose in nearly all age groups last year, ending a decline in teen births that had been going on since the early 1990s and rising above the replacement rate in general for the first time since 1971. As with most social phenomena, this one no doubt has many causes, and actually immigration (immigrant women tend to have more children, for an intersecting number of reasons) is no doubt a bigger cause. But I wonder whether we have reached a level of no-access that more unintended pregnancies are resulting in births than used to.

Amanda Marcotte made some interesting speculations about what else this could mean last week in her post "Could it be easier to force childbirth when abortion is legal". She wonders whether, because there is no outrage over a legal prohibition in many of those areas, there is less organizing around issues of access. Certainly there are women's health organizations and abortion access organizations that are trying hard to increase access for women who live in regions without their own providers, but it might be a good deal harder for those activists to drum up support (especially volunteers and money) because there is no legal issue for people to fight.

The theme for this year's Blog for Choice is "why it is important to vote pro-choice." I would extend that to "why it is important to vote, talk, agitate and live pro-choice." Voting goes an important distance toward protecting legal rights. We certainly cannot afford another Supreme Court Justice who is opposed to abortion or weak on privacy rights, for example. But until the rights that are protected by law are made real by ensuring access (geographic and financial) to abortion services, they are pretty unevenly distributed, available to women with privilege to travel if needed, or with the good fortune to live in a place with providers.

The law is only the foundation for our rights. Real live access -- to abortion, to education, to opportunity or to anything else -- depends on much more than the law. We all need to walk the walk so that it is safe for people to provide the services that the law says we have a right to use.

And that is not a matter of voting. That is a matter of speaking up in the eleven months of the year that there are no elections. It is a matter of declaring that we will not tolerate the infringement of anybody's rights, regardless of where they live or how much money they have.

It is a matter of finally understanding that class and race and gender and geography all intersect in ways that put some US residents at much greater disadvantage than others, and it is about all of us understanding that such inequality is wrong.

And that goes beyond voting. That means we need to act.

Now.

Loudly.

Without rest, until we all are free.

 

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