MUCH TO CONSIDER
The debate around elective surgeries, particularly those related to reproductive health, has been a contentious issue for decades. While much of the discourse has focused on abortion, the implications for other elective surgeries, such as hysterectomies, have not been thoroughly explored. This essay examines the pro-choice debate beyond abortion, the historical and political context of Roe v. Wade, and the potential future restrictions on women's healthcare.
The landmark Supreme Court decision in Roe v. Wade in 1973 established a woman's legal right to have an abortion. This ruling was based on the constitutional right to privacy, effectively ensuring that women could make decisions about their bodies without excessive government interference. However, the ruling also ignited a fierce and enduring debate between the pro-choice and pro-life movements. For decades, this issue has served as a wedge in American politics, with both sides using it to mobilize support and influence elections.
The pro-life movement, grounded in religious and moral convictions, argues that life begins at conception and that abortion is morally wrong. In contrast, the pro-choice movement emphasizes a woman's right to autonomy and control over her own body, advocating for access to safe and legal abortion. This ideological divide has made abortion a political hot potato, with each side seeking to sway public opinion and legislative action.
In 2022, the Supreme Court's decision to overturn Roe v. Wade in Dobbs v. Jackson Women's Health Organization marked a significant shift in the legal landscape of reproductive rights. The ruling returned the authority to regulate abortion to individual states, leading to a patchwork of laws across the country. Some states have enacted strict bans or severe restrictions on abortion, while others have moved to protect and expand access. This judicial reversal has emboldened conservative lawmakers to further restrict access to necessary and life-saving healthcare for women.
The increasing restrictions on reproductive healthcare evoke comparisons to Margaret Atwood's dystopian novel, "The Handmaid's Tale." In Atwood's fictional world, women are subjugated and stripped of their reproductive rights, serving as mere vessels for procreation. The parallels between this dystopian vision and current reality are unsettling. As access to abortion becomes more limited, questions arise about the potential for further encroachments on women's bodily autonomy.
One area of concern is the possibility that elective surgeries, such as hysterectomies, could face increased scrutiny and regulation. A hysterectomy, the surgical removal of the uterus, is often performed for medical reasons, including cancer, fibroids, and severe endometriosis. However, it can also be an elective procedure for women who do not wish to bear children. The notion that elective surgeries might be conflated with birth control is not far-fetched, given the current climate of reproductive politics.
I have experienced firsthand the challenges and frustrations associated with accessing elective surgeries. I suffered from fibroids, burst cysts, and ovarian cysts for decades. I was 33 when, my gynecologist suggested I consider having a hysterectomy. I had mentioned that I was not interested in becoming a parent biologically, and if I changed my mind, there were options like surrogacy and adoption. Contemplating the suggestion, it seemed like a no-brainer given my long history of pain and numerous abdominal surgeries aimed at improving my quality of life. However, when I inquired through my insurance, I was told that I could not have a hysterectomy despite my medical history. The reason was more shocking and offensive than I could have imagined: I was informed that as a 33-year-old woman, I could not make that decision until I was over 40, and there were considerations like my lack of a husband to make family planning decisions with. I was gobsmacked. The insurance company I pay for by working nearly 60 hours a week, and a fictitious man had more governance over my body and future than I did.
“I was gobsmacked. The insurance company I pay for by working nearly 60 hours a week, and a fictitious man had more governance over my body and future than I did.” - Lauren NApier
The 1970s saw substantial progress in women's rights, including the 1972 ruling in Eisenstadt v. Baird, which extended the right of privacy in contraceptive decisions to unmarried individuals, and the 1976 Reproductive Health Care Rights Law, which laid the groundwork for broader medical decision-making autonomy.
A pivotal moment in ensuring women's autonomy in medical decision-making was the Patient Self-Determination Act of 1990 (PSDA). This federal legislation required healthcare providers to inform patients of their rights to make decisions about their medical care, including the right to accept or refuse treatment and the right to prepare advance directives. This act reinforced the importance of individual autonomy in healthcare decisions, irrespective of marital status.
In terms of state laws, it took until the mid-1980’s for most states had statutes or case law recognizing the rights married women, to make their own medical decisions. Broadly speaking, the shift towards recognizing individual autonomy in medical decisions, regardless of marital status, was part of the larger trend of legal reforms in the latter half of the 20th century.
It took legislators to reach the last decade of the 20th century to enact the Patient Self-Determination Act of 1990 (PSDA), pivotal legislation ensuring women's autonomy in medical decision-making was her own.
The lack of imagination in policy-making is evident in the failure to recognize the broader implications of restricting elective surgeries. The potential for regulations that prohibit women from removing her uterus, fallopian tubes or ovaries along with the urethra and clitoris - parts of anatomy that most male legislators couldn’t likely identify on a diagram is a stark reminder of how little our legislators care about our wellbeing, mental and physical health as well as the slippery slope of eroding reproductive rights. If the autonomy to choose an abortion can be undermined, what is to stop similar restrictions on other forms of reproductive healthcare?
It is important to acknowledge that single women comprise 23% of the electorate and should be considered when legislating these laws. Historically, legislation has passed that granted men sole permission to make medical decisions about their wives' health in both emergency and non-emergency scenarios. For instance, until relatively recent reforms, various state laws allowed husbands to have the final say in their wives' medical treatments, reflecting deeply ingrained gender biases in healthcare decision-making. Such laws underscore the persistent challenge of ensuring that women, particularly single women, retain autonomy over their bodies and medical decisions.
The possibility that hysterectomies could be the next target of regulation is troubling. Such a move would not only undermine women's health but also their right to make decisions about their bodies. Elective surgeries, like hysterectomies, are vital options for women facing a range of health issues and personal circumstances. Limiting access to these procedures would represent a significant regression in women's healthcare and autonomy.
The pro-choice debate must expand to address the full spectrum of reproductive rights, including elective surgeries. As we grapple with the consequences of Roe v. Wade's overturning, it is crucial to consider the broader implications for women's healthcare. The restrictions on abortion are just the beginning; the potential for further encroachments on women's bodily autonomy is a pressing concern.
Are we prepared to face a future where elective surgeries, such as hysterectomies, are restricted or banned? The lack of imagination in recognizing these threats is not lost on those who advocate for comprehensive reproductive rights. It is imperative to remain vigilant and proactive in defending women's healthcare choices, ensuring that the dystopian visions of "The Handmaid's Tale" do not become our reality.