Sunday, January 13, 2008

The more things change: thoughts on "progress" in 20 years of reproductive health

Twenty years ago, when I was in my idealistic mid-20s, I was a health educator at Action for Boston Community Development Inc. (ABCD), working in Boston teaching sex ed to kids in middle schools, and counseling skills to family planning counselors in community health centers. At that time, kids had a lot of questions: exactly how are babies made? And once they grow, how do they get out? Does sex feel good? What does it mean to be gay? Counselors also had a lot of questions: how do I encourage my clients to use birth control when they don’t mind getting pregnant? How do I best help them protect themselves from HIV? How do I talk to a pregnant client about their options when I’m not comfortable with some of the options myself?

Now, as a woman in my more-realistic mid-40s, I can clearly look back 20 years to 1988, and I realize that the issues that we were dealing with then regarding sexuality, abortion, teen pregnancy, and sex education (who should provide it and what should it consist of), are the same issues we are dealing with today. Not a lot has changed. Indeed, we have gone backwards instead of forwards in some of these areas.

I find this very sad. Why have we made no progress in 20 years?

Twenty years ago, the AIDS epidemic was on the forefront of everyone’s mind. At that time, contracting HIV was a death sentence. We were trying desperately to prevent kids from contracting HIV through the use of condoms and safer sex. Teen pregnancy was also on everyone’s mind, and we were teaching about birth control, decision making skills, refusal skills: survival skills. The kids and adults I worked with didn’t love the idea of abortion, but they realized that sometimes it was the best choice. Some folks thought that kids should learn abstinence, but in inner city Boston, most folks thought that kids needed concrete advice about birth control since so many kids became sexually active at a very young age.

I remember during the elder George Bush’s presidency that Title X, the federal family planning funding, was encumbered with rules that forced us to split off services that gave information about abortion, causing real problems in the provision of family planning services. And I remember in 1993, how relieved we were when President Clinton removed those barriers to services and care.

Now the younger George Bush has been in office for almost 8 years, and with religious belief trumping science at almost every turn, we have had years of abstinence-only sex education which seems to be increasing the teen pregnancy problem once again; we have the FDA refusing to allow provision of morning-after contraception to young women who need it; we have a parade of right-wing anti-gay men being outed as regular people after all; we have the erosion of Roe vs. Wade; and we have presidential candidates congratulating pregnant teen television stars who chose not to have abortions.

We are living in very, very strange times indeed.

I recently came upon a faded cut-out copy of the poem “On the Pulse of the Morning” by Maya Angelou, written for Bill Clinton’s inauguration in 1993. We who worked in family planning felt so hopeful then, to have a new Democratic president who was intelligent and filled with ideas for change, and who understood what was necessary to protect the reproductive health of young people.

I am hoping to have that same feeling of hope and change next January, when our new president, whoever he or she may be, starts his or her new presidency. I am hopeful…but I am realistic, too. I realize that there are many in this country to who don’t agree on issues of sex education, teen pregnancy, choice, and other issues of reproductive health. But we have to move forwards, not backwards. Hopefully our new president will be able to forge the compromise necessary so that in another 20 years we haven’t gone even further backwards. Hopefully our new president will encourage government policies on these issues based on science, not on religious belief. I am hopeful. Are you?

(This is a test drive for a possible op-ed piece. Let me know what you think!)

1 comment:

nachtwache said...

Ah, you asked. Being rather conservative, I do think abstinence should be talked about. It gives girls the power to say "no" and feel OK about it. Our daughter is a success story. She does it to honor G-d. We didn't pound it in. I talked to her about relationships etc., I was also realistic and had no problems putting her on birth control. It was more to stabilize the hormones, but the side benefit was birth control.
She chose abstinence. Many of the teens in our church youth group wore chastity rings, that appealed to her and she asked for one. She's now 24, still wears it and is very active in her church.
I just can't get myself to opt for abortion. Good thing I don't work in your field and never had to face that choice.
Your piece is well written. A lot depends on upbringing, personality and environment. Nowadays, most kids will be sexually active, not that it didn't happen in the past. I was 19 when I became a mother, I had always wanted to be a mom. My mom and I didn't have an open and honest relationship as my daughter and I have. I was married before our son was born and engaged before I got pregnant. :)
Even then I would never consider abortion for myself.