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Still fighting: A story of reproductive health and rights

The fight for reproductive health care

By Natalie Eastwood

More than a century ago, Goucher graduates were fighting for legal contraceptives in the U.S. Today, much has changed, but access to reproductive health care and resources remains tenuous. Sexuality, gender, sexual health, and sexual rights are just as much part of the conversation around people’s bodies as the ability to get pregnant and prevent pregnancy is. For this feature, we look at the history of the movement for reproductive health care, including birth control, better birth outcomes, and expanded access for underserved communities, through the eyes of a few Goucher graduates. Here are their stories.

THE POWER OF CHOICE

In the U.S. prior to the 20th century, there were many folk methods for birth control; the first rubber condoms were introduced in 1855. But there was a kind of religious morality that developed around sex in the 19th century, and, in 1873, the Comstock Act banned contraceptives, as well as the spread of information about contraceptives.

People fought back. Bessie L. Moses 1915 was an obstetrician and gynecologist who became the first woman obstetrical intern at Johns Hopkins Hospital. She educated her patients on contraceptives, despite the law forbidding it.

Moses is best known for opening the Baltimore Bureau for Contraceptive Advice in 1927, Baltimore’s first birth control clinic. She got around the Comstock Act by operating as a research facility, with only married women for patients. Because Moses couldn’t get a local hospital to sponsor the facility, she opened it in a Baltimore rowhome. The bureau eventually became Planned Parenthood of Maryland. Within the first five years of opening the clinic, Moses treated 1,000 patients. In 1937, she wrote a book, Contraception as a Therapeutic Measure. Moses established additional clinics throughout Maryland and frequently lectured at women’s colleges.

Of course, discussion of the early birth control movement must include Margaret Sanger, who opened the first U.S. birth control clinic. Sanger has been long overdue for a reckoning, as she is infamous for promoting eugenics—a reminder that rights for women throughout U.S. history have served white women first. In July 2020, Planned Parenthood announced it would remove Sanger’s name from its New York clinic.

A NEW FIELD OF MEDICINE

While Moses was part of the movement for the choice to prevent a pregnancy, others were part of the burgeoning science to help create one, both of which gave some women more freedom. Georgeanna Seegar Jones ’32 was one of the first—if not the first— reproductive endocrinologist.

In 1936, she discovered that the pregnancy hormone is dispensed from the placenta, rather than the pituitary gland, as previously thought. A few years later, Jones identified the luteal phase defect, in which the body does not secrete enough progesterone, sometimes causing infertility and miscarriages. Jones also identified “Savage Syndrome,” which is now known as ovarian resistance syndrome.

From 1938 to 1978, Jones was gynecologist-in-charge at the Gynecological Endocrine Clinic at Johns Hopkins Hospital. With her husband, surgeon Howard Jones Jr., they created the Division of Reproductive Endocrinology at the hospital.

As Jones and her husband were readying for retirement in 1978, a reporter asked them: “The first test-tube baby has been born in England. Do you think we could have in vitro fertilization here?” And so the Jones team came out of retirement. They helped a woman have a baby by cultivating her egg and the father’s sperm in a petri dish. It took 41 tries. At first controversial, the couple soon opened their own clinic, the Jones Institute for Reproductive Medicine, which has helped thousands of parents.

According to Howard Jones’ obituary in The New York Times, “They were the only American gynecolo­gists invited to the Vatican in 1984 to advise Pope John Paul II about reproductive technology.”

During Jones’ tenure at Johns Hopkins Hospital, the birth control movement evolved. The U.S. Supreme Court legalized the pill for married people in 1960 and nonmarried people in 1972. The Comstock Act was appealed in 1965. Abortions were legalized in 1972.

LUCKY NUMBER SEVEN

Paula Mahone ’80, now retired, was a perinatolo­gist, a doctor specializing in high-risk pregnancy. One of the issues facing pregnant women in the U.S., Mahone says, is that doctors don’t always listen to their patients; they might insist on unnecessary medical protocols that don’t improve outcomes and sometimes get in the way of a natural process. So Mahone instilled philosophies used by midwives into her own practice. She was met with disrespect from her peers. “It was almost as if because my partner and I were women, and maybe even Black, that our peers thought we weren’t doing high-risk medicine, that we just do homespun, pat you on the back, tell you that you’re loved kind of medicine,” Mahone says. “One doctor told me, ‘You just make patients feel good.’ That’s a great thing to say, but there is medicine involved here.”

In 1997, Bobbi McCaughey walked into Mahone’s office, 10 weeks pregnant with seven heartbeats in her uterus. At 30 and a half weeks, Mahone determined it was time to deliver the babies by Cesarian section. Mahone and her partner became the first to deliver seven healthy babies. The media attention was out of proportion to what they accomplished, she says. Mahone did what she did for all of her patients—listen with empathy, make a plan, ensure her patient could follow through on what was being asked, and adjust the plan accordingly.

Mahone wasn’t prepared for the public reaction to the births. “The outpouring of love and pride from the Black community was incredible,” Mahone says. Around the world, people sent them baby dolls—in sets of seven—and wrote letters. One woman told Mahone in a letter that “when they had the press conference, and two Black women walked out—she said she was dancing around her living room, screaming,” Mahone says. College and high school students wrote to them, too, asking about their stories as Black women in medical school and the professional medical community.

Read more about the career of Paula Mahone, the 2021 Marguerite Barland ’60 Merit Award winner, online at https://blogs.goucher.edu/magazine/paula-mahone-80/.

PRO-HAPPINESS

When pro-choice activist and author Cristina Page ’93 met a pro-life activist whose feminist values aligned surprisingly well with her own, they decided to travel the country visiting abortion clinics to see if there was common ground within the abortion debate. They then cowrote an opinion piece for The New York Times, “The Right to Agree,” in 2003. The bipartisan tactics aren’t working, Page says, but contraceptives, financial and child care support for parents, and access to health care decrease abortion rates. “These are measures that are quantifiable in their effect,” Page says, “and anti-choice Americans should take note that if in fact they’re being intellectually honest, then the pro-choice agenda is just much more in keeping with the results they seek.”

They received some negative feedback on the piece, mostly related to contraceptives. What Page discovered through her research is a well-financed campaign in the U.S. and abroad to scale back access to contraceptives. The pro-life activists, it seemed, were and are fighting to preserve a patriarchal set of family values that limits women’s freedoms. That’s when Page decided to write her book, How the Pro-Choice Movement Saved America: Freedom, Politics and the War on Sex, to show how contraceptives and legalized abortion lower abortion rates.

Today, Roe vs. Wade and Planned Parenthood are at risk of being overturned and defunded. In several states, access to abortion has become so difficult it is effectively nonexistent. And employers with religious or moral objections can still refuse to provide birth control coverage for employees under the ACA, a Trump administration rule that the Supreme Court upheld in July 2020. Despite this, Page, who consults for national women’s rights groups, is resolute in the common-ground approach. It’s a matter of raising the voices of people in the pro-life movement who are “solution seekers” and willing to use logic to decrease the need for abortions, she says.

OLD AND NEW PRACTICES ALIGN

Doctors aren’t the only ones trying to improve birth outcomes.

“I am a 27-year-old Black woman of Caribbean descent. I am a mental health counselor. I am a doula. I am a daughter, a granddaughter, a sister. I believe in the power of a woman and what we can do.” This is KerriAnne Sejour ’15.

A doula offers a woman emotional support during all stages of her pregnancy, delivery, and after birth, which is different from a midwife, who is medically trained to deliver babies. As a doula, Sejour educates people about their bodies, the realities of giving birth, and access to resources so that they can have autonomy over their pregnancy and delivery experience. “I help women understand that their bodies are amazing,” she says.

As a mental health counselor, Sejour serves people who identify as LGBTQIA+ and people of color, specifically Black women. There is mistrust of the medical system for many Black people, Sejour says. “Black women are still five times more likely to die in childbirth compared to their white woman counterparts,” Sejour says. “That’s because they don’t have the same access to resources, support, and information. It’s also because Black women are not listened to when they express how they’re feeling during and after childbirth.”

Historically, Black women and women of color have been used without their consent to benefit reproductive advancements, Sejour says, yet they have yet to receive access to their health rights. Of the many examples throughout history, Sejour recognizes the Latina women who were coerced (by withholding their access to medical care) to become sterilized, which resulted in complete hysterectomies. These horrors are not unique, and it’s why, Sejour says, history needs to be remembered so that when health care policies are written, people who aren’t white are included.

Both of her roles—as a doula and counselor— emphasize the “old practices” that Black women and women of color have used for decades but are rarely given credit for, Sejour says. The essence of the “old practices” is treating the wholeness of a person. “I feel called to this approach because I think it treats women as the expert,” Sejour says. “This is your body. You have every right to do what you want to do with your body, so how would you like to navigate this journey?”

BETTER CARE FOR MORE PEOPLE

For transgender men, intersex people, and nonbinary people, the fight for reproductive health care has far to go. La Sarmiento ’86, who is nonbinary, emphasizes that they do not speak for anyone’s experiences but their own. Sarmiento was a massage therapist for over 30 years, and is now a mindfulness meditation teacher who leads many workshops, including one specifically for the LGTBQIA+ community.

To talk about reproductive health as solely a woman’s experience is limiting. “There are lots of issues when [society views] people who identify as women as the only people who can get pregnant,” Sarmiento says, “Gender and sex are very different things. You can have various physical parts of oneself functioning in certain ways, but you may see yourself in a totally different way.” Trans men and people within the gender-nonconforming community may still go to a gynecologist, use tampons, want to have children, and use birth control. According to the 2011 National Transgender Discrimination Survey, about 62% percent of trans men reported “having to teach their medical care providers about transgender care.” And that’s when they aren’t outright being refused treatment.

A gender-nonconforming person experiences the additional challenge of being understood within their identity/ies before they can approach issues related to their reproductive health and rights. Something as simple as going to the doctor can be uncomfortable, Sarmiento says, because the receptionist will likely address them as a woman. For Sarmiento, who is a person of color and an immigrant, such microaggres­sions are prevalent.

IN THE CLASSROOM

Human sexuality educator Deborah Roffman ’68 started teaching in the 1970s, when people were organized into tight boxes based on their gender and sexuality. Now, she’s answering questions related to being transgender and asexual, identities that have always existed but have not been widely accepted.

As a white, cisgender woman, Roffman is aware of her “blinders” to how she approaches topics related to race, gender, and sexuality. She educates herself by reading, but it’s her students who have the most impact. Her students are direct with her, Roffman says, and when they tell her things like, “It’s not only women and girls who get periods,” she thanks them and reflects on ways to make her curriculum and classroom more inclusive. “For people who are in the majority,” Roffman says, “it is our moral responsibility to make sure we are looking from behind the eyes of all of our students.”

The fight for accessible, comprehensive, and safe reproductive health care is constant. Legal rights are taken away as new ones are secured. Organizations are defunded even as the conversation expands. Still, people will push on to move our society forward and help more people live freely and safely.

 

 

 

(Photo at top): Margaret Handy 1911, not featured in this story, is also part of Goucher’s history. She was an activist for women’s rights, education, and sexual health.