Abstract
In No Real Choice: How Culture and Politics Matter for Reproductive Autonomy, Katrina Kimport repeatedly illustrates how making sense of a pregnancy and having the ability to exert different pregnancy options are much more complex than our current cultural narratives suggest. Recruiting pregnant people from prenatal clinics, Kimport interviewed 58 mostly poor and low-income African Americans from Louisiana, a state with many abortion restrictions, and Maryland, a state with fewer abortion restrictions. The majority of the respondents were already parenting at least one child, and half had obtained at least one abortion in the past.
One major contribution of this book to the reproductive health and abortion social science literature is this unique sample. Most abortion research comes from abortion clinic data rather than from prenatal clinics; thus Kimport’s respondents had different stories to tell about their decisions leading to their different pregnancy outcomes. Moreover, marginalized populations still are not given enough attention in reproductive health care; and whereas these sample demographics were not intentionally sought, Kimport uses a lens on power and inequality to discuss the many life circumstances facing these respondents.
Kimport’s main thesis reveals that people do not just “choose” between abortion or pregnancy, but rather must weigh whether they want to consider these options and, if so, if they are feasible given the multitude of possibilities and constraints surrounding people’s lives. These include personal circumstances such as finances, relationship status, life goals, physical and mental health, and previous reproductive health care experiences with clinics and or physicians—and, relatedly, larger societal structures such as clinic costs, insurance coverage, marginalization of abortion from mainstream medicine, anti-abortion cultural narratives, classist, racist, and sexist cultural narratives about motherhood, reproductive health policies and regulations, and the classism, sexism, and racism that run through many societal structures. For example, Kimport adds richness and depth to what others have found as barriers to reproductive care, such as people’s difficulty in finding an available clinic, often on their own without assistance from health care providers, while hoping the available clinic meets their needs. Kimport summarizes the difficulties in paying for abortion and related services (e.g., the required two clinic visits in Louisiana), getting time off from work, finding transportation, and the inability to obtain sufficient financial and emotional help from social support systems. The author adeptly shows readers that this plethora of barriers leads to lessened reproductive autonomy, which impedes people’s ability to choose abortion but also impedes their ability to choose when to parent and under which circumstances.
Very interestingly, Kimport also moves our reproductive justice knowledge forward with revealing how misinformation, sometimes put forward from the anti-abortion movement, along with anti-abortion cultural narratives are powerful influencers in people’s reproductive decision-making. Kimport contends that with few cultural narratives to choose from, many respondents drew on anti-abortion cultural narratives to explain their reproductive decision-making, potentially unconsciously as a strategy to deflect other racist and classist motherhood narratives. Many of the respondents viewed abortion as wrong, but acceptable under certain circumstances, which ranged from health reasons, to rape, to not being able to provide a good life for a child. Some drew on religiously based narratives for opposing abortion, and some drew on narratives of responsible reproduction, feeling that pregnancy was a risk to be taken if one consents to have sex—if someone is responsible enough to have sex, they should not be irresponsible and have an abortion. Of note, this level of responsibility was not given to the men also responsible for the pregnancies.
Some respondents believed that abortion can cause physical (i.e., infertility) or mental (i.e., depression) problems, based on misinformation or extrapolation from personal knowledge. Moreover, some people used cultural narratives post facto to justify their unrelated pregnancy decisions. Essentially, given the lack of reproductive narratives to draw on that respectfully describe people’s complex reproductive landscapes, people are drawn to simplistic cultural narrative explanations that ultimately reinforce structural inequalities. In showing this, Kimport has greatly expanded our knowledge on the impacts on people’s abortion and pregnancy decisions from the anti-abortion movement’s policy restrictions and cultural narratives.
Through methodical and thoughtful in-depth analysis of her rich and intense data, Kimport displays the complex choices that her respondents made between discovering they were pregnant and deciding the outcome of the pregnancy. Adding to a small body of literature on constrained choices, Kimport argues that for many people, abortion is not an available choice; and thus, not all people who remain pregnant do so because they want to have a baby. In fact, many respondents who found abortion unobtainable for a variety of reasons were not necessarily pleased about remaining pregnant or having a(nother) baby given their strained life situations. Our social framing of choice between termination or continuation of pregnancy does not take the multitude of individual and social circumstances into account. These respondents were not powerless; they made decisions, were thoughtful, and exerted agency, albeit within limited circumstances. In other words, these respondents were making constrained choices.
Kimport provides good background information on the general reproductive access landscape in the United States to solidly center her findings. Written toward an academic audience, I believe this book is a must-read for reproductive justice scholars and would be a good syllabus addition for a graduate-level social science course in health, health disparities, class, race, gender, reproduction, or culture. The book makes particularly cogent ties to the 1social science of reproduction literature and cultural sociology.
Reflecting on the rich stories woven throughout No Real Choice, the reading audience can conclude that as a society we need more reproductive and abortion cultural narratives that cover the full spectrum of people’s lived experiences. This is what is needed to not limit people’s thoughts, explanations, and behaviors, because cultural narratives serve as internalized and even unconscious ways of understanding the world. Expanding our understanding and discussion of reproductive autonomy will help personal, public, and policy discussions and will give people more real choice, rather than constrained choice.