Abstract
At the one-year mark since the overturning of Roe v. Wade, there is an urgent, vital need for feminist scholarship that addresses the ways structural stigma and oppressive policy affect diverse groups of women and people assigned female at birth (AFAB). Accordingly, in this introduction to the special issue of Psychology of Women Quarterly, we provide a historical overview and timeline of reproductive rights and (in)justice in the United States in order to illustrate how we have arrived at this perilous moment in history. Reproductive (in)justice exacerbates inequities regarding who has been encouraged to reproduce, who has been denied reproductive autonomy, and who has been required to reproduce and refused the right to parent their children in safe environments. Accordingly, we aver the importance of centering an intersectional and reproductive justice framework in understanding how coalescing forms of oppression (e.g., racism, capitalism, sexism, ableism) circumscribe reproductive autonomy. We begin the special issue with articles that examine how social policy and structural oppression have violated women's and people AFAB reproductive healthcare, followed by articles that examine how such policy and oppression affect women's reproductive decision-making. We conclude this special issue with an article that centers reproductive justice advocacy in the ongoing fight for reproductive rights and bodily autonomy.
Throughout history, women and people assigned female at birth (AFAB) have fought against systems and laws seeking to infringe upon and rob them of their bodily autonomy. In this introductory article, as with the special issue more generally, we acknowledge that pregnancy impacts people across the gender spectrum. We retain the use of women when referring to major legal cases and previous scholarship.
Rights to bodily autonomy have been disputed extensively within the United States’ (U.S.) legal system. In the landmark case, Griswold v. Connecticut (1965), the U.S. Supreme Court declared that, by virtue of having a “right to privacy,” states could not prohibit the prescription, sale, or use of contraceptives. Indeed, according to this ruling, childbearing was considered a private decision in which states had no role. In 1973, Jane Roe (the pseudonym used by Norma McCorvey) sued Norman Wade, the district attorney of Dallas County, Texas, over a Texas law prohibiting abortion except for life-saving circumstances. The Supreme Court quashed this law on the basis that a woman's constitutional right to privacy also extended to her decision to terminate a pregnancy. Further, the Supreme Court declared that states could not interfere with abortion-related decisions unless there was a compelling reason for regulation. The historic ruling in Roe v. Wade made abortion access a federally protected right, returning reproductive decision-making to women and people AFAB.
Over time, subsequent legal cases and statutes have attempted to chisel away at reproductive autonomy (e.g., Gonzales v. Carhart, 2007; Hyde Amendment; Rust v. Sullivan, 1991). Yet, in 1992, the Supreme Court reaffirmed Roe v. Wade, stating that, although Supreme Court precedents are not necessarily eternal, there must be a compelling reason to abandon them (i.e., Planned Parenthood of Southeastern Pennsylvania v. Casey ). With the increasing politicization of the Supreme Court, the right to bodily autonomy has been progressively more obstructed and jeopardized. Most recently, in 2022, the Supreme Court upheld a Mississippi law prohibiting abortions after 15 weeks of gestation, except for instances of fetal abnormalities or rigidly defined medical emergencies (i.e., Dobbs v. Jackson Woman's Health Organization). In doing so, the Supreme Court declared that the Constitution did not guarantee a right to privacy. This ruling obliterated the federally protected right to abortion, as decided by Roe v. Wade (1973), thereby relegating abortion access to the purview of individual states. Since this ruling, 13 states with trigger laws in effect (i.e., laws that would ban abortion if Roe v. Wade was overturned) banned abortions. Furthermore, bounty-style laws have been enacted to criminalize those who provide or aid others in seeking an abortion (i.e., Oklahoma’s House Bill 4327; Texas’ Senate Bill 8).
Notably, reproductive autonomy has been inequitably and unjustly applied to people based on race, socioeconomic status, and ability status. Namely, women of color, poor women, and women with disabilities have often lacked autonomy when it is related to contraceptive choice, reproductive freedom, and other aspects of reproductive justice. Accordingly, we ground this special issue within a framework that reveals how coalescing forms of oppression, including capitalism, racism, sexism, cissexism, and ableism (to name a few), prevent humans from realizing their optimal reproductive well-being (Crenshaw, 1989; SisterSong, n.d.). The history of who has been allowed to reproduce, who has been required to reproduce, who has been prevented from reproducing, and who has been exploited such that they are unable to offer their children a healthy life post-reproduction reflects the compounded impact of this matrix of domination. However, it is important we acknowledge we are missing some important parts of the story. For instance, the experiences of queer ciswomen and transwomen are future directions for reproductive justice research in psychology. The articles in this special issue do not explicitly convey their experiences.
The evolving political landscape and the vanquishing of federally protected right to abortion present a charge for feminist scholars not only to better understand the ways diverse cisgender women and people AFAB have been affected (or may be affected) by this historic court ruling, but also to engage in rigorous scholarship that promotes advocacy for abortion rights. In this special issue, our goal is to bring awareness and attention to reproductive (in)justice, which is defined broadly to include the right to access contraception, abortion, pregnancy care, and options for childbirth and parenting in safe, healthy environments (SisterSong, n.d.). In doing so, we seek to better understand (a) how restricted access to abortion and contraception may affect individuals’ health; (b) the role of abortion stigma in affecting individuals’ health and reproductive decision-making; (c) how reproductive (in)justice differentially affects individuals from marginalized groups; (d) how restrictive legislation around reproductive health affects individuals; (e) how psychologists and mental health providers can build coalitions with other stakeholders to advocate for reproductive justice; and (f) how reproductive justice efforts enhance positive outcomes and well-being among individuals.
Articles in this Special Issue
This special issue includes a variety of articles that address how a lack of bodily autonomy is steeped in stigma and overlapping systems of oppression that is reinforced by and promulgated through various forms of tyrannical social systems (e.g., Kumar et al., 2009). This special issue highlights the experiences of Black and Latina women, low-income women, women with mental health concerns, and childfree women, all of whom have intersecting oppressed identities targeted disproportionately by restrictive reproductive policies. We begin this special issue with articles that highlight the ways in which structural injustice infringe upon reproductive autonomy. In the first article, Jozkowski et al. (2023) explore how abortion stigma shapes public perception of attributions of responsibility and punishment for illegal abortion. In doing so, the authors elucidate public perception of the circumstances under and extent to which various actors (e.g., pregnant person, healthcare provider, person involved in pregnancy, person aiding abortion access) should be held responsible and punished for illegal abortion. Next, Neilson et al. (2023) highlight the necessity of medication abortion and telemedicine as vital forms of reproductive healthcare and explore how interpersonal and structural violence shape access to and the experience of medication abortion among Black, Latinx, and lower-income women.
In the third article, Downey et al. (2023) explore how restrictions to bodily autonomy and social welfare programs can be understood through a morality lens that is steeped in the legacy of coverture. Emerging from English Common Law, coverture abolished women's autonomous legal identities under the guise of protecting “vulnerable” women, while reinforcing sexist stereotypes and prohibiting women from equal participation in society. Relatedly, and expanding beyond the lens of abortion stigma, the fourth article posits how reproductive objectification is shaped by ambivalent sexism and the objectification of women, ultimately denying personhood to women and people AFAB (Dyar et al., 2023).
After presenting a framework of the ways in which abortion stigma and overlapping forms of oppression affect reproductive justice, we present articles that explore individuals’ experiences with healthcare systems and reproductive decision-making. Situating Black women's experiences within a legacy of slavery, Howell (2023) describes the ways in which racism, sexism, and classism converge to affect middle-class Black women's experiences of gendered racism in healthcare settings and with gynecological trauma. Then, Wexler et al. (2023) discuss how adoption is often misperceived as an antidote to abortion among anti-abortion advocates. Wexler et al. complicate the narrative that adoption is a socially beneficial alternative to abortion for birth parents, adoptees, and adoptive parents alike by connecting such messages to a legacy of colonialism, racism, classism, and imperialism.
Next, Klann and Wong (2023) explore pregnancy-decision making among women with mental health concerns within the natalism spectrum (Fikslin, 2021). Although many women experience natalist messages, or pressures to have children (Mollen, 2014), those with marginalized identities, including those with mental disabilities, may experience messages that they are ill-equipped to have children (anti-natalist messages). Thus, in a mixed-method study, Klann and Wong examine the relations among psychological distress, parenting self-efficacy, perceived harm from pregnancy, and likelihood of choosing an abortion in a hypothetical pregnancy scenario among women experiencing mental health disturbances. Following, Lemke et al. (2023) examine psychological outcomes (i.e., self-esteem, well-being, and sexual quality of life) associated with sterilization attainment or denials among childfree women and people AFAB. We conclude the special issue with an article by Abbott et al. (2023) that used a feminist collaborative autoethnography to examine how personal and professional experiences as both reproductive beings and health service psychologists overlap, as well as ways in which they, as reproductive justice advocates, can sustain themselves during a perilous and vulnerable time in our sociopolitical history.
Implications for Research, Practice, Training, and Advocacy
Our special issue offers an initial look into the landscape of reproductive (in)justice in the period preceding and in the wake of the Dobbs’ decision (Dobbs v. Jackson Women's Health, 2022). As we write this introductory article, we have just marked one year since the decision was reached. Accordingly, the ramifications of the decision continue to unravel and will take more time to comprehensively assess. Ongoing longitudinal and recent research, however, portend reason for concern. For example, researchers have followed and compared groups of women who have sought and obtained an abortion alongside those who have sought and been denied an abortion. Results have shown that those denied an abortion were twice as likely to be partnered in poor-quality relationships compared to those who obtained abortions (Upadhyay et al., 2022), and more likely to experience enduring financial problems, including incurring unpaid debt, evictions, and bankruptcies (Miller et al., 2020). Moreover, research conducted post-Dobbs reveals that states with restricted abortion access or enacted bans have experienced a decrease in maternal care providers; an increase in maternal and infant mortality, particularly among women of color; greater racial disparities in health care; and higher death rates for women ages 15–44 years (Declercq et al., 2022).
These inauspicious findings create an imperative for quality scholarship and activism. Although we aimed to build this special issue to encompass the experiences of as many people impacted by threats to reproductive justice as possible, we acknowledge those voices missing, particularly lesbian, gay, bisexual, transgender, queer, intersex, and asexual [LGBTQIA+] people. Scholars should continue pursuing research that centralizes the experiences of sexual minority women and AFAB people in post-Roe U.S., as well as those most likely to be impacted by reproductive oppression, also including women and AFAB Black, Indigenous, People of Color, people with disabilities, those living in rural communities and reproductive deserts, those with incomes in the lowest brackets. Using frameworks of reproductive justice, intersectionality, and feminist theories, we encourage researchers to study the consequences of the Dobbs’ decision, including issues of accessibility to reproductive healthcare, abortion stigma and shame, maternal and infant morbidity and mortality, the impact on foster care and adoption practices and systems, and forced pregnancy. We hope scholars will employ an array of methodologies, including qualitative, quantitative, and mixed-method designs, to answer pressing questions about how the Dobbs’ decision relates to people's mental and physical health outcomes.
Psychologists can approach their work with a sustained focus on reproductive justice in the myriad of roles they serve, including as practitioners, advocates, and educators. We urge psychologists to stay abreast of state and federal policies as they affect their work with clients. In their roles as advocates and trainers, psychologists can ensure the information they provide students, clients, and the wider public is grounded in science and devoid of myths that often punctuate discussions about abortion and other issues pertaining to reproductive healthcare (see Mollen et al., 2018).
