All over the country, from Denver to Minneapolis and beyond, billboards recently sprang up featuring a smiling white boy cradling a white infant. “My brother is a blessing,” reads the text above the children’s heads. “He has Down syndrome.”

The ads, sponsored by the national group PROLIFE Across AMERICA (PAA), come emblazoned with a telephone number offering “trained professionals who can help educate, provide facts, and counseling” to pregnant and “post-abortive” women—facts that will presumably include, based on PAA’s website, wildly inaccurate claims like “94 percent of women regret their decision to abort.”

PAA’s billboards, however, are just one tiny example of the ways in which those in the anti-reproductive rights movement are muddling their messages with false disability rights advocacy, reinforcing discriminatory frameworks and creating more obstacles for actual people with disabilities in the process. So far, however, most reproductive health and justice activists have themselves failed to prioritize disability rights as an essential goal. Until they do so, the conversation about the best ways to support people with disabilities will continue to be dictated—and dramatically skewed—by anti-choicers.

A Cynical, Sick Strategy

Designed to tug at the heartstrings, the message of PAA’s Down syndrome-focused ad is clear: Babies with disabilities—particularly children with Down syndrome—need to be “saved” from abortion.

What’s more, the billboard’s takeaway hinges on a few factual inferences. It says that people with disabilities matter, and that they can be blessings to a family. Given that people with disabilities are too often stigmatized as burdens, rather than individuals with dignity and agency, these are both true and important declarations.

However, the presentation of the billboard itself gives the first clue that there is more motivating its creators than advocacy for people with disabilities. For one thing, it makes a point of presenting the younger boy as the one with the disability, stating that he is the blessing, rather than both children. This language reinforces a discriminatory narrative: that people with disabilities are Others, to be pointed out and scrutinized by everyone rather than accommodated as a default part of the group.

PAA’s billboard places the emphasis on the child’s disability rather than the child himself and the world he lives in. A better narrative would have acknowledged and attempted to combat the primary obstacles that people with disabilities confront. These are not genetic, mental, or physical, as the ad implies. Rather, they are societally created: uncut curbs that can be crossed only by people who are not using wheelchairs and scooters, automated touchscreens that work only for people who are not blind, or police officers who are not trained to de-escalate situations involving people with mental disabilities.

This disconnect between legitimate advocacy and PAA’s billboard message is symptomatic of one of the anti-choice movement’s major objectives. Much like with their pushes for sex-selective abortion bans, which rely on racist rhetoric to make it more difficult for women of color to obtain abortions, anti-choicers seek to justify restricting reproductive health care under the guise of fighting for disability rights.

While nine states have 20-week post-fertilization abortion bans that have acute effects on individuals and families who decide to end pregnancies after learning of fetal conditions that may not be visible earlier in pregnancy, North Dakota is the only one to explicitly ban abortion on the basis of what the state calls “genetic abnormality.” Proponents of this law believe it gives a right to life to those fetuses that might, through the process of birth, become people with disabilities. This is dubious, given that many disabilities are not present at birth, not genetic in basis, or both.

Moreover, the language of the law is itself offensive. It is as if variations between bodies are “abnormal” only when they pertain to disabilities—as opposed to differing hair color, sex, or sizes. And because North Dakota provides no way to ascertain whether someone chose an abortion “solely” for “genetic abnormality” or “sex,” the practical impact of the law is to place women, doctors, and other members of the medical community under suspicion.

Although the law is, for now, only on the books in one state, it is markedly similar to model federal legislation crafted by Americans United for Life. Moreover, its terminology is echoed by the National Right to Life Committee, which says in talking points crafted for its followers that “you can show them that aborting a child because of possible abnormality is nothing less than blatant and deadly discrimination against people with disabilities.”

Working for “Life,” But Against Disability Rights

Even as the anti-choice movement feigns concern about disability in the womb for the purpose of banning and further stigmatizing abortion, it is still an integral part of a radically conservative approach to governance that actively works against the interests of people with disabilities.

Perhaps no one personifies the issue better than former Sen. Rick Santorum (R-PA), who routinely invokes the love he has for his young daughter Bella, who has Trisomy 18, as an argument for restricting abortion rights everywhere and for all reasons. When it comes to banning abortion, at least, Santorum’s no-exceptions approach makes him appear to be ideologically consistent.

But that is far from the case on all issues. In a piece Santorum wrote titled “Celebrating Bella: Our Gift from God,” he said:

It’s important for us to continually affirm life and our belief in the fundamental right to life by supporting those who work to ensure that all families with special-needs children are able to provide for them.

Working to support families who have children with disabilities is not what he’s doing when he trots Bella out to argue against the United Nations Convention on the Rights of Persons with Disabilities (CRPD), a treaty that firmly acknowledges disability rights as human rights—and that remains shamefully unratified by the United States. Santorum falsely claimed that CRPD would transfer parenting authority to a “faceless and distant United Nations bureaucrat,” a charge that Secretary of State John Kerry said was “just not factual” and that Eleanor J. Bader debunked for Rewire.

But the issue is bigger than one billboard, one politician, or one treaty. The fact of the matter is that the anti-abortion rights movement consistently fails to act to improve the lives of people with disabilities who are already here.

If you want to support people with disabilities, you need to put your money where your mouth is. You need to support funding for education, health care, and social services. Yet this pious constituency that claims to care so much about saving babies does not do that.

In a 2012 article for the American Prospect, Judith Lewis Mernit outlined how many self-described “pro-life” legislators at state and federal levels use their votes to undermine services that are vital for people with disabilities, by slashing services like early education and therapy for children with developmental disabilities, targeting for removal or reduction state-level early intervention programs for children receiving matching funds under the federal Individuals with Disabilities Education Act (IDEA), and proposing changes that would undermine the availability of Medicaid.

As a presidential candidate, Santorum vowed to “cut back a lot on the Department of Education” without mentioning whether he would spare IDEA from such cuts. Meanwhile, Rep. Trent Franks (R-AZ), the perpetual House sponsor of a 20-week abortion ban, told the National Review Online that having been born with congenital defects himself and having a late brother with Down syndrome informs his long career of anti-abortion rights advocacy. Yet he also co-sponsored a bill to repeal Medicaid expansion—which expedites and grants health-care access to more people with disabilities. Legislators like these enjoy strong backing from anti-choice groups, which typically fail to mount resistance or even muster a comment about this behavior from their star champions.

In fact, anti-abortion rights organizations usually stay out of debates that have nothing to do with abortion, letting the proverbial bullets strike their beloved babies and children where they may. Unless, of course, they can insert abortion within those discussions. Last year, the National Right to Life Committee took no position on Medicaid expansion; its Cleveland and Cincinnati affiliates, meanwhile, sued to block it within Ohio, claiming the typical “abortion-inducing drugs” falsehood leveled against Obamacare. But in an unusual move, its statewide Ohio affiliate actually supported expansion. Even so, this step toward advocacy in favor of improving quality of life for those people who actually have been born is the exception among anti-choice groups, not the rule. As Mike Gonidakis, president of Ohio Right to Life, told Irin Carmon at MSNBC, “We were the first and probably only perceived social conservative organization that came out and supported Medicaid expansion.”

When the government is not supposed to provide support, the solution offered by Santorum and his allies is to have charities and faith-based organizations step up to support people with disabilities and their families. This is not a moral option, nor is it sustainable or practical. Our government has a responsibility to assure the dignity and equality of everyone, including people with disabilities.

For that matter, it is not appropriate to create situations in which nonprofit faith-based organizations must step in to provide services when truly public, government-accountable ones are intentionally defunded. Individuals’ needs don’t go away, so this inevitably leads to “common ground” solutions, through which progressives and conservatives can hug it out by redirecting tax dollars to churches and religious organizations that provide at least some services to people with disabilities.

These agencies, however, often don’t have to adhere to anti-discrimination laws because of religious exemptions. And, for that matter, it’s dangerous to delegate care of people with disabilities to groups that actively refuse to provide all forms of reproductive health care, especially when even secular health providers can fail to account for the reality that people with disabilities are people—and just as in need of reproductive health care as everyone else.

Changing the Conversation

There is no question that those in the anti-abortion rights movement are insidiously using narratives around disability rights to push for restrictions on the procedure. This is evidence, however, that progressive activists must prioritize disability rights as a vital reproductive justice issue, especially as the availability of prenatal testing for genetic traits becomes more ubiquitous in the United States.

More than 90 percent of women who receive a prenatal diagnosis of fetal Down syndrome, for example, choose to have an abortion. Although Down syndrome is associated with higher maternal age, today pregnant women of all ages are routinely offered simple screenings that reveal the statistical likelihood of chromosomal conditions. If a greater chance of Down syndrome is revealed, a woman may choose to undergo amniocentesis or chorionic villus sampling to confirm a diagnosis.

It should be noted that some women thoughtfully forgo prenatal screening altogether. “We declined prenatal testing because we would welcome another child with Down Syndrome,” author Amy Julia Becker wrote in the New York Times in September 2010. While making it clear that she is not opposed to prenatal testing and acknowledging that it has benefits, Becker offers a critique commonly espoused by members of the disability rights movement:

The way these tests are administered, the way information is provided to women and the way our culture talks about and conceives of individuals with chromosomal abnormalities contribute to my concern that prenatal testing more often serves to devalue all human life and to offer parents and doctors an illusion of control.

This critique should be adopted widely and vocally within the reproductive justice community. Hear me out: Absolutely, pregnant women should have access to prenatal testing, as well as accurate, timely information about their results. A woman who decides abortion is best for her should be accommodated without shaming or restrictive laws, regardless of whether prenatal testing has suggested or confirmed that if her pregnancy goes to term, a baby with a disability will be born.

However, such testing is often framed as a way to “empower” parents over “risks” versus “normal outcomes,” to paraphrase the marketing brochure of MaterniT21 PLUS, one brand of prenatal test. Becker pointed out in her Times article that doctors-in-training told her that before they met her daughter, “they thought Down syndrome was the worst thing to happen to a child.” Other personal essays, such as this piece from Amy Atkins, have recounted midwives reacting with horror at the comparatively high chances of an infant being born with a chromosomal condition. These attitudes all contribute, in part, to the disgusting and pervasive discrimination against disability within and outside of the reproductive rights movement.

Reproductive justice is about more than supporting people in their decisions about pregnancy; it includes a call for adequate resources so that people can have healthy pregnancies and raise children in safe communities, regardless of privilege or lack thereof. Under a reproductive justice framework, those at the margins are pushed to the center of analysis and activism. It’s well past time for that analysis to more robustly include the needs of those people with disabilities, as well as the families who support them.

Backing policies to improve the lives of people with disabilities, embracing disability rights leaders as reproductive justice leaders in their own right, and insisting that the medical community provide unquestioned support to women who choose to continue or end a pregnancy after receiving a prenatal diagnosis—these are not threats to the fundamental right to choose abortion. There should be no stigma attached to choosing to raise a child with a disability, just as there should be none for choosing to end a pregnancy for any reason.

So far, however, the discussion largely remains dictated by anti-abortion rights concern-trollers and a few bigoted voices claiming to be “pro-choice.” One such figure is Richard Dawkins, who recently tweeted that he believes that a woman who finds she is carrying a fetus with Down syndrome should “[a]bort it and try again. It would be immoral to bring it into the world if you have a choice.” He doubled down in a blog post that had “apology” in the title but defended his initial words.

Whether the objections come from those in the medical community or self-styled leftists like Dawkins, it’s not ethical to pressure women to abort fetuses that test positive for potential disabilities. In fact, it’s downright horrific to insinuate that someone’s life exists because of someone else’s immoral decision to allow it. This should not, under any conditions, be considered the “pro-choice” response to disability.

But in the absence of engagement on disability rights from actual leaders of the reproductive health, rights, and justice movements, it’s not difficult to see how someone could see these prejudiced views as the sole answer to “advocacy” from the anti-abortion contingent. It is up to all of us to do better—we know the “pro-life” movement doesn’t have it covered, no matter how hard they try to make it seem that way.