UPDATE, October 14, 2021: On April 13, the Sixth Circuit Court of Appeals upheld Ohio’s Down syndrome abortion ban as constitutional, reversing the court’s earlier decison and lifting an injunction issued by a federal judge in March 2018. The Sixth Circuit’s decision allows Ohio to enforce the law.
UPDATE, March 15, 2018: On March 14, a federal judge blocked the Down syndrome abortion ban.
I am a woman with a significant disability. I am also pro-choice and a staunch proponent of reproductive rights. Until recently, these two important identities have intersected fairly seamlessly. Increasingly, however, disability rights and reproductive rights are being pitted against one another—and that is incredibly troubling to me.
In December, Ohio passed a Down syndrome abortion ban, making it unlawful for health-care providers to perform abortions based on a fetal diagnosis of Down syndrome. Similar laws have passed in North Dakota and Indiana, and more states are expected to consider such legislation in the near future.
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Ostensibly, these types of laws appear to be aligned with disability rights. Indeed, anti-choice advocates have claimed that the goal of these bills are to prohibit discrimination based on disability. I completely disagree and strongly believe these laws are dangerous and offensive to both the disability community and women.
I was born with arthrogryposis, a disability that affects my muscles and joints. I am a power wheelchair user and have limited use of both my arms and legs. Although characteristics of arthrogryposis could not be detected on an ultrasound in utero when I was born, they can be now. For me, prenatal diagnosis of a disability is personal. I am grateful for my life, not despite my disability but because of it. Nonetheless, as a woman, I believe reproductive rights are paramount and any attempt to limit a woman’s constitutional right to choose is objectionable.
Both reproductive rights and disability rights are based on a common principle: bodily autonomy. I have encountered countless threats to my autonomy simply because I am disabled. Shockingly, health-care providers have suggested that I undergo a hysterectomy more times than I can count. These actions were not based on medical necessity but rather the view that I should not reproduce.
My experiences are not unique or uncommon. In fact, disabled people have faced a long history of threats to bodily autonomy, including forced sterilization. Eugenics aimed to “improve” the human race by restricting procreation of those deemed undesirable—women of color, poor women, and women with disabilities. In the infamous 1927 Buck v. Bell case, the U.S. Supreme Court ruled that it was constitutional to sterilize disabled women against their wishes. Following this alarming decision, more than 30 states implemented laws that permitted the practice; by the late 20th century, roughly 70,000 Americans, many of whom had disabilities, had been subjected to compulsory sterilization.
Because of my personal experiences and that of many others with disabilities, I am incredibly aware of the effects of eugenic ideologies and object to any instance of it. However, contrary to what anti-choice advocates and legislators assert, Down syndrome abortion ban laws are not needed to halt modern-day eugenic practices. Ensuring that everyone has the right to choose what to do with their body does not mean accepting eugenics ideologies.
There is one notable similarity between eugenics and Down syndrome abortion ban statutes that must be acknowledged: the curtailment of reproductive rights when disability is involved. During the height of the eugenics movement, restricting reproductive rights meant ensuring that disabled women did not reproduce, which included both sterilization and termination of pregnancies. Today, policies are being implemented to forestall abortions when there is a prenatal diagnosis of disability. Ironically, both types of laws are based on disability, though one set of legislation intends to stop pregnancies while the other aims to force them.
Make no mistake, Down syndrome abortion bans are simply another way to chip away at abortion access writ large. Similar to laws that prohibit abortion based on the race or the gender of the fetus, Down syndrome abortion bans call into question patients’ reasons for having an abortion—adding another potential barrier between an individual and the care to which they are legally entitled.
Of course, it upsets me that some people choose to terminate their pregnancies if there is a prenatal diagnosis of a disability, and that pro-choice groups often use fetal anomalies as an unquestioning, default justification for abortion. This type of messaging only serves to advance the belief that disability is a tragedy that must be avoided. More recently, during the height of the Zika crisis, pro-choice activists again relied on ableist rhetoric to support the cause. We can support reproductive rights without perpetuating ableism.
The solution lies in addressing structural aspects that limit someone’s decision about their pregnancy. Unquestionably, families who have children with disabilities need more support. Raising a disabled child is expensive and can be challenging. Policymakers and advocates should focus on ways to alleviate these stressors, such as increasing financial supports and in-home services.
If lawmakers are truly concerned about fighting discrimination against people with disabilities, there is plenty that can be done. This past year has been incredibly challenging for people with disabilities. From attempts to undermine the Americans with Disabilities Act to repeated attempts to take away our health care, people with disabilities are facing threats like never before at the hands of the same legislators supporting Down syndrome abortion ban laws. GOP lawmakers cannot claim that they are concerned about the wellbeing of people with disabilities if they only care about fetuses with disabilities and not actual disabled people.
We also need to change society’s perception of disability. For far too long, disability has been perceived as something bad that should be avoided whenever possible. However, as someone who has lived for 36 years I can positively say that I am a proud disabled woman. My disability has made me who I am today, and that is something I am thankful for. This messaging is especially important for health-care providers, such as genetic counselors.
People who receive a prenatal fetal diagnosis of Down syndrome or another disability must be provided information on all options available to them. This not only includes information on abortion, but also information on what it is like to have a disabled child and access to firsthand accounts from families and disabled people. Providing comprehensive information and support allows patients to make informed decisions about what is best for them and their family. More importantly, this approach shifts away from a focus on the fetus and its diagnosis and instead respects the right to bodily autonomy.
Pitting disability rights against reproductive rights is dangerous and wholly inappropriate. Anti-choice activists must stop using people with disabilities as pawns in their mission to undermine reproductive rights. As disabled individuals, we cannot let them continue doing so.
The right to abortion is legally grounded and must be maintained. We must trust people to make their own decisions about their body, based on what they feel is best. Now is the time for reproductive rights advocates and disability rights advocates to come together to ensure that everyone enjoys bodily autonomy, no matter what.