About Beyond Choice
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||About Beyond Choice
With reproductive freedom in jeopardy, Alexander Sanger, grandson of renowned family planning advocate Margaret Sanger and a longtime leader in the reproductive rights movement, has taken an urgent, fresh look at the pro-choice positionand even the pro-life positionand finds them necessary, but insufficient. In Beyond Choice he offers the first major re-thinking of these positions in thirty years.
May 14, 2004:
Click here to listen to an interview with Alexander Sanger on Bill Thompson's "Eye On Books."
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A Conversation with Alexander Sanger, author of BEYOND CHOICE: Reproductive Freedom and the 21st Century (PublicAffairs; February 2004)
Q: Why did you decide to write this book?
A: I have been involved in this fight for most of my adult life. Reproductive freedom reached its legal high point when Roe v. Wade was decided in 1973. We have not succeeded either in making abortion morally acceptable or in making Roe an accepted part of our constitutional law, like Brown v. Board of Education for instance. More ominously, ever since Roe there has been a steadily increasing number of laws passed at the state and federal levels restricting access to reproductive health services, especially for poor women and teenagers. While some polls indicate that there is as much support for reproductive freedom as ever, other polls indicate decreasing support among young people. All this said to me that we weren’t just losing a political and legal battle; we were losing the battle of ideas. It is time to reframe the debate in a way that made people understand what reproductive freedom was really all about.
Q: How has being the grandson of birth control activist Margaret Sanger changed your life or influenced your views?
A: My grandmother had an immense impact on my life. My motivation to join her cause came because for some inexplicable reason my grandmother selected me when I was about 13 years old as the backup to my father to carry out her funeral arrangements. She must have seen something in me that I didn’t see in myself and that I was somehow worthy of this task—a task at which I failed miserably when my father disregarded her express wishes and buried her as he saw fit.
At any rate, when at college I read through her papers, letters, diaries, speeches and memoirs, I began to understand that she was fighting for the liberation of women. As a nurse she saw all too many women dying in childbirth or from illegal abortions; she saw women, and men, worn down from the burden of raising and supporting more children than they could handle; and she saw women unable to contribute equally with men in the political and economic life of their communities. The root cause of all this in her view was enforced motherhood and a woman’s lack of control over her childbearing. This harmed not just women and children, but men too; indeed all of society. I learned this at age 20 and I’ve never forgotten it.
Q: What is the main argument you make in the book in favor of abortion?
A: Abortion should be viewed as less of a rights issue and more of a reproductive issue. Abortion can only be understood in the context of human reproduction. Having an abortion is fundamentally a biological decision—it prevents the birth of a child. Humanity exists because our ancestors have successfully had children and grandchildren. Men and women, however, do not have children randomly. They have children strategically. Each of us is here today because every one of our ancestors saw to it that at least one of their children survived to adulthood and in turn had children. This took planning, effort and making tradeoffs. Children don’t survive on their own. Child survival takes not only a successful pregnancy and childbirth, but also takes years and years of parenting, preferably by both parents, and also sometimes by aunts, uncles and grandparents.
Women face huge risks to their health from pregnancy and childbirth. The biggest killer of women over time has been childbirth. When women die, their children are more likely to die as well. Women have evolved to minimize these risks by planning and spacing their children and by limiting the number of children they bear. Women have used a variety of methods to accomplish this, including extensive breastfeeding, abstinence, non-procreative sex, birth control and abortion. All these are methods of exercising reproductive freedom.
Q: What exactly does it mean to have a reproductive strategy? Do human beings really have such plans when even they are not conscious of them?
A: The biological goal of women and men is to have children who will survive to in turn have children. They use reproductive strategies to do this. A reproductive strategy is a set of behaviors, conscious and subconscious, instinctual and deliberate, that a male or female will engage in at every stage of the reproductive process so that they will have offspring who will in turn successfully reproduce. Everyone has a reproductive strategy, even though men and women often pursue strategies that they don’t know are such. Much of our sexual and mating behavior is innate and instinctual.
Successful reproduction involves a man and a woman, both of whom are capable of reproducing, finding each other, bonding, having sex, getting pregnant, giving birth to a living child, nurturing and raising that child, and having that child repeat the same process, and often helping raise the grandchildren. Every step of the reproductive process involves choices, tradeoffs and obligations. The primary biological obligation men and women have is survival---their own and that of their child. A woman’s survival depends directly on her ability to control pregnancy and childbearing. Children’s survival depends on their condition at birth, their parent’s survival, especially their mother’s survival, and the nurturing they receive from their parents.
I believe that humanity has reproduced successfully by not leaving reproduction to chance or to nature and by exercising as much control over it as possible. Humans succeed reproductively when they adjust their reproductive strategies depending on the environment in which they find themselves and when they strategize at every turn to meet their biological goals.
Q: Why do you say that abortion is morally right?
A: A proper morality must encourage the survival of humanity. This must include granting men and women the reproductive freedom necessary to insure their own survival and that of their children. This is why not just legal abortion is good; it is why abortion is good. By exerting control over our biological destiny, we are insuring that destiny. The future of the human race has not been and can not be left to chance or to fate. We have survived because we have taken control of our reproduction and our biological destiny.
Looking at reproduction with a perspective based on evolutionary biology can simultaneously support both reproductive freedom and a proper respect for the sanctity of human life. The biological goal of the human race is more than mere existence of life. Biology tells us that “life” is something more than existence. “Life” includes the creation of life, its survival, its health and viability, and the reproduction of its next generation. The distinction I am drawing between life as mere existence and life as something more comprehensive is fundamental.
Q: In the book you say that choice is not just important for women but for men as well. Why is this, since they technically are not the ones having the child?
A: Men want to have children and grandchildren, just like women do. A man will see his children survive in good health when the mother is healthy, has a successful pregnancy and survives childbirth to help nurture and raise the child. To this extent reproductive freedom for women is also in a man’s reproductive interest.
But a man and woman’s reproductive interests aren’t always in alignment. A child has a combination of the genes of each parent. Though it takes a couple to have a child, reproductive success is not measured as a couple, it is measured individually for each male and female, when they pass their genes down to the next generation and to the next generation and so on. If a man or woman does not mate successfully, then his or her genes die out. Men and women will fight and compete with and among each other to be sure that they do mate and have children who will survive and reproduce.
A man’s basic biological problem with women’s reproductive freedom is that even if he succeeds in mating, he has absolutely no assurance (until the advent of DNA testing) that he is the genetic father of the children that his “mate” produces. It is in a man’s genetic interest to know who his children are. I believe only by eliminating paternity uncertainty can we get men to support reproductive freedom. Technology in the form of condoms and DNA testing now allows this. If men no longer fear infidelity, the biological foundation for these patriarchal practices will crumble.
Q: You also note that teen pregnancy can sometimes be a good reproductive strategy. How can this be when it is seen as such a negative thing in our society?
A: We have to remember that it is normal for women to have children. Women now ovulate earlier than ever, and before they are finished with their education or are ready for marriage, they are ready for sex and can get pregnant. Young women frequently come to the conclusion that it is a better reproductive strategy for them to have their children earlier than later.
There are a few reasons for this. First, there is a growing shortage of eligible men as women in poorer communities age. Second, young women’s health, the health of the families and their environment are such that it is riskier for these young women to postpone childbearing than to start now. Teens in poor communities, and their mothers, age quicker, grow sicker and die younger than those in wealthier communities. In a culture where the extended family helps bring up the children, it is vital for child survival that the children’s mother, grandmother and other relatives are as healthy as possible. Third, there is evidence that teen age girls give birth to healthier babies that they would if they waited until their 20’s to give birth. While there is a risk that their children may not fare as well in life than the children of older women, for some young teens this is a risk worth running.
In an environment where life is short and where earlier births are less risky, it makes evolutionary sense for women to have their children as early as possible. To postpone such goals as childbearing is to risk foregoing them. Society may not like the choices they make, but given their circumstances, the choices made by poor teens are a clear indication of reproductive strategies at work. If society believes this strategy to be wrong, it can only cure it by eliminating the environmental factors that lead poor women down this reproductive path.
Q: Why do you write that you would favor a society in which condoms and abortion were the main methods of birth control instead of the birth control pill?
A: No technology provides benefits without drawbacks. The collective use that some people make of reproductive technologies has unintended consequences for society. The use of these technologies may lead to undesirable health consequences for women, men and children; their use may result in harmful reproductive and sexual behavior; and as a result their use may have negative biological and evolutionary consequences. These negative consequences need to be balanced against the benefits that the technologies bring by enhancing control over reproduction.
The birth control pill is no exception. The use of hormonal contraception carries its own risks, not just because it does not prevent the transmission of STDs, but in some cases may increase the risk. The effect of hormonal contraceptives on STDs, HIV and resulting infertility is “unsettled,” but studies have found both an increased risk of chlamydia and gonorrhea among pill users as compared with non-users and a decreased risk of being hospitalized with PID. Some scientists believe that use of hormonal contraception increases the chances of HIV infection. The result of these unintended consequences is direct reproductive harm, i.e. infertility.
Hormonal contraception is generally considered remarkably safe and, more importantly, provides major health benefits by enabling women to control when they get pregnant and by allowing women to avoid the many medical risks that are inherent in any pregnancy. One solution to this dilemma, which is increasing in use in the United States and elsewhere, is the promotion of the exclusive use of condoms for both pregnancy prevention and STD prevention, with a backup of emergency contraception if the condom breaks and of abortion if a pregnancy ensues.
Q: When you argue for reproductive freedom, do you include genetic engineering? Why or why not?
A: Not everyone can get pregnant and have a child the old fashioned way. Infertility affects up to 20% of couples. Others who don’t suffer from infertility nevertheless run an unacceptable risk of having a child with severe birth defects. Genetic screening and engineering can help solve these problems. Genetic screening allows parents to affirmatively decide whether or not a particular child should be born and to plan accordingly. A potential birth defect, disability or disease in the child will have biological, familial and societal consequences that parents have to weigh. The issue is one of allowing parents the best chance of biological success and of family happiness. To the extent that “wantedness” will increase the parental commitment to and investment in that child, it is a good thing.
Genetic engineering is quite a different matter than genetic screening and diagnosis. It is not safe to use genetic engineering to put the genetic future of the human race, our evolutionary future, in our conscious (as opposed to subconscious) hands. Until now sexual reproduction has been the key to our evolutionary success. Sex between males and females and the process of sexual selection has likely evolved in part as a way to create genetic variety and to mix genetic material to create offspring that can better ward off pathogens. I view with enormous skepticism any human attempt to improve upon that process through genetic engineering.
As regards cloning, the main problem with it, other than that it does not yet work in humans, is that there is no mixing of two parents’ genes in the conception of the child; rather it is the duplication of the genes of one parent. By eliminating sexual selection and reproduction, cloning makes it easier for pathogens to survive, grow and kill us. This is a danger to everyone in society and is unacceptable.
Q: With the new federal ban on partial birth abortion in place, doesn’t that say that most Americans are opposed to abortion? Shouldn’t that therefore be the law of the land?
A: Whatever the ill-defined “partial birth abortion” may be, the objections to it are some combination of 1) it is gruesome, 2) it is performed late in a pregnancy, and 3) maybe the child could survive. The answer as to why this, or any other abortion procedure, should not be outlawed is that it is in fact an abortion, and abortion at every stage of a pregnancy should be available to the women who need it to carry out their reproductive strategies.
Governments have as one of their purposes “to maintain the biologic functioning of group members.” Abortion at any stage, especially after the first stages of a pregnancy, can be a complex surgical procedure and great skill is required to be sure that the woman can conceive and give birth again. The abortion procedures used after the mid point of a pregnancy are designed to maximize the women’s chances of having a successful pregnancy in the future.
The proscription of the so-called partial birth abortion procedure had no biological justification at all. Its moral justification was undercut by the fact that the law left in place another abortion procedure that the law’s proponents conceded was equally distasteful to them. The law requires that any abortion procedure performed after fetal viability can only be done if there is a significant health risk to the mother.
Even if a majority of citizens finds the procedure distasteful and say they would never use it, they do not have the right to change the purpose of why governments were created in the first place, which is to insure everyone’s ability to reproduce successfully. Banning any abortion procedure harms that ability.
Q: What role should the American government, specifically, take in promoting healthy and safe procreation by its citizens?
A: Governments should insure the provision of health services, including fertility and birth control services and genetic screening, that help people get pregnant when they want and not get pregnant when they don’t want. Furthermore, government should insure pre-natal care services for those who want to give birth, as well as abortion services for those who do not want to give birth. Government should not be in the business of making reproductive decisions on behalf of its citizens or dictating certain reproductive results.
Most restrictions on access to abortion do not make biological sense. Waiting periods and other regulations designed to frustrate and delay a woman’s access under the guise of patient safety are no more than a ruse. They only serve to delay the abortion or to make the woman give birth when she does not want to, both of which are contrary to her biological interests. The denial of insurance or Medicaid coverage for an indigent woman’s abortion is similarly misguided and cruel. It forces some women to give birth when they believe it is not in their biological interest. Poor women weather faster than well-to do women, and pregnancy and childbirth for them carry extra risks. Women in these circumstances especially need to control pregnancy and childbearing as a matter of their own and their children’s survival.
Parental consent for pregnant teens seeking an abortion is similarly designed to force teens to give birth. It is for the teen, with in most cases her kin network, to evaluate the risks and decide this. When parental consent laws intervene, it is the teen’s parents that can force her to give birth. Parents cannot force their daughter to have an abortion under current law, although if the law were to be consistent, it would allow parents to do this. Parental involvement laws ignore the fact that a minor daughter is not the property of her parents. They also ignore the biological reality that she is the means by which the parent’s reproductive strategy is to be carried out. While the teen and her parents might have the same reproductive strategy, they may not or they may have divergent views of childbirth in this particular circumstance. I would argue that it is the person with the greater investment in the child and who bears the health risk, the teenage daughter, whose views should control.
Q: What do you say to counter the argument that abortion is murder?
A: Life should be respected at all stages of development. We are more than animals. That has been my entire point. Animals by and large do not take conscious control of their reproduction to the extent humans do. Humanity has evolved to take conscious control of reproduction and has done so in order to survive and to preserve life. Taking control of reproduction is respectful of life. At times it means not conceiving a life, and at times it means not letting unborn life be born. When humanity does this, it often does so in pursuance of a reproductive strategy that will best enable it to preserve and nurture other life. We cannot repeal the laws of natural selection. Nature does not let every life form survive. Humanity uniquely, and to its benefit, can exercise some dominion over this process and maximize the chances for human life to survive and grow. Without this, no other human goals are possible. A world without reproductive freedom is the animal world. This is bad biology and is bad for humanity.
Q: Do you think the minds of pro-life supporters can be changed?
A: Anyone with an open mind should be influenced by this book. Being pro-life must mean more than being anti-abortion. It must mean being in favor of life’s continuance on earth. I believe that being in favor of life’s continuance and propagation means that the abortion option must remain available.
Banning abortion is an attempt to change human reproductive behavior. It is not that human behavior can’t be influenced or changed by law. Humans are not genetic and reproductive robots. But there are biological limits to what law and culture can achieve in changing the biological process, just as Marxists found out there are limits to what changes politics can bring about in the social and economic spheres. More importantly, we should not want to change these biological and evolutionary processes, even if we had the power to do so. What makes us think that we can develop rules to cover every human circumstance? People make reproductive decisions in a fluctuating environment. Any attempt to enact rules to control human reproduction within the context of each person’s particular and changing environment would have all the simplicity, clarity and compassion of the Internal Revenue Code.
I believe that the pro-choice position generally benefits humanity, and that the anti-abortion position does not.
To interview Alexander Sanger, please contact Jaime Leifer, Senior Publicist, PublicAffairs, 212-397-6666 x532; or Kasey Pfaff, 212-397-6666 x238, firstname.lastname@example.org