To an outsider, the United States is known for many things: hollywood, ‘Friends’, outsize food portions, and on a less savoury note —Trump and a wildly complicated political battleground. There are many women’s rights issues that Americans are fighting for, but today, we focus on female reproductive healthcare. 

For those unfamiliar with how politicised healthcare is in America, it may come as a surprise that a country so developed has no national paid maternity leave policy and no uniform health coverage. The short answer is that the US is hugely diverse, which makes it extremely difficult to enact laws that appease everyone. 

The current topic of contention is how the government is seeking to implement measures that hinder the process of procuring an abortion and to cease free contraception. The jury is out till March and April 2020, when the Supreme Court will make rulings on the two matters. 

We speak with Lillian, a 30-year-old UX content strategist and first-generation American with immigrant parents, to discuss the question: Why don’t American women have control over their reproductive rights? 

Where she lives and works (a tech company in the San Francisco Bay Area) might mean liberal laws and more access to top notch healthcare, but she still believes that it is important to keep informed about what is happening countrywide.

In her words, reproductive healthcare affects every woman in the country, so as an American, she has a moral and ethical responsibility to discuss paid maternity leave, abortion rights and access to contraception.

In the US, healthcare is so complicated because many issues are governed by state law and not policies at a federal level. Because of our country’s size and how it’s made up of so many different cultures, the laws can vary quite drastically from state to state. 

I live in California, which is a pretty liberal blue state. But if you were to go across the country towards the south, states such as Mississippi and Georgia tend to be more conservative and the different beliefs there result in very different laws, such as much higher barriers to abortion.

I think what would benefit us as Americans is having standard guidelines in place at a federal level. However, what we first need are more female leaders to represent us in making the decisions. 

2018 was a big win for women in House and Senate seats as 102 women now serve in the house and 23.5 per cent of the 435 total seats are occupied by women, but it is still a far cry from even half of the decision makers being female. 

White men continue to be the majority of lawmakers, and to have them make policies that directly affect women just doesn't make any sense to me.

Why would we trust men to make the best decisions for women? I think women should be given a choice to decide for ourselves. 

It can be difficult enough just trying to get the men in our lives — fathers, brothers, and partners — to understand our experience, let alone lawmakers who often have their own political agendas. By having men decide what’s best for women from a policy standpoint, we lose the ability to voice what really matters to us as women. 

While I know that talking is not the same as making immediate policy impact, I think when you can’t rely on the government, it becomes more important than ever to educate ourselves, and support one another. Women’s reproductive healthcare rights especially are important to talk about as it directly impacts us and our bodies. 

My friends and I frequently talk about the news headlines we see on rising healthcare costs for the average American. There are also increasingly many documentaries about how healthcare has become really corporatised — it’s less about patient care but more about how to make money. It has made us realise how privileged and lucky we are that living in San Francisco, we have paid maternity leave coverage and easy access to abortion and contraception. 

In the Bay Area tech companies where I work, I believe that the standard is four months of leave, although it might depend on your situation and how your birthing process goes. However without a standard, you could get up to seven months paid leave or be forced to go back to work within 10 days of giving birth. 

It is so shocking to think that less than two weeks after giving birth, someone could be forced to go back into the office! It’s such a far cry from how the United Kingdom guarantees 39 weeks of paid leave for mothers and Singaporean mothers are entitled to 12 weeks of paid maternity leave. It is extremely tough to be a working mum here, without even considering the high cost of childcare. And it is frustrating to think that the autonomy to decide when we are ready to go back to work is entirely out of our hands because the deciding power completely rests with state governments and companies. 

Abortions in San Francisco only get banned after 24 weeks. However Alabama has banned abortion outright, while states such as Georgia, Kentucky, Ohio and Mississippi have enacted “heartbeat bills”, which ban abortion at six weeks. That’s before most women even know that they are pregnant! 

Living in another state with such stringent abortion laws would make me feel powerless - I have no control over my own personal narrative and life choices. It’s one thing to decide whether or not to have an abortion, but another thing to not even have that as an option. This might not be my reality right now but it definitely makes me wonder what could be. 

Regardless of what and how you feel about abortion being ethically correct or wrong, I think it is important for women to have that choice and that is why I think it is important to speak about this topic.

This month, the Supreme Court is set to hear on a Louisiana case, which will determine whether doctors performing abortions must have admitting privileges at nearby hospitals. If passed, this would mean that abortions can only be carried out by doctors who can hospitalise patients. However it’s very difficult for doctors specialising in abortion to get admitting privileges because they are given out based on factors such as the number of patients doctors admit each year, and doctors specialising in abortion rarely need to hospitalise patients. So if the bill is passed, the number of doctors able to perform abortions will decrease and clinics will shut down, and this won’t even be because they are lacking in medical capabilities. 

When you are a kid, it’s easy to take health for granted and I wasn’t always convinced that I needed a primary healthcare provider. However in the past five years, especially as I think about starting a family, I have started to pay more attention to access to reproductive healthcare and what resources are available to me. Hearing about struggles from friends and acquaintances has made me realise the importance of gynaecology checkups and how getting pregnant isn’t so easy, so I want to educate myself as much as possible on fertility matters. 

Besides, the country’s lack of universal healthcare coverage means I’ve got to pay more attention to not just my job scope and salary but the sort of healthcare insurance that a company provides. 

It’s absolutely problematic because it will curb the progress made by the birth control mandate introduced under the ACA (The Affordable Care Act, otherwise commonly known as “ObamaCare”) when it was enacted in 2010. The birth control mandate made access to contraceptives easier for women because all employers are required to offer contraceptive coverage.

For the last 10 years, it served as an example of how having laws in place at the federal level can benefit women across the country. Having that at the highest level of law was reassuring because it meant there is little chance of companies and individuals of middle-level authority making decisions that are prejudiced against women.

Studies showed that women were able to financially save and better support themselves and their families because of it. Now it’s scary to consider that the progress made might change just because of the current administration's proposals that companies can be exempted on religious or moral grounds.  

Based on my social circle, the sense I get is that reproductive healthcare is more accessible to women living in San Francisco largely because most people here can afford to pay for the resources they need, and are working at companies with good reproductive healthcare coverage. But what happens if you live somewhere else in the US?

Although Planned Parenthood offers free contraception, it shouldn’t be the only resource that women rely on to get contraception. 

Access to abortion is often coupled with religion or politics but I don’t think this should be the case at all.

Affinities to religion are very diverse in the US and to allow companies to make a call on whether they will or will not cover contraception based on it is just another way of discriminating against people with different beliefs. 

This has nothing to do with what is actually beneficial for women, and has everything to do with the administration’s own religious, political and moral values. 

Frankly, it shows a complete lack of understanding about human behaviour as well as willful denial of reality. 

International Women’s Day is an opportunity to celebrate women everywhere and how far we have come. It is also a time to reflect on what more can be done. I still think there needs to be a balance between individual rights and economic growth but for this to happen, we need more women in leadership positions in the government and companies. 

Listening offers a space for conversation and if people can have a productive conversation about a topic as contentious as reproductive healthcare, I think we can slowly start moving towards a world where easy, fair access to reproductive healthcare for women is a reality. 

Pictures by Lillian. 

This story is the third part of a series titled: ‘What gender inequality looks like in my country’. Over four stories, this series aims to shed light on the rights that women are fighting for around the world.

The first story about balancing parenting in Japan can be read here: https://dayre.me/story/f6483a70fc
The second story about what happens to educated women in India can be read here: https://dayre.me/story/0ebd8279d7
The fourth story about why there is such a high standard for beauty in South Korea can be read here: https://dayre.me/story/a10818413b

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