Being Pro-Choice Isn't Just About Abortion

This article originally appeared on VICE UK.

We're all pro-choice aren't we? All us reasonable people anyway. Not religious extremists or UKIP voters, but everyone else. But while I imagine people reading this probably consider themselves pro-choice, but not everyone knows what the term should really mean.

People talk confidently about choice, but the small print on their "My Body, My Choice" T-shirt often reads: "Some choices only." We are big on " no means no" until the dissenting voice is a woman in labor railing against a caesarean section that doctors say may be best for her baby.

When we move beyond talking about the choice not to be pregnant (valid and important) to a choice within pregnancy (as valid, as important) the message that women should be guardians of what goes on in their uteruses seems to get lost. But whether or not you ever have children, the right to be treated with dignity during pregnancy and birth should matter to you if you're pro-choice.

Why is it that women find themselves treated as second-class citizens across societies? That we can become pregnant and give birth (whether or not we ever do) has been used as the excuse to hold women back and, often, to hold them down for a very long time. The end results of that (discrimination, abuse, control, and societal barriers) stem from our perceived status as wombs with legs. That's why advocating for pregnant women is advocating for every woman—it provides a strong platform on which to insist these barriers are broken down elsewhere.

The violation of human rights during pregnancy and birth is no imaginary first world issue—it's frighteningly real across the world. As ever, those who also endure discrimination because of poverty, race, immigration status, or disability will suffer the most, but a disregard for women's basic humanity binds us all. There are Tanzanian women bleeding to death because they can't pay for the necessary drugs, African-American women dying in childbirth at four times the rate of their white counterparts, and Indigenous Australians being flown hundreds of miles against their wishes to give birth alone.

Less dramatic, but profound for many who experience it, are the everyday failures to obtain consent for invasive procedures in UK maternity units. If you are an undocumented woman in London you may well find yourself chased by bailiffs for the thousands of pounds you owe the NHS for your life-saving caesarean. Or you might decide to give birth alone on the bathroom floor to save yourself from being hounded for money you simply don't have.

It's hard to successfully assert the importance of women's basic human dignity elsewhere—to deal with the numbers who are being raped, having their genitals mutilated, or are unable to choose if and who they marry—if there's a socially acceptable sideline of this rumbling along unchecked in pregnancy and birth.

Take the story of Kelly, a two-time rape victim who was given a vicious, unnecessary, and gratuitously large episiotomy (cut in the perineum) as she repeatedly shouted "no." It's all captured graphically on video here. Despite the video evidence, she has had little success taking legal action. Though you'd be unlikely to find the same thing happening in a UK hospital, Birthrights (the charity I co-chair) surveyed women in 2013 and found that 25 percent of those whose babies were born using forceps felt they hadn't given consent. Forceps are akin to large, metal salad servers in the vagina so, yes—we should definitely be asking first.

If you still can't get worked up about all of this, perhaps the most compelling reason to champion women's reproductive rights collectively rather than selectively is the very real negative impact that a lack of protection of pregnant and birthing women has on our right to abortion.

Human rights are interlinked and interdependent; to protect one we have to stand up for them all. If that sounds like empty rhetoric then consider how, in the US, the anti-abortion movement is making damaging progress every day. So effective are they that activists believe there's a very real chance of abortion becoming illegal in the not-too-distant future. One particularly effective strand of this attack on women has come through what the anti-choicers have realized is a weak link in the reproductive rights chain: the rights of pregnant and birthing women.

By repeatedly pitting mother against fetus outside of the abortion debate they have made huge legal inroads. Women in the US are being arrested, prosecuted, and jailed for stillbirths, for drinking during pregnancy and for trying to end their lives while pregnant. Mentally competent women like Laura Pemberton are being dragged from their homes, while in labor, to have court-ordered caesarean sections. The number of these legal attacks is escalating rapidly and this is no coincidence. Anti-choice judges and prosecutors are pushing cases through deliberately and explicitly because they've realized it furthers an anti-choice cause. A recent case in England around fetal alcohol syndrome had significant involvement from the Pro-Life Research Unit for similar reasons.

Individual women are the initial casualties of these violations, but the stamping on their individual choices eventually impacts on us collectively. That's the thing about reproductive choice: it should belong to the individual and remain outside of the political to-and-fro. There should be an acceptance that, although my choice may well be different from yours, I'm the only person who can make it. Once we start interfering in, dictating to, and punishing women for their choices, choice itself becomes a sharp and dangerous political weapon.

To avoid that we need to stand by women throughout their lives and protect them as they exercise their right to say what happens to their bodies. We need to accept that they might not always make what others think is the right choice but that there is no one else better placed to try.

I've called my book on women's rights in childbirth All That Matters, because a healthy baby is not all that matters. It all matters. We all matter. All the choices matter. And if you don't believe that then please don't call yourself pro-choice.

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All that Matters: Women's Rights in Childbirth is published as an ebook by Guardian Shorts.