A Pro-Choice To-Do List For the New Decade

2009 ended with every writer under the sun reviewing the past decade: the best, the worst, the bizarre. I guess we as a world are going to ignore the fact that there was no year "0" and pretend that this means that 2010 is the beginning of a brand new decade. And who am I to buck popular will on what is fundamentally an irrelevant question? Since this is the start of a new decade, I'd like to take the time to look forward towards the next 10 years in the struggle for reproductive rights and justice.

After all, the past decade was a pretty bleak one. The pro-choice movement didn't advance the ball down the field, and even our defensive maneuvers didn't work so well at times. We rounded out the decade taking a timid position on health care reform in hopes that things wouldn't get worse, and unfortunately it looks like they will. But if we stop playing not to lose and start playing to win, I suspect we might send the right wing into retreat and actually gain ground in improving women's lives and the sexual health of a nation.

With that in mind, here's my wish list of things the pro-choice movement should set out to do in the next 10 years. And I mean set out to do, not just pay lip service to.

Repeal the Hyde Amendment. The health care reform debate demonstrated that standing on the ground we've already lost doesn't do us a bit of good. Pro-choicers should have demanded that health care reform include abortion funding for everyone covered by the federal government who is currently cut out of the loop -- including federal employees, Medicaid recipients, and our veterans -- but instead we just asked for the status quo. The result was the Stupak-Pitts amendment and the potential for women on private insurance to lose abortion coverage. Obviously, timidity doesn't work.

More importantly, the pro-choice movement needs to stand for justice. The way that Medicaid recipients and soldiers are left financially abandoned when seeking abortion is a travesty of justice, and it's not enough to simply complain about it. We need to start taking action to pressure legislators to repeal the Hyde amendment, and create the public will to do so.

Institute comprehensive sex education in all public schools. Abstinence-only is a zombie that keeps coming alive, and we keep valiantly fighting to kill it. But getting rid of abstinence-only -- with its retrograde attitudes towards gender, homophobia, and blatant lies -- is not enough. We need to demand that our kids get real sex education that will help them make healthy choices while also respecting their autonomy and individuality.

Address the shortage of abortion providers. We all know the drill: the average age of an abortion provider in this country is soaring upwards, and many doctors who deserve to retire and spend their days playing golf stay in the business because there's so many women who need abortions and so few people to provide them. Few counties have abortion providers, and many women have to travel hundreds, sometimes thousands of miles to get one. And it's because younger doctors don't want to perform abortions. They don't have any memories of the horrors of septic abortions (unlike many older doctors), and the harassment they face if they join up seems like too much trouble.

The problem is complex, but not unfixable. We should lobby for stronger protections for abortion clinic workers, so that fear doesn't drive would-be providers away. More importantly, we need to find a way to get people with the right attitudes and the right skills into the business. Programs encouraging bright, young pro-choice people into medical school to train as ob-gyns who perform abortions is a good start. Pushing medical schools not only to teach the procedures for abortion, but also to highlight the dangers of self-abortion would also help. Perhaps a scholarship program for medical students who train to be abortion providers, or a debt forgiveness program for those doctors that provide abortion? There are endless possibilities, and we should undertake them.

Reduce the unintended pregnancy rate. Bluntly put, the provider shortage is a matter of not just too little supply but also too much demand. As a nation, we have way more unintended pregnancies than we should, because we as a nation aren't using contraception as much or as effectively as we could. Luckily, this is a fight that we are already fighting, right now by extensively researching why it is that contraception intentions so often fail.

Getting people to a place where they can and will use contraception more effectively when they don't want pregnancy will be an enormous task. A lot of it will require cultural shifts, mainly getting past hang-ups about sex that cause people to feel that preparing is "slutty," and moving towards a culture where having a child is seen more as an active choice and not so much something that just happens to you. It will require a culture where women are empowered to demand that their male partners take their health and desires into account, where condoms are just a sign of respect and not some emasculating bummer. But we shouldn't fear that this is too much to take on; the feminist movement has produced remarkable changes in a short period of time before, and we can do it again.

Dramatically reduce the STD transmission rate. The same sort of cultural and economic changes that will help lead to lower rates of unintended pregnancy will help result in fewer STD transmissions. More openness, less shame, more backbone in the bedroom-all of these things make it easier to use condoms every time, get tested regularly, and get treated as soon as you exhibit symptoms, all of which are factors in reducing the transmission rate.

These are just some ideas for a 10-year pro-choice agenda to move the ball down the field. The comment section is open; I'm interested in hearing what you want to see made priorities and what should be done to reach those goals.