Choice and Coercion: Birth Control, Sterilization, and Abortion in Public Health and Welfare

By Johanna Schoen

University of North Carolina Press, 331 pp., $19.95 (paperback)

On March 11, the United Nations Commission on the Status of Women concluded a two-week session called to revisit the platform of the landmark 1995 women’s conference in Beijing. One of the commission’s final orders of business was to buck the Bush administration by passing a resolution–over the objections of the U.S. delegate–stating that “the neglect of women’s reproductive rights severely limits their opportunities in public and private life.”

And so, as an Associated Press report noted, the “meeting to fight for women’s equality ended as it had begun, with the United States at odds with much of the rest of the world on issues of reproductive health and abortion.”

How does a country in which the right to abortion was ostensibly secured more than 30 years ago still find itself internationally isolated on these issues? The quick answer might be that right-to-lifers are presently holding sway in the White House. But any full answer would also take into account a host of other factors and influences from the country’s present and past.

In her new book, Choice and Coercion, Johanna Schoen digs deep and wide into the history that set the stage for today’s debates about reproductive rights. An assistant professor of history and women’s studies at the University of Iowa, Schoen did her doctoral studies at UNC-Chapel Hill.

In the course of her research at the North Carolina State Archives, Schoen gained access to an extraordinary set of records from the N.C. Eugenics Board, a state panel that approved more than 7,600 surgical sterilizations between 1929 and 1974. Individuals subjected to the procedure were deemed by the board to be “feebleminded,” “moronic,” “delinquent” or “promiscuous,” as the administrative papers put it. Ninety-nine percent were women, and the program disproportionately targeted African Americans.

While weighing how to best share her findings, in 2002 Schoen received a call from a Winston-Salem Journal reporter who was looking into the state’s eugenic sterilizations. She shared her boxes of papers on the program, and the newspaper put a team of reporters on the story.

The result was “Against Their Will: North Carolina’s Sterilization Programs,” a five-part series published in December 2002 that finally forced this hidden history into the open. Gov. Mike Easley was quick to respond to the disclosures, issuing an apology for this “sad and regrettable chapter in the state’s history,” and backing a restitution program for sterilization victims that became law in August 2003. North Carolina, Schoen notes, was the first state in the country to establish such a program.

For all its impact, the newspaper series could only cover so much ground, given space limitations. In Choice and Coercion, Schoen takes a more thorough look at the many and conflicted ways sterilization and other birth control measures evolved. “North Carolina’s record on reproductive health evokes the Jekyll-and-Hyde nature of state involvement in such matters,” she explains.

“Sometimes, methods of reproductive control could offer women greater autonomy. Women gained reproductive control, for example, when state officials began to offer birth control through North Carolina’s public health clinics and when, several decades later, state legislators enacted a voluntary sterilization law and liberalized North Carolina’s abortion law. But birth control, sterilization, and abortion found legislative support partly because supporters used eugenic rhetoric and arguments for population control to promote them. Women lost reproductive autonomy when social workers threatened pregnant women on welfare with sterilization and attempted to tie offers of financial help to the use of contraceptives.”

For all her familiarity with these issues in this state, Schoen expands her study far outside of North Carolina to compare the experiences of women in other locales, from Florida to New York, from Puerto Rico to India. Along the way, she builds a useful framework for understanding why, despite much progress over the years at home and abroad, “poor women’s ability to exercise their reproductive rights remains under constant attack.”

Schoen will discuss Choice and Coercion Friday, April 1, 7 p.m. at the Regulator Bookshop in Durham, and Tuesday, April 5, 3:30 p.m. at the Bull’s Head Bookshop on the UNC Campus.