Sex and the Single Woman Peace Corps Volunteer: No Equity

256px-US-PeaceCorps-Logo.svgThirty-one years ago, my former husband Tim and I did what thousands of (mostly) young Americans have done every year since 1961: We set off as Peace Corps volunteers. Unlike most, we had the added adventure of becoming parents while on assignment.

Throughout my pregnancy, I had assistance from a supportive Peace Corps network. I was married and had an “acceptable” pregnancy. But things would have been very different—then and to this day—if I had been single or had wanted an abortion.

Peace Corps is a model for international volunteer programs, in part due to the emphasis it places on volunteers’ health. From the moment we arrived in Tunisia, Peace Corps staff made sure we had regular check-ups and  knew to contact the Peace Corps nurse if anything went wrong. Indeed, several months into our placement, Tim was diagnosed with acute appendicitis and had emergency surgery in an excellent private hospital. Even though we were living in spartan quarters in the market town of Siliana—hardly more than a wide, dusty spot in the road—we received the same health services as diplomats in the capital, Tunis.

Peace Corps’ emphasis on good health also extended to sex. Condoms and other birth control methods were readily available, and we were encouraged to use them. But underlying this openness about sexual health was a clear message that pregnancy was not considered an acceptable condition for an unmarried volunteer. Single motherhood was not an image that Peace Corps wanted to broadcast. Only in a few countries could a volunteer stay if she became pregnant. There had to be high-quality medical facilities available and she had to be in good standing: good health, stable placement, stable marriage. Anything less and a pregnant woman was sent home.

Katie Early One

The author with baby Meghan

Tim and I were considered model volunteers; he worked in dairy production and I was an extension worker in beekeeping. We enjoyed our work, felt we were gaining as much as we were giving and had a good relationship with Peace Corps staff.  Even though our pregnancy wasn’t perfectly timed, Tim and I wanted to stay in Tunisia. My assignment was changed so that I didn’t spend so much time walking the hills in my rural extension job, and toward the end of my pregnancy we moved closer to Tunis so I could be near my obstetrician.

When I delivered our beautiful girl, Meghan, it was in a modern hospital with expert medical staff.

But I was, and remain, acutely aware that I had an “acceptable” pregnancy. Volunteers facing an unplanned pregnancy were and are still treated very differently. Unmarried women who want to go through with their pregnancy are required to leave their post. And whether married or single, women who seek an abortion are flown to the U.S. on the pretense of medical need. They are left to arrange and pay for the procedure on their own, then return to their post as if nothing happened.

Volunteers are governed by a law passed in 1979 that prohibits Peace Corps from covering abortion care for volunteers (but not staff) for any reason. In 34 years, nothing has changed. Two things gall me about this.

First, there’s the silence imposed on a woman’s unplanned pregnancy and decision to seek an abortion. This silence, judgment and temporary exclusion from service is abortion stigma, and it can have devastating effects on women. They may delay seeking abortion care, thus forcing them to have a more difficult or expensive procedure, or they may seek a clandestine, unsafe procedure rather than confess the pregnancy.

Katie Early

The author at her daughter’s wedding

I’m also upset by the blatant hypocrisy of this policy. While Peace Corps will cover every other medical need a volunteer might have, it won’t extend that coverage to abortion—not even if a woman’s life or health are in danger or if she has been a victim of rape—a significant risk for women volunteers who often live in rural and conservative communities. The law is not only hypocritical, it’s discriminatory: It only affects women, who make up 60 percent of Peace Corps volunteers. Virtually all other women who have federal health coverage—including federal employees [pdf], women enrolled in Medicaid [pdf] or women in the military—abortion is at least covered in cases of rape, incest and life endangerment.

Earlier this year, the late Sen. Frank Lautenberg (D-N.J.), a champion for reproductive rights throughout his long career, introduced the Peace Corps Equity Act, legislation that would begin to balance the scales for women in Peace Corps. Following his death, Sen. Jeanne Shaheen (D-N.H.) stepped in to carry on his work, standing up for Peace Corps volunteers just as she stood up for women in the military last year with similar legislation. Thanks to their leadership, the Foreign Operations Appropriations bill contains language that will ensure that Peace Corps volunteers have the same rights as other women under federal health plans.

This summer I was thrilled to walk my beautiful baby—now an intelligent and stunning 29-year old woman—down the aisle at her wedding. I am grateful for all the support that Peace Corps gave Tim and me to bring her into this world. All women should have that support when faced with decisions about pregnancy, whatever their outcome.

Please join me in showing support for women in the Peace Corps by signing this petition so that we can bring an end to this inequity!

Read more Ms. Blog coverage on this issue here.

Peace Corps logo from Wikimedia Commons

IPAS_EarlyK_LThumbKatie Early is Director of Development at Ipas, an international reproductive health organization based in Chapel Hill, N.C.

Comments

  1. Trisha Gensic says:

    Interestingly enough, Katie, as an even earlier volunteer (40 years ago / Afghanistan), during our orientation/training in-country we were told that (I’ll never forget the wording) “all pregnancies will be terminated”. When asked if they were talking about the volunteer or the child they just smirked. All things considered, I guess they’ve creeped along, eh?

  2. Patricia Jensen says:

    Interesting. I will bet they provide erectile dysfunction drugs for ALL men (single, married, other) WHILE they discriminate against women.

    • I can tell you my PC office did not supply any erectile dysfunction drugs that I am aware of, and that was only 3 years ago. We could get condoms if we wanted and I believe the female volunteers could get birth control pills but that was about it. So rest assured that your tax dollars were not being spent on erectile dysfunction drugs for volunteers, nor did I see either of our Peace Corps doctors (both female) discriminate against any volunteers based on their gender.

  3. Peace Corps Indonesia gives you a choice: abortion or termination (though you leave in good standing). However, this is for married and unmarried couples. I’m wondering if this is a worldwide change, or if there is just a threat to the fetus specifically in this country.

  4. Patricia: They do not. It was one of the first joke questions that came up in my training group. You sign a waiver when you sign your contract that basically says you are willing to go to a hardship area that means if you want it that bad- order it off the internet or have someone in the U.S send it to you or don’t come\go home.

  5. Joyce Matthews says:

    I served in Ukraine 03-05, and I am usually an ardent supporter of the Peace Corps. I had a wonderful, mostly positive experience. That said, I did gripe about this very same thing to anyone who would listen during my service (when I first heard the policy). I felt it was extremely unfair for all of the reasons you mention in your piece, but also because the stigma on single parentage and the related proscriptions didn’t apply to male volunteers. My understanding of the rule was/is that if an unwed male PCV impregnated a woman in country during his service — whether a fellow PCV or a host country national — he was not sent home or otherwise penalized/stigmatized in any way. Additionally, I don’t recall there being any possible way for an unwed and pregnant PCV to remain in country once her baby was born. These archaic policies impose value judgements on women volunteers and warrant review and revision by the powers that be.

  6. double_sigh says:

    When I was in Peace Corps (’98-’00) there was no difference between how single women and married women were treated. If you got pregnant you either had an abortion or were medically separated. No one – married or single – is allowed to carry a baby to term in country. Husbands have the choice to continue their service or to Early Terminate (most choose the following option).

    There is a part of me that feels that the policy is unfair, but I understand the Peace Corps not wanting to take on the liability of newborns in the field. I also understand that since abortion is such a hot topic item that the federal government just can’t pay for it. I just don’t see what Peace Corps could do differently – there’s no way they could pay for the abortion in the current political environment (or any political environment in the last few decades) nor can they have women giving birth in the field. I just don’t see what you think they should do.

  7. Wow – talk about uninformed. The PC Manual, which is available as a public record, has a specific section on Volunteer pregancy, including what is the criteria for allowing a pregnant Volunteer to continue service. There is no language (or distinction) on whether the Volunteer is married or not. So, the statement from the author that unmarried pregnant women are required to leave post is patently false. As an agency, the PC has policies and regulations in place that are designed to protect the mother and child. If people have been told otherwise, then it was an individual (idiotic) staff member’s fault and not the agency. Sorry for your experience(s) but projecting this on PC as a whole is ignorant, deceptive, and unproductive.

    4.0 Procedures to Determine Whether a V/T May Continue Service
    4.1 Medical Approval
    In order for a pregnant V/T to continue service, the PCMO, in consultation with OMS, must determine that:
    (a) Health facilities in-country are adequate for the delivery, given the V/T’s general health and any potential complications;
    (b) Host country facilities are adequate for prenatal, obstetric, postnatal, and infant care according to the OMS Technical Guidelines; and
    (c) The V/T’s project location presents no health hazards that would prevent the V/T from remaining there during pregnancy or after the birth of a child, or, if hazards do exist, an in-country transfer to a safer location is feasible.
    4.2 Programmatic Approval
    To determine whether the pregnant V/T may continue in service, the CD shall determine that the V/T will be able to continue to serve effectively after the birth of the child.

  8. I’m currently serving as a PCV in Africa and in my country of service (and I believe all pc programs) women are not allowed to continue peace corps service if they are pregnant. If one becomes pregnant, she is med–evacuated to the US where she has some choices. She can return to her home of record and carry out the pregnancy or she can choose to terminate the pregnancy (and either return to service or return to her home of record). If she chooses the former, Peace Corps will pay for her medical costs due to the pregnancy, but not for the baby’s health care costs. If she chooses the latter, she must pay for the abortion, but will have access to counseling services through peace corps. She can withdraw money from her readjustment allowance to pay for the abortion.

    Personally, I’m okay with the Peace Corps policy that requires pregnant women, married or single, to return to the states. Even in a relatively developed african country (like the one where I live), accessing the BEST healthcare available, the quality of care that we receive is still far, far, far behind the kind of care we would receive in the states. Our medical officers are very competent and can handle routine issues well; but, many more complicated or serious medical conditions cannot be adequately addressed in-country. In addition to pregnancy, volunteers flown to America (or South Africa) for orthopedic surgery to repair broken bones, neurological issues, even for complicated dental repairs.

    I get the it’s not fair argument, where men are not as accountable as women for the pregnancies that they cause. I will say that in this country, all the men were warned that they will be financially responsible for any children they father while here (at least it’s something). From the PC perspective, I think the termination of service for women and not for men is less a punitive issue than a medical issue. The woman is removed from the developing country because Peace Corps cannot continue to promise acceptable medical care in-country. As the man does not personally have a change in medical needs, he is not removed from country.

    I am totally on-board with the fact that Peace Corps should pay for pregnancy termination, at least in a way that is equitable with the coverage other federal employees receive. The author is right. We are at much greater risk for rape in many of our countries of service. Even with adequate access to birth control, sometimes there are things outside of our control.

  9. I could be wrong, but I thought in Malawi in 89-91 you could go home and have an abortion and return. You could not stay and carry to term.

    • I am a Medical Officer for the Foreign Service and was also a Peace Corps Volunteer in Nepal (1979-1981). The rule then, as it likely is now, is that volunteers that became pregnant had to either separate or terminate the pregnancy in order to remain overseas as a volunteer. As a Medical Provider I totally understand this. Peace Corps is not equipped to cover the medical needs of children and/or pregnant women. Many of the Health Care providers have not been trained in those skills and do not really need them to become Peace Corps Medical Officers. And what about the liability? What if a child has significant needs due to a congenital problem? Could the parents say that this would not have occurred had they not been overseas and thus the USG is liable for payment of damages? It is just a big can of worms and the easiest way to deal with it is to disallow it. When I was a volunteer they DID pay for terminations. Not sure what they are doing in the post-GW Bush days. I think that policy may have ended though. I am glad they are cracking down on male volunteers having to pay for the children they spawn in-country! What an embarrassment. When I was a volunteer, someone who had impregnated a local woman would have been given “the Pan Am Award” and sent home with an expectation to pony up for all of the expenses. Not so sure how this was enforced but it didn’t happen when I was there…..
      Good discussion! M

  10. My understanding when I was in (Jamaica, 2001-2004) was that even a married couple who became pregnant would be medically separated because there was not enough money in the PC budget to cover dependents and health care expenses incurred during birth. However, as Joyce pointed out, a male who impregnated a woman who was not looking for PC to cover the cost of a child (typically, a host country national) would not be required to leave his post, only women (married or not) who chose to continue the pregnancy would be separated. While I realized that PC would not cover the cost of an elective abortion due to an undesired pregnancy, I did not realize they would not cover a pregnancy that was a result of a rape or which was medically necessary for the health of the pregnant woman. That is absurd!

    Thank you for sharing this story and a link in which we women RPCVs can support the next generation of women to join PC.

  11. My understanding was that if an unwed male Peace Corps volunteer got someone pregnant, Peace Corps would even help cover medical expenses for the mother in that situation.

  12. The lack of abortion coverage is something that always fried me as a PCV in Guatemala.

    It would be good to clarify that current policy states that any pregnant PCV (married or unmarried) *may* continue to serve if medically approved. (At least in Guatemala they emphasized this was extremely unlikely to happen and I know a married couple that got pregnant and was terminated, though they did want to leave.) There is no official comment as to whether the marriage status of the PCV affects this, but I am not sure how that works in practice – I would guess that all things equal, marriage would favor those women who petition to stay. This probably happens too infrequently to really judge though. Married women are also denied abortion coverage of course.

    Prenatal and obstetric care may be approved should the pregnant volunteer remain in country – same as for the non-volunteer partner of a volunteer . All children born during a volunteer’s service will receive health coverage until the volunteer finishes, as well. And a return flight to the US with their parent(s), apparently! I’m curious how often pregnant volunteers have actually been able to stay in country, though, in the last few years… I would guess very little.

    Source: http://files.peacecorps.gov/manuals/manual/200_Volunteers/260-269_Trainee_and_Volunteer_Medical_Support/MS_263/Volunteer_Pregnancy.pdf

  13. Thanks for sharing your experience. As a currently serving pregnant PCV I can tell you that there have been several changes just in the last year that affect ALL currently serving volunteers with regards to pregnancy. As JT wrote, it depends on where your site is, your health, and if you can get easy access to quality healthcare but you CAN continue to serve as I am. There is no distinction between married or unmarried volunteers and in my country of service there have been pregnant volunteers who are in both categories. It is also true that male volunteers who impregnate a non-volunteer will have their medical care mostly taken care of regardless if they decide to stay together.

    I can only speak about my own experience but I have continued to feel extremely supported and the staff here have listened to all of my concerns and made all sorts of accommodations for me. I realize how very lucky I am!

    I recently read an eye-opening story on Peace Corps Worldwide that sheds light on the intentions of the first PC Administration. Seems that Betty Harris was a HUGE advocate for women to decide if they wanted to continue to serve while pregnant regardless of their circumstances. An excerpt from the story of how Betty convinced Sargent Shriver to allow women the right to choose:

    ““I went in screaming over this one. I screamed to everyone. I could scream to, including Sarge, saying that the one thing that all women in all countries have in common was childbirth, and if we really want to insult these countries-to say, in effect, that your country’s so dirty that this healthy, nutritional American woman cannot bear a child there-if you really want to insult them, fellas, this is the way to do it.”

    Read the whole story here:
    http://peacecorpsworldwide.org/babbles/2010/03/30/mad-woman-part-four/

    I feel fortunate that the tide is changing and hopefully one day PC will support all the rights of women to choose…

  14. I got pregnant while serving in the Peace Corps around two years ago. I was single and the father was another PCV. What PCV Meredith said is what the books say should and will be done. That is not the case. From my experience Peace Corps main focus was to get me out of the country and shut me up. There was no payment of medical expenses or anything of the sort. I was highly disappointed in how the whole situation went about and the huge difference between treatment of myself and the male PCV. There could definitely be changes made in that area.

  15. The lady is trying to impose her own culture and mores upon ANOTHER COUNTRY. Americans have their own ideals about abortion and unwed mothers. The majority of developing countries I’ve worked in have cultures that denounce single motherhood mainly for religious but often financial reasons. (Her poverty-stricken family has to support her if the child’s father won’t or can’t.) The stigma is very difficult to bear. People of other countries should not have to deal with a single, “in-your-face” pregnant American woman in a position of power (medical) when their culture denounces such.

  16. Seems like a liability issue. Pregnant workers are fired and allowed to re apply after medical assessment. If Peace Corps is willing to treat the medical condition, they are willing to allow the normal outcome and insure it. aThat’s until the outcome is 18. They are also allowing to accomodate the medical condition throughout service and application. The best analogy is welfare, HHS, where all Peace Corps workers actually are placed in the US, due to income, so welfare recipients can have children like anyone else, increasing income and living conditions as would be in Peace Corps. Peace Corps ‘brats’ like military ‘brats.’ Tradition of families. It makes sense to cover the condition like everyone else. Peace Corps workers alteady cost $60,000 + a year, each……..

    We also cant project our way of living onto host countries as neocolonialist civil law, society changers as the Acting Ditector has with her recent tenure. For exsmple, typrs of couples or partners identified bt Peace Corps by required affidavit are not allowed to apply or serve in countries Peace Corps has blacklisted (the countries cant even take the applicatiins) for non compliance with US and Peace Corps laws and policy. Peace Corps needs to consider its affect before arbitrarily changing laws and policies. It all just seems like a politician’s special interests agenda being forced on the world with penalties and possible punitive damages, like aid reductions.

  17. “Virtually all other women who have federal health coverage—including federal employees [pdf], women enrolled in Medicaid [pdf] or women in the military—abortion is at least covered in cases of rape, incest and life endangerment.”

    Did Roe V. Wade get overturned or something? If I’m understanding this statement correctly, if the Peace Corps get government funding of some kind like the military I don’t know why the Peace Corps couldn’t have the same standards regarding abortion when it comes to rape, incest, or when the women’s life is in danger. Reproductive health is a part of women’s health (as much as ‘certain’ people would like to turn a blind eye to that). So women’s well-being doesn’t matter as much as men’s well-being? Promoting patriarchal bias & actions has to be anything but ‘peaceful’ or ‘American’ (That American Flag on that Peace Corps’ Symbol is a LIE!).

    “Volunteers are governed by a law passed in 1979 that prohibits Peace Corps from covering abortion care for volunteers (but not staff) for any reason. In 34 years, nothing has changed. Two things gall me about this.”

    BUT being a volunteer & not a ‘staff member’ I guess I can see how there can be certain different treatment like a 1st class citizen & a 2nd class citizen. As much as women hate to admit it, Women ARE at more risk overseas than men because of the whole ‘rape,’ unintended pregnancy thing. With absolutely no equalizer to women with that & for men who impregnate other women (volunteer or other) also not being treated as bad as the impregnated women (volunteer or other) if not worse (I think impregnating men cause much more damage than impregnated women ever could), I’m more shocked than surprised women would volunteer to these programs at all. “Screw the world that screws women” is the only message I’m getting from the Peace Corps if what this article says is true.

  18. This is interesting. All my life, I dreamed of becoming a Peace Corps volunteer. It was my plan when I finished college. But I got pregnant my sophomore year, and I have up that dream.

  19. “While Peace Corps will cover every other medical need a volunteer might have, it won’t extend that coverage to abortion—not even if a woman’s life or health are in danger or if she has been a victim of rape—a significant risk for women volunteers who often live in rural and conservative communities.” I feel I must disagree somewhat with this one statement; I was assigned to a very rural & conservative community in west Africa during my service, and I never felt I was at “significant risk” for rape or that my life/health was in danger in my village. I did feel less safe in the capital/bigger cities. I feel that’s somewhat of a sweeping statement that could possibly deter future possible volunteers from considering that what is for most very rewarding service. Thanks.

  20. This chain of comments is fascinating in the variety of experience and perception of policy and practice.

  21. PC Azerbaijan has a blanket rule that all PCVs who are pregnant should return home in good standing. Since health care is not the best quality there, they feel that prenatal care and any medical care for pregnant women should be done state side. I think at least make it everyone, or no one. That way it’s not hypocritical.

  22. I’m looking into going into the peace corps and I was wondering if my girl friend and I join together if we would be allowed to live and sleep together? Will somebody let me know if there is a rule against that. Thank you

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