My Body, Whose Choice?

It’s time to move past “my body, my choice.” We urgently need health care policy that not only protects reproductive choice but enacts reproductive care.

January 2019 Women’s March in New York City. (Terry Ballard / Wikimedia Commons)

“My body, my choice” implies that “when we own our bodies, we are powerful.” Ownership is power. Power is control. Owning our bodies means we control them, right?

Not necessarily, and that’s okay. Health care should be about care, not ownership.

The idea of “my body, my choice” sets a floor of freedom from external control in reproductive decision-making. But in practice, this rhetoric argues for reproductive rights by asserting ownership. And self-ownership is as inequitably distributed as wealth in the United States.

My research as a philosopher and bioethicist questions a self-ownership approach to reproductive rights activism, which leans on an unjust history of ownership, and fails to acknowledge the care needed to enact reproductive choices. 

Abortion remains legal across the United States. But state, and increasingly, municipal governments are passing controversial laws that Shannon Brewer, the director of Mississippi’s sole abortion clinic, describes as “inherently racist and classist; they keep Black and brown people down.” Perhaps our bodies are ours. But our choices belong to predominately white male legislators, and the Supreme Court which will be hearing a case on Mississippi’s abortion laws in its next term.

“My body, my choice” speaks to a Roe-era approach to reproductive rights: the right to privacy and freedom from external control. Yet all health care—including abortion care—is about much more. 

When I needed an abortion, I had access to time off, a clinic in my community staffed by expert medical providers, enough money to pay upfront for my care and private insurance that reimbursed me as it would for any other medical expense. As a white, middle-class, cisgender woman without student debt and with inherited family wealth, I could literally own—meaning afford—my choice.

Yet many people cannot own the same choice in the same way. 

State restrictions on abortion care cause clinics to close and increase travel distances and costs to get to an abortion provider. They mandate waiting periods requiring people to make multiple visits, increasing lost wages for time spent at or getting to appointments, and costs of travel or child care.

At the federal level, the Hyde Amendment has prohibited federal spending on abortion services for the past 40 years. For millions of people covered by Medicaid, the vast majority of whom are people of color and LGBTQ, health insurance does not cover abortion.

Anti-choice critics argue that abortion care should not be covered like any other medical cost, and restrictions are necessary given disagreement about the ethics of abortion. For others who face the same decision about whether to continue a pregnancy, their moral views may lead them to a different decision.

As a bioethicist, I frequently encounter different opinions about the morality of a variety of medical interventions. Yet we do not deny health coverage to individuals simply because there are ethical disagreements about the permissibility of things like chemotherapy, blood transfusion or organ donation.

Fellow pro-choice advocates might worry that by questioning “my body, my choice” and a core tenant of reproductive rights activism, I am undermining the entire movement. Claiming self-ownership is a powerful and important step in asserting the rights of women and people of color, who were historically excluded from ownership—or owned—and whose reproductive rights have been consistently denied. 

It’s time to move past “my body, my choice.” We urgently need health care policy that not only protects reproductive choice but enacts reproductive care. Whether Roe survives this Supreme Court, the power to protect reproductive rights and enact reproductive justice currently rests with Congress.

President Biden submitted a federal budget without the Hyde Amendment which the House recently passed. Senate must do the same. Two pieces of active legislation before Congress would not only remove harmful and discriminatory restrictions but ensure equitable reproductive access.

The Equal Access to Abortion Coverage in Health Insurance Act would codify the repeal of Hyde and require both public and private health insurance to cover abortion costs as any other medical procedure. The Women’s Health Protection Act would establish the right to abortion in federal legislation and prevent local governments from enacting discriminatory, unjust and illogical legislation to restrict rights to abortion services.

The oppressive history of ownership persists through misogynistic and racist pay gapsracial wealth gaps and disparities in homeownership. We cannot let it also persist in racist and misogynistic wealth gaps when it comes to owning our own bodies. And if we are to truly own our own bodies, we must be able to care for them.

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Elizabeth Lanphier is a moral philosopher and bioethicist working on topics including health care access, feminist philosophy, reproductive rights, pediatric ethics, and mass incarceration. She is an assistant professor at the University of Cincinnati and a non-resident research fellow at the Institute for Philosophy and Public Policy at George Mason University. Follow her on Twitter at @EthicsElizabeth.