Choice Matters: Reproductive Justice and the Availability of VBAC

• In Event: 2156 - Reproductive Control and Decision-Making

Abstract

A Reproductive Justice (RJ) perspective considers the “full spectrum” of reproductive experiences as a continuum in which restrictions on abortion are connected to restrictions of women’s birth choices. This research uses this perspective to analyze the effects of state laws governing reproductive rights on the availability of vaginal birth after cesarean (VBAC) for women with a previous cesarean delivery. The American College of Obstetricians and Gynecologists issued a bulletin that severely restricted VBAC access in June 1999. This study uses multilevel logistic models (MLM) of births to women with a previous cesarean from 1995-2015 to test the proposition that laws governing abortion that prioritize fetal rights over maternal rights also affect the birth choices available to pregnant women who carry their pregnancies to term. The models analyze the effects of state-level reproductive regimes, in the form of laws governing abortion, midwifery, and pregnant women’s drug use, on the probability of VBAC, revealing that VBAC became an issue of reproductive choice after June 1999. The odds of VBAC among mothers with a previous cesarean are unrelated to the reproductive regime prior to June 1999 but restrictions on abortion access were associated with lower odds of VBAC after June 1999, while laws that protect women’s health clinics from violence are associated with a higher probability of VBAC. I argue that restrictions of reproductive freedom limit women’s health options beyond the arena of abortion.

Author

• Louise Marie Roth, University of Arizona