Rethinking feminism: Poverty and health care

Guest post by Aspazia of Mad Melancholic Feminista

(Ed. note: I'm extremely pleased to welcome Aspazia to The Reaction as a new guest blogger. Aspazia, who writes a wonderful blog called Mad Melancholic Feminista, is, by her own admission, a philosophy professor in rural Pennsylvania and a feminist activist. Indeed, her blog offers "a feminist analysis of what it means to live in the Prozac Nation". Intriguing, no? Aspazia is an excellent writer, and, whether she's addressing present-day issues like poverty and health care within a feminist framework, as in this post, or defending her beloved Continental philosophy against its critics (see here), her blogging consists of what I would call thought-posts. I encourage you to take the time to read this one, the first of what I hope will be many here. And I encourage you to check out Mad Melancholic Feminista regularly. -- MJWS)

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I imagine that over the next few weeks I will be exploring what I think are the challenges for feminists in this new century. This past year I have devoted a lot of time to rethinking not only what feminists need to do politically, but also how Women's Studies programs need to change to remain relevant to this generation of students we are teaching. I don't yet have a plan for how I will be addressing these issues in my posts, but today I will focus on health care, reproductive rights, and poverty.

A month ago, I decided to transfer all of my OBGYN care to Planned Parenthood. I want Planned Parenthood to get my money and continue to stay in business in this small county, and so I gave up some of my privilege to basically attend a free clinic to get my yearly exams and birth control. I am not going to pretend that this has been an easy decision, or that I don’t consider switching back to the clean, sparkling, and less crowded office of my old gynecologist.

Sitting in the waiting room of Planned Parenthood, when you have never had to spend time in such a setting for health care, is unsettling. I had an appointment at 4, and didn’t get into see the nurse practitioner until 6. Furthermore, the waiting room is rather dingy, with dilapidated furniture, low lighting, and packed with all the residents in my county that I would never have occasion to meet, talk to, or spend time with. Planned Parenthood is one of the most popular providers to the migrant population here. They do not perform any abortions at our clinic site, but rather spend a lot of time offering affordable health care to men and women in Adams County. Half of the patients sitting with me in the waiting room spoke no English, a third were young girls who already had children or feared they were pregnant, and the last third were men.

I sat in my chair, listening to the conversations around me, mainly teenage girls with dead-end jobs, and two children, talking about their loser boyfriends who drank too much and didn’t help out with the kids. These young women were the age of many of my students, but clearly were never encouraged to attend college, especially the private college where I teach. These women were poor: they were raised in poverty and likely to continue the cycle. They had probably dropped out of high school once they got pregnant, and were now likely to raise their kids in the same environment they grew up in. Almost all of these young women were church going folk, and none of them were self-proclaimed feminists. They were at Planned Parenthood because that was the only health care provider they could afford. Moreover, they were likely to be treated with some dignity there. At least two young women, perhaps students at my college, came in to get birth control and the difference between them and these young mothers was stark. In fact, these young mothers shot angry glances at the well dressed, blonde, bejeweled, young, college women coming in for pills, especially when one was sweetly playing with one mother's little boy.

When I finally got in to see the nurse practitioner, the first question she asked me was why I was coming here to get my pap smear. "For solidarity," I said. She lit up, patted my back, and then proceeded with my exam. She apologized for the wait, and I dismissed it as no big deal. Of course, I hated it, but I was trying to consciously question my economic and race privilege and thereby force myself to live what I teach my students. I ask my students to work in agencies like Planned Parenthood, with this population of local residents almost every year, and yet, I don’t put myself in the same situation I ask my students to be in. So, this was "putting my money where my mouth is".

The health care, however, was excellent. Having a feminist nurse practitioner talk to me about the negative reactions I might have to the form of birth control I use (the Nuva-Ring) was amazing. No other doctor had taken the time to go over all of these issues with me in such detail before. She was also human; she seemed interested in my life, my goals, and my health. While my other gynecologist was efficient and had a pristine office setting, he had never talked to me for more than 5 minutes before.

I have chewed on this experience for over a month, and wanted to write about it to start thinking more about what I think should be the priority issues for feminists in this day and age. And, while having the right to control one’s fertility is paramount, I also think that we should be striving in general for better health care information and access for all of our citizens.

While I have participated in or read numerous debates on health care all over the blogosphere, at dinner parties, or with my students, nothing will ever bring this point home to you until you put yourself in the same situation as the poor in our country. If you are someone who argues that we should set up "medical savings accounts" or that we should pass more of the cost of insurance onto the “consumer” rather than the employer, then sit for a few hours in a clinic or hospital E.R. room and pay attention to the kind of health care available to the poor in this country. You don’t have to go to Guatemala on a church missionary trip or volunteer with Doctors Without Borders to see what crushing poverty does to the self-esteem and thereby future life chances of people. That kind of crushing poverty is right here in our communities.

Young girls and boys grow up without any well care visits, without the nutrition they need, and for certain, without any knowledge of their bodies. If you add on top of that school programs, targeting precisely this population -- which is lower income White, African-American, Latino, and around here a Russian immigrants -- with the misinformation of abstinence only programs, you are guaranteeing an even harder life for these folks. Rather than being treated with the same dignity that many of us can expect due to health insurance, middle class income, and white privilege, these young children grow up being reminded daily that no one cares about them: whether that be their neighbors, their government, their educators, their physicians (if they even have any), or their employers.

Just sitting in a depressing waiting room of a health clinic (let me note, however, that thanks to Kate Michelman, Planned Parenthood does a reasonably good job creating settings that enable their patients to feel they are being treated with dignity more than other clinic providers) gives you a sense of what these children grow up expecting about how life is, how others will treat them, and what they deserve. It doesn’t look good.

Sure, I am bound to hear from commenters, and perhaps from some of my former students, who will give me a lecture on "personal responsibility". Fine, you know what, I support and embrace "personal responsibility," too. But where I part company with many of the personal responsibility crowd is that I recognize that much of what we have, who we are, and where we are going has been the product of others who have invested in us, cared about us, and given us the opportunity to see a bright future. While I could go on and on judging these young women for getting pregnant so young, or the young men who irresponsibly impregnated them, and for all of them giving up on a better future, what exactly would I be accomplishing?

The fact is that these young women and young men need our attention, our resources, and a sense that we give a damn about them as much as we do children born to the kind of privilege that I was born into. Yes, ultimately, we are the product of many choices that we made. But, to make good choices in life, you need good information, you need to be given a sense that you matter or that you have value. Churches are certainly places well equipped to do the latter work. And, thank goodness many churches do actually fulfill Jesus’ mission to care for the poorest among us. But many other "Christians" in this day and age would rather blame the victim, and deny them the help they need, justifying this behavior by calling these young people "sinners" or "wicked". Certainly this rhetoric is a helpful way to blind us from our own complicity in their poverty.

I started this with the intention of tying this into what I think the future of feminism should look like. And my bottom line here is that feminists need to care about poverty (and believe me, I know that many of us do). They don’t just need to care about poor women, or the poor women who have had to degrade themselves by becoming "exotic dancers" or who have been raped or molested. Certainly we do need to care about these women. But we need to reach out and work with those who we might have dismissed in the past as "the patriarchy" or "conservatives" to fight the poverty that is right in our backyards and likely to turn our "1st World Nation" into a populace that is simply not literate enough to maintain a democracy.

We need to invest in all of our citizens, and fight the labels, rhetoric, and bigotry that justify our continued mistreatment of the poor. Perhaps more of us need to give up some of our privileges in order to ensure that more of us get the basics. We need to be open to all solutions for getting good health care to every citizen, and not allow partisan bickering to divide us. I know that we can transcend politics, especially if we start in our local communities.

The risk here for many feminists is that we would be neglecting the specific agenda already laid out. But, I am sorry, I just don’t believe that feminist politics -- whether we are talking about NOW or Feminist Majority -- are going to be effective until they give up the old paradigms, and the old political rhetoric, and start attracting more men and women to participate in their activism.

We may need to rethink how we sell our message, what we call ourselves in the public realm, and how we frame our issues. If we don’t do this, we are simply inefficacious. We are sacrificing good works for purity of message.