Book Review Lauren Rabaino

8/6/2019 Book Review Lauren Rabaino

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Lauren RabainoDec. 8, 2009WGS 350-70

The book Choice and Coercion by Johanna Schoen is a critical look at the birth control

policies in North Carolina and, more broadly, the United States. Schoen does not only look at

birth control in terms of contraceptives, but also sterilization, abortion, and forced foam powders

and jellies. According to the publisher's Web site, because of Schoen's book, in August 2003,

North Carolina became the first state to offer restitution to victims of state-ordered sterilizations

carried out by its eugenics program between 1929 and 1975 (UNC Press). An overall theme of

this book revolves around the notion that early birth control movements were not conducted for

the freedom and choice of the female, but as conscious decisions to limit reproduction of

undesired sectors of the population based on socioeconomic factors. Her concluding argument is

that coercion as a means of reproduction control is inhumane, unethical and ineffective.

The first chapter of the book is dedicated solely to outlining the history and progression

of birth control adoption at the state level. From its inception, the integration of birth control into

health clinics was a movement led by women -- specifically, women like Lena Hillard who

travelled all of North Carolina giving condoms to women and Margaret Sanger (l.n. 323-34). The

early stages of the movement were about female empowerment, but as men came into the

picture, and began to professionalize birth control in the medical field, the motives shifted to

focus on eugenic and economic concerns (l.n. 335-35). The trend in place is much like the early

professionalization of science: Women take an active role in a field or specialty, men decide to

Schoen, Johanna. Choice and Coercion Birth Control, Sterilization, and Abortion in Public Health and Welfare (Gender and American Culture) .New York: The University of North Carolina, 2005. Print.



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take leadership of said field, then like clockwork, women start to become negatively impacted

because of patriarchal standards that exclude them from the decision-making process. But the

professionalization of birth control did have a positive side: it allowed for a model of widespread

distribution, meaning easy accessibility and inexpensiveness for women.

Schoen argues that women were coerced because of the socioeconomic burden they

brought to the state, rather than for their own, personal well-being. She supports this theory with

a case study involving a young, unmarried woman from a welfare-supported family who was

sterilized after giving birth to a baby. The woman, Nial Cox, was deemed mentally-deficient, not

based on psychological tests, but on the fact that her family relied on welfare and she married out

of wedlock (l.n. 1, 024-29). She was one of more than eight thousand people sterilized in North

Carolina from 1929-1975. This draws upon the gender role themes we looked at in class. Women

were more likely to be seen as "feebleminded" in the eyes of those conducting the sterilization

tests because they had children before marriage and were thus deemed "immature." Yet women

were only stuck in these situations because the role of the woman was to be the child-rearer, so

men often left them to bear the burden alone. Then, men were the ones making the decision to

sterilize the women at a governmental level, thus creating a cycle whereby women have no

power to change the gender role assumptions or defend themselves against judgments of mental

incapability.

Schoen looks at how the illegality of abortions impacted physicians, women, and the

state. In the 18th and 19th centuries, early abortions were not punishable by law (l.n. 1, 891-902).With the commercialization of birth control, women were empowered through easy access and

thus sexual freedom. But Schoen argues that the illegalization of abortions in North Carolina

turned the tables when people started arguing that women would rely on unsafe, back-street



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abortions because the argument shifted from being about reproductive rights to an argument

about medical health (l.n. 1,915-25). Although the health of women is certainly a huge concern,

in the long term, the focus on the reason for abortions is important, too, in shaping political and

personal decisions about the procedure. Much of the evidence in this chapter relies on Schoen's

reading of 24 abortion cases that reached the North Carolina Supreme Court from 1880-1973

(l.n. 1, 962-75). Although this number represents a very small proportion of the total abortions

that happened in that time span of almost 100 years, the stories are first-hand encounters that

give primary details on what women endured. One woman had to get three abortions in her

lifetime: one left her with an infection, another time she had to sex with a doctor before he'd

perform it, and another time ended in sterilization (l.n. 1, 877-90). Schoen's method for this

chapter was to choose the most heart-wrenching of the case studies available, so one has to

interpret them knowing that they're at the worse end of the spectrum and not necessarily

representative of every woman's experience.

The greatest shortcoming of Schoen's book is that it relies so much on the historical

progression of events that she sometimes forgets to make an argument. The order and manner in

which medical developments unraveled are important to the general understanding of her

arguments, but that history shouldn't outweigh her arguments. Her concluding argument is that

coercion is ineffective and that the only way to empower women through reproductive health

choices is by educating them and through "participation in the economic and political lives of

their communities" (l.n. 3, 289-93). Her overarching insights aren't new to me after completingthis WGS class and they’re not new to the general field of women’s studies considering this was

published in 2005, but her insights and information about specific eugenics situations via

coercion were new and valuable to me as a reader.



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The book has had an impact on how North Carolina reflects on its involuntary

sterilization methods of the past, as evidenced by the fact it was the first state to offer restitution.

Other states should follow suite based on the stories and arguments relayed in Schoen's book and

offer restitution in their states. Although that won't even come close to making up for the many

women's lives that were damaged, it's a start.

Word Count: 1,000 exactly!

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Book Review Lauren Rabaino