Coming to an art house near you this weekend is the documentary Birthright: A War Story.  It is directed by award-winning journalist and filmmaker Civia Tamarkin, and co-written and produced by award-winning filmmaker Luchina Fisher.  Why do we need another documentary on what seems to be about the pro-life verses pro-choice argument?  Tamarkin, when I spoke to her, said she had set out to make the “Inconvenient Truth of Reproductive Rights”. Based on information in the film, it is very much needed. Birthright aims to expose just how much more is at stake in terms of reproductive rights than abortion, and does so to such a degree that it borders on terrifying, even for those well-versed in the subject. It makes clear how attempts by the religious right to chip away at Roe v Wade, under the guise of fetal rights and what is put forth with the label  “personhood”, are creating an ever more dangerous environment for all women, regardless of political affiliation.

The main question posed by the film is why, if the vast majority of the public supports a woman’s right to choose and Roe v Wade remaining in place, are states around the country passing laws making it nearly impossible to end a pregnancy safely?  Why are they putting more limits on women making their own decisions about care during pregnancy and childbirth?

Director Tamarkin includes interviews with advocates on both sides of the issue.  Women are profiled who have had experiences that highlight the changes happening across the country putting the safety and wellbeing of women at risk. Birthright: A War Story depends heavily on these first-hand accounts that includes a variety of economic situations and ethnicities. These are stories in which women’s rights were placed beneath the rights of their fetuses, even when they themselves were in imminent danger of death.

Particularly shocking and eye-opening is one scene with casual interviews of young women being asked to define Roe v. Wade. None of those questioned knew the answer.  Several say it is some sort of legislation passed a long time ago that has little bearing on the present.  They couldn’t be more wrong.  Additionally, many interviewed were women of color.  The reproductive justice movement is about protecting all women, as women of color and poor women are further marginalized by the expansion of restrictions.  One woman featured talks about the fact that to end her pregnancy, she would have to go several states away, and it would cost thousands of dollars. It’s no exaggeration to say we are headed back to a time when women without financial means will resort to making the sorts of life-threatening choices best left in the past.  This country has one of the highest birth-related mortality rates of any developed country, and these state-based law changes will only make that worse, although the right-to-life advocates don’t say that.  Though they position themselves now as focusing on women’s health, they are really only representing fetal rights, which they inadvertently or not, are placing above the mother through the language of the laws. President of the National Right to Life Committee Carol Tobias, who is a significant contributor to the film, says so directly and unapologetically.

Tamarkin clearly shows that complacency and trust in federal and state laws where keeping women safe is of the highest priority when pregnant has led us to an alarming place for all women. We are once again made secondary citizens, this time to an unborn fetus.   One story shared is of a woman who is against abortion, but wanted natural birth. She was first told to either get a C-section or leave the hospital, and was subsequently given a cesarean without her consent, which led to complications.  It isn’t just women who declare themselves pro-choice with their rights at stake.

Did you know the Catholic church is buying up hospitals, and changing the policies about pregnant and sexually active women? Between 2001 and 2016, the number of acute care hospitals that are Catholic owned or affiliated grew by 22%, while the overall number of acute care hospitals dropped by 6%, and there are 5 states where over 40% are operating under Catholic health restrictions, and five more have between 30% and 40%.

Birthright covers this change, and some of what it means for women now. I remember my own mother telling me she gave birth to me in a Catholic hospital. When there were complications, they told my father I would be the one they would save, should it require a choice. I’m glad everything turned out ok, but should they then or now have the power to make any decisions that compromise women’s bodily autonomy? It’s the height of systemic misogyny.  In doing research, I’ve discovered that current Catholic directives for healthcare don’t value one life over the other, and that would be a relief, if the language of the directive wasn’t open to such interpretation. Do you want your hospital to decide what reproductive emergency constitutes a direct threat to the mother, such that it calls for terminating a pregnancy?

I did also find that they can’t and won’t end an ectopic pregnancy unless it is an imminent threat to the mother, that their directives on fertilization are less than ideal, and they will not offer any contraception, including inside marriage.  There are many other directives that point to healthcare directly influenced by the laws of Catholicism, which, and I’m speaking as a former Catholic, isn’t exactly woman-friendly.

Why is it subtitled ‘a war story’? Based on the interviews these women, in is clear we are part of a real war, fighting for bodily autonomy.  It was begun and is now spearheaded by the right-to-life movement, and aided by the conservative right they helped place in office.

Tamarkin says she was partly motivated to make this documentary when the Hobby Lobby Supreme Court ruling, which said the company could deny coverage for contraceptives to their female employees, didn’t set off alarms for women across the country.  The fact that staunch anti-abortionist Tom Price and former president of Americans United for Life Charmaine Yoest have both been placed at the head of Health and Human Services by the new administration should only reaffirm the desperate times in which all of us who believe in reproductive justice find ourselves.

For women who believe they are the masters of their own fate, who watch A Handmaid’s Tale and believe it is fiction and always will be, Birthright: A War Story will be either galvanizing or motivating to get more involved and learn more about how we are losing rights for our own bodies every day.  Many who see Birthright will ask themselves questions, and many will find themselves afraid. Some people may even get involved. Based on Birthright, there’s a lot of fighting to do.


Cinema Siren interview with Birthright director Civia Tamarkin and writer Luchina Fisher

Cinema Siren: I had no idea so many Catholic hospitals were cropping up. Can you talk a bit about how that has had and continues to have an impact on reproductive rights?

Civia Tamarkin: It has happened over the last decade. When faced with econonomic problems, so many public and private hospitals faced insolvency and became primed for merger and takeover. Catholic healthcare, although there are several types of Catholic healthcare, but they all fall under the umbrella, has aggressively moving into communities, as the white knight, taking over these hospitals.  One reason is it’s advantageous for them for tax breaks, but it certainly is a way of offering services to the community, while at the same time, being able to promulgate their religious doctrine.  In the film the head of Catholic healthcare says even the pope considers it an important part of their mission. What has happened over the years is one in 6 acute care hospitals in this country are connected to the Catholic church, which means they are beholden to their directives. What’s so terrifying about that, is when the merger first takes place, not on the radar of many communities, many of the doctors do not realize the implications of it, and most of them think nothing is going to change.  Then the merger happens and they begin receiving notices that they can no longer, in the OBGYN department, administer contraceptives, they can’t do in-vitro, or vasectomies, or prescribe the morning-after pill in cases of rape, or do tubal ligations at the same time as a C-section.  But the worst involves miscarriage mismanagement, and the inability to terminate a non-viable pregnancy. What’s important about that is it’s the perfect example of the “fetus first” mentality, which is just exploding across this country.  It’s entrapping women who are carrying a much-wanted pregnancy in many cases, not just those who wish to terminate, but those who are carrying a pregnancy, the mentality in this country, and we see it playing out in these Catholic hospitals, is that every woman capable of becoming pregnant, and 6 million women a year become pregnant in this country, is at risk.  Whether she personally apposes abortion or not. It is a problem for the birthing process as well, because you now have this intervention by the Catholic church, and indeed by legislators, in the process of pregnancy and birthing.  That’s what’s frightening.

CT: It’s open for interpretation but it’s very specific in the doctrine as laid out by the conference of catholic bishops.

CSiren: What is concerning is that what constitutes a clear and present danger to the mother is so subjective, and if the doctrine stipulates to only wait until then to offer care, it means much more stress and potential problems for the pregnant woman.  Who decides when a woman is sick enough to terminate a pregnancy?

CT: Exactly. In our film, a doctor says “The question is at what point do you decide a mother’s life is at risk?”  Of course also women are at risk of being arrested or prosecuted if they take any action to save themselves, under fetal endangerment.  It’s really a matter of extrapolating child endangerment laws and manipulating them, in order to establish the personhood of the fetus.  Women carrying a much-wanted pregnancy are caught up in this.  It’s a frightening situation because there’s an agenda here. What started out as laws that were well-intentioned and necessary, in terms of child protection, are being distorted and manipulated, and are leading to women’s autonomy being taken away.

CSiren: Can you talk a little about personhood and how it is diametrically opposed to women’s autonomy?  and again, great name—it even sounds noble.

Luchina Fisher: The opposition wanted a name that would work to make their cause resonate like women’s rights, or gay rights, as as you say, sound noble, but it’s impossible to, constitutionally, protect two individuals in the same body equally. What personhood does is establish the personhood of a fetus or the rights of the unborn and that causes by its very nature a number of serious problems for the woman carrying that fetus. It interferes with her own autonomy, of her ability to make decisions, and it means the government is intervening into her pregnancy and her body from the very start. From the moment that she conceived. There are all sorts of issues of establishing personhood, which is why no matter where the laws have been tried, it’s been defeated, because once people understood what “personhood” meant for the woman carrying the fetus, it was clear that it would remove all her rights of a living person.  It’s impossible balancing act.

CT: They don’t stop trying.  There are legislators right now drafting legislation that abortion would be aggravated homicide.  With the strength of 33 Republican governors just waiting to sign bills, the opposition will keep trying to take the rights away from women.  Personhood means that ultimately any decisions by a woman carrying a fetus can be analyzed and judged by the government as endangerment.  There’s no limit to where that can go in terms of removing the constitutional rights of women.  Beyond it being all that, it’s also a potentially life-threatening situation.  As one of the doctors in our film says, “at what point do we say yes, you’re sick enough? at what point do we thing you are in danger of dying enough so that we will assist your body in evacuating this non-viable pregnancy?”

Why must a woman wait to become septic, why does she has to wait until she’s at death’s door, which is what has happened all across the country? It’s a public health issue.  Yes of course, it’s a constitutional issue, and a human rights issue, but what people don’t address is, it’s a public health issue.  There is a direct correlation between the states with the number of reproductive restrictions and high maternal and neonatal mortality.  The maternal mortality rate is highest in the entire developed world in Texas, and it’s not surprising given how many more restrictions there are in that state.  

I didn’t want to do an abortion film, I wanted to do a wake-up call to every woman, that shows every woman, regardless of her view on abortion, and regardless of her political leanings is at risk.  There’s an extreme public health crisis attendant to all these restrictions.  You start defunding family planning, and women who cannot safely carry a pregnancy for health reasons don’t have access to contraceptives or prenatal care or sterilization, so you are dealing with a fallout and collateral damage that is far-reaching.  The reason people should sit up and take notice is that it’s not about abortion.  Yes, it’s about a woman’s fundamental right to bodily autonomy, but it’s about a nation’s public health crisis.  It’s outrageous that the US ranks 50th among developed countries.  That our maternal mortality rate is higher than Iraq.

It’s so important for people to realize what’s happening.  We set out to make the “Inconvenient Truth” of reproductive rights. It isn’t easy to know what’s happening, or to know how far the opposition has gotten in implementing their strategy to remove women’s rights, but we have to come together, unified, to take back and assure our autonomy.